Cheng Shengnan, Zhang Mingchang, Chen Hua, Fan Wanlin, Huang Yukan
Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Medicine (Baltimore). 2019 May;98(19):e15595. doi: 10.1097/MD.0000000000015595.
Meibomian gland dysfunction (MGD) is a common disease in ophthalmic clinic. This study aimed to explore ocular Demodex infestation on the microstructure changes of the meibomian glands (MGs) in patients with MGD by in vivo confocal microscopy (IVCM).We retrospectively reviewed 103 eyes of 52 patients with MGD and 62 eyes of 31 non-MGD patients. All enrolled patients underwent IVCM examination. The following IVCM parameters were recorded: the MG acinar density (MAD), MG acinar longest diameter (MALD), MG acinar shortest diameter (MASD), MG orifice area (MOA), severity of MG fibrosis (MF), MG acinar irregularity (MAI), meibum secretion reflectivity (MSR), inhomogeneous appearance of walls of acinar units (AWI) and periglandular interstices of acinar units (API), and the number of Demodex.The positive rate of Demodex infestation in MGDs was 89.32%, and statistically higher than control group (controls; P < .001). All parameters showed statistically significant differences between MGDs and controls (P < .001), and Demodex-negative group and Demodex-positive group (P < .05) in both MGDs and controls, except MAD (P = .826) in controls. The number of Demodex was positively correlated with MALD, MASD, MF, MAI, MSR, AWI, and API in MGDs and controls (P < .05), and negatively correlated with MAD and MOA in MGDs (P < .05). MOA showed a strong significant correlation with the number of Demodex in controls (P < .001), whereas there was no significant difference between the number of Demodex and the MAD in controls (P = .448).Demodex can cause microstructural changes of MGs, which can cause or aggravate MGD, and the more the number of Demodex infestation, the more serious the structural damage.
睑板腺功能障碍（MGD）是眼科门诊的常见疾病。本研究旨在通过活体共聚焦显微镜（IVCM）探讨睑缘蠕形螨感染对MGD患者睑板腺（MG）微观结构变化的影响。我们回顾性分析了52例MGD患者的103只眼以及31例非MGD患者的62只眼。所有纳入研究的患者均接受了IVCM检查。记录了以下IVCM参数：MG腺泡密度（MAD）、MG腺泡最长直径（MALD）、MG腺泡最短直径（MASD）、MG开口面积（MOA）、MG纤维化严重程度（MF）、MG腺泡不规则度（MAI）、睑脂分泌反射率（MSR）、腺泡单位壁的不均匀外观（AWI）和腺泡单位的腺周间隙（API）以及蠕形螨数量。MGD患者中蠕形螨感染的阳性率为89.32%，统计学上高于对照组（P <.001）。除对照组中的MAD（P =.826）外，MGD组与对照组（P <.001）以及MGD组和对照组中蠕形螨阴性组与蠕形螨阳性组之间的所有参数均显示出统计学上的显著差异（P <.05）。MGD组和对照组中蠕形螨数量与MALD、MASD、MF、MAI、MSR、AWI和API呈正相关（P <.05），与MGD组中的MAD和MOA呈负相关（P <.05）。对照组中MOA与蠕形螨数量呈强显著相关（P <.001），而对照组中蠕形螨数量与MAD之间无显著差异（P =.448）。蠕形螨可导致MG的微观结构变化，进而导致或加重MGD，蠕形螨感染数量越多，结构损伤越严重。
