| Purpose: To describe associations between symptoms and signs of dry eye disease(DED)and meibomian gland morphology.Methods: A total of 378 patients(378 eyes)diagnosed with DED in dry eye outpatient department of Affiliated Hospital of Yanbian University from August 2021 to January 2022 were selected.The meibomian gland morphology and function features in the middle third of upper and lower lids of meibomian gland images obtained by Sirius system were scored by ophthalmologists and the associations with signs and symptoms of DED were evaluated.Results:(1)Among 378 patients,111(29.37%)were male and 267(70.63%)were female,aged from 19 to 83 years,with an average of(47.62±11.85)years.The noninvasive tear breakup time(NIT-BUT)was(3.18±1.56)s,the average noninvasive tear breakup time(NIFAvg-BUT)was(6.56±1.74)s,the test paper infiltration height of Schirmer I test(SIT)was(5.06±3.30)mm/5min,the ocular surface disease index(OSDI)score was(28.85±12.72)points,and the corneal and conjunctival fluorescent staining(FL)score was(3.46±2.26)points.(2)The total abnormal morphology of meibomian gland of upper lids was positively correlated with OSDI score(P<0.001),and the morphological abnormalities of distorted,tortuous,hooked,ghost,short,abnormal gap and no extension to lid margin were significantly positively correlated with OSDI score(P<0.05).In the lower lids,there was no significant correlation between the abnormal morphology of meibomian gland and OSDI score(P>0.05).It is worth noting that the total meibomian morphological abnormalities score of upper lids were higher than that of lower lids in patients with severe subjective symptoms(7.02 vs.6.43),and the total meibomian morphological abnormalities score of lower lids were higher than that of upper lids in patients with mild and moderate subjective symptoms(6.34 vs.3.49;6.81 vs.5.34).(3)The distorted,tortuous,hooked,ghost,short,abnormal gap and total abnormal meibomian gland in the upper lids were significantly negatively correlated with NIF-BUT and NIFAvg-BUT(P<0.05).The tortuous meibomian gland was negatively correlated with NIFAvg-BUT(P<0.05),while other meibomian gland morphological abnormalities were not significantly correlated with NIF-BUT and NIFAvg-BUT(P>0.05).In the three NIF-BUT groups,the total score of abnormal morphology of theupper lids were higher than that of the lower lids(6.34 vs.3.54;6.29 vs.5.55;6.92 vs.6.55).Among the three NIFAvg-BUT groups,the total score of abnormal morphology of the upper lids were higher than that of the lower lids only in the group with the shortest NIFAvg-BUT(7.07 vs.6.49).(4)The total number of abnormal meibomian gland morphology was significantly negatively correlated with the test paper infiltration height of SIT(P<0.001).Scores of morphological abnormalities such as distorted,tortuous,hooked,ghost,short,abnormal gap in the upper lids were negatively correlated with the test paper infiltration height of SIT(P<0.001)In the lower lids,only drop out meibomian gland scores were negatively correlated with the test paper infiltration height of SIT(P<0.05).In the three groups of patients,the total meibomian gland abnormality score in the lower lids were higher than that in the upper lids(6.63 vs.3.82;6.46 vs.5.09;6.47 vs.6.40).(5)In upper lids,there was a significant positive correlation between the distorted,tortuous,hooked,ghost,short,abnormal gap and total abnormal meibomian gland and the corneal and conjunctival FL scores(P<0.05).There was no significant correlation between the meibomian gland morphological abnormalities of lower lids and the corneal and conjunctival FL scores(P>0.05).The total meibomian morphology score of the upper lids was higher than that of the lower lids in patients with the corneal and conjunctival FL scores >4(6.99 vs.6.79),but in patients with the corneal and conjunctival FL scores <4,the total morphological abnormalities of the lower lids was higher than that of the upper lids(6.56 vs.3.86;6.33 vs.5.47).(6)MGYLS and MGYSS of upper and lower lids were significantly positively correlated with OSDI score,NIFAvg-BUT,NIF-BUT,SIT and the corneal and conjunctival FL score(P<0.001).Conclusion:(1)The symptoms and signs of DED are affected by the most abnormal morphology of meibomian glands in the upper lids.The more abnormal the morphology of meibomian glands,the heavier the symptoms of dry eyes and the more obvious the signs.Most meibomian gland morphologic features were not associated with the severity of DED symptoms or signs in lower lids.(2)In most patients with mild to moderate dry eyes,the meibomian gland morphological abnormality score of the lower lids is higher than that of the upper lids,and in most patients with severe dry eyes,the meibomian gland morphological abnormality score of the upper lids is higher than that of the lower lids.(3)Meibomian gland yielding liquid secretion and secretion properties affect the secretory function of meibomian gland,and then affect the symptoms and signs of DED. |
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