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Meibomian gland dysfunction in Graves' orbitopathy

Young Shin Kim1, Ae Young Kwak2, Sang Yeul Lee2

  • 1Department of Ophthalmology, Soonchunhyang University College of Medicine, Bucheon.

Canadian Journal of Ophthalmology. Journal Canadien D'Ophtalmologie
|August 11, 2015
PubMed
Abstract

Insights

Graves' orbitopathy (GO) patients exhibit significant meibomian gland dysfunction and dry eye symptoms. A novel meibography system revealed increased gland changes correlated with GO severity, including proptosis and lid fissure widening.

Area of Science:

  • Ophthalmology
  • Endocrinology
  • Medical Imaging

Background:

  • Graves' orbitopathy (GO) is an autoimmune condition affecting the eye socket.
  • Meibomian gland dysfunction (MGD) is frequently observed in GO patients, contributing to dry eye disease.
  • Novel imaging systems are needed to better characterize MGD in GO.

Purpose of the Study:

  • To assess meibomian gland morphology in GO patients using a new meibography system.
  • To correlate meibography findings with clinical signs of GO and ocular surface disease.
  • To evaluate the utility of meibography in understanding MGD in the context of GO.

Main Methods:

  • Retrospective observational case series involving 51 GO patients and 31 controls.
  • Meibography imaging system used to evaluate meibomian gland structure.
  • Ocular Surface Disease Index (OSDI) questionnaire, tear film break-up time (BUT), palpebral fissure height, and exophthalmos were assessed.

Main Results:

  • GO patients showed significantly shorter tear film BUT, higher OSDI scores, and higher meibography scores compared to controls.
  • A negative correlation was found between meibography score and tear film BUT in GO patients (r = -.503, p < .001).
  • Meibography scores positively correlated with exophthalmos and palpebral fissure height in multivariable analysis.

Conclusions:

  • GO patients experience more severe dry eye and tear film instability.
  • The meibography system identified a higher prevalence of obstructive MGD in GO patients.
  • Meibomian gland changes detected by meibography are associated with GO severity, including proptosis and lid fissure widening.

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