Ansari Shora M, Nguyen Tracy, Khankan Rima, Chen Elaine, Osei Kwaku, Pang Yi
Southern California College of Optometry, Marshall B. Ketchum University, Fullerton, California, USA.
State University of New York College of Optometry, New York City, New York, USA.
Ophthalmic Physiol Opt. 2025 Sep;45(6):1244-1260. doi: 10.1111/opo.13552. Epub 2025 Jul 2.
Despite extensive research on meibomian gland dysfunction (MGD) in adults, studies on paediatric populations remain limited. This review aims to provide a comprehensive analysis of the morphological characteristics of meibomian glands (MGs) in healthy children, focusing on identifying baseline features and factors influencing gland structure and function. Understanding these characteristics is critical for early detection of MGD, which can lead to ocular surface disorders such as dry eye disease (DED). By addressing the existing knowledge gap in paediatric populations, this review seeks to inform clinical practice and guide future research in paediatric ocular health.
The analysis included 35 studies assessing MG characteristics using infrared meibography in children. MG loss was reported using various methods, including meiboscore, meiboscale and percentage of area loss. Significant MG loss was noted in healthy, asymptomatic children. Variability in grading methods, imaging techniques and participant demographics revealed inconsistent trends in MG loss between the upper and lower eyelids. MG tortuosity was observed in healthy children but inconsistently defined and quantified across studies. Notable associations were found between MG abnormalities and systemic conditions such as juvenile systemic lupus erythematosus and diabetes mellitus. Dietary factors, body mass index and screen time were identified as potential influencers of MG morphology.
MG loss and tortuosity are observed in children, but their significance remains unclear. These changes may represent normal variations or indicate a potential progression to MGD and DED. To better understand this, standardised assessment tools and longitudinal studies in the paediatric population are needed to determine which MG changes might lead to MGD. Additionally, exploring the relationship between MG characteristics, systemic health and lifestyle factors, such as screen time and diet, could help identify potential long-term effects. Gaining insights into these factors may improve early detection of the pathological changes that contribute to DED.
尽管对成人睑板腺功能障碍（MGD）进行了广泛研究，但针对儿童群体的研究仍然有限。本综述旨在全面分析健康儿童睑板腺（MG）的形态特征，重点是确定基线特征以及影响腺体结构和功能的因素。了解这些特征对于早期发现MGD至关重要，MGD可能导致眼表疾病，如干眼病（DED）。通过填补儿童群体现有知识空白，本综述旨在为临床实践提供信息，并指导儿童眼部健康的未来研究。
该分析纳入了35项使用红外睑板腺造影评估儿童MG特征的研究。使用多种方法报告了MG丢失情况，包括睑板腺评分、睑板腺分级和面积丢失百分比。在健康、无症状儿童中发现了显著的MG丢失。分级方法、成像技术和参与者人口统计学的差异揭示了上下眼睑MG丢失的不一致趋势。在健康儿童中观察到了MG迂曲，但各研究中对其定义和量化并不一致。发现MG异常与青少年系统性红斑狼疮和糖尿病等全身性疾病之间存在显著关联。饮食因素、体重指数和屏幕使用时间被确定为MG形态的潜在影响因素。
在儿童中观察到了MG丢失和迂曲，但其意义尚不清楚。这些变化可能代表正常变异，也可能表明向MGD和DED的潜在进展。为了更好地理解这一点，需要在儿童群体中使用标准化评估工具和进行纵向研究，以确定哪些MG变化可能导致MGD。此外，探索MG特征、全身健康与生活方式因素（如屏幕使用时间和饮食）之间的关系，有助于识别潜在的长期影响。深入了解这些因素可能会改善对导致DED的病理变化的早期检测。
