Department of Ophthalmology and Visual Sciences, Escola Paulista de Medicina, Hospital São Paulo, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
Academia Nacional de Medicina, Programa Jovens Lideranças Médicas, Rio de Janeiro, RJ, Brazil.
Arq Bras Oftalmol. 2024 Mar 4;87(2):e20220319. doi: 10.5935/0004-2749.2022-0319. eCollection 2024.
To assess Meibomian gland dysfunction using meibography in patients with xeroderma pigmentosum and correlate with ocular surface changes.
This cross-sectional study evaluated patients with xeroderma pigmentosum. All patients underwent a comprehensive and standardized interview. The best-corrected visual acuity of each eye was determined. Detailed ophthalmic examination was conducted, including biomicroscopy examination of the ocular surface, Schirmer test type I, and meibography, and fundus examination was also performed when possible. Meibomian gland dysfunction was assessed by non-contact meibography using Oculus Keratograph® 5M (OCULUS Inc., Arlington, WA, USA). Saliva samples were collected using the Oragene DNA Self-collection kit (DNA Genotek Inc., Ottawa, Canada), and DNA was extracted as recommended by the manufacturer. Factors associated with abnormal meiboscores were assessed using generalized estimating equation models.
A total of 42 participants were enrolled, and 27 patients underwent meibography. The meiboscore was abnormal in the upper eyelid in 8 (29.6%) patients and in the lower eyelid in 17 (62.9%). The likelihood of having abnormal meiboscores in the lower eyelid was 16.3 times greater than that in the upper eyelid. In the final multivariate model, age (p=0.001), mutation profile (p=0.006), and presence of ocular surface malignant tumor (OSMT) (p=0.014) remained significant for abnormal meiboscores. For a 1-year increase in age, the likelihood of abnormal meiboscores increased by 12%. Eyes with OSMT were 58.8 times more likely to have abnormal meiboscores than eyes without ocular surface malignant tumor.
In the final model, age, xeroderma pigmentosum profile, previous cancer, and clinical alterations on the eyelid correlated with a meiboscore of ≥2. Meibomian gland dysfunction was common in patients with xeroderma pigmentosum, mainly in the lower eyelid. The severity of Meibomian gland dysfunction increases with age and is associated with severe eyelid changes.
使用睑板腺照相术评估 Xeroderma pigmentosum 患者的睑板腺功能障碍，并与眼表变化相关联。
这是一项横断面研究，评估了 Xeroderma pigmentosum 患者。所有患者均接受了全面且标准化的访谈。每只眼的最佳矫正视力均进行了测定。详细的眼科检查包括眼表面的生物显微镜检查、I 型 Schirmer 试验和睑板腺照相术，如果可能还进行了眼底检查。使用 Oculus Keratograph® 5M（Oculus Inc.，Arlington，WA，USA）进行非接触式睑板腺照相术评估睑板腺功能障碍。使用 Oragene DNA 自采集试剂盒（DNA Genotek Inc.，Ottawa，Canada）采集唾液样本，并按照制造商的建议提取 DNA。使用广义估计方程模型评估与异常睑板腺评分相关的因素。
共纳入 42 名参与者，其中 27 名患者进行了睑板腺照相术。8 名（29.6%）患者的上眼睑和 17 名（62.9%）患者的下眼睑的睑板腺评分异常。下眼睑异常睑板腺评分的可能性是上眼睑的 16.3 倍。在最终的多变量模型中，年龄（p=0.001）、突变谱（p=0.006）和眼表恶性肿瘤（OSMT）的存在（p=0.014）对异常睑板腺评分仍有显著意义。年龄每增加 1 岁，异常睑板腺评分的可能性增加 12%。有 OSMT 的眼睛比没有眼表恶性肿瘤的眼睛更有可能出现异常的睑板腺评分，其可能性是后者的 58.8 倍。
在最终模型中，年龄、Xeroderma pigmentosum 特征、既往癌症和眼睑的临床改变与睑板腺评分≥2 相关。睑板腺功能障碍在 Xeroderma pigmentosum 患者中很常见，主要在下眼睑。睑板腺功能障碍的严重程度随年龄增长而增加，并与严重的眼睑变化相关。
