Distribution and Characteristics of Meibomian Gland Dysfunction Subtypes: A Multicenter Study in South Korea
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Purpose: We sought to evaluate the distribution and characteristics of meibomian gland dysfunction (MGD)and the treatment patterns for symptomatic MGD patients in South Korea. Methods: One hundred ninety-six right eyes of 196 MGD patients were enrolled. For each patient, meibumexpressibility in the central eight glands in both the upper and lower eyelids was examined. Each upperand lower eyelid was separately classified into one of the following three subtypes: nonobvious obstructive(low-delivery without lid margin abnormality), obvious obstructive (low-delivery with lid margin abnormality),and hypersecretory (high-delivery with lid margin abnormality). All treatment plans were also recorded. Results: The mean number of expressible glands of the central eight glands in the upper eyelids (3.9 ± 2.6)was significantly higher than that in the lower eyelids (2.2 ± 2.4, p < 0.001). Obvious obstructive MGD wasthe most common subtype, followed by the hypersecretory and nonobvious obstructive subtypes in boththe upper and lower eyelids. Of the 196 subjects, 38 (19.4%) had upper and lower eyelids that were assignedto different categories. Eyelid hygiene was the most prescribed treatment (74.5%), followed by lubricant eyedrop usage (71.5%). Physicians tended to determine treatment plans based on the subtype of the upper eyelidrather than that of the lower eyelid. Conclusions: The majority of subjects were classified as having the obvious obstructive subtype of MGD, and19.4% had upper and lower eyelids that were different subtypes. Eyelid hygiene was the most prescribedtreatment for MGD patients, and treatment patterns were mostly determined based on the subtype of theupper eyelids.
Abstract
Purpose: We sought to evaluate the distribution and characteristics of meibomian gland dysfunction (MGD)and the treatment patterns for symptomatic MGD patients in South Korea. Methods: One hundred ninety-six right eyes of 196 MGD patients were enrolled. For each patient, meibumexpressibility in the central eight glands in both the upper and lower eyelids was examined. Each upperand lower eyelid was separately classified into one of the following three subtypes: nonobvious obstructive(low-delivery without lid margin abnormality), obvious obstructive (low-delivery with lid margin abnormality),and hypersecretory (high-delivery with lid margin abnormality). All treatment plans were also recorded. Results: The mean number of expressible glands of the central eight glands in the upper eyelids (3.9 ± 2.6)was significantly higher than that in the lower eyelids (2.2 ± 2.4, p < 0.001). Obvious obstructive MGD wasthe most common subtype, followed by the hypersecretory and nonobvious obstructive subtypes in boththe upper and lower eyelids. Of the 196 subjects, 38 (19.4%) had upper and lower eyelids that were assignedto different categories. Eyelid hygiene was the most prescribed treatment (74.5%), followed by lubricant eyedrop usage (71.5%). Physicians tended to determine treatment plans based on the subtype of the upper eyelidrather than that of the lower eyelid. Conclusions: The majority of subjects were classified as having the obvious obstructive subtype of MGD, and19.4% had upper and lower eyelids that were different subtypes. Eyelid hygiene was the most prescribedtreatment for MGD patients, and treatment patterns were mostly determined based on the subtype of theupper eyelids.
참고문헌 (38)
- Korb DR, "Meibomian gland dysfunction and contact lens intolerance", J Am Optom Assoc, 51, pp.243~251 (1980)
- Nelson JD, "The international workshop on meibomian gland dysfunction: report of the definition and classification subcommittee", Invest Ophthalmol Vis Sci, 52, pp.1930~1937 (2011)
- Kim HM, "The relationship between morphology and function of the meibomian glands", Eye Contact Lens, 44, pp.1~5 (2018)
- Sirigu P, "Human meibomian glands : the ultrastructure of acinar cells as viewed by thin section and freeze-fracture transmission electron microscopies", Invest Ophthalmol Vis Sci, 33, pp.2284~2292 (1992)
- Driver PJ, "Meibomian gland dysfunction", Surv Ophthalmol, 40, pp.343~367 (1996)
- Jester JV, "Meibomian gland studies : histologic and ultrastructural investigations", Invest Ophthalmol Vis Sci, 20, pp.537~547 (1981)
- Kozak I, "Morphologic and volumetric studies of the meibomian glands in elderly human eyelids", Cornea, 26, pp.610~614 (2007)
- Seifert P, "Immunocytochemical and ultrastructural evaluation of the distribution of nervous tissue and neuropeptides in the meibomian gland", Graefes Arch Clin Exp Ophthalmol, 234, pp.648~656 (1996)
- McCulley JP, "Meibomian keratoconjunctivitis", Am J Ophthalmol, 84, pp.788~793 (1977)
- Viso E, "Prevalence of asymptomatic and symptomatic meibomian gland dysfunction in the general population of Spain", Invest Ophthalmol Vis Sci, 53, pp.2601~2606 (2012)
- Amano S, "Estimation of prevalence of meibomian gland dysfunction in Japan", Cornea, 36, pp.684~688 (2017)
- Amano S, "Clinic-based study on meibomian gland dysfunction in Japan", Inves Ophthalmol Vis Sci, 58, pp.1283~1287 (2017)
- Alghamdi YA, "Epidemiology of meibomian gland dysfunction in an elderly population", Cornea, 35, pp.731~735 (2016)
- Siak JJ, "Prevalence and risk factors of meibomian gland dysfunction : the Singapore Malay Eye Study", Cornea, 31, pp.1223~1228 (2012)
- Lekhanont K, "Prevalence of dry eye in Bangkok, Thailand", Cornea, 25, pp.1162~1167 (2006)
- Lin PY, "Association between symptoms and signs of dry eye among an elderly Chinese population in Taiwan : the Shihpai Eye Study", Invest Ophthalmol Vis Sci, 46, pp.1593~1598 (2005)
- Blackie CA, "Nonobvious obstructive meibomian gland dysfunction", Cornea, 29, pp.1333~1345 (2010)
- Shimazaki J, "Meibomian gland dysfunction in patients with Sjogren syndrome", Ophthalmology, 105, pp.1485~1488 (1998)
- Foulks GN, "Meibomian gland dysfunction : a clinical scheme for description, diagnosis, classification, and grading", Ocul Surf, 1, pp.107~126 (2003)
- Nichols KK, "The international workshop on meibomian gland dysfunction: executive summary", Invest Ophthalmol Vis Sci, 52, pp.1922~1929 (2011)
- Eom Y, "Correlation between quantitative measurements of tear film lipid layer thickness and meibomian gland loss in patients with obstructive meibomian gland dysfunction and normal controls", Am J Ophthalmol, 155, pp.1104~1110 (2013)
- Eom Y, "Comparison of conjunctival staining between lissamine green and yellow filtered fluorescein sodium", Can J Ophthalmol, 50, pp.273~277 (2015)
- Bron AJ, "Grading of corneal and conjunctival staining in the context of other dry eye tests", Cornea, 22, pp.640~650 (2003)
- Duke-Elder WS, "System of ophthalmology. Vol. XIII", pp.241~ (1974), H. Kimpton
- "The definition and classification of dry eye disease: report of the Definition and Classification Subcommittee of the International Dry Eye WorkShop (2007)", Ocul Surf, 5, pp.75~92 (2007)
- Lemp MA, "Advances in understanding and managing dry eye disease", Am J Ophthalmol, 146, pp.350~356 (2008)
- Bron AJ, "The contribution of meibomian disease to dry eye", Ocul Surf, 2, pp.149~165 (2004)
- Eom Y, "Comparison of meibomian gland loss and expressed meibum grade between the upper and lower eyelids in patients with obstructive meibomian gland dysfunction", Cornea, 33, pp.448~452 (2014)
- Goto E, "Low-concentration homogenized castor oil eye drops for noninflamed obstructive meibomian gland dysfunction", Ophthalmology, 109, pp.2030~2035 (2002)
- Korb DR, "Effect of periocular humidity on the tear film lipid layer", Cornea, 15, pp.129~134 (1996)
- Arita R, "Increased tear fluid production as a compensatory response to meibomian gland loss : a multicenter cross-sectional study", Ophthalmology, 122, pp.925~933 (2015)
- Dougherty JM, "Analysis of the free fatty acid component of meibomian secretions in chronic blepharitis", Invest Ophthalmol Vis Sci, 27, pp.52~56 (1986)
- Craig JP, "Exploring the predisposition of the Asian eye to development of dry eye", Ocul Surf, 14, pp.385~392 (2016)
- Wan T, "Incomplete blinking may attribute to the development of meibomian gland dysfunction", Curr Eye Res, 41, pp.179~185 (2016)
- Jung JW, "Analysis of factors associated with the tear film lipid layer thickness in normal eyes and patients with dry eye syndrome", Invest Ophthalmol Vis Sci, 57, pp.4076~4083 (2016)
- Song JY, "Association between menstrual irregularity and dry eye disease : a population-based study", Cornea, 35, pp.193~198 (2016)
- Na KS, "The ocular benefits of estrogen replacement therapy : a population-based study in postmenopausal Korean women", PLoS One, 9, pp.e106473~ (2014)
- Sullivan DA, "Androgen deficiency, meibomian gland dysfunction and evaporative dry eye", Ann N Y Acad Sci, 966, pp.211~222 (2002)
