In Vivo Transillumination Biomicroscopy and Photography of Meibomian Gland Dysfunction

Robin, Jeffrey B.; Jester, James V.; Nobe, Janis R.; Nicolaides, Nicholas C.; Smith, Ronald E.

doi:10.1016/s0161-6420(85)33848-4

Cited by 141 publications

(64 citation statements)

References 9 publications

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“…Earlier studies using meibography have observed visible loss of MG as a pathognomonic feature of human MGD, and has been referred to as "gland dropout" (Robin et al, 1985;Mathers, 1993). Because meibography appears to only detect the acinar portion of the gland, our findings suggest that "gland dropout" does not involve destruction of the gland per se, but only loss of acinar tissue differentiation along the central duct.…”

Section: Discussionsupporting

confidence: 48%

“…A number of changes occur in the human MG with age that are thought to account for the increased frequency of meibomian gland dysfunction (MGD) in older populations (Hom et al, 1990;Mathers et al, 1991;Mathers and Lane, 1998) including MG "dropout," orifice plugging, cystic dilation of the duct, and atrophy of the MG acini (Gutgesell et al, 1982;Robin et al, 1985;Hykin and Bron, 1992;Mathers, 1993;Obata et al, 1994;Obata, 2002). These structural changes are thought to lead to altered or reduced tear outflow leading to disruption of the tear film, increased tear evaporation, and increased tear osmolarity that cause ocular discomfort, eye irritation, and chronic blepharitis.…”

Section: Introductionmentioning

confidence: 99%

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Volumetric Reconstruction of the Mouse Meibomian Gland Using High‐Resolution Nonlinear Optical Imaging

Jester

Nien

Winkler

et al. 2011

The Anatomical Record

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Recent studies suggest that mouse meibomian glands (MG) undergo age-related atrophy that mimics changes seen in age-related human MG dysfunction (MGD). To better understand the structural/functional changes that occur during aging, this study developed an imaging approach to generate quantifiable volumetric reconstructions of the mouse MG and measure total gland, cell, and lipid volume. Mouse eyelids were fixed in 4% paraformaldehyde, embedded in LR White resin and serially sectioned. Sections were then scanned using a 20× objective and a series of tiled images (1.35 × 1.35 × 0.5 mm) with a pixel size of 0.44 μm lateral and 2 μm axial were collected using a Zeiss 510 Meta LSM and a femtosecond laser to simultaneously detect second harmonic generated (SHG) and two-photon excited fluorescence (TPEF) signals from the tissue sections. The SHG signal from collagen was used to outline and generate an MG mask to create surface renderings of the total gland and extract relevant MG TPEF signals that were later separated into the cellular and lipid compartments. Using this technique, three-dimensional reconstructions of the mouse MG were obtained and the total, cell, and lipid volume of the MG measured. Volumetric reconstructions of mouse MG showed loss of acini in old mice that were not detected by routine histology. Furthermore, older mouse MG had reduced total gland volume that is primarily associated with loss of the lipid volume. These findings suggest that mice MG undergo "dropout" of acini, similar to that which occurs in human age-related MGD.

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Section: Discussionsupporting

confidence: 48%

Section: Introductionmentioning

confidence: 99%

Volumetric Reconstruction of the Mouse Meibomian Gland Using High‐Resolution Nonlinear Optical Imaging

Jester

Nien

Winkler

et al. 2011

The Anatomical Record

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“…We used two techniques for evaluating meibomian gland function: (1) observation of meibomian gland orifices using biomicroscopy and (2) transillumination observation techniques using a light probe (meibography) [26][27][28][29][30][31][32] . Lack of secretion following the application of moderate digital pressure on the tarsus of the upper eyelid was considered as a decrease in the secretion [33] .…”

Section: Assessment Of Mgdmentioning

confidence: 99%

“…This device presents advantages over a conventional transilluminator, because the fine tip of the light guide can be hidden behind an everted eyelid, making it possible to observe gland structure without interferometer. Loss of visible meibomian gland structure has been observed in patients with severe MGD [28][29][30]32] . Therefore, the presence of gland dropout at the central two thirds of the lower tarsus indicated the presence of MGD in this study.…”

Section: Assessment Of Mgdmentioning

confidence: 99%

Androgen Status of the Nonautoimmune Dry Eye Subtypes

2006

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Purpose: To evaluate androgen levels of patients diagnosed with nonautoimmune dry eye, either with meibomian gland dysfunction (MGD) or without MGD (non-MGD), and normal control subjects. This is a prospective, comparative, case-control study. Methods: Sixty-four (32 men and 32 women) subjects were enrolled for each of the three diagnostic groups. All dry eye patients were symptom positive. Nonfasting testosterone (T), sex hormone-binding globulin, serum albumin, dehydroepiandrosterone (DHEA), and DHEA sulphate levels of all study participants were determined using either automated immunoenzymatic assay, or standard radioimmunoassay. Analysis of variance was used to compare androgen levels among the three diagnostic groups in a gender-based design, followed by post-hoc multiple comparisons with the Tukey honestly significant difference test. Results: Mean T levels in men and women of the three diagnostic groups were not significantly different (p = 0.808, p = 0.156, respectively; ANOVA). Statistical analyses of the three diagnostic groups revealed a significant difference for men and women in bioavailable T levels (p = 0.002, p = 0.014, respectively; ANOVA), DHEA levels (p = 0.009, p = 0.004, respectively; ANOVA), and DHEA sulphate levels (p = 0.001, p = 0.001, respectively; ANOVA), whereas there was no statistically significant difference between non-MGD dry eye patients and controls for any of the measured androgen levels according to the post-hoc tests. Conclusion: This study demonstrates that the androgen pool of nonautoimmune dry eye patients with MGD is significantly depleted compared with that of non-MGD and control cases.

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“…7 When meibomian gland dysfunction occurs, tear film becomes destabilized, giving rise to dry eye symptoms such as foreign body sensation, eye fatigue, or epiphora. [7][8][9][10] McCulley et al 11 reported that among patients with meibomian gland dysfunction, the amount of tear is often decreased. In addition, Zengin et al 12 reported that the tear break up time decreases in these patients because the tear film has become destabilized, thus increasing tear evaporation.…”

mentioning

confidence: 99%

The Effect of Low-Dose Doxycycline Therapy in Chronic Meibomian Gland Dysfunction

Yoo

Lee

Chang

2005

Korean J Ophthalmol

103

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Blepharitis is a relatively common disorder that manifests various clinical signs such as foreign body sensation, tearing and dry sensation, etc. The complete treatment of this condition is believed to be difficult because of abnormal meibomian gland function and changes in the normal flora of conjunctiva. Consequently, the course is often chronic, frustrating both clinicians and patients. Meibomian gland dysfunction is a common type of chronic blepharitis and although it is so common it can be easy to overlook clinically. Because symptoms can improve with appropriate treatment, it is very important to identify the disorder in patients who complain of dry eye symptoms.Chronic meibomian gland dysfunction particularly affects the lipid layer of tear film, destabilizing the tear film and quickening the tear film's evaporation, and ultimately causes many disorders of the external eye, including dry eye syndrome. 1In order to treat this dysfunction, physicians have reported prescribing 200 mg twice-daily doxycycline (α -6 deoxy-5 hydroxytetracycline), a long acting analogue of tetracycline that inhibits collagenase and also has antichemotactic effects, thus improving patients' symptoms by stabilizing the lipid layer of tear film. Recently, in the field of dentistry, low-dose doxycycline hyclate (20 mg) has been used to treat and prevent periodontitis by inhibiting collagenase. 3 The authors wanted to investigate the effectiveness of such therapy in the chronic meibomian gland dysfunction patients.One hundred fifty patients were selected (55 male, 95 female) that reported to the department of ophthalmology between January and December of 2003 and newly diagnosed with chronic meibomian gland dysfunction with grade 2 or worse meibomian gland destruction or meibomian gland Department of Ophthalmology, Dankook University College of Medicine, Cheonan, KoreaPurpose: The aim was to investigate the effect of low dose doxycycline (20 mg) therapy in patients with chronic meibomian gland dysfunction that were refractory to conventional therapy. Methods: The randomized prospective study enrolled 150 patients (300 eyes) who have chronic meibomian gland dysfunction and who didn't respond to lid hygiene and topical therapy for more than 2 months. All topical therapy was stopped for at least 2 weeks prior to beginning the study. After conducting the tear break up time test (TBUT) and Schirmer test, the authors randomly divided the patients into three groups a high dose group (doxycycline, 200 mg, twice a day), a low dose group (doxycycline, 20 mg, twice a day) and a control group (placebo). After one month, the author repeated the TBUT and Schirmer tests, and analyzed the degree of symptomatic improvement. Results: Compared to the control group, both the high and low dose group showed statistically significant differences after treatment in TBUT, Schirmer test, the number of symptoms reported and the degree of improvement of subjective symptoms. However, there was no statistically significant difference between the high and low dose ...

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In Vivo Transillumination Biomicroscopy and Photography of Meibomian Gland Dysfunction

Cited by 141 publications

References 9 publications

Volumetric Reconstruction of the Mouse Meibomian Gland Using High‐Resolution Nonlinear Optical Imaging

Volumetric Reconstruction of the Mouse Meibomian Gland Using High‐Resolution Nonlinear Optical Imaging

Androgen Status of the Nonautoimmune Dry Eye Subtypes

The Effect of Low-Dose Doxycycline Therapy in Chronic Meibomian Gland Dysfunction

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