Cornea, Cataract and Refractive Surgery Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
Indian J Ophthalmol. 2022 May;70(5):1539-1545. doi: 10.4103/ijo.IJO_2245_21.
To assess the role of noninvasive ocular surface analyzer (OSA) in workup of meibomian gland dysfunction (MGD) and to estimate hospital-based prevalence of MGD using this objective device.
The study recruited 113 consecutive participants attending the ophthalmology outpatient department of a tertiary care hospital. All participants were administered a symptom questionnaire. Participants underwent a comprehensive ocular examination, including slit-lamp biomicroscopy and meibomian gland expression. Lipid layer thickness (LLT), noninvasive tear breakup time (NIBUT), tear meniscus height (TMH), and meibomian gland loss (MGL) were assessed using OSA. The presence of either or both reduced/absent meibum secretion and cloudy to toothpaste-like secretion was diagnosed as MGD.
Prevalence of total MGD was 57.52% (95% confidence interval [95% CI]: 48.3%-66.8%) and that of symptomatic MGD was 42.5% (95% CI: 33.2%-51.7%). Prevalence of total and symptomatic MGD was highest in those aged ≥50 years (P < 0.001 and P = 0.004, respectively). Computer vision syndrome increased the odds of symptomatic MGD (odds ratio [OR]: 4.3). NIBUT and MGL significantly differed in MGD and non-MGD groups (P = 0.023 and P < 0.001, respectively). LLT significantly differed between asymptomatic and symptomatic cases (P = 0.033). MGL >25% increased the odds of having MGD (OR: 19.1). Significant negative correlations were observed between MGL and NIBUT (P = 0.04) and between MGL and LLT (P = 0.02). MGL demonstrated the highest diagnostic accuracy for MGD (AUC = 0.827, sensitivity = 75.4%, specificity = 85.4%, cut-off value: ≥26%).
MGD is a common disorder in adults attending the ophthalmology outpatient services of a tertiary eye care hospital. Incorporating noninvasive OSA in clinical practice can aid in rapid and reliable measurements of MGD-related parameters.
评估非侵入性眼表分析（OSA）在睑板腺功能障碍（MGD）中的作用，并使用这种客观设备估计医院中 MGD 的患病率。
这项研究招募了 113 名连续到三级医院眼科门诊就诊的参与者。所有参与者都接受了症状问卷评估。参与者接受了全面的眼部检查，包括裂隙灯生物显微镜检查和睑板腺分泌。使用 OSA 评估脂质层厚度（LLT）、非侵入性泪膜破裂时间（NIBUT）、泪膜高度（TMH）和睑板腺缺失（MGL）。如果存在减少/缺乏睑板腺分泌物和混浊至牙膏样分泌物，则诊断为 MGD。
总 MGD 的患病率为 57.52%（95%置信区间[95%CI]：48.3%-66.8%），症状性 MGD 的患病率为 42.5%（95%CI：33.2%-51.7%）。≥50 岁人群的总 MGD 和症状性 MGD 患病率最高（P<0.001 和 P=0.004）。计算机视觉综合征会增加症状性 MGD 的几率（比值比[OR]：4.3）。MGD 和非 MGD 组的 NIBUT 和 MGL 差异有统计学意义（P=0.023 和 P<0.001）。无症状和有症状病例之间的 LLT 差异有统计学意义（P=0.033）。MGL>25%会增加 MGD 的几率（OR：19.1）。MGL 与 NIBUT 之间存在显著负相关（P=0.04），与 LLT 之间也存在显著负相关（P=0.02）。MGL 对 MGD 的诊断准确性最高（AUC=0.827，敏感性=75.4%，特异性=85.4%，截断值：≥26%）。
MGD 是三级眼科医院眼科门诊就诊成年人中的常见疾病。在临床实践中纳入非侵入性 OSA 可以帮助快速可靠地测量 MGD 相关参数。
