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Microstructural proofs of dry eye changes

Teodora Marinova, Vesela Ivancheva, Valeri Sheherov, Christina Grupcheva

Abstract

PURPOSE: To evaluate and to demonstrate the morphological changes of the Meibomian glands in patients with evaporative `dry eye` compared to normal subjects by in vivo laser scanning confocal microscopy and to correlate these changes to the clinical observations and tear functions.

DESIGN: Prospective over controlled case series

METHODS: The study was based on trans-tarsal images (optical slices) of 30 normal and 19 diseased lids (patients with subjective complaints and objective symptoms of evaporative `dry eye`). Each participant was examined by in vivo laser scanning confocal microscopy (HRTII Rostock corneal module). The results were compared to histological findings of normal or pathologically changed Meibomian glands.

RESULTS: Patients with evaporative `dry eye` presented with destructive changes of the Meibomian glands as follows: occlusion of the lumen, impaired morphology of the acines, lack of normal structure and infiltration with inflammatory cells. Reported ocular surface and tear function abnormalities were correlated to the Meibomian glands dysfunction. In all cases the lid hygiene and anti-inflammatory treatment demonstrated tendency to restoration of the structure.

CONCLUSION: In vivo laser scanning confocal microscopy can effectively demonstrate the morphological changes of the Meibomian glands in patients with evaporative dry eye symptoms. This new noninvasive technology is useful as a supplementary diagnostic tool for in vivo assessment of the histopathology of many ocular surface disorders and monitoring of the therapeutic effect in patients with Meibomian glands dysfunction. Glandular acinar density and acinar unit diameter seemed to be promising new parameters of Meibomian glands in vivo confocal microscopy. The examination has the potential to change the evaporative dry eye treatment approach.


Keywords

dry eye; Meibomian glans; in vivo laser confocal microscopy

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References

Bron A. Diagnosis of dry eye. Surv Ophthalmol 2001;45:S221-6.

Marco Roncone, Hannah Bartlett *, Frank Eperjesi Essential fatty acids for dry eye

M.A. Lemp, Advances in understanding and managing dry eye disease, Am. J. Ophthalmol. 146 (2008) 350-356.

H.D. Perry, Dry eye disease: pathophysiology, classification, and diagnosis, Am. J. Manag. Care, 14 (2008) S79-87.

K. Gumus, D.H. Cavanagh, The role of inflammation and antiinflammation therapies in keratoconjunctivitis sicca, Clin. Ophthalmol. 3 (2009) 57-67.

M.E. Johnson, P.J. Murphy, Changes in the tear film and ocular surface from dry eye syndrome, Prog. Retin. Eye Res. 23 (2004) 449-474.

SchaumbergDA, SullivanDA, Buring JE, DanaMR. Prevalence of dry eye syndrome among US women. Am J Ophthalmol 2003;136:318-26.

Lin PY, Tsai SY, Cheng CY, Liu CH, Chou P, Hsu WM. Prevalence of dry eye among an elderly Chinese population in Taiwan: the Shihpai Eye Study. Ophthalmology 2003;110:1096-101.

Chia EM, Mitchell P, Rochtchina E, Lee AJ, Maroun R, Wang JJ. Prevalence and associations of dry eye syndrome in an older population: the Blue Mountains Eye Study. Clin Experiment Ophthalmol 2003;31(3):229-32.

McCarty CA, Bansal AK, Livingston PM, Stanislavsk YL, Taylor HR. The epidemiology of dry eye in Melbourne, Australia. Ophthalmology 1998;105(6):1114-9.

Bron AJ. Diagnosis of dry eye. Surv Ophthalmol 2001;45(Suppl 2):S221-6.

Moss S, Klein R, Klein B. Prevalence of and risk factors for dry eye syndrome. Arch Ophthalmol 2000;118:1264-8.

Foulks G, Lemp M, Jester J, Sutphin J, Murube J, Novack G. Report of the International Dry Eye Workshop (DEWS). Ocul Surf 2007;5:65-203.

Matsumoto Y, Dogru M, Sato EA, Katono Y, Uchino Y, Shimmura S, Tsubota K. The application of in vivo confocal scanning laser microscopy in the management of Acanthamoeba keratitis. Mol Vis 2007; 13:1319-26.

McCulley JP, Shine WE. Meibomian gland function and the tear lipid layer. Ocul Surf 2003; 1:97-106.

Hom MM, Martinson JR, Knapp LL, Paugh JR. Prevalence of meibomian gland dysfunction. Optom Vis Sci 1990; 67:710-2.

Stanek S. Meibomian gland status comparison between active duty personnel and U.S. veterans. Mil Med 2000; 165:591-3.

Grupcheva CN, Meibomian gland dysfunction and contact lens - can we do better?: Eye Health Advisor 2011:13-1

Nemeth J,Fodor E,Berta A, Komar T, Petricek I, Higazy M, Nemec P, Prost M, Semak G, Grupcheva H, Evren O, Schollmayer P, Samalha A, Hlavackova K, LIPCOF in the Diagnosis of Dry Eye - Multicenter Study. TFS Florence (Poster).

Yukihiro Matsumoto, Enrique Adan Sato, Osama M.A. Ibrahim, Murat Dogru, Kazuo Tsubota The application of in vivo laser confocal microscopy to the diagnosis and evaluation of meibomian gland dysfunction: Molecular Vision 2008; 14:1263-1271




DOI: http://dx.doi.org/10.14748/ssm.v45i1.991

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About The Authors

Teodora Marinova
Medical University of Varna
Bulgaria

Department of Ophthalmology and Visual Science

Vesela Ivancheva
Medical University of Varna

Department of Ophthalmology and Visual Science, Medical University of Varna, Bulgaria Specialised Eye Hospital - Varna, Bulgaria

Valeri Sheherov
Medical University of Varna

Department of Ophthalmology and Visual Science, Medical University of Varna, Bulgaria Specialised Eye Hospital - Varna, Bulgaria

Christina Grupcheva
Medical University of Varna
Bulgaria

Department of Ophthalmology and Visual Science, Medical University of Varna, Bulgaria Specialised Eye Hospital - Varna, Bulgaria

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