Influence of Meibomian Gland Dysfunction and Friction-Related Disease on the Severity of Dry Eye

Vu, Chi Hoang Viet; Kawashima, Motoko; Yamada, Masakazu; Suwaki, Kazuhisa; Uchino, Makoto; Shigeyasu, Chika; Hiratsuka, Yoshimune; Yokoi, Norihiko; Ohta, Michio

doi:10.1016/j.ophtha.2018.01.025

Cited by 40 publications

(32 citation statements)

References 33 publications

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“…In fact, we observed that MBI was significantly shorter in pseudophakic patients than in phakic subjects, a finding that was supported by previous results showing that the blink rate was higher in dry eyes than in normal eyes [23,24,26]. In addition, it is increasingly recognized that friction-related diseases (FRDs), such as superior limbic keratoconjunctivitis, lid wiper epitheliopathy, and conjunctivochalasis, are a major dynamic cause of DED [35,36]. A recent study suggested that there is a strong negative association between TBUT and FRD, regardless of the DED status or subtype [36].…”

Section: Discussionsupporting

confidence: 71%

Discrepancies in Persistent Dry Eye Signs and Symptoms in Bilateral Pseudophakic Patients

Hanyuda

Ayaki

Tsubota

et al. 2019

JCM

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Despite the increased awareness of early prophylaxis and treatment for dry eye disease (DED) during the first few weeks after cataract surgery, the chronic effect of cataract surgery on the risk of ocular surface abnormalities has not been fully explored. This study was to assess the prevalence of DE subjective symptoms and clinical tests according to the cataract surgery. A total of 172 patients who underwent bilateral cataract surgeries at least 5 months before the recruitment date and 1225 controls with no cataracts were evaluated for their subjective DE symptoms (dry sensation, foreign-body sensation, ocular pain, ocular fatigue, sensitivity to bright light, and blurred vision) and ophthalmic parameters (tear break-up time, keratoconjunctival staining scores, and maximum blinking interval). The presence of subjective DE symptoms was generally inversely associated with cataract surgeries, whereas abnormal clinical tests were more pronounced among postsurgical cataract patients than among controls. Pseudophakic patients showed a 57% increased prevalence of severe keratoconjunctivitis, compared to controls (P = 0.02). In contrast, among subjective DE symptoms, significantly lower odds of sensitivity to bright light were detected among cases than controls; the multivariable-adjusted odds ratio (95% confidence interval) comparing pseudophakic patients with noncataract patients was 0.56 (0.34–0.92) (P = 0.02). In conclusion, persistent tear instability and corneal epitheliopathy were found even at several months or more after cataract surgery. This study demonstrates the importance of evaluating ocular surface conditions in pseudophakic patients, even if they lack DE symptoms.

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Section: Discussionsupporting

confidence: 71%

Discrepancies in Persistent Dry Eye Signs and Symptoms in Bilateral Pseudophakic Patients

Hanyuda

Ayaki

Tsubota

et al. 2019

JCM

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“…We collected data from the DECS-J, which was a cross-sectional observational study conducted at 10 eye clinics in Japan [ 6 , 18 , 19 ]. All investigators at the study sites were specialists in ocular surface disorders and DED and belonged to the Japanese Dry Eye Society.…”

Section: Methodsmentioning

confidence: 99%

Characteristics and Utility of Fluorescein Breakup Patterns among Dry Eyes in Clinic-Based Settings

et al. 2020

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(1) Background: To evaluate the characteristics of fluorescein breakup patterns (FBUPs) among patients with dry eye disease (DED) and efficacy of FBUPs as a diagnostic test for DED subgroups. (2) Methods: The study enrolled 449 patients with DED. FBUPs were categorized as follows: area break (AB), line break (LB), spot break (SB), dimple break (DB), and random break (RB). Schirmer value, fluorescein breakup time (FBUT), keratoconjunctival score, DED subgroups and subjective symptoms were examined. (3) Results: LB patients presented with short FBUT and high keratoconjunctival score. AB patients presented with short FBUT, high cornea and keratoconjunctival scores. SB patients were young with short FBUT. DB patients exhibited low keratoconjunctival score. RB patients were young, with long FBUT and low keratoconjunctival scores. Among DED subgroups, LB and AB constituted 74.7% of aqueous-deficiency dry eye (ADDE). SB and DB constituted 42.4% of short FBUT dry eye (short FBUT-DE). Post-test probabilities and positive likelihood ratios for ADDE were 58.7% and 1.63, respectively; those for short FBUT-DE were 46.3% and 2.02, respectively. Patients with SB and AB exhibited significantly severe subjective symptoms than other FBUPs. (4) Conclusions: FBUPs are associated with both objective findings and symptoms of DED and may be a clinical tool for identification of DED subgroups.

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“…The AD dry eye group was comprised of subjects who fulfilled the following criteria: (1) the presence of dry eye symptoms and (2) decreased tear production (Schirmer value ≤ 5 mm). The short TBUT dry eye subgroup included subjects who met the following conditions: (1) the presence of dry eye symptoms, (2) abnormal tear stability (TBUT ≤ 5 s), (3) no abnormality in tear production (Schirmer value > 5 mm), and (4) no abnormality in the ocular surface vital staining test (keratoconjunctival score < 3) [ 17 ].…”

Section: Methodsmentioning

confidence: 99%

“…We considered that subjects had friction-related conditions when any of the following conditions were present: lid wiper epitheliopathy (in the upper and lower lids), conjunctivochalasis (at the central site of the lower eyelid) or superior limbic keratoconjunctivitis [ 17 , 20 , 21 , 22 ].…”

Section: Methodsmentioning

confidence: 99%

“…Typical pictures of the following signs/findings were distributed to each investigator to aid in the examination: (1) one or more abnormal findings around the meibomian gland orifices, such as vascular engorgement, anterior or posterior displacement of the mucocutaneous junction or irregularity of the lid margin (2) orifice obstruction, such as plugging, pouting and ridges [18]; and (3) hypersecretion or hyposecretion of the meibum [19]. We diagnosed MGD when all the signs and findings listed in the criteria were present [17].…”

Section: Meibomian Gland Function (Mgd+/−)mentioning

confidence: 99%

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Association of Systemic Comorbidities with Dry Eye Disease

Kawashima

Yamada

Shigeyasu

et al. 2020

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We investigated the association between dry eye disease and systemic comorbidities, including dry eye subtype, quality of life (QOL) and health utility among patients with dry eye disease. This cross-sectional, observational study enrolled 449 patients with dry eye disease (386 females; mean age, 62.6 ± 15.7 [range, 21–90] years). Ophthalmic examination findings included tear film break-up time (TBUT), Schirmer I value and keratoconjunctival staining score. QOL and health utility were evaluated using the Dry Eye-Related Quality-of-Life Score (DEQS) and Human Utility Index Mark 3 (HUI-3), respectively. Background information, including systemic comorbidities, was obtained. Prevalence of systemic comorbidities was 48.8% (219/449). No significant difference occurred between DEQS and systemic comorbidity. However, patients with dry eye disease and systemic comorbidities (depression and insomnia) exhibited significantly worse ocular surface parameters, particularly regarding TBUT, than those without. Dry eye disease with insomnia or depression comorbidity significantly correlated with friction-related diseases (including conjunctivochalasis or lid wiper epitheliopathy). A high prevalence of several systemic comorbidities occurred in patients with dry eye disease. This study shows an association between ocular signs and systemic comorbidities, particularly depression and insomnia. Ophthalmologists should be aware of patients’ systemic comorbidities in the diagnosis and management of dry eye disease.

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Influence of Meibomian Gland Dysfunction and Friction-Related Disease on the Severity of Dry Eye

Cited by 40 publications

References 33 publications

Discrepancies in Persistent Dry Eye Signs and Symptoms in Bilateral Pseudophakic Patients

Discrepancies in Persistent Dry Eye Signs and Symptoms in Bilateral Pseudophakic Patients

Characteristics and Utility of Fluorescein Breakup Patterns among Dry Eyes in Clinic-Based Settings

Association of Systemic Comorbidities with Dry Eye Disease

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