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Hou X, Liu C, Luo Y, Yu N, Chen P, Zhuang J, Yu K. Quantitative evaluation of morphological and functional changes in meibomian glands and lipid layer thickness in patients with and without keratoconus. Graefes Arch Clin Exp Ophthalmol 2024:10.1007/s00417-024-06443-8. [PMID: 38502350 DOI: 10.1007/s00417-024-06443-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 03/06/2024] [Accepted: 03/08/2024] [Indexed: 03/21/2024] Open
Abstract
PURPOSE To quantitatively evaluate the morphological parameters of meibomian glands (MGs) and lipid layer thickness (LLT) in patients with keratoconus (KC). METHODS In this prospective, cross-sectional study, 164 eyes of 164 keratoconus patients and 64 eyes of 64 age-matched control subjects were included. An advanced automatic MG analyzer was used to quantitatively measure the morphological and functional parameters of MGs. Morphological and functional parameters of MGs, LLT, and other ocular surface parameters were compared between the control and KC groups. RESULTS The mean meibomian gland diameter, length, square, and gland area ratio (GA) were all significantly decreased in the KC group (all P < 0.05), while no significant difference was observed in the gland tortuosity index (TI) and gland signal index (SI) between the KC and control groups (all P > 0.05). There was no significant difference in the number of total and incomplete blinking among patients with different stages of keratoconus (all P > 0.05). The gland diameter, square, and TI were all negatively associated with KC severity (all P < 0.05), while no significant difference was observed among all stages of KC in gland length, GA, and SI (all P > 0.05). Moreover, the LLTs were positively correlated with the gland diameter, square, GA, and TI and negatively correlated with anterior corneal curvature or KC severity (all P < 0.05). CONCLUSIONS Atrophic morphological changes in the meibomian glands were closely correlated with the severity of keratoconus. Gland diameter may be a sensitive functional morphology metric of meibomian glands in patients with keratoconus.
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Affiliation(s)
- Xiangtao Hou
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, No.7 Jinsui Road, Tianhe District, Guangzhou, 510060, China
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, 510060, China
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, China
| | - Chang Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, No.7 Jinsui Road, Tianhe District, Guangzhou, 510060, China
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, 510060, China
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, China
| | - Yiqi Luo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, No.7 Jinsui Road, Tianhe District, Guangzhou, 510060, China
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, 510060, China
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, China
| | - Na Yu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, No.7 Jinsui Road, Tianhe District, Guangzhou, 510060, China
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, 510060, China
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, China
| | - Pei Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, No.7 Jinsui Road, Tianhe District, Guangzhou, 510060, China
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, 510060, China
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, China
| | - Jing Zhuang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, No.7 Jinsui Road, Tianhe District, Guangzhou, 510060, China.
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, 510060, China.
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, China.
| | - Keming Yu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, No.7 Jinsui Road, Tianhe District, Guangzhou, 510060, China.
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, 510060, China.
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, China.
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Wolffsohn JS. 2022 Glenn A. Fry Award lecture: Enhancing clinical assessment for improved ophthalmic management. Optom Vis Sci 2024; 101:12-24. [PMID: 38350054 DOI: 10.1097/opx.0000000000002102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024] Open
Abstract
ABSTRACT Detailed clinical assessment is critical to allow sensitive evaluation of the eye and its management. As technology advances, these assessment techniques can be adapted and refined to improve the detection of pathological changes of ocular tissue and their impact on visual function. Enhancements in optical medical devices including spectacle, contact, and intraocular lenses have allowed for a better understanding of the mechanism and amelioration of presbyopia and myopia control. Advancements in imaging technology have enabled improved quantification of the tear film and ocular surface, informing diagnosis and treatment strategies. Miniaturized electronics, large processing power, and in-built sensors in smartphones and tablets capacitate more portable assessment tools for clinicians, facilitate self-monitoring and treatment compliance, and aid communication with patients. This article gives an overview of how technology has been used in many areas of eye care to improve assessments and treatment and provides a snapshot of some of my studies validating and using technology to inform better evidence-based patient management.
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Amano S, Shimazaki J, Yokoi N, Hori Y, Arita R. Meibomian Gland Dysfunction Clinical Practice Guidelines. Jpn J Ophthalmol 2023; 67:448-539. [PMID: 37351738 DOI: 10.1007/s10384-023-00995-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 12/21/2022] [Indexed: 06/24/2023]
Affiliation(s)
- Shiro Amano
- Ochanomizu Inoue Eye Clinic, 4-3 Kandasurugadai, Chiyoda-ku, Tokyo, 101-0062, Japan.
| | - Jun Shimazaki
- Department of Ophthalmology, Tokyo Dental College Ichikawa General Hospital, Ichikawa, Japan
| | - Norihiko Yokoi
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yuichi Hori
- Department of Ophthalmology, Toho University Omori Medical Center, Tokyo, Japan
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Feng J, Wang J, Wu B, Shao Q, Zang Y, Cao K, Tian L, Jie Y. Association of meibomian gland morphology with orifice plugging and lid margin thickening in meibomian gland dysfunction patients. Int Ophthalmol 2023:10.1007/s10792-023-02721-2. [PMID: 37140834 DOI: 10.1007/s10792-023-02721-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 04/09/2023] [Indexed: 05/05/2023]
Abstract
PURPOSE We sought to investigate the association of meibomian gland morphology with lid margin abnormalities in patients with meibomian gland dysfunction. METHODS This retrospective study included 368 eyes of 184 patients. Meibography was used to evaluate meibomian gland (MG) morphological features, such as dropout, distortion, thickened ratio and thinned ratio. Lid margin photography was used to evaluate lid margin abnormalities including orifice plugging, vascularity, irregularity and thickening. The association between MG morphological features and lid margin abnormalities was analyzed using a mixed linear model. RESULTS The study found a positive correlation between plugging of gland orifices grade and MG dropout grade in both the upper lids (B = 0.40, p = 0.007) and the lower lids (B = 0.55, p = 0.001). Plugging of gland orifices grade was also positively correlated to MG distortion grade in the upper lids (B = 0.75, p = 0.006). In the upper lids, MG thickened ratio increased first (B = 0.21, p = 0.003) and then decreased (B = - 0.14, p = 0.010) with a higher lid margin thickening grade. MG thinned ratio was negatively correlated with lid margin thickening (B = - 0.14, p = 0.002, B = - 0.13, p = 0.007). MG distortion grade decreased with lid margin thickening (B = - 0.61, p = 0.012). CONCLUSION Orifice plugging was correlated to meibomian gland distortion and dropout. Lid margin thickening was associated with meibomian gland thickened ratio, thinned ratio, and distortion. The study also suggested that distorted and thinned glands may be transitional phases between thickened glands and glands dropout.
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Affiliation(s)
- Jun Feng
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Science Key Lab, No. 1 Dong Jiao Min Xiang, Dong Cheng District, Beijing, 100730, China
| | - Jingyi Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Science Key Lab, No. 1 Dong Jiao Min Xiang, Dong Cheng District, Beijing, 100730, China
| | - Binge Wu
- Department of Ophthalmology, The Second Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou, China
| | - Qiyan Shao
- Department of Ophthalmology, The Second Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou, China
| | - Yunxiao Zang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Science Key Lab, No. 1 Dong Jiao Min Xiang, Dong Cheng District, Beijing, 100730, China
| | - Kai Cao
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Science Key Lab, No. 1 Dong Jiao Min Xiang, Dong Cheng District, Beijing, 100730, China
| | - Lei Tian
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Science Key Lab, No. 1 Dong Jiao Min Xiang, Dong Cheng District, Beijing, 100730, China
| | - Ying Jie
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Science Key Lab, No. 1 Dong Jiao Min Xiang, Dong Cheng District, Beijing, 100730, China.
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Impact of Bariatric Surgery-Induced Weight Loss on Anterior Eye Health in Patients with Obesity. Nutrients 2022; 14:nu14122462. [PMID: 35745192 PMCID: PMC9227522 DOI: 10.3390/nu14122462] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 06/09/2022] [Accepted: 06/10/2022] [Indexed: 01/27/2023] Open
Abstract
The aim of the present research was to assess the effect of bariatric surgery-induced weight loss on the tear film and ocular surface of patients with obesity. A total of 29 participants with obesity (aged 47.2 ± 10.1 years, 8 male) were measured at baseline and followed up one year after Roux-en-Y gastric bypass (RYGB) surgery. General anthropometric data, as well as serum lipid markers of cholesterol, were assessed in all individuals. Bilateral anterior eye measurements of tear meniscus height (TMH), non-invasive tear breakup time, bulbar and limbal redness and infrared meibography were captured using the Keratograph K5M (Oculus) and ocular surface damage was evaluated using fluorescein sodium and lissamine green staining. Bariatric surgery resulted in significant loss of weight (body mass index p < 0.001) and an improvement in the blood lipid profile (p < 0.01) in all participants. However, there were no statistically significant differences between the baseline and one-year follow-up for any of the measured clinical ocular surface and tear film variables (all p > 0.05). Although there were trends for a reduced TMH and a decrease in meibomian gland dropout after bariatric surgery, these differences were also insignificant (p > 0.05). In conclusion, weight reduction through bariatric surgery did not have an effect on the tear film or ocular surface in unselected patients with obesity.
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Comparative of meibomian gland morphology in patients with evaporative dry eye disease versus non-dry eye disease. Sci Rep 2021; 11:20729. [PMID: 34671059 PMCID: PMC8528818 DOI: 10.1038/s41598-021-00122-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 09/27/2021] [Indexed: 12/15/2022] Open
Abstract
Many recent studies have showed that morphological changes are one of the key signs of meibomian gland disease (MGD). These changes can be seen even before symptom onset, potentially underestimating the prevalence of MGD; however, until now, there is no conclusive information about the impact of meibomian gland (MG) morphology in tear film physiology and disease. This study aimed to investigate the prevalence of anatomical and morphological MG alterations between patients with evaporative dry eye disease (DED) and healthy controls. Retrospective chart review of seventy-five patients with evaporative DED and healthy individuals who had dry eye assessments included Ocular Surface Disease Index questionnaire, meibum quality, meibum expressibility, lid margin abnormality, ocular staining, non-invasive tear film break-up time, and meibography. We did not find significant differences in MG alterations in the upper lid between healthy and DED subjects. Patients with evaporative DED presented MG alterations in the lower lid more frequently than healthy subjects (54.8 vs. 30.3%; p = 0.03). The presence of shortened glands was the only MG alteration that was more prevalent in the lower lid in dry-eye patients than in healthy subjects (p < 0.05). Subjects with evaporative DED presented more alterations in the lower lid than healthy subjects.
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