Transcript Epidemiology of Meibomian Gland Dysfunction in an Elderly

Yousef A Alghamdi, MD; Allison L McClellan, OD; Nabeel M Shalabi, MD
Anat Galor, MD, MSPH
Miami Veterans Administration Medical Center, Bascom Palmer Eye Institute, University of Miami, Miami, FL
Supported by the Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development,
Clinical Sciences Research and Development’s Career Development Award CDA-2-024-10S (Dr. Galor), NIH Center Core
Grant P30EY014801, Research to Prevent Blindness Unrestricted Grant, Department of Defense (DOD- Grant#W81XWH09-1-0675 and Grant# W81XWH-13-1-0048 ONOVA) (institutional).
The authors have no financial interests to disclose
Introduction
 Meibomian gland dysfunction (MGD)
 Chronic, diffuse abnormality of the meibomian glands
 Characterized by terminal duct obstruction and/or
qualitative/quantitative changes in the glandular secretion
 Leading cause of evaporative dry eye
 Prevalence of MGD ranges from 35% to 61%
Study country
USA
n
398
Frequency
38.9% (95% CI, 34.0–
44.0)
Reference
Hom et al.
China
115
34.8% (95% CI, 26.2–
44.4)
Zhang et al.
Malaysia
231
43.0% (95% CI, 36.7–
50.0)
Ong BL
Japan
54
61.0% (95% CI, 46.6–
73.9)
Shimazaki et al.
Frequency of MGD in Selected Clinical Populations
Introduction Cont.
 Many gaps in the literature regarding the epidemiology of MGD
 Most clinic based studies have large female populations
 Little has been published on associations between specific MGD
sub-types (meibum quality versus vascularity, for example) and
patient profiles
Purpose
 To study the epidemiology of meibomian gland
dysfunction (MGD) in an elderly, predominantly male
population.
Methods
 Patients with normal eyelid and corneal anatomy were
prospectively recruited from the Miami Veterans Affairs eye
clinic.
 Patients were assessed for…
 Dry eye symptoms
 Dry eye questionnaires (dry eye questionnaire 5 (DEQ5)
 Ocular surface disease index (OSDI))
 Dry eye signs
 Osmolarity
 Tear break up time
 Corneal staining
 Schirmer’s strips with anesthesia
Main Outcomes Measured
 Correlations between meibomian gland (MG)
parameters and local (dry eye) and systemic
(demographics) factors
 The studied MG parameters were eyelid vascularity
and meibum quality; a score of ≥2 in either parameter
was considered abnormal
Results
 Mean age of the 118 patients was 65 (SD=11); 86% were
male and 62% had at least one abnormal MG
parameter (vascularity 22% (n=26), abnormal quality
58% (n=68))
 Demographically, white patients were more likely to
have abnormal vascularity than non-whites (35%
(n=23) versus 2.5% (n=1) and 15% (n=2) for blacks and
others respectively, (p < 0.0005))
 Ethnicity and age did not correlate with MG
parameters
Results
 MG abnormalities were weakly associated with each
other (r=0.19, p=0.51) and not at all with dry eye
symptoms (r=0.007-0.17, p>0.05 for all)
 Some MG parameters were associated with some dry
eye signs (osmolarity with vascularity, OD only r=-0.2,
p=0.03, TBUT with both vascularity and meibum
quality, both eyes r=-0.25-0.35, p<0.05, Schirmer with
vascularity, OD only r=-0.2 (p=0.03)
 Corneal staining was not associated with MG
parameters
Conclusion:
 MGD is a frequent finding in an elderly,
predominantly male population with racial differences
noted in the frequency of abnormal eyelid vascularity
but not in MG quality
References
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