Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan.
Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Hsinchu, 30010, Taiwan.
BMC Ophthalmol. 2023 Apr 11;23(1):154. doi: 10.1186/s12886-023-02878-5.
To identify the characteristics of asymptomatic meibomian gland dysfunction (MGD), symptomatic MGD, and MGD coexisting with dry eye disease (DED).
This cross sectional study enrolled a total of 153 eyes of 87 MGD patients. Participants filled in ocular surface disease index (OSDI) questionnaires. Age, gender, Schirmer's test, meibomian gland (MG) related parameters, lipid layer thickness (LLT) and blinking were compared among patients with asymptomatic MGD, symptomatic MGD, and MGD with DED. Multivariate regression was used to analyze the significant factor of DED in MGD. Spearman's rank correlation analysis was used to evaluate the association between the significant factors and MG function.
There was no difference in age, Schirmer's test, lid changes, MG secretion, and MG morphology among three groups. The OSDI of asymptomatic MGD, symptomatic MGD and MGD coexisting with DED were 8.5 ± 2.9, 28.5 ± 12.8 and 27.9 ± 10.5, respectively. Patients with MGD coexisting with DED exhibited more frequent eye blinking than that of patients with asymptomatic MGD (8.1 ± 4.1 vs. 6.1 ± 3.5 blinks/20 sec, P = 0.022), and reduced LLT than that of patients with asymptomatic MGD (68.6 ± 17.2 vs. 77.6 ± 14.5 nm, P = 0.010) and symptomatic MGD (78.0 ± 17.1 nm, P = 0.015). Multivariate analysis identified LLT (per nm, OR = 0.96, 95% CI = 0.93-0.99, P = 0.002) as a significant factor associated with DED development in MGD. The number of expressible MG was positively correlated with LLT (Spearman's correlation coefficient = 0.299, P = 0.016) but negatively correlated with the number of blinking (Spearman's correlation coefficient = -0.298, P = 0.016) in MGD patients with DED, and these findings were not identified in those without DED.
Asymptomatic MGD, symptomatic MGD, and MGD coexisting with DED share similar characteristics, including meibum secretion and morphology, but MGD patients coexisting with DED exhibited significantly reduced LLT.
确定无症状性睑板腺功能障碍（MGD）、有症状性 MGD 和 MGD 合并干眼（DED）的特征。
本横断面研究共纳入 87 例 MGD 患者的 153 只眼。参与者填写眼表疾病指数（OSDI）问卷。比较无症状性 MGD、有症状性 MGD 和 MGD 合并 DED 患者的年龄、性别、泪液分泌试验（Schirmer 试验）、睑板腺（MG）相关参数、脂质层厚度（LLT）和眨眼情况。采用多元回归分析 MGD 中 DED 的显著因素。采用 Spearman 秩相关分析评估显著因素与 MG 功能之间的相关性。
三组患者的年龄、Schirmer 试验、眼睑变化、MG 分泌和 MG 形态均无差异。无症状性 MGD、有症状性 MGD 和 MGD 合并 DED 的 OSDI 分别为 8.5±2.9、28.5±12.8 和 27.9±10.5。与无症状性 MGD 患者相比，MGD 合并 DED 患者的眨眼频率更高（8.1±4.1 次/20 秒 vs. 6.1±3.5 次/20 秒，P=0.022），LLT 更低（68.6±17.2 纳米 vs. 77.6±14.5 纳米，P=0.010；78.0±17.1 纳米，P=0.015）。多因素分析发现 LLT（每纳米，OR=0.96，95%CI=0.93-0.99，P=0.002）是 MGD 患者发生 DED 的显著相关因素。MG 可挤出数量与 LLT 呈正相关（Spearman 相关系数=0.299，P=0.016），但与 DED 患者的眨眼次数呈负相关（Spearman 相关系数=-0.298，P=0.016），而在无 DED 的患者中则没有发现这种相关性。
无症状性 MGD、有症状性 MGD 和 MGD 合并 DED 具有相似的特征，包括睑脂分泌和形态，但 MGD 合并 DED 的患者 LLT 明显降低。
