Quantitative Analysis of Changes to Meibomian Gland Morphology Due to S-1 Chemotherapy

The aim of this prospective, noncomparative, observational case series was to evaluate changes to meibomian gland morphology in patients undergoing S-1 chemotherapy with the use of noninvasive meibography and analytical software.

Patients aged ≥20 years and undergoing S-1 chemotherapy were included. Ophthalmologic examinations were performed before S-1 administration (Pre) and at 1, 3, and 6 months afterward (1M, 3M, and 6M, respectively). Meibography images were analyzed using analytical software. The ratio of the total meibomian gland area relative to the whole measurement area (meibomian gland area ratio [MGAR]) and the rate of change to the MGAR (MGAR at Pre, 1M, 3M, or 6M)/(MGAR at Pre) × 100 were calculated.

In total, 28 eyelids of seven men (mean age, 68.9 ± 6.3 years) were studied. The mean MGAR of the upper and lower eyelids significantly decreased at 3M (P = 0.0246 and P = 0.00892, respectively) and 6M (P < 0.0001 and P < 0.0001, respectively). There was a significant negative correlation between the cumulative dose of S-1 and the rate of change to the MGAR of the upper (P < 0.0001, r = -0.77) and lower (P < 0.0001, r = -0.785) eyelids. However, there was no other significant difference.

The meibomian gland area decreased after S-1 administration with significant correlations between the rate of change to the MGAR and the mean cumulative dose of S-1.

Systemic S-1 administration decreased the MGAR in a dose-dependent manner; thus, clinicians should pay more attention to morphologic changes to the meibomian glands during early treatment with S-1.