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Quantitative evaluation of lipid layer thickness and blinking in children with allergic conjunctivitis
Boyu Yang1, Kuiyao Wen1, Jing Li1
1State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, 510000, Guangdong, China.
Insights
Children with allergic conjunctivitis (AC) show thinner lipid layers and altered blinking patterns, impacting ocular surface health. These findings in pediatric AC patients highlight the need for timely diagnosis and treatment.
Area of Science:
- Ophthalmology
- Pediatric Eye Care
- Ocular Surface Disease
Background:
- Allergic conjunctivitis (AC) is a common ocular condition in children.
- The impact of AC on the ocular surface, particularly the lipid layer and blinking dynamics, requires further quantitative investigation.
Purpose of the Study:
- To quantitatively assess lipid layer thickness (LLT) and blinking patterns in children with AC.
- To compare these parameters between children with AC and healthy controls.
- To analyze differences in LLT and blinking among subtypes of AC.
Main Methods:
- A case-control study involving 81 children with symptomatic AC and 82 age-matched healthy controls.
- Assessment included routine eye examination, LipiView interferometry for LLT and blinking, fluorescein tear breakup time (TBUT), tear meniscus height, and meibomian gland evaluation.
- AC patients were subcategorized into seasonal/perennial allergic conjunctivitis and vernal/atopic keratoconjunctivitis groups.
Main Results:
- Children with AC exhibited significantly thinner LLT, reduced TBUT, and altered blinking (decreased total, increased partial blinking), especially in severe forms like VKC/AKC.
- AC patients showed significant meibomian gland dysfunction, including loss, poor expressibility, and abnormal quality, more pronounced in severe AC.
- Thinner LLT correlated significantly with reduced TBUT and increased meibomian gland loss.
Conclusions:
- Reduced LLT and abnormal blinking in pediatric AC may lead to long-term lipid layer deficiency.
- These ocular surface changes in AC warrant consideration for accurate diagnosis and targeted treatment strategies.
- Early identification and management of these factors are crucial for improving outcomes in pediatric allergic conjunctivitis.
Purpose:
To quantitatively evaluate the lipid layer thickness (LLT) and blinking in children with or without allergic conjunctivitis (AC), and to compare those between the different types of AC.
Methods:
For this case-control study, 81 children with symptomatic AC with an average age of 9.62 ± 2.67 years were enrolled and subdivided according to the subtypes of AC, including seasonal/perennial allergic conjunctivitis group and vernal keratoconjunctivitis (VKC)/atopic keratoconjunctivitis (AKC) group. Another 82 age-matched healthy children were enrolled as control group. All subjects underwent routine eye examination and measurements of LLT, the number of incomplete or total blinking, partial blinking rate by the LipiView interferometer over a 10-s period. Other ocular surface assessment included fluorescein tear breakup time (TBUT), lower tear meniscus height, meibomian gland loss (MGL), meibum expressibility and quality.
Results:
Pediatric patients with AC had significant thinner LLT, shorter TBUT, decreased total blinking but increased partial blinking rate, especially in those with VKC/AKC (all P < 0.05). A significant deterioration of meibomian gland parameters was observed in AC group when compared with control subjects, demonstrated by severe upper and lower MGL, lid margin abnormalities, decreased meibum expressibility, and abnormal meibum quality, all of which were worse in the severe type of AC (all P < 0.05). Thinner LLT was significantly correlated with decreased TBUT (β = 3.666, P < 0.001) and severity of upper MGL (β = - 7.701, P = 0.002).
Conclusion:
Decreased LLT and blinking disorders in pediatric patients with AC may contribute to lipid layer deficiency in the long run, which should be considered and appropriately diagnosed for a more precise treatment.
