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Experimental Eye Research Oct 2017Meibomian glands secrete meibum, which gives rise to the lipid layer of the tear film and thereby prevents excessive evaporation of tear fluid. Meibomian gland... (Review)
Review
Meibomian glands secrete meibum, which gives rise to the lipid layer of the tear film and thereby prevents excessive evaporation of tear fluid. Meibomian gland dysfunction (MGD) is a major causative condition of evaporative dry eye, which is more common than the aqueous-deficient type of dry eye. Noninvasive meibography relies on infrared light and an infrared-sensitive camera to reveal the morphology of meibomian glands in both the upper and lower eyelids, whereas tear interferometry allows both qualitative and quantitative evaluation of the lipid layer of the tear film. These two techniques not only provide valuable clinical information related to dry eye but also allow clinical evaluation of MGD. Tear interferometry also has the potential to distinguish the condition of the tear film between normal individuals and dry eye patients. Furthermore, combined evaluation of the noninvasive breakup time of the tear film and the interferometric fringe pattern as determined by tear interferometry allows classification of the subtype of dry eye disease.
Topics: Diagnostic Techniques, Ophthalmological; Dry Eye Syndromes; Humans; Interferometry; Meibomian Glands; Optical Imaging; Photography; Tears
PubMed: 28950939
DOI: 10.1016/j.exer.2017.06.010 -
Turkish Journal of Ophthalmology Apr 2021To evaluate aqueous and lipid tear film parameters and the meibomian glands (MGs) with non-contact meibography in patients with vitiligo.
OBJECTIVES
To evaluate aqueous and lipid tear film parameters and the meibomian glands (MGs) with non-contact meibography in patients with vitiligo.
MATERIALS AND METHODS
This case-control study was conducted in the right (OD) and left (OS) eyes of 43 patients with vitiligo and 43 controls in Birjand, Iran. In addition to demographic information and skin disease characteristics, the Ocular Surface Disease Index (OSDI) questionnaire was completed for each patient, followed by eye examinations including slit lamp examination, Schirmer test, strip meniscometry (SMTube), and tear break-up time (TBUT) measurement. The MGs were also imaged using a non-contact meibography system (SBM System, Italy). The data were analyzed using SPSS version 22.0 with a significant level of less than 0.05.
RESULTS
Patients had higher OSDI score than controls but it was not significant (10.90±13.03 vs. 5.57±6.85; p=0.07). There were significant differences between the groups in mean Schirmer test values for both eyes (OD: 8.07±5.47 vs. 17.37±6.52; OS: 7.60±5.00 vs. 17.30±6.44, p<0.001) and mean SMTube results (OD: 4.49±2.40 vs. 9.74±3.67; OS: 4.30±2.81 vs. 9.65±4.52; p<0.001). However, mean TBUT did not differ between the groups (OD: 9.14±3.17 vs. 10.12±2.08, p=0.27; OS: 9.16±3.30 vs. 10.05±2.10, p=0.25). Meibography also showed no significant difference in MG dropout between the groups (OD: 20.86±9.79 vs. 21.05±12.07; p=0.74; OS: 18.16±8.83 vs. 19.53±10.30; p=0.51).
CONCLUSION
Vitiligo is associated with a reduction in the production of aqueous tear film, but does not affect the structure and function of the MGs.
Topics: Adult; Case-Control Studies; Dry Eye Syndromes; Female; Humans; Incidence; Iran; Male; Meibomian Glands; Slit Lamp Microscopy; Tears; Vitiligo
PubMed: 33951893
DOI: 10.4274/tjo.galenos.2020.78027 -
Advances in Experimental Medicine and... 1998Meibomian gland disease--and, in particular, obstructive meibomian gland disease--makes an important contribution to ocular surface disease, in the form of meibomian... (Review)
Review
Meibomian gland disease--and, in particular, obstructive meibomian gland disease--makes an important contribution to ocular surface disease, in the form of meibomian keratoconjunctivitis. With improved methods for the study of meibomian oil composition and function, we are moving closer to the possibility of distinguishing the contribution of meibomian deficiency, as opposed to inflammatory events, to this disorder. More importantly, where aqueous tear deficiency and meibomian gland disease coincide in patients with dry eye, we are closer to the possibility of distinguishing their relative contributions to the dry eye state. This has implications for future therapies.
Topics: Androgens; Animals; Estrogens; Homeostasis; Humans; Lipids; Meibomian Glands; Models, Biological; Oils; Tears
PubMed: 9634898
DOI: 10.1007/978-1-4615-5359-5_40 -
Eye & Contact Lens Nov 2017Meibomian glands secrete lipids (meibum) that form the surface lipid layer of the tear film and thereby prevent excessive evaporation of tear fluid. Meibomian gland... (Review)
Review
Meibomian glands secrete lipids (meibum) that form the surface lipid layer of the tear film and thereby prevent excessive evaporation of tear fluid. Meibomian gland dysfunction is a major cause of evaporative dry eye, which is more prevalent than aqueous-deficient dry eye. Noninvasive meibography with infrared light and an infrared charge-coupled device camera can detect morphological changes of meibomian glands in both upper and lower eyelids, whereas tear interferometry allows qualitative and quantitative evaluations of the lipid layer of the tear film. Such assessment of meibomian gland morphology provides clinical information that contributes to the diagnosis of evaporative dry eye, whereas that of the lipid layer of the tear film allows the monitoring of meibomian gland function. In addition, the balance between the lipid and aqueous layers of the tear film revealed by tear interferometry has provided both support for the operation of a compensatory system that maintains tear film homeostasis as well as insight into the pathophysiology of dry eye.
Topics: Diagnostic Techniques, Ophthalmological; Dry Eye Syndromes; Humans; Interferometry; Lipid Metabolism; Lipids; Meibomian Glands; Tears
PubMed: 28410282
DOI: 10.1097/ICL.0000000000000369 -
International Ophthalmology Aug 2022To evaluate the use of meibography as an objective measure of the effects of incision & curettage (I&C) chalazion surgery on meibomian gland loss and morphology as well...
PURPOSE
To evaluate the use of meibography as an objective measure of the effects of incision & curettage (I&C) chalazion surgery on meibomian gland loss and morphology as well as dry eye syndrome.
METHODS
This prospective, interventional clinical study included adult patients with a primary chalazion which persisted despite conservative treatment. All patients underwent I&C surgery. The following parameters were compared both preoperatively and 21 days postoperatively: meibography, tear breakup time (TBUT), Schirmer test, meibum expression, tear meniscus height, meibomian gland dysfunction (MGD) grading, and the Ocular Surface Disease Index (OSDI).
RESULTS
Thirty eyelids were enrolled in the study. The mean age ± SD was 40.56 ± 13.94 years. Meibography demonstrated a significant decrease in meibomian gland loss (P = 0.00) and improvement in morphology. The most common meibomian gland pathology preoperatively noted was morphological signs of atrophy that included fluffy areas and tortuous glands. Both of these findings improved postoperatively (P = 0.04 and P = 0.02, respectively). There were a significant change in MGD grading and a significant decrease in meibum expression score postoperatively (P = 0.00). TBUT and tear meniscus height also improved significantly (P = 0.00 and P = 0.003, respectively). The OSDI score improved significantly as well (P = 0.00).
CONCLUSION
While incision and drainage surgery is a time-honored, standard treatment for chalazion, meibography now demonstrates a global improvement in the meibomian glands, not just the ones involved with the chalazion. In addition to the improvements in the clinical and dry eye syndrome parameters improvements, meibography findings demonstrate that early I&C surgery restores the meibomian glands architecture significantly.
Topics: Adult; Chalazion; Dry Eye Syndromes; Eyelid Diseases; Humans; Meibomian Gland Dysfunction; Meibomian Glands; Prospective Studies; Tears
PubMed: 35412124
DOI: 10.1007/s10792-022-02307-4 -
Experimental Eye Research Oct 2017
Topics: Eyelid Diseases; Humans; Meibomian Glands
PubMed: 28802859
DOI: 10.1016/j.exer.2017.08.006 -
Experimental Eye Research Oct 2017The epidermal growth factor receptor (EGFR) signaling has a pivotal role in the regulation of morphogenesis during development and maintenance of homeostasis in adult... (Review)
Review
The epidermal growth factor receptor (EGFR) signaling has a pivotal role in the regulation of morphogenesis during development and maintenance of homeostasis in adult eyelid and its adnexa. Studies have demonstrated that during eyelid morphogenesis the EGFR signaling pathway is responsible for keratinocyte and mesenchymal cell proliferation and migration at the eyelid tip. For meibomian gland morphogenesis, EGFR signaling activation stimulates meibomian gland epithelial cell proliferation. EGFR signaling pathway functions through multiple downstream signals such as ERK, Rho/ROCK and integrin and is regulated by a variety of upstream signals including Adam17, GPR48 and FGFR signaling. Herein we review the literature that describe the role of EGFR and its related signaling pathways in eyelid and meibomian gland morphogenesis.
Topics: Cell Movement; Cell Proliferation; Epithelial Cells; ErbB Receptors; Eyelids; Humans; Meibomian Glands; Signal Transduction
PubMed: 28950938
DOI: 10.1016/j.exer.2017.04.006 -
Der Ophthalmologe : Zeitschrift Der... Oct 2009The Meibomian glands are large sebaceous glands that are located as separate gland strands in parallel arrangement within the tarsal plates of the eyelids. Their oily... (Review)
Review
The Meibomian glands are large sebaceous glands that are located as separate gland strands in parallel arrangement within the tarsal plates of the eyelids. Their oily product (meibum) is secreted by a holocrine mechanism during which the secretory cells (meibocytes) are completely transformed into the meibum after synthesis and accumulation of lipids. After production in the gland acini, meibum is transported through the ductal system via the connecting duct (ductule) and the central duct towards the orifice at the free lid margin close to the inner lid border. The embryological development of the Meibomian glands takes place during the differentiation of the eyelids in the sealing phase of the eyelids. They are not directly associated with hair follicles but share important similarities in embryology, structure and keratinization potency with the cilia. Similar to the sebaceous glands Meibomian glands are regulated via sex hormones and androgens have a supporting function whereas estrogens act antagonistically. However, in contrast to other sebaceous glands they also have a distinct innervation, apart from sympathetic and sensory primarily by parasympathetic fibers that share the innervation pattern of the lacrimal glands. The anatomy, embryology and histology of the Meibomian glands are explained here, mainly with respect to humans, in an extensive review.
Topics: Humans; Meibomian Glands; Models, Anatomic
PubMed: 19856010
DOI: 10.1007/s00347-009-2006-1 -
Ophthalmic & Physiological Optics : the... Sep 2020To assess the impact of daily disposable soft contact lenses on meibomian gland morphology over a period of 12 months.
PURPOSE
To assess the impact of daily disposable soft contact lenses on meibomian gland morphology over a period of 12 months.
METHODS
Forty-one subjects (33 experienced and 8 neophytes) were fitted with either silicone-hydrogel or hydrogel daily contact lenses. The study protocol included four visits: baseline, day-2 for contact lens fit and follow-up measurements, as well as after 6 and 12 months of lens wear. Non-contact infrared meibography images were acquired with Keratograph 5M topographer (www.oculus.de) and analysed with an automated method, which objectively estimates the area of gland atrophy, gland length and width, number of glands and gland irregularity. Protocol at follow-up visits also included symptom assessment with the Ocular Surface Disease Index and clinical assessment of tear meniscus height, bulbar and limbal redness, tear osmolarity, non-invasive fluorescein break-up time and ocular surface staining.
RESULTS
Statistically significant differences were found in gland atrophy (p = 0.02) and length (p = 0.008) between experienced and novel contact lens wearers at the baseline visit. Changes over time (after 6 and 12 months) were found in gland atrophy (p = 0.02) and the number of glands (p = 0.01) in subjects fitted with hydrogel contact lenses. Changes in gland atrophy between baseline and 12 months of lens wear correlated with changes in corneal staining (r = 0.40, p = 0.03) and fluorescein break-up time in subjects fitted with silicone-hydrogel lenses (r = 1-0.43, p = 0.02).
CONCLUSIONS
Contact lens wear impacts meibomian gland morphology. However, changes are either long-term or characteristic to an early phase. Subjects with no history of contact lens wear exhibit better meibomian gland condition than experienced wearers. During one year of contact lens wear, meibomian gland morphology changes in subjects wearing daily disposable hydrogel lenses.
Topics: Adult; Contact Lenses, Hydrophilic; Female; Follow-Up Studies; Humans; Male; Meibomian Glands; Osmolar Concentration; Patient Satisfaction; Prospective Studies; Tears; Vision, Ocular; Young Adult
PubMed: 32716128
DOI: 10.1111/opo.12720 -
Cornea Jun 2020To evaluate the effect of obstructive sleep apnea-hypopnea syndrome (OSAHS) on the meibomian glands, ocular surface, and tear parameters.
PURPOSE
To evaluate the effect of obstructive sleep apnea-hypopnea syndrome (OSAHS) on the meibomian glands, ocular surface, and tear parameters.
METHODS
The study included 59 individuals (32 subjects with OSAHS, 27 control subjects) who underwent polysomnography in the Chest Diseases Clinic. The right eyes of all individuals were evaluated in the Ophthalmology Clinic. The first noninvasive tear break-up time (f-NTBUT) and the average noninvasive tear break-up time were measured, and Schirmer test was applied. Meibography was taken (Sirius; CSO, Florence, Italy), and meiboscore was used for indexing meibography. Finally, a sample was taken for conjunctival impression cytology.
RESULTS
In the study and control groups, the median of f-NTBUT was 2.1 seconds [interquartile range (IQR); 1.5-5.0] and 5.7 seconds (IQR; 2.9-8.8) and the median of average noninvasive tear break-up time was 5.6 seconds (IQR; 3.6-9.5) and 7.2 seconds (IQR; 4.2-10.7), respectively (P = 0.007 and P = 0.487, respectively). The mean Schirmer value was 16.3 ± 5.9 mm (range; 5-25) and 17.3 ± 6.6 mm (range; 5-30) in the study and control groups (P = 0.604). In upper eyelid meibography, the median of loss in the meibomian glands was 20.10% (IQR; 11.60%-40.80%) in the study group and 14.70% (IQR; 10.40%-21.30%) in the control group (P = 0.043). In lower eyelid meibography, the median of loss in the meibomian glands was 19.00% (IQR; 13.60%-35.30%) in the study group and 12.40% (IQR; 9.10%-16.40%) in the control group (P = 0.002). The median of the Nelson grade in conjunctival impression cytology was 1 (IQR; 0-1) in the study group and 1 (IQR; 0-1) in the control group (P = 0.445).
CONCLUSIONS
The loss in the meibomian glands together with the shortened f-NTBUT shows that there could be a predisposition in OSAHS for evaporative dry eye originating from meibomian gland damage.
Topics: Adult; Aged; Dry Eye Syndromes; Female; Follow-Up Studies; Humans; Male; Meibomian Glands; Middle Aged; Polysomnography; Prospective Studies; Sleep Apnea Syndromes; Tears; Young Adult
PubMed: 31939920
DOI: 10.1097/ICO.0000000000002252