Alterations in tear function and meibomian gland dysfunction across various phenotypes of polycystic ovary syndrome

The aim of this study was to investigate the relationship between tear function changes and meibomian gland dysfunction in various phenotypes of polycystic ovary syndrome (PCOS). In this prospective case-control study, 4 separate case groups were formed for 4 different phenotypes of PCOS, which are variants of clinical presentation. A total of 160 women were included in the study, 32 women for each group and 32 healthy women as control group. Ocular surface disease index (OSDI), Oxford score for corneal and conjunctival involvement, Schirmer 1 and 2 tests, noninvasive tear breakup time (NIBUT), lower lid meibomian drop-out grades by non-contact meibography, and meibomian gland disease (MGD) distortion and shortening scores were compared between all groups. When the PCOS group was compared with the control group, phenotype A showed the most significant differences in NIBUT (p = 0.003), MGD (p = 0.002) and OSDI (p = 0.004). Although the mean Schirmer 1 and Schirmer 2 tests value were lower in the PCOS group compared to the control group, no significant difference was detected in any phenotype (p = 0.911, p = 0.117). A statistically significant weak negative correlation was observed between NIBUT and OSDI values (r = - 0.206, p = 0.027). There was a statistically significant positive and very weak correlation between OSDI and BMI (r = 0.079, p = 0.041). Tear film instability attributed to MGD was found to be significantly different in all PCOS patients compared to healthy subjects regardless of phenotype, and this difference was statistically higher in phenotype A.