Vol 6 (2021): Continuous Publishing
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Published online: 2021-07-15

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Association of risk factors with severity of meibomian gland dysfunction

Prempal Kaur1, Nitika Goyal1, Karamjit Singh1, Anubha Bhatti1, Navdeep Kaur1
Ophthalmol J 2021;6:76-82.

Abstract

Background: Meibomian gland dysfunction (MGD) is an alteration in the function of meibomian glands, leading to decreased tear film stability. We aimed to assess the severity of MGD and correlate it with various risk factors.

Material and methods: After taking permission from the Institutional Ethical Committee, a prospective observational case-control study was conducted in a tertiary care centre on 100 consecutive patients diagnosed with MGD. After taking informed consent, patients were assessed for the severity of MGD and correlated with risk factors.

Results: The mean age of cases and controls was 53.61 ± 14.02 and 50.7 ± 13.0 years, respectively. Watering and heaviness were found to be the most common symptom in patients diagnosed with MGD. A significant correlation was observed between MGD and elderly females, contact lens wearers, smokers, diabetics, excessive use of visual display terminal, rheumatoid arthritis, use of anti-allergics, anti-hypertensive, anti-depressant, and topical antiglaucoma drugs (p < 0.05). Increasing severity of MGD was associated with female sex, serum triglycerides > 150 mg/dL, total cholesterol > 200 mg/dL, serum low-density lipoprotein (LDL) > 130 mg/dL and serum high-density lipoprotein (HDL) > 40 mg/dL.

Conclusion: The observations in the study suggest a positive correlation between the severity of MGD and dyslipidemia, a modifiable cardiovascular risk factor. A thorough systemic workup is advisable in patients presenting to an ophthalmologist with severe MGD. Identifying and removing or modifying risk factors aggravating MGD would help alleviate their symptoms and improve their quality of life.

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References

  1. Nelson JD, Shimazaki J, Benitez-del-Castillo JM, et al. The international workshop on meibomian gland dysfunction: report of the definition and classification subcommittee. Invest Ophthalmol Vis Sci. 2011; 52(4): 1930–1937.
  2. Knop E, Knop N, Millar T, et al. The international workshop on meibomian gland dysfunction: report of the subcommittee on anatomy, physiology, and pathophysiology of the meibomian gland. Invest Ophthalmol Vis Sci. 2011; 52(4): 1938–1978.
  3. McCulley JP, Sciallis GF. Meibomian keratoconjunctivitis. Am J Ophthalmol. 1977; 84(6): 788–793.
  4. Lemp MA, Nichols KK. Blepharitis in the United States 2009: a survey-based perspective on prevalence and treatment. Ocul Surf. 2009; 7(2 Suppl): S1–S14.
  5. Hom MM, Martinson JR, Knapp LL, et al. Prevalence of Meibomian gland dysfunction. Optom Vis Sci. 1990; 67(9): 710–712.
  6. Rolando M, Zierhut M. The ocular surface and tear film and their dysfunction in dry eye disease. Surv Ophthalmol. 2001; 45 Suppl 2: S203–S210.
  7. McCulley JP, Dougherty JM, Deneau DG. Classification of chronic blepharitis. Ophthalmology. 1982; 89(10): 1173–1180.
  8. Shine WE, McCulley JP, Shine WE, et al. The role of cholesterol in chronic blepharitis. Invest Ophthalmol Vis Sci. 1991; 32(8): 2272–2280.
  9. Pinna A, Blasetti F, Zinellu A, et al. Meibomian gland dysfunction and hypercholesterolemia. Ophthalmology. 2013; 120(12): 2385–2389.
  10. Guliani BP, Bhalla A, Naik MP. Association of the severity of meibomian gland dysfunction with dyslipidemia in Indian population. Indian J Ophthalmol. 2018; 66(10): 1411–1416.
  11. Pult H, Riede-Pult BH, Nichols JJ. Relation between upper and lower lids' meibomian gland morphology, tear film, and dry eye. Optom Vis Sci. 2012; 89(3): E310–E315.
  12. Arita R, Itoh K, Inoue K, et al. Noncontact infrared meibography to document age-related changes of the meibomian glands in a normal population. Ophthalmology. 2008; 115(5): 911–915.
  13. Machalińska A, Zakrzewska A, Safranow K, et al. Risk Factors and Symptoms of Meibomian Gland Loss in a Healthy Population. J Ophthalmol. 2016; 2016: 7526120.
  14. Akkaya S, Atakan T, Acikalin B, et al. Effects of long-term computer use on eye dryness. North Clin Istanb. 2018; 5(4): 319–322.
  15. Altinors DD, Akça S, Akova YA, et al. Smoking associated with damage to the lipid layer of the ocular surface. Am J Ophthalmol. 2006; 141(6): 1016–1021.
  16. Shamsheer RP, Arunachalam C. A Clinical Study of Meibomian Gland Dysfunction in Patients with Diabetes. Middle East Afr J Ophthalmol. 2015; 22(4): 462–466.
  17. Kumar D, Chaubey D, Pratap D. A Clinical Study of Meibomian Gland Dysfunction in Patients with Diabetes in Bundelkhand region. IOSR J Dent Med Sci. 2017; 16(06): 14–18.
  18. Kim YS, Kwak AeY, Lee SY, et al. Meibomian gland dysfunction in Graves' orbitopathy. Can J Ophthalmol. 2015; 50(4): 278–282.
  19. Dao AH, Spindle JD, Harp BA, et al. Association of dyslipidemia in moderate to severe meibomian gland dysfunction. Am J Ophthalmol. 2010; 150(3): 371–375.e1.
  20. Mobin D. A study on meibomian gland disorders and lipid levels in north Indian population. Int J Med Sci Clin Invent. 2017; 4(8).
  21. Irfan KS, Agrawal A, Singh A, et al. Association of Lipid Profile with Severity of Meibomian Gland Dysfunction. Nepal J Ophthalmol. 2020; 12(24): 216–235.
  22. Bukhari AA. Associations between the grade of meibomian gland dysfunction and dyslipidemia. Ophthalmic Plast Reconstr Surg. 2013; 29(2): 101–103.