Dou Zexia, Sun Ming, Huang Yue, Zhao Shaozhen
Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, 300384, China.
Int Ophthalmol. 2025 Apr 12;45(1):155. doi: 10.1007/s10792-025-03446-0.
This study aimed to investigate the morphological features of eyelid margin in dry eye patients and determine their correlations with conjunctival goblet cells, MUC5AC secretion, and clinical tests of tear film.
Patients diagnosed with dry eye disease (DED) were asked to complete the evaluations of symptoms and signs of dry eye, including Ocular Surface Disease Index (OSDI) questionnaire, Lipid layer thickness (LLT), partial blinking (PB) rate, tear-film breakup time (TBUT), Schirmer's I test (SIt), and meiboscore. Marx line (ML), lid wiper epitheliopathy (LWE), and meibomian orifices (MOs) were used as indicators of morphological features of the eyelid margin. PAS staining of conjunctival goblet cells and MUC5AC measurement of the tear samples were also performed.
A total of 30 patients diagnosed with DED were included. The ML score was correlated with the SIt. The MOs showed a significant negative correlation with the TBUT and LLT. The LWE was corrected to TBUT and meiboscore, and also associated with decreased conjunctival goblet cell density and MUC5AC concentration in the tear film rather than ML and MOs in the eyelid margin of dry eye patients. The tear MUC5AC concentration had a significant positive correlation with conjunctival goblet cell density.
The eyelid margin is crucial for maintaining the integrity of tear film and ocular surface. Attracting more attention to the eyelid margin is beneficial to routine clinical practice, and lid wipers could be used to evaluate the secretion of MUC5AC in the tear film secreted by conjunctival goblet cells.
本研究旨在探讨干眼患者睑缘的形态学特征，并确定其与结膜杯状细胞、MUC5AC分泌及泪膜相关临床检测指标之间的相关性。
被诊断为干眼病（DED）的患者需完成干眼症状和体征的评估，包括眼表疾病指数（OSDI）问卷、脂质层厚度（LLT）、不完全眨眼（PB）率、泪膜破裂时间（TBUT）、泪液分泌试验I（SIt）及睑板腺功能评分。采用马克思线（ML）、睑板前唇上皮病变（LWE）及睑板腺开口（MOs）作为睑缘形态学特征的指标。同时还进行了结膜杯状细胞的PAS染色及泪液样本的MUC5AC检测。
共纳入30例诊断为DED的患者。ML评分与SIt相关。MOs与TBUT和LLT呈显著负相关。LWE与TBUT及睑板腺功能评分相关，且与干眼患者睑缘的ML和MOs无关，而是与结膜杯状细胞密度降低及泪膜中MUC5AC浓度降低有关。泪液MUC5AC浓度与结膜杯状细胞密度呈显著正相关。
睑缘对于维持泪膜和眼表的完整性至关重要。在日常临床实践中，更多关注睑缘有益，并且睑板前唇可用于评估结膜杯状细胞分泌的泪膜中MUC5AC的情况。
