粘膜類天疱瘡患者における眼症状の有無別によるマイボーム腺機能不全およびドライアイ疾患の比較研究
Anjali Verma1, Dipankar De2, Barkha Gupta1
1Department of Ophthalmology, Post Graduate Institution of Ophthalmology, PGIMER, Chandigarh, India.
Purpose:
A comparative evaluation of Meibomian Gland (MG) dysfunction and Dry Eye Disease (DED) between patients of Mucous Membrane Pemphigoid (MMP) with and without obvious ocular complaints and their age-matched controls.
Methods:
This cross- sectional study included three groups: Group 1- MMP with ocular symptoms; Group 2 - MMP without ocular symptoms who were under treatment in the autoimmune bullous disease clinic of the Dermatology Department; Group 3- healthy age-matched controls. Meibography was performed using an infrared analyzer, and the MG area loss was recorded using meibography images.
Results:
A total of 123 eyes from 64 subjects were included, 35 in group 1, 24 in group 2 and 64 in group 3. The mean ocular surface disease index (OSDI) score in group 1 (35.29 ± 14.03) was higher than in group 2 (16.71 ± 5.76) and group 3 (17.34 ± 12.23) [p < 0.01]. Ocular group 1 had the highest rate of severe grade Meibomian gland area loss (78.5%), followed by group 2 (21.4%) and the control group (0%), (p < 0.01).
Conclusions:
This study objectively demonstrated the MG damage in patients with MMP and highlighted subclinical ocular disease activity in asymptomatic patients with MMP presumed to have no ocular involvement. Based on these findings, it may be advisable to recommend regular ophthalmological evaluations and meibography for MMP patients without obvious ocular symptoms, to detect the early signs of ocular involvement. Early detection could prompt modifications in their systemic therapy, helping to prevent the progression of this potentially blinding disease.
