Matthieu Randon1,2, Vittoria Aragno1,2, Rachid Abbas3, Hong Liang1,4, Antoine Labbé1,2,4, Christophe Baudouin5,6,7. 1. Department of Ophthalmology III, Quinze-Vingts National Ophthalmology Hospital, DHU Sight Restore, INSERM-DHOS CIC, Paris, France. 2. Department of Ophthalmology, Ambroise Paré Hospital, APHP, University of Versailles Saint-Quentin-en-Yvelines, Versailles, France. 3. Department of Biostatistics and Epidemiology, Gustave Roussy, Villejuif, France; INSERM U1018, CESP, Université Paris-Sud, Université Paris-Saclay, Villejuif, France. 4. Sorbonne Universités, UPMC Univ Paris 06, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, 75012, Paris, France. 5. Department of Ophthalmology III, Quinze-Vingts National Ophthalmology Hospital, DHU Sight Restore, INSERM-DHOS CIC, Paris, France. cbaudouin@15-20.fr. 6. Department of Ophthalmology, Ambroise Paré Hospital, APHP, University of Versailles Saint-Quentin-en-Yvelines, Versailles, France. cbaudouin@15-20.fr. 7. Sorbonne Universités, UPMC Univ Paris 06, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, 75012, Paris, France. cbaudouin@15-20.fr.
Abstract
AIM: Meibomian gland dysfunction (MGD) is one of the most common disorders in ophthalmology. The aim of this study was to evaluate the use of this in vivo confocal microscopy (IVCM)-MGD description to classify patients affected by clinical MGD and measure the correlation with standard clinical criteria and subjective symptoms. METHODS: One hundred eyes of 100 patients suffering from MGD and 15 eyes of normal subjects were included. A comprehensive evaluation with the ocular surface disease index (OSDI), Schirmer test, tear break-up time (TBUT), tear osmolarity, Oxford score, Meibomian gland expression, palpebral IVCM, and meibography was performed. Then each patient was classified using a new IVCM classification: type 0 for normality, type 1 for meibum obstruction, type 2 for inflammation, and type 3 for fibrosis. RESULTS: The mean age of patients was 52 ± 20 years old, the OSDI was 38 ± 23, the BUT 5 ± 2.6 s, the Schirmer test 13 ± 7 mm, tear osmolarity 300 ± 11 osmol/L, the Oxford score 0.5 ± 0.6, the meibum expression score 1.7 ± 1.02, and the meibography score 1.3 ± 0.9. The IVCM MG classification of the 15 normal subjects was 0. For MGD patients, 29% were in type 1, 40% were type 2, and 31% were type 3. The patients in IVCM MG type 2 had a higher OSDI (p = 0.001) compared with the other types. There was a strong correlation between the IVCM score and the meibography score (r = 0.71 p < 0.0001). CONCLUSION: This new IVCM classification provided a practical pathophysiological system for MGD. By giving objective criteria, this IVCM classification may help advance the understanding of patients' symptoms and enhance treatment effectiveness in MGD.
AIM: Meibomian gland dysfunction (MGD) is one of the most common disorders in ophthalmology. The aim of this study was to evaluate the use of this in vivo confocal microscopy (IVCM)-MGD description to classify patients affected by clinical MGD and measure the correlation with standard clinical criteria and subjective symptoms. METHODS: One hundred eyes of 100 patients suffering from MGD and 15 eyes of normal subjects were included. A comprehensive evaluation with the ocular surface disease index (OSDI), Schirmer test, tear break-up time (TBUT), tear osmolarity, Oxford score, Meibomian gland expression, palpebral IVCM, and meibography was performed. Then each patient was classified using a new IVCM classification: type 0 for normality, type 1 for meibum obstruction, type 2 for inflammation, and type 3 for fibrosis. RESULTS: The mean age of patients was 52 ± 20 years old, the OSDI was 38 ± 23, the BUT 5 ± 2.6 s, the Schirmer test 13 ± 7 mm, tear osmolarity 300 ± 11 osmol/L, the Oxford score 0.5 ± 0.6, the meibum expression score 1.7 ± 1.02, and the meibography score 1.3 ± 0.9. The IVCM MG classification of the 15 normal subjects was 0. For MGD patients, 29% were in type 1, 40% were type 2, and 31% were type 3. The patients in IVCM MG type 2 had a higher OSDI (p = 0.001) compared with the other types. There was a strong correlation between the IVCM score and the meibography score (r = 0.71 p < 0.0001). CONCLUSION: This new IVCM classification provided a practical pathophysiological system for MGD. By giving objective criteria, this IVCM classification may help advance the understanding of patients' symptoms and enhance treatment effectiveness in MGD.
Authors: James S Wolffsohn; Reiko Arita; Robin Chalmers; Ali Djalilian; Murat Dogru; Kathy Dumbleton; Preeya K Gupta; Paul Karpecki; Sihem Lazreg; Heiko Pult; Benjamin D Sullivan; Alan Tomlinson; Louis Tong; Edoardo Villani; Kyung Chul Yoon; Lyndon Jones; Jennifer P Craig Journal: Ocul Surf Date: 2017-07-20 Impact factor: 5.033
Authors: Osama M A Ibrahim; Yukihiro Matsumoto; Murat Dogru; Enrique Sato Adan; Tais Hitomi Wakamatsu; Jun Shimazaki; Hiroshi Fujishima; Kazuo Tsubota Journal: Ophthalmology Date: 2012-06-18 Impact factor: 12.079
Authors: Ebenezer Daniel; Maureen G Maguire; Maxwell Pistilli; Vatinee Y Bunya; Giacomina M Massaro-Giordano; Eli Smith; Pooja A Kadakia; Penny A Asbell Journal: Ocul Surf Date: 2019-04-22 Impact factor: 5.033