Characterization of Meibomian Gland Dysfunction in Patients with Rosacea

Abstract

Background: Rosacea frequently evolve the eyes with impact on life and vision quality. There are gaps in the understanding of ocular involvement, specially related to eyelid glands, which share common features to sebaceous glands.Purpose: Describe ocular surface disease related to Rosacea and its associations.Methods: Ninety-three individuals were selected to this cross-sectional, observational, non-interventionist study, divided into groups: rosacea (n=40) and controls (n=53). We investigated objective parameters of the ocular surface (conjunctival hyperemia, tear film stability and volume, meibomian gland dysfunction, dry eye disease, ocular surface staining) comparing healthy individuals with rosacea patients.Results: 69.23% of rosacea group were women, mean age of 47.34 ± 12.62 years old. Compared to matched controls there was no statistically significant differences regarding to visual acuity (p=0.987) and tear film parameters (tear meniscus height (p=0.338), non-invasive tear film rupture time (NIBUT) (p= 0.228), invasive rupture time (TBUT) (p=0.471) and Schirmer's test (p=0.244)) as well as conjunctival hyperemia (p = 0.106), and fluorescein staining (p = 0.489). Significant association was found in meibography evaluation (p = 0.026), mucous layer integrity (p = 0.015) and ocular surface symptoms (p <0.0001). Rosacea patients also showed important eyelid changes: glandular expressibility (p <0.001), glandular secretion pattern (p <0.001) and telangiectasia (p <0.001) compared to controls.Conclusion: Meibomian gland dysfunction is frequently associated to dermatologic conditions and is characterized by morphological findings in the meibography as well as lipid secretion impairment that lead to evaporative dry eye and ocular surface dysfunction and inflammation.