School of Medical Science, University of Hyderabad, Hyderabad, India.
School of Medical Science, University of Hyderabad, Hyderabad, India.
Exp Eye Res. 2022 Sep;222:109188. doi: 10.1016/j.exer.2022.109188. Epub 2022 Jul 14.
Tear film and MG morphology play an essential role in detecting dry eyes and Meibomian Gland Dysfunction (MGD). Previous studies have reported these changes in cases diagnosed with dry eyes. However, it is important to study these changes among subjects with symptoms of dry eyes without signs. Hence, this study evaluated the changes in the tear film and meibomian gland (MG) morphology among subjects with pre-clinical dry eye and compared it with the normals defined by the Ocular Surface Disease Index score. One hundred and fifty subjects were enrolled in this prospective cross-sectional study. All the subjects completed the Ocular Surface Disease Index (OSDI) questionnaire and the Computer Vision Syndrome Questionnaire (CVS-Q). Tear film tests such as non-invasive break-up time (NIBUT), tear meniscus height (TMH), lipid layer pattern, Schirmer's test, and corneal staining were performed. Images were captured from both the upper and the lower eyelids to study the MG morphology. TMH, MG length, thickness, loss, and tortuosity were measured using ImageJ software. Subjects were differentiated into two groups based on an OSDI threshold score of ≥13 as preclinical dry eye and normals. Among all the subjects, 43.6% of them were categorized as pre-clinical dry eye, and 56.4% as normals. In the pre-clinical dry eye group, a significant reduction in NIBUT (Z = -2.13, p = 0.03) and MG length of the lower lid (Z = -2.58, p = 0.01) was found when compared to normals. TMH, Schirmer's test, and MG width did not vary among both groups (p > 0.05). Similarly, MG loss and tortuosity score was higher in the pre-clinical dry eye group, but did not show any statistical significance (p > 0.05). The majority of the young individuals presenting for the regular eye examination may have pre-clinical dry eye based on their OSDI scores. Hence, it is important to administer the OSDI questionnaire and perform non-invasive tests such as NIBUT and IR imaging of MG as a part of the routine eye examination.
泪膜和睑板腺形态在干眼症和睑板腺功能障碍(MGD)的诊断中起着至关重要的作用。之前的研究已经报道了这些在干眼症患者中的变化。然而,研究有干眼症症状但无体征的患者的这些变化也很重要。因此,本研究评估了有临床前期干眼症的患者的泪膜和睑板腺(MG)形态的变化,并将其与眼表面疾病指数(OSDI)评分定义的正常者进行了比较。本前瞻性横断面研究纳入了 150 名受试者。所有受试者均完成了眼表面疾病指数(OSDI)问卷和计算机视觉综合征问卷(CVS-Q)。进行了泪膜测试,如非侵入性泪膜破裂时间(NIBUT)、泪膜高度(TMH)、脂质层模式、泪液分泌试验和角膜染色。从上下眼睑拍摄图像以研究 MG 形态。使用 ImageJ 软件测量 TMH、MG 长度、厚度、缺失和扭曲。根据 OSDI 阈值评分≥13 将受试者分为临床前期干眼症和正常者两组。在所有受试者中,43.6%的人被归类为临床前期干眼症,56.4%的人被归类为正常者。在临床前期干眼症组中,与正常者相比,NIBUT(Z=-2.13,p=0.03)和下眼睑 MG 长度显著降低(Z=-2.58,p=0.01)。TMH、泪液分泌试验和 MG 宽度在两组之间没有差异(p>0.05)。同样,临床前期干眼症组的 MG 缺失和扭曲评分较高,但无统计学意义(p>0.05)。根据 OSDI 评分,大多数前来进行常规眼部检查的年轻人可能患有临床前期干眼症。因此,在常规眼部检查中,重要的是要进行 OSDI 问卷和 NIBUT 等非侵入性测试以及 MG 的 IR 成像。