Department of Biomedical Engineering, Faculty of Fundamental Problems of Technology, Wrocław University of Science and Technology, Wroclaw, Poland.
Department of Optometry and Vision, Faculty of Optics and Optometry, Complutense University of Madrid, Madrid, Spain.
Cornea. 2019 Dec;38(12):1506-1512. doi: 10.1097/ICO.0000000000002141.
To objectively and quantitatively characterize meibomian gland morphology and to investigate the influence of morphological variations on gland function and ocular surface and tear film parameters.
One hundred fifty subjects were enrolled. The examinations included tear osmolarity, tear meniscus height, bulbar conjunctival hyperemia, noninvasive tear film breakup time, lid margin thickness, foam secretion, meibomian gland expressibility, count of functioning glands, corneal and conjunctival staining, fluorescein breakup time, lid wiper epitheliopathy, and Schirmer test. Patient symptoms were assessed using the Ocular Surface Disease Index questionnaire. Images from noncontact meibography were analyzed using an automated method that objectively estimates dropout area, number of glands, gland length and width, and gland irregularity.
Gland irregularity highly correlated with dropout area (r = -0.4, P < 0.001) and showed significant partial correlations with fluorescein breakup time (r = 0.162, P = 0.049) and the Ocular Surface Disease Index questionnaire (r = -0.250, P = 0.002) Subjects with dropout area <32% were divided into 2 groups: high and low irregularity. Gland expressibility was statistically significantly different between the 2 groups (U = 319.5, P = 0.006). In the high irregularity group, gland irregularity correlated with the Schirmer test (r = 0.530, P = 0.001) and corneal fluorescein staining (r = -0.377, P = 0.021).
Automated morphological analysis of meibomian gland structure provides additional quantitative and objective information regarding gland morphology. The link between dropout area and gland function is not clear. Assessment of gland irregularity might better predict gland function and its effects on ocular surface and tear film parameters.
客观、定量地描述睑板腺形态，并研究形态变化对腺体功能以及眼表面和泪膜参数的影响。
共纳入 150 例受试者。检查项目包括泪液渗透压、泪膜高度、球结膜充血、非侵入性泪膜破裂时间、睑缘厚度、泡沫分泌、睑板腺分泌功能、功能腺计数、角膜和结膜染色、荧光素破裂时间、睑板腺擦拭上皮病变和泪液分泌试验。使用眼表面疾病指数问卷评估患者症状。使用一种自动方法分析非接触式睑板腺照相图像，客观估计缺如面积、腺体数量、腺体长度和宽度以及腺体不规则性。
腺体不规则性与缺如面积高度相关（r = -0.4，P < 0.001），与荧光素破裂时间（r = 0.162，P = 0.049）和眼表面疾病指数问卷（r = -0.250，P = 0.002）呈显著部分相关。将缺如面积 <32%的受试者分为 2 组：高不规则性和低不规则性。2 组间睑板腺分泌功能存在统计学差异（U = 319.5，P = 0.006）。在高不规则性组中，腺体不规则性与泪液分泌试验（r = 0.530，P = 0.001）和角膜荧光素染色（r = -0.377，P = 0.021）相关。
睑板腺结构的自动形态分析提供了关于腺体形态的额外定量和客观信息。缺如面积与腺体功能之间的联系尚不清楚。评估腺体不规则性可能更好地预测腺体功能及其对眼表面和泪膜参数的影响。
