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Assessment of Meibomian Gland (MD) Impairment Among Seasonal Allergic Conjunctivitis (SAC) Patients - PubMed

  • ️Sat Jan 01 2022

Assessment of Meibomian Gland (MD) Impairment Among Seasonal Allergic Conjunctivitis (SAC) Patients

Limei Liu et al. Med Sci Monit. 2022.

Abstract

BACKGROUND Allergic conjunctivitis, one of the frequently occurring ocular surface diseases, can cause mucus discharge, itchy sensation, conjunctival hyperemia, and papillary formation. Seasonal allergic conjunctivitis (SAC) is associated with xerophthalmia and instability of tear film. Meibomian gland (MG) can secrete lipids to avoid xerophthalmia. However, there have been few reports on MG morphological alterations of SAC patients. This study aimed to examine the morphological alterations of MG among SAC patients. MATERIAL AND METHODS Our study included 89 eyes from 89 patients with SAC and 112 eyes of healthy volunteers. The symptoms were assessed by ocular surface disease index (OSDI) questionnaire. Then, the tests shown below were carried out, including tear evaporation rate from the ocular surface (TEROS), slit-lamp examination, break-up time (BUT) of tear film, Schirmer test I, vital staining, meibography, and meibum expression grading. MG was examined with laser scanning confocal microscopy (LSCM). RESULTS Relative to the control group, the OSDI was significantly higher in the SAC group. TEROS values, BUT, vital staining, MG expression, MG distortion rates, and MG dropout grades were significantly worse in the SAC group compared with the control group. As suggested by LSCM, SAC patients had markedly worse averages of parameters compared with controls. CONCLUSIONS The patients with SAC have more significant morphological and cytological changes in the MG. The Keratograph 5M system and LSCM are effective methods for evaluating MG status and ocular surface diseases.

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Conflict of interest statement

Conflict of interest: None declared

Figures

Figure 1
Figure 1

LSCM images of MG orifices and morphologic changes in SAC patient compared with normal control subject. (PPT, WPS office 2016, Kingsoft Software Company). (A) The MG orifices showed obvious obliteration and narrowing in an SAC patient. (B) Representative image of MG orifices in a normal control. (C) Representative LSCM image for MG in an SAC patient. MG acinar unit diameters were enlarged. (D) LSCM image of a normal subject displaying a number of compact MG acinar units.

Figure 2
Figure 2

Morphologic changes of MGs evaluated by LSCM. (PPT, WPS Office 2016, Kingsoft Software Company). (A) Seasonal allergic conjunctivitis (SAC) patient. (B) Normal control. More extensive periglandular inflammatory cell infiltration was detected in SAC patients compared with the normal control subjects. (C) The conjunctival ICD measured through LSCM apparently increased in the SAC patients compared with normal controls. * P<0.05 versus control group.

Figure 3
Figure 3

Comparison of LSCM parameters between SAC and control groups. (PPT, WPS Office 2016, Kingsoft Software Company). (A) Mean MGAUD value remarkably decreased in the SAC patients relative to the control group. (B) Mean MGAUA value evidently increased in SAC patients relative to the normal controls. (C) Mean MGALD parameter apparently increased in SAC patients relative to normal controls. (D) The difference in mean MGASD value was not significant between SAC patients and normal controls. * P<0.05 versus control group.

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