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Ophthalmic Plastic and Reconstructive... May 2024Experimental investigation in human eyelids to confirm that exposing excised tarsal plates to ultraviolet-A radiation can induce a stiffening effect through the...
PURPOSE
Experimental investigation in human eyelids to confirm that exposing excised tarsal plates to ultraviolet-A radiation can induce a stiffening effect through the riboflavin-photosensitized crosslinking of tarsal collagen.
METHODS
Thirteen tarsal plates excised from nonfrozen human cadavers were irradiated with ultraviolet-A rays (365 nm wavelength) at an irradiance of 75 mW/cm2 for 3 minutes, equivalent to a radiation fluence of 13.5 J/cm2, in the presence of a riboflavin derivative as a photosensitizer. The tensile stress (strength) and Young's modulus (stiffness) of both nonirradiated and irradiated specimens were measured with the BioTester 5000 in the uniaxial mode at a strain of 10% and analyzed statistically. Individual specimens excised from 2 cadavers were also examined by routine histopathologic protocols to assess the effect of radiation on the Meibomian glands and collagen organization.
RESULTS
The irradiation enhanced both stiffness and strength of the human tarsal specimens, the difference between the test samples and controls being statistically significant (p < 0.0002 for n = 13). Histology indicated no damage to tarsal connective tissue or to Meibomian glands, and revealed a more compact packing of the collagen network located around the glands, which may be beneficial. The existence of collagen compaction was also supported by the reduction of samples' thickness after irradiation (p = 0.0645).
CONCLUSIONS
The irradiation of tarsal tissue with ultraviolet-A light of tarsus appears to be a safe and effective method for reducing eyelid laxity in human patients.
PubMed: 38722762
DOI: 10.1097/IOP.0000000000002709 -
International Journal of Ophthalmology 2024To investigate a pioneering framework for the segmentation of meibomian glands (MGs), using limited annotations to reduce the workload on ophthalmologists and enhance...
AIM
To investigate a pioneering framework for the segmentation of meibomian glands (MGs), using limited annotations to reduce the workload on ophthalmologists and enhance the efficiency of clinical diagnosis.
METHODS
Totally 203 infrared meibomian images from 138 patients with dry eye disease, accompanied by corresponding annotations, were gathered for the study. A rectified scribble-supervised gland segmentation (RSSGS) model, incorporating temporal ensemble prediction, uncertainty estimation, and a transformation equivariance constraint, was introduced to address constraints imposed by limited supervision information inherent in scribble annotations. The viability and efficacy of the proposed model were assessed based on accuracy, intersection over union (IoU), and dice coefficient.
RESULTS
Using manual labels as the gold standard, RSSGS demonstrated outcomes with an accuracy of 93.54%, a dice coefficient of 78.02%, and an IoU of 64.18%. Notably, these performance metrics exceed the current weakly supervised state-of-the-art methods by 0.76%, 2.06%, and 2.69%, respectively. Furthermore, despite achieving a substantial 80% reduction in annotation costs, it only lags behind fully annotated methods by 0.72%, 1.51%, and 2.04%.
CONCLUSION
An innovative automatic segmentation model is developed for MGs in infrared eyelid images, using scribble annotation for training. This model maintains an exceptionally high level of segmentation accuracy while substantially reducing training costs. It holds substantial utility for calculating clinical parameters, thereby greatly enhancing the diagnostic efficiency of ophthalmologists in evaluating meibomian gland dysfunction.
PubMed: 38721512
DOI: 10.18240/ijo.2024.03.01 -
Current Eye Research Jul 2024The study aimed to investigate the factors associated with anterior location of Marx's line in ocular surface and living habits, especially in tear film.
PURPOSE
The study aimed to investigate the factors associated with anterior location of Marx's line in ocular surface and living habits, especially in tear film.
MATERIALS AND METHODS
This cross-sectional study enlisted 483 participants with meibomian gland dysfunction, who were divided into two groups: 160 participants with mild anterior location of Marx's line and 323 participants with moderate-to-severe anterior location. Participants completed a survey of demographic characteristics (sex, age, length of visual terminal use, sleep duration, skin property), and the Ocular Surface Disease Index and Standard Patient Evaluation of Eye Dryness questionnaires. They also underwent slit-lamp examinations of the lids, and measurements of non-invasive tear break up time, tear meniscus height, fluorescein tear break up time, lipid layer thickness, partial blink rate, lid wiper epitheliopathy, and meibomian gland dropout.
RESULTS
The tear meniscus height (mild:0.21(0.18-0.25), moderate-to-severe:0.19(0.16-0.23), = 0.004), fluorescein tear break up time(mild:3(2-4),moderate to severe:2(1-3), = 0.000), max LLT(mild:87(62-100), moderate-to-severe:99(69-100), = 0.04), average LLT(mild:64.5(47.5-96.75), moderate-to-severe:74(53-100), = 0.012), min LLT(mild:52(38-75), moderate-to-severe:59(41-85), = 0.029) differed significantly between mild and moderate-to-severe anterior location of Marx's line, and associated to the anterior location of Marx's line(r=-0.134, = 0.03; r=-0.194, = 0.000; = 0.093, = 0.041; = 0.119, = 0.009; = 0.105, = 0.022) However, no statistical significance was observed in the OSDI, SPEED, partial blink rate, non-invasive tear breakup time, lipid layer thickness, meibomian gland dropout and lid wiper epitheliopathy( > 0.05). Meanwhile, in the demographic characteristics, statistically significant correlations were associated with skin property( = 0.154, = 0.001) and sleep duration(r=-0.124, = 0.006), but not with age, sex, and the length of visual terminal use ( > 0.05).
CONCLUSIONS
Lower TMH and shorter TBUT positively correlated with anterior location of the Marx's line, and were risk factors. Meanwhile, participants with oily skin and shorter sleep duration were more likely to exhibit anterior location of Marx's line.
Topics: Humans; Cross-Sectional Studies; Male; Female; Tears; Middle Aged; Meibomian Glands; Adult; Meibomian Gland Dysfunction; Surveys and Questionnaires; Blinking; Dry Eye Syndromes; Aged; Risk Factors
PubMed: 38717137
DOI: 10.1080/02713683.2024.2324432 -
Journal of Ophthalmology 2024To determine the relationship between dyslipidemia and dry eye disease (DED), as well as its influence on tear film and meibomian glands.
PURPOSE
To determine the relationship between dyslipidemia and dry eye disease (DED), as well as its influence on tear film and meibomian glands.
METHODS
This cross-sectional study included 40 patients with a mean age of 35.2 ± 13.9 years without any history of dyslipidemia. DED and serum lipid profile were evaluated after 8 hours of fasting. Patients were classified according to serum lipid levels with the following cut-off values: total cholesterol (TC) (200 mg/dl), high-density lipoprotein (HDL) (40 mg/dl), low-density lipoprotein (LDL) (130 mg/dl), and triglycerides (TG) (150 mg/dl). The relationship between serum lipid levels and DED was analyzed with the following variables: dry eye questionnaire-5 (DEQ-5), first (F-NIBUT) and average (A-NIBUT) noninvasive breakup time, tear meniscus height (TMH), lipid layer grade (LLG), conjunctival bulbar redness (CBR), and upper (U-LAMG) and lower (L-LAMG) loss area of meibomian glands.
RESULTS
Regarding tear film, patients with elevated TC and LDL levels reported significantly higher DEQ-5 scores and TMH ( < 0.05), while those with lower HDL levels showed significantly higher LLG ( < 0.05). Regarding MGD, patients with elevated TC, LDL, and TG, as well as lower HDL levels showed significantly higher L-LAMG ( < 0.05). HDL was correlated with LLG ( < 0.05), while TC was correlated with TMH ( < 0.05) and L-LAMG ( < 0.05), respectively.
CONCLUSIONS
Disorders in TC, HDL, LDL, and TG levels were associated with DED, having an impact on the tear film and meibomian glands, specifically in DEQ-5 scores, LLG, and L-LAMG.
PubMed: 38716087
DOI: 10.1155/2024/7345270 -
Clinical Ophthalmology (Auckland, N.Z.) 2024To evaluate the effect of eyelid hygiene after cataract surgery on eyelid and ocular surface findings, subjective symptoms and visual function, including functional... (Clinical Trial)
Clinical Trial
PURPOSE
To evaluate the effect of eyelid hygiene after cataract surgery on eyelid and ocular surface findings, subjective symptoms and visual function, including functional visual acuity (FVA) and higher order aberration, in a randomized controlled study.
METHODS
Fifty patients who underwent cataract surgery at a single institution were involved. Twenty-five patients were instructed to wipe their eyelids twice a day from one to four weeks postoperatively, whereas the other 25 patients did not perform any eyelid hygiene. Optical measurement, FVA, meibomian glands, the grade of meibum, lid margin findings, fluorescein corneal staining findings, dry eye-related subjective symptoms and surgical satisfaction were assessed both preoperatively and one month postoperatively.
RESULTS
In the eyelid hygiene group, the visual maintenance ratio of FVA improved significantly (p = 0.048) and the higher order aberration of the 4th + 6th order deteriorated less (p = 0.027) compared with the control group. Multiple regression analyses showed that the change in visual maintenance ratio was associated with surgical satisfaction (p = 0.003), change in corneal staining score (p = 0.007), history of eye diseases (p = 0.029) and eyelid hygiene (p = 0.048).
CONCLUSIONS
Eyelid hygiene after cataract surgery may be effective for visual function measured with an FVA test.
PubMed: 38715985
DOI: 10.2147/OPTH.S462871 -
Ophthalmic & Physiological Optics : the... Jul 2024To investigate whether there is a measurable change in meibomian gland morphological characteristics over the course of a day (12 h) and over a month.
PURPOSE
To investigate whether there is a measurable change in meibomian gland morphological characteristics over the course of a day (12 h) and over a month.
METHODS
The study enrolled 15 participants who attended a total of 11 study visits spanning a 5-week period. To assess diurnal changes in meibomian glands, seven visits were conducted on a single day, each 2 h apart. For monthly assessment, participants attended an additional visit at the same time of the day every week for three consecutive weeks. Meibography using the LipiView® II system was performed at each visit, and meibomian gland morphological parameters were calculated using custom semi-automated software. Specifically, six central glands were analysed for gland length ratio, gland width, gland area, gland intensity and gland tortuosity.
RESULTS
The average meibomian gland morphological metrics did not exhibit significant changes during the course of a day or over a month. Nonetheless, certain individual gland metrics demonstrated notable variation over time, both diurnally and monthly. Specifically, meibomian gland length ratio, area, width and tortuosity exhibited significant changes both diurnally and monthly when assessed on a gland-by-gland basis.
CONCLUSIONS
Meibomian glands demonstrated measurable structural change over short periods of time (hours and days). These results have implications for innovation in gland imaging and for developing precision monitoring of gland structure to assess meibomian gland health more accurately.
Topics: Humans; Meibomian Glands; Pilot Projects; Female; Male; Middle Aged; Adult; Aged; Meibomian Gland Dysfunction; Tears; Circadian Rhythm; Time Factors
PubMed: 38708449
DOI: 10.1111/opo.13321 -
Annals of Anatomy = Anatomischer... May 2024The ocular system is in constant interaction with the environment and with numerous pathogens. The ATP-binding cassette (ABC) transporters represent one of the largest...
The ocular system is in constant interaction with the environment and with numerous pathogens. The ATP-binding cassette (ABC) transporters represent one of the largest groups among the transmembrane proteins. Their relevance has been demonstrated for their defense function against biotic and abiotic stress factors, for metabolic processes in tumors and for their importance in the development of resistance to drugs. The aim of this study was to analyze which ABC transporters are expressed at the ocular surface and in the human lacrimal apparatus. Using RT-PCR, all ABC transporters known to date in humans were examined in tissue samples from human cornea, conjunctiva, meibomian glands and lacrimal glands. The RT-PCR analyses revealed the presence of all ABC transporters in the samples examined, although the results for some of the 48 transporters known in human and analyzed were different in the various tissues. The present results provide information on the expression of ABC transporters at the mRNA level on the ocular surface and in the lacrimal system. Their detection forms the basis for follow-up studies at the protein level, which will provide more information about their physiological significance at the ocular surface and in the lacrimal system and which may explain pathological effects such as drug resistance.
PubMed: 38697581
DOI: 10.1016/j.aanat.2024.152272 -
The Ocular Surface Jul 2024To investigate the roles of HDAC1/2 and HDAC3 in adult Meibomian gland (MG) homeostasis.
PURPOSE
To investigate the roles of HDAC1/2 and HDAC3 in adult Meibomian gland (MG) homeostasis.
METHODS
HDAC1/2 or HDAC3 were inducibly deleted in MG epithelial cells of adult mice. The morphology of MG was examined. Proliferation, apoptosis, and expression of MG acinus and duct marker genes, meibocyte differentiation genes, and HDAC target genes, were analyzed via immunofluorescence, TUNEL assay, and RNA in situ hybridization.
RESULTS
Co-deletion of HDAC1/2 in MG epithelium caused gradual loss of acini and formation of cyst-like structures in the central duct. These phenotypes required homozygous deletion of both HDAC1 and HDAC2, indicating that they function redundantly in the adult MG. Short-term deletion of HDAC1/2 in MG epithelium had little effect on meibocyte maturation but caused decreased proliferation of acinar basal cells, excessive DNA damage, ectopic apoptosis, and increased p53 acetylation and p16 expression in the MG. By contrast, HDAC3 deletion in MG epithelium caused dilation of central duct, atrophy of acini, defective meibocyte maturation, increased acinar basal cell proliferation, and ectopic apoptosis and DNA damage. Levels of p53 acetylation and p21 expression were elevated in HDAC3-deficient MGs, while the expression of the differentiation regulator PPARγ and the differentiation markers PLIN2 and FASN was downregulated.
CONCLUSIONS
HDAC1 and HDAC2 function redundantly in adult Meibomian gland epithelial progenitor cells and are essential for their proliferation and survival, but not for acinar differentiation, while HDAC3 is required to limit acinar progenitor cell proliferation and permit differentiation. HDAC1/2 and HDAC3 have partially overlapping roles in maintaining survival of MG cells.
Topics: Animals; Meibomian Glands; Mice; Histone Deacetylase 1; Homeostasis; Histone Deacetylases; Histone Deacetylase 2; Apoptosis; Cell Proliferation; In Situ Nick-End Labeling; In Situ Hybridization; Cell Differentiation
PubMed: 38679196
DOI: 10.1016/j.jtos.2024.04.005 -
BMC Ophthalmology Apr 2024Evaluation of clinical efficacy and safety of tobramycin/dexamethasone eye ointment in treating persistent corneal epithelial dysfunction (PED) after cataract surgery.
OBJECTIVE
Evaluation of clinical efficacy and safety of tobramycin/dexamethasone eye ointment in treating persistent corneal epithelial dysfunction (PED) after cataract surgery.
METHODS
26 cases diagnosed as PED after cataract surgery accept the tobramycin/dexamethasone ophthalmic ointment and intense pulse light treatment in the Xiamen University of Xiamen eye center between September 2016 and April 2022 were retrospectively analyzed, mainly including clinical manifestations, characteristics of morphological changes imaged by in vivo confocal microscopy, meibomian glands infrared photography, lipid layer thickness (LLT), management and therapeutic effects.
RESULTS
There were 26 eyes, include 8(35%) males and 15(65%) females with an average age of 69.6 ± 5.2 years(50 to 78 years). The mean hospitalization time was (18.4 ± 7.5) days after cataract surgery. Twenty patients had meibomian gland dysfunction. Infrared photography revealed varying loss in the meibomian glands, with a mean score of 3.8 ± 1.2 for gland loss. The mean LLT was 61.6 ± 8.4 nm. After treatment, 20 patients were cured, and 3 received amniotic membrane transplantation. After treatment, the uncorrected visual acuity (UCVA) and best-corrected vision activity (BCVA) improved (P < 0.001), and there was no significant difference in intraocular pressure (IOP) before and after treatment (P > 0.05).
CONCLUSIONS
The early manifestation of PED after surgery is punctate staining of the corneal epithelium. Tobramycin and dexamethasone eye ointment bandages have a good repair effect. The meibomian gland massage combined with intense pulse light treatment can effectively shorten the course of the disease.
Topics: Humans; Female; Male; Aged; Middle Aged; Dexamethasone; Retrospective Studies; Epithelium, Corneal; Visual Acuity; Tobramycin; Glucocorticoids; Cataract Extraction; Corneal Diseases; Anti-Bacterial Agents; Microscopy, Confocal; Postoperative Complications; Ointments
PubMed: 38671418
DOI: 10.1186/s12886-024-03466-x -
Lasers in Medical Science Apr 2024Intense pulsed light (IPL) is a non-laser, high-intensity light source that has been shown to play a valuable role in dermatology and has been adopted in ophthalmology... (Review)
Review
Intense pulsed light (IPL) is a non-laser, high-intensity light source that has been shown to play a valuable role in dermatology and has been adopted in ophthalmology for treating meibomian gland dysfunction (MGD). In this review, we discuss the mechanism of action of IPL, including its benefits in ophthalmology. IPL therapy has been shown to improve tear film stability, meibomian gland (MG) function, and subjective symptoms of ocular dryness in MGD patients. Moreover, emerging evidence suggests that IPL therapy is beneficial for other ocular surface diseases, such as blepharitis and chalazia. Hence, it can be inferred that IPL has potential as a therapeutic modality in future applications. Large clinical and experimental trials are needed to exploit the full potential of IPL as a treatment for recurrent chalazia, Sjögren's syndrome, and other causes of dry eye disease (DED). This paper reviews the published literature related to the application of IPL for treating ocular surface diseases.
Topics: Humans; Intense Pulsed Light Therapy; Dry Eye Syndromes; Meibomian Gland Dysfunction; Blepharitis; Meibomian Glands
PubMed: 38656565
DOI: 10.1007/s10103-024-04060-9