Department of Ophthalmology, University Hospital Duesseldorf, Heinrich-Heine University, Duesseldorf, Germany.
Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, University Paris-Saclay, Paris, France.
Ocul Surf. 2017 Apr;15(2):179-192. doi: 10.1016/j.jtos.2017.01.006. Epub 2017 Jan 27.
Meibomian gland dysfunction (MGD) is a common and chronic disorder that has a significant adverse impact on patients' quality of life. It is a leading cause of evaporative dry eye disease (DED), as meibomian glands play an important role in providing lipids to the tear film, which helps to retard the evaporation of tears from the ocular surface. MGD is also often present in conjunction with primary aqueous-deficient DED. Obstructive MGD, the most commonly observed type of MGD, is the main focus of this article. MGD is probably caused by a combination of separate conditions: primary obstructive hyperkeratinization of the meibomian gland, abnormal meibomian gland secretion, eyelid inflammation, corneal inflammation and damage, microbiological changes, and DED. Furthermore, skin diseases such as rosacea may play a part in its pathology. Accurate diagnosis is challenging, as it is difficult to differentiate between ocular surface diseases, but is crucial when choosing treatment options. Ocular imaging has advanced in recent years, providing ophthalmologists with a better understanding of ocular diseases. This review presents a literature update on the 2011 MGD workshop and an optimized approach to accurate diagnosis of MGD using currently available methods and tests. It also outlines the emerging technologies of interferometry, non-contact meibography, keratography and in vivo confocal laser microscopy, which offer exciting possibilities for the future. Selected treatment options for MGD are also discussed.
睑板腺功能障碍（MGD）是一种常见的慢性疾病，对患者的生活质量有重大的不良影响。它是蒸发性干眼症（DED）的主要原因，因为睑板腺在为泪膜提供脂质方面起着重要作用，有助于延缓眼表面泪液的蒸发。MGD 也常与原发性水液缺乏性 DED 同时存在。阻塞性 MGD 是最常见的 MGD 类型，是本文的主要关注点。MGD 可能是由多种独立的情况引起的：原发性睑板腺阻塞性过度角化、睑板腺分泌异常、眼睑炎症、角膜炎症和损伤、微生物变化和 DED。此外，如酒渣鼻等皮肤病可能也参与其病理过程。准确诊断具有挑战性，因为很难区分眼表面疾病，但在选择治疗方案时至关重要。近年来，眼成像技术取得了进展，使眼科医生更好地了解眼疾。本综述介绍了 2011 年 MGD 研讨会的文献更新，以及使用目前可用的方法和测试对 MGD 进行准确诊断的优化方法。它还概述了干涉测量、非接触式睑板腺照相术、角膜地形图和活体共聚焦激光显微镜等新兴技术，为未来提供了令人兴奋的可能性。还讨论了 MGD 的一些治疗选择。
