Association of Age and Ocular Surface Parameters with Meibomian Gland Morphology
Overview
This study evaluated the relationship between age, ocular surface parameters, and morphological changes in meibomian glands (MGs) using noninvasive infrared meibography in 155 participants. Findings highlight significant associations between MG loss rates, dry eye symptoms, and tear film stability, emphasizing the role of MG morphology in dry eye disease.
Background
Meibomian glands secrete lipids essential for tear film stability, and dysfunction of these glands (MGD) is a leading cause of evaporative dry eye disease. MGD is characterized by gland obstruction and altered secretions, contributing to ocular surface irritation and tear film instability. Objective assessment of MG morphology, particularly via infrared meibography, facilitates diagnosis and monitoring but is not yet widely used clinically. This study aims to clarify the relationships between MG morphological changes, demographic factors, and dry eye parameters.
Data Highlights
Parameter
Measurement Method
Notes
MG Morphology
Infrared Meibography (Sirius Meibography Module)
Quantitative analysis of gland loss and morphological changes
Tear Breakup Time (TBUT)
Fluorescein strip with cobalt blue filter
Time between last blink and tear film breakup
Schirmer I Test
Strip wetting after 5 minutes under anesthesia
Measures basal tear secretion
Ocular Surface Disease Index (OSDI)
Validated questionnaire (0-100 scale)
Assesses dry eye symptoms severity
Key Findings
MG loss rates increase with advancing age, indicating age-related morphological alterations.
Higher OSDI scores correlate with greater MG loss and morphological abnormalities, linking gland changes to symptom severity.
Reduced tear breakup time (TBUT) is associated with increased MG morphological alterations, reflecting tear film instability.
Noninvasive infrared meibography provides rapid, reproducible visualization of MG morphology with minimal patient discomfort.
MG morphological changes are significant contributors to dry eye disease pathophysiology, beyond traditional clinical signs.
Clinical Implications
Infrared meibography should be considered a valuable diagnostic tool for assessing MG morphology in patients with dry eye symptoms, facilitating early detection of MGD. Understanding the relationship between MG loss and tear film instability can guide targeted therapeutic interventions to improve ocular surface health. Clinicians should incorporate objective MG evaluation alongside symptom assessment for comprehensive dry eye management.
Conclusion
This study underscores the importance of age and ocular surface parameters in influencing meibomian gland morphology, reinforcing the role of MG assessment in dry eye diagnosis and treatment. Noninvasive meibography emerges as a practical method to enhance clinical evaluation of MGD.
References
TFOS DEWS III Report 2017 -- Definition and Classification of MGD
Tapie 1977 -- Initial Description of Meibography
Sirius Meibography Module (CSO, Florence, Italy) -- Device Used for Imaging
