Effect of meibomian gland morphology on functionality with applied treatment

Bilkhu, Paramdeep; Vidal-Rohr, Maria; Trave-Huarte, Sonia; Wolffsohn, James S.

doi:10.1016/j.clae.2020.12.065

Cited by 13 publications

(8 citation statements)

References 34 publications

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“…Therefore, the presence of dry eye and/or various degrees of ocular surface inflammation in individuals with obesity is perfectly plausible. Nevertheless, the average meibomian gland loss (dropout) assessed in our obese patients was not at a level that is believed to impact the overall secretion of meibum [40].…”

Section: Discussionmentioning

confidence: 75%

Impact of Bariatric Surgery-Induced Weight Loss on Anterior Eye Health in Patients with Obesity

et al. 2022

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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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Section: Discussionmentioning

confidence: 75%

Impact of Bariatric Surgery-Induced Weight Loss on Anterior Eye Health in Patients with Obesity

et al. 2022

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“…7 The reason of a greater frequency of alterations in the inferior eyelid in subjects with dry eyes (54.8 vs 30.3%, p= 0.03, OR 2.78, 1-06,7.26) may be related to that the damage of the meibomian glands of the lower eyelid has a greater impact on the development of MGD according to that reported by Eom et al 17 The only morphological alteration statistical different between evaporative dry eye and healthy subjects was shortening of MG. 6,8,17 This is consistent with that reported by Bilkhu et al who found that expression is dependent on residual gland length in the LL, with no gland <70 % of the lower lid length giving clear meibum expression and glands of less than 10 % of the lid length did not express and those less than 25 % did not express or the meibum was inspissated. 18 Daniel et al 19 analyzed 394 ULs and found out that the presence of tortuous glands in the UL were associated with a better TBUT and longer Schirmer test. In our ndings, there was also a statistically signi cant positive correlation of the presence of tortuous glands in the UL with a better initial and average NIKBUT.…”

Section: Discussionmentioning

confidence: 99%

Comparative of Meibomian Gland Morphology in Patients With Evaporative Dry Eye Versus Non-Dry Eye

Crespo-Treviño

Salinas-Sánchez

Amparo

et al. 2021

Preprint

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Many recent studies have demonstrated 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 MG morphology in tear film physiology and disease. This study aimed to investigate the prevalence of anatomical and morphological MG alterations between patients with evapo-rative DED and healthy controls. Retrospective chart review of Seventy-five patients with evaporative dry eye and healthy individuals who had dry eye assesments 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 dry-eye subjects. Patients with evaporative dry eye 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 dry eye presented more alterations in the lower lid than healthy subjects.

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“…322 We have shown that examination of the meibomian glands can inform the likely improvements with eyelid debridement and warm compresses. 323 Consistent lid eversion with a robust technique (as we have evaluated) 324 is critical to meibography, with some articles reporting regeneration of the glands, 325 which seems unlikely over the short time periods and with the interventions reported.…”

Section: Technology-driven Enhancements In Ocular Surface Disease Dia...mentioning

confidence: 95%

“…Microwave-heated compresses work well 340,341 and are better than the traditionally advocated water-warmed flannels, 342,343 as they maintain the required temperature 344 of approximately 40°C 345 ; however, there is still scope to refine the treatment protocol and to assess whether mechanical in-office 346–348 or portable devices we have evaluated 349 outperform simple approaches. We have shown that the meibomian glands do need to be more than 10% of their original length to have potential of expressing meibum 323 . More information is also needed on the benefits of wet versus dry heat 350,351 and whether this is based on an individual's ocular surface biomarkers.…”

Section: Technology-driven Enhancements In Ocular Surface Disease Dia...mentioning

confidence: 99%

“…We have shown that the meibomian glands do need to be more than 10% of their original length to have potential of expressing meibum. 323 More information is also needed on the benefits of wet versus dry heat 350,351 and whether this is based on an individual's ocular surface biomarkers. In the TFOS DEWS II management report, we identified that there are few dry eye treatment direct comparator trials, and rather new treatments are evaluated against a placebo.…”

Section: Technology-driven Enhancements In Ocular Surface Disease Dia...mentioning

confidence: 99%

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2022 Glenn A. Fry Award lecture: Enhancing clinical assessment for improved ophthalmic management

Wolffsohn

2024

Optom Vis Sci

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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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Effect of meibomian gland morphology on functionality with applied treatment

Cited by 13 publications

References 34 publications

Impact of Bariatric Surgery-Induced Weight Loss on Anterior Eye Health in Patients with Obesity

Impact of Bariatric Surgery-Induced Weight Loss on Anterior Eye Health in Patients with Obesity

Comparative of Meibomian Gland Morphology in Patients With Evaporative Dry Eye Versus Non-Dry Eye

2022 Glenn A. Fry Award lecture: Enhancing clinical assessment for improved ophthalmic management

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