Evaluation of Tear Film Lipid Layer Thickness Measurements Obtained Using an Ocular Surface Interferometer in Nasolacrimal Duct Obstruction Patients

Chung, Sok Joong; Lee, Sang Min

doi:10.3341/kjo.2018.0012

Cited by 10 publications

(13 citation statements)

References 15 publications

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“…The occurrence of PANDO is beneficial for maintaining proper tear osmolarity and protecting the corneal epithelium, as evidenced by the results of the ocular surface disease index questionnaire: postmenopausal women with PANDO had few typical symptoms of meibomian gland dysfunction, such as foreign body sensation, burning, or dryness but frequently complained of glare and blurring caused by epiphora. These findings are consistent with those of previous studies that showed greater ocular surface discomfort symptoms in patients with PANDO [ 5 , 31 ].…”

Section: Discussionsupporting

confidence: 93%

Changes in the meibomian glands in postmenopausal women with primary acquired nasolacrimal duct obstruction: a prospective study

Jin

Zhang

2023

BMC Ophthalmol

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Background Primary acquired nasolacrimal duct obstruction (PANDO) is frequently encountered in perimenopausal women, causing tear flow stagnation and resulting in a variety of ocular discomfort symptoms. However, little is known about the alterations in the meibomian gland in postmenopausal women with PANDO. Hence, this study investigated the changes in the meibomian gland and ocular surface in postmenopausal women with PANDO. Methods This prospective study included 60 eyes of 60 postmenopausal women with PANDO (PANDO group) and 30 eyes of 30 postmenopausal women without PANDO (control group). The PANDO group was further subdivided into incomplete and complete PANDO groups, based on the degree of nasolacrimal duct obstruction. The patients’ symptoms were evaluated using the ocular surface disease index questionnaire. The meibomian gland and ocular surface were assessed using the Keratograph 5 M. Other ophthalmologic examinations included the tear break-up time, corneal fluorescein staining, meibomian gland expression, and Schirmer I test. The correlations between the degree of nasolacrimal duct obstruction and other metrics were analyzed. Results The loss ratio of the upper eyelid was greater in the incomplete PANDO group than in the control group (p = 0.023). Meibomian gland distortion of the upper eyelid was more severe in the control group than in the complete PANDO group (p = 0.022). The non-invasive tear meniscus height was greater, whereas the intensity of corneal fluorescein staining was lower in the PANDO group than in the control group (all p < 0.05). The degree of nasolacrimal duct obstruction was positively associated with the non-invasive tear meniscus height and ocular surface disease index scores (p < 0.001 and p < 0.001, respectively). Corneal fluorescein staining and meibomian gland distortion of the upper eyelid were negatively correlated with the degree of nasolacrimal duct obstruction (p = 0.01 and p = 0.007, respectively). Conclusion Postmenopausal women with PANDO exhibit significant morphological changes in the meibomian gland. More attention should be paid to meibomian gland loss in postmenopausal women with incomplete PANDO, as it is crucial for identifying meibomian gland impairments in patients with PANDO.

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Section: Discussionsupporting

confidence: 93%

Changes in the meibomian glands in postmenopausal women with primary acquired nasolacrimal duct obstruction: a prospective study

Jin

Zhang

2023

BMC Ophthalmol

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“…In eyes with entropion, epiphora can occur due to ocular irritation and reflex lacrimal hypersecretion [ 27 ]. Elevated tear meniscus can affect LLT: LLT increases after surgery for nasolacrimal duct obstruction [ 28 , 29 ]. Therefore, there is a possibility of the LLT increase after entropion repair in the present study is a result of epiphora resolution, instead of improved MGD.…”

Section: Discussionmentioning

confidence: 99%

Quantitative analysis of morphological and functional alterations of the meibomian glands in eyes with marginal entropion

Yang

Kim

et al. 2022

PLoS ONE

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Purpose To quantitatively analyze morphological and functional alterations of the meibomian glands in eyes with marginal entropion and their changes after surgery. Methods Sixty eyes of 52 patients with marginal entropion and underwent meibography and interferometer were included. One-hundred and seventeen age- and sex-matched eyes with minimal to mild meibomian gland dysfunction (MGD) were recruited as control eyes. Meibomian gland loss (MGL) and lipid layer thickness (LLT) were compared between eyes with marginal entropion and control eyes. Subgroup analysis was performed according to the extent of entropion. MGL and average LLT at 1 and 5 months after surgery were compared with those of 20 eyes with marginal entropion followed without surgery. Results In eyes with marginal entropion, MGL was higher (27.7% vs. 12.8%, P = 0.014), and average LLT was thinner (64 nm vs. 86 nm, P = 0.005) than those in control eyes. MGL was higher in eyes with more extensive entropion (> 2/3 eyelid width) than in eyes with less extensive entropion (≤ 1/3 eyelid width) (40.5% vs. 13.2%, P = 0.001). Average LLT increased after surgery (97 nm at 1 month, P = 0.003; 75 nm at 5 months, P = 0.319), and thicker than that of eyes followed without surgery (97 nm vs. 66 nm, P = 0.046). MGLs after surgery remained unchanged from the preoperative MGL (all P > 0.7). Conclusion Marginal entropion is associated with morphological and functional alterations of the meibomian glands. Functional improvement after entropion repair suggests that marginal entropion could cause or exacerbate MGD. Further studies are required to establish the role of entropion repair in managing MGD.

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“…Fibers of the tarsal orbicularis oculi muscles, innervated by CNVII, surround the canalicular system and lacrimal sac. They drive the tears into the lacrimal system and down the duct with blinking [47,48,[50][51][52].…”

Section: Lacrimal Drainage System and Tear Productionmentioning

confidence: 99%

“…The trigeminal brainstem neurons also communicate with the thalamus, which supports lacrimation, spontaneous blinking, and emotional elements of the blink reflex [27,52]. Changes in physiology anywhere along the pathway (such as from surgery or aging) can affect the residence time of tears and drainage efficiency [51,[53][54][55][56][57][58].…”

Section: Lacrimal Drainage System and Tear Productionmentioning

confidence: 99%

Neurostimulation for dry eye disease

London

Pincovich

Solomon

2022

Current Opinion in Allergy &Amp; Clinical Immunology

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Purpose of reviewTo review the neuroanatomy and physiology of the basal and reflex tearing and present the available and developing therapies using the concept of neurostimulation in dry eye disease (DED). Recent findingsThe most prevalent current DED treatments seek to supplement low tear volume and tear components or reduce inflammation. Neurostimulation is a unique approach gaining momentum in recent years, geared toward increasing the production of all basal tear components by stimulating the nerves responsible for producing the various tear components. The neuroanatomy of the lacrimal unit provides several possible access points to stimulate tear production through two arms of the sensory trigeminal nerves. Modes of stimulation include chemical or energy in electrical or magnetic form. Research thus far has shown that neurostimulation can achieve lacrimal, goblet cell, and meibomian gland stimulation. Subjectively it improves symptoms of DED. Clinically, neurostimulation has improved the signs and symptoms of DED by increasing basal tear production and tear volume.

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Evaluation of Tear Film Lipid Layer Thickness Measurements Obtained Using an Ocular Surface Interferometer in Nasolacrimal Duct Obstruction Patients

Cited by 10 publications

References 15 publications

Changes in the meibomian glands in postmenopausal women with primary acquired nasolacrimal duct obstruction: a prospective study

Changes in the meibomian glands in postmenopausal women with primary acquired nasolacrimal duct obstruction: a prospective study

Quantitative analysis of morphological and functional alterations of the meibomian glands in eyes with marginal entropion

Neurostimulation for dry eye disease

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