The function and morphology of Meibomian glands in patients with thyroid eye disease: a preliminary study

Abstract

BackgroundTo investigate function and morphology of the meibomian gland (MG) in patients with thyroid eye disease (TED).MethodsIn this prospective case series study, patients with unilateral or bilateral TED were consecutively enrolled. The diagnosis of TED was based on the typical orbital findings and/or radiographic evidence. The disease activity of TED was classified according to the clinical activity score (CAS). Degrees of lagophthalmos and exophthalmos, blinking rates, and results of the Schirmer test 1 were also recorded. All patients completed the SPEED questionnaire and underwent MG assessment, including lipid layer thickness (LLT), MG dropout (MGd), and MG expression.ResultsIn total 31 eyes from 17 patients with unilateral or bilateral TED were included. Patients were divided into inactive TED (CAS 0−1; 20 eyes from 11 patients) and active TED (CAS 2−3, 11 eyes from 6 patients) groups. MGd was significantly more severe in the active TED than the inactive TED group [Median (Inter-quartile region): 3.0 (2.0−3.0) vs. 2.0 (1.0−2.0) degree, P = 0.04]. However, patients with active TED had thicker LLT than those with inactive TED (90.0 [80.0−100.0] vs. 65.0 [47.8−82.5] nm, P = 0.02), and LLT was positively correlated with lagophthalmos (r = 0.37, P = 0.04).ConclusionsPatients with active TED had more severe MGd, but thicker LLT. Active TED may cause periglandular inflammation of MGs, leading to MGd, but compensatory secretion from residual MGs and lagophthalmos-induced forceful blinking might temporarily release more lipids over the tear film.

In vivo confocal microscopy assessment of meibomian glands microstructure in patients with Graves’ orbitopathy

“…We found that eyes with GO were characterized by greater MG dropout, tear lm instability (shorter BUT), and ocular surface epithelial damage (higher CFS), as well as worser MG secretion; some of these ndings were consistent with previous reports [27,43,44]. In our study, the SIT between the inactive GO group and controls showed no signi cant difference.…”

“…However, in patients with active GO, tear secretion was signi cantly reduced, compared to the inactive GO group and controls. These results were consistent with some previous studies [13,44], although others demonstrated con icting ndings [27,51]. Eckstein et al [13] reported that high TSHR autoantibody activity in patients with active GO might impair the lacrimal gland, which could physiologically express TSHR.…”

“…Anti-in ammatory treatment signi cantly reduced the nerve growth factor level in tears, increased tear lm stability and production, and diminished congestive symptoms. Wang et al [27] also described functional and morphological MG alterations in patients with GO. Notably, they found that patients with active GO had more severe MG dropout.…”

“…Most previous studies focused on aqueous tear de ciency in patients with GO; however, they neglected MGD in these patients. Only a few studies have focused on MGs in patients with GO [26,27]. Thus, this study used IVCM to examine the morphological changes, particularly in terms of microstructure, in the MGs of patients with GO; it also evaluated correlations of these changes with clinical manifestations of GO.…”

Modified meibography in malignant eyelid tumors of epithelial origin

“…При контактной мейбографии (трансиллюминации) исследование проводят со стороны наружной поверхности века без его выворачивания (в этом случае МЖ имеют темный цвет) с использованием аппарата LipiView II Ocular Surface Interferometer, «TearScience, Inc.», а также аппарата для витрэктомии с оптиковолоконным источником света, снабженным устройством для трансиллюминации (Millenium system, «Bausch & Lomb», San Leandro, CA, СШA) [9,10,13]. Исследование структуры мейбомиевых желез при помощи конфокального микроскопа HRT (Heidelberg Retina Tomograph II -Rostock Cornea Module, «Heidelberg Engineering», Dossenheim, Германия) показало невысокое качество изображения [14,15]. Предпринимаются попытки визуализировать МЖ, используя аппараты OCT (Optical Coherent Tomograph) высокого разрешения когерентного инфракрасного света длиной волны 1060 нм, при этом полученные изображения также не были достаточно информативны [13,[16][17][18].…”