Evaluation of ocular psoriasis with meibography

Abstract

Background Previous studies has shown that dry eye test abnormalities, meibomian gland dysfunction (MGD), may occur in psoriasis. Objectives The authors aimed to evaluate the dry eye disease (DED), MGD, in psoriasis patients with meibography which is a current, objective, noninvasive method for patients with meibomian gland diseases, to investigate the relationship between disease severity and ocular involvement. Methods This study included 50 participants with psoriasis and 50 healthy individuals. All subjects were examined by the same dermatologist and referred for ophthalmological examination including meibomian gland obstruction, lid margin alterations assessment, ocular surface disease index assessment, tear film break-up time test, Schirmer test, corneal conjunctival fluorescein staining assessment. Additionally, upper and lower lids were evaluated for meibomian gland loss with meibography. Results MGD (28%), meibomian gland loss (MGL) (29.5%), upper meiboscore (0.61 ± 0.81), lower meiboscore (0.46 ± 0.61), DED (22%) were significantly higher in the psoriasis group compared with the control group (p = 0.008, p < 0.001, p = 0.027, p = 0.041, p = 0.044, respectively). There was a significant relationship between MGD and psoriasis area severity index (PASI) (p = 0.015, Odds Ratio = 1.211). There was a significant positive relationship between MGL with PASI (p < 0.001, r = 608) and psoriasis duration (p < 0.001, r = 0.547). Study limitations Smaller study group and inability to detect quality changes of meibum with meibography were limitations of the study. Conclusions Psoriasis may affect the meibomian gland morphology, may cause structural changes in meibomian glands, and as a result of these may cause MGD and DED. Therefore, ophthalmologists and dermatologists should be aware of this situation and co-evaluate the patients in this respect.

Ocular complications in adults with psoriasis: a cross-sectional study in a referral center in Brazil

“…Previous studies have shown that DED is more prevalent among adults with psoriasis than among healthy controls; however, the present study is the first to establish a protective correlation between psoriasis severity, indicated by the PASI score, and DED [ 21 – 23 ]. Contrary to previous findings, the present study’s findings revealed that severe psoriasis protects against DED [ 21 , 24 ].…”

“…In a recent meta-analysis [ 15 ], the prevalence of MGD and DED in the general population were 21.2% and 8.1%, respectively, with some variation across studies [ 25 – 27 ]. In previous studies on adults with psoriasis, the rates of MGD and DED varied from 28–46% to 16–27%, respectively [ 21 – 24 ]. Consistent with the literature, the present study showed that the most commonly reported symptoms, such as burning, itching, tearing, and foreign body sensation, were associated with ocular surface diseases.…”

Evaluation of Dry Eye, Central Corneal and Epithelial Thickness in Psoriasis Patients: Case Control Study

“…7 Kemeriz et al demonstrated that TBUT was lower, OSDI and corneal staining scores were higher, MGD was common, meibomian gland loss increased in psoriasis patients when compared to the control group, and there was no significant difference in the Schirmer test. 18 Taheri et al determined that TBUT and Schirmer test were lower in psoriasis patients, and a significant degree of meibomian gland atrophy was observed in meibography; however, there was no significant difference in the SM tube test (Echo Electricity, Japan), another test employed to analyze aqueous secretion. 19 Aragona et al demonstrated that the OSDI score, TBUT, Schirmer test, lipid layer thickness, corneal and conjunctival staining, squamous metaplasia in impression cytology, corneal esthesiometry findings, and MGD score were significantly worse in psoriasis patients, and there was no significant difference in the meibomian gland secretion in meibography.…”

Dry eye syndrome symptoms in patients with psoriasis

“…21 Automatic meibography of lower eyelid glands enabled the imaging of Meibomian glands, assessment of their loss and hence-loss of lipid component of the precorneal tear film that prevents tear evaporation. 22 NIBUT indicates the stability of the tear film. 21 Decreased NIBUT suggests DES.…”

“…Research has shown that subjects with lower lipid layer thicknesses have a higher probability of Meibomian gland dysfunction 21 . Automatic meibography of lower eyelid glands enabled the imaging of Meibomian glands, assessment of their loss and hence—loss of lipid component of the precorneal tear film that prevents tear evaporation 22 . NIBUT indicates the stability of the tear film 21 .…”