Department of Ophthalmology, Yonghe Cardinal Tien Hospital, New Taipei City, Taiwan; Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.
Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Am J Ophthalmol. 2020 Nov;219:240-252. doi: 10.1016/j.ajo.2020.06.029. Epub 2020 Jul 2.
Previous studies have suggested an association between dyslipidemia and meibomian gland dysfunction (MGD). The aim of this prospective, nonrandomized clinical study is to evaluate the possible association of dyslipidemia and its treatment with meibomian gland (MG) morphologic changes by standardized meibography.
Prospective, nonrandomized clinical study.
Two groups of participants were enrolled: group 1, comprised of patients under regular 3-hydroxy-3-methyl-glutaryl-coenzyme A (HMG-CoA) reductase inhibitor (statin) treatment for dyslipidemia, and group 2, those with newly diagnosed dyslipidemia who were under lifestyle interventions. Meibography was performed at baseline and at both the 6- and 12-month visits and were graded by meiboscores. Participants underwent slit lamp examination for signs of changes in meibum quality and MG lid morphologic features. The Ocular Surface Disease Index questionnaire was given to measure subjective symptoms of ocular surface disease. Dry eye parameters including tear meniscus height, noninvasive first and average tear film break-up time, and Schirmer test results were also recorded.
Ninety-eight participants completed this longitudinal study over 12 months. There were statistically significant changes in total meiboscores (P = .01) and upper eyelid meiboscores (P = .012), lid margin abnormality scores (P = .0059), and meibum quality (P = .0002) in the statin group during follow-up visits. Similar changes of upper eyelid meiboscores (P = .046) and meibum quality (P = .046) were noted in the nonstatin group.
Meibomian gland atrophy and deterioration of meibum quality continued in the long term among participants with dyslipidemia even under statin usage.
先前的研究表明血脂异常与睑板腺功能障碍(MGD)之间存在关联。本前瞻性、非随机临床研究的目的是通过标准化的睑板腺照相术评估血脂异常及其治疗与睑板腺(MG)形态变化之间的可能关联。
前瞻性、非随机临床研究。
纳入了两组参与者:第 1 组包括正在接受常规 3-羟基-3-甲基戊二酰辅酶 A(HMG-CoA)还原酶抑制剂(他汀类药物)治疗血脂异常的患者,第 2 组为新诊断为血脂异常并正在接受生活方式干预的患者。在基线和 6 个月及 12 个月访视时进行睑板腺照相术,并通过睑板腺评分进行分级。参与者接受裂隙灯检查以评估睑脂质量和 MG 睑缘形态特征的变化迹象。使用眼表疾病指数问卷评估眼表疾病的主观症状。还记录了干眼参数,包括泪膜高度、非侵入性泪膜破裂时间的第一和平均时间以及 Schirmer 测试结果。
98 名参与者在 12 个月的时间内完成了这项纵向研究。在他汀组中,总睑板腺评分(P=.01)、上睑睑板腺评分(P=.012)、睑缘异常评分(P=.0059)和睑脂质量(P=.0002)在随访期间均有统计学意义的变化。在非他汀组中,也观察到上睑睑板腺评分(P=.046)和睑脂质量(P=.046)的相似变化。
即使在使用他汀类药物的情况下,血脂异常患者的睑板腺萎缩和睑脂质量恶化仍会持续很长时间。