Proposed Diagnostic Criteria for Obstructive Meibomian Gland Dysfunction

Arita, Reiko; Itoh, K.; Maeda, Syuji; Maeda, Koshi; Furuta, Ayumu; Fukuoka, Shima; Tomidokoro, Atsuo; Amano, Shiro

doi:10.1016/j.ophtha.2009.04.037

Cited by 259 publications

(243 citation statements)

References 25 publications

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“…There were significant differences in NITBUTs, OSDI and MGL between the MGD group and the control group. These findings were similar to those of previous studies (20,21). In the present study, the NITBUTs in the MGD group were shorter than those in the control group, indicating that MGD affected the stability of the tear film.…”

Section: Discussionsupporting

confidence: 93%

A novel noninvasive ocular surface analyzer for the assessment of dry eye with Meibomian gland dysfunction

Zhang

Huang

et al. 2017

Experimental and Therapeutic Medicine

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Abstract. Meibomian gland dysfunction (MGD) is a major cause of dry eye, and the purpose of the present study was to evaluate the differences between dry eye patients with MGD and controls using a novel noninvasive ocular surface analyzer. A total of 33 dry eye patients with MGD and 31 controls were enrolled in the present study. Testing included administration of the Ocular Surface Disease Index (OSDI), followed by Keratogragh 5M (Oculus, Wetzlar, Germany), measurements of the noninvasive tear film break-up times (NITBUTs), the first tear film break-up point and the morphology of meibomian gland. Meibomian gland loss (MGL) on the upper lid was evaluated using noncontact meibography. The first NITBUT (NITBUTf) was significantly shorter than the average NITBUT (NITBUTav; Mann-Whitney U-test, P<0.01). There was a weak negative Spearman correlation between NITBUTf and OSDI (rs=-0.251, P=0.046) as well as between NITBUTav and OSDI (rs=-0.250, P=0.046). Furthermore, MGL showed a statistically significant Spearman correlation with OSDI (rs= 0.562; P<0.01). In the MGD group, NITBUTf was significantly shorter (P<0.01), and MGL and OSDI score were significantly greater (P<0.01 and <0.01, respectively) than in the control group. In the MGD group, the first tear film break-up point was most frequently located in the inferonasal quadrant, while it was most frequently located in the supertemporal quadrant in the control group, and there was a significant difference with this regard (χ 2 =3.937, P=0.047). In the MGD group, there were significantly more breakups in the lower quadrant than in the upper quadrant (P=0.011), whereas no differences in the number of breakups in each quadrant were observed in the control group (P= 0.429). Furthermore, there was no significant difference in the breakups in the lower quadrants of the two groups (χ 2 =0.525, P=0.469). In the MGD group, there were significantly more breakups in the lower quadrant than in the upper quadrant (P=0.011), whereas no differences in the number of breakups in each quadrant were observed in the control group (P= 0.429). Furthermore, there was no significant difference in the breakups in the lower quadrants of the two groups (χ 2 =0.525, P=0.469). As the NITBUTs showed only a weak correlation with OSDI, they may not be a strong indicator of the OSDI. However, MGL indicated changes of meibomian gland morphology in the MGD group and the first tear film break-up point was likely located in the inferonasal quadrant in the MGD group.

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Section: Discussionsupporting

confidence: 93%

A novel noninvasive ocular surface analyzer for the assessment of dry eye with Meibomian gland dysfunction

Zhang

Huang

et al. 2017

Experimental and Therapeutic Medicine

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“…7 In the present study, we When the diagnosis for obstructive MGD was made on the basis of any one of three scores (ocular symptom score, lid margin abnormality score, and meibo-score) being abnormal, the sensitivity was 80% and the specifi city was 33.3%. When the diagnosis for obstructive MGD was made on the basis of all three scores being abnormal, the sensitivity was 68.0% and the specifi city was 80%.…”

Section: Discussionmentioning

confidence: 92%

“…In a recent study, we proposed that the ocular symptom score, lid margin abnormality score, and a score for morphologic changes of the meibomian glands observed with meibography (meiboscore) can be used to diagnose MGD. 7 Although these diagnostic criteria have a high effi cacy for differentiating patients with obstructive MGD from healthy individuals, 7 the reliability of these criteria for differentiating patients with obstructive MGD from those with aqueous defi ciency dry eye (ADDE) requires further study. Here, we compared the results of various examinations of patients with obstructive MGD with those of patients with ADDE to evaluate the use of these diagnostic criteria for differentiating patients with obstructive MGD from those with ADDE.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of diagnostic criteria for the differential diagnosis between obstructive meibomian gland dysfunction and aqueous deficiency dry eye

Arita

Itoh

Maeda³

et al. 2010

Jpn J Ophthalmol

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Although the criteria were moderately reliable for differentiating patients with obstructive MGD from those with ADDE when the diagnosis of obstructive MGD was made on the basis of three abnormal scores, they do not provide comprehensive diagnostic tools for differentiating MGD, ADDE, and healthy individuals. We need to add other parameters such as the Schirmer test value and the meibum score to the diagnostic criteria to enhance their reliability for differentiating MGD and ADDE.

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“…The exclusion criteria were: (1) patients who had undergone trabeculectomy with MMC in the lower area ( Fig. 1), (2) patients who had used or were using contact lenses, and (3) patients with severe allergic conjunctivitis, Stevens-Johnson syndrome, or chronic graft-versus-host disease; any of these conditions can cause obstructive meibomian gland disorder [15][16][17][18][19][20]. Long-term use of antiglaucoma eye drops containing benzalkonium chloride (BAC) reportedly causes dry eye symptoms, meibomian gland loss, tear dysfunction, and ocular surface disease (OSD) [21,22].…”

Section: Patientsmentioning

confidence: 99%