| Objective: Morphology，structure and functioning of meibomian gland and Palpebralmargin and eye anterior segment were observed and examined in patients older than50to compare the differences in MGD and Non-MGD patients, so as to explore therelationship among varied indicators and seek a clinical diagnostic method for betterearly diagnosis and treatment of this disease.Methods: A non-interventional and prospective method was selected for this study.120(240eyes) Patients (50years old and above) admitted to Xiamen eye centreaffiliated to Xiamen university from September2012to June2013were selected asstudy subjects (consisting MGD group and Non-MGD group). Their basic informationwas recorded and a questionnaire was given. The examination items each patient tookincluded: eye symptoms, slit lamp examination of the anterior segment, tear break-uptime, Schirmer test, corneal fluorescent staining, meibomian gland structure andfunction, the structure and function of the palpebral margin. Collected clinical datawere processed and analyzed based on MGD diagnosis standards. Case control studywas used for patients with confirmed Meibomian gland dysfunction.Results:1. Of the120selected patients,69(133eyes) were diagnosed as MGDpatients with varied severity with a prevalence rate of57.73%. There were31malesand38females in the MGD group while51(107eyes) in the non-MGD group.2. The prevalence rate in varied age ranges (50-59,60-69,70-79,80yearsand above) were46.43%,57.50%,61.29%and66.67%, respectively, which showedsignificant differences (r=0.253, P=0.005; P <0.05). A weak positive correlation wasfound between age and prevalence rate. The prevalence rate (60.32%) in femaleabove50years of age was higher than that in male (54.39%) of the same age rangebut without significant difference (χ2=0.43, v=1, P>0.05). MGD severity in differentage groups and correlation analysis between age and MGD severity showed nosignificant difference (χ2=0.265, v=3, P=0.966； P>0.05and r=-0.102, P=0.298；P>0.05, respectively).3. Eyelid neovascularization grading score in MGD patients was significantly higher than that in non-MGD patients (t=4.671, P<0.05).Eyelid neovascularization grading in varied age ranges showed no significantdifference (χ2=1.322, v=3, P=0.724) and significant correlation was found betweenage and eyelid neovascularization grading score (r=0.090, P=0.293).4. Palpebral hyperemia in patients with MGD was significantly higher thanthat in non-MGD patients (t=2.486, P <0.05). Palpebral hyperemia grading in variedage ranges showed no significant difference (χ2=2.795, v=3, P=0.424) and weakcorrelation was found between palpebral hyperemia grading score and age (r=0.083，P=0.251).5. There was a significant difference in Break-up time, Schirmer test, cornealfluorescein staining and meibomian gland opening grading score between MGD andnon-MGD patients (t=-8.64,-4.59,5.18,9.662； P <0.05).Eyelid neovascularization grading and secretion patterns in MGD patients withdifferent neovascularization gradings showed significant difference while secretionability, tear break-up time, Schirmer test and corneal fluorescein staining showed nosignificant difference.6. Eye symptom scores in MGD patients was significantly higher than that innon-MGD patients (t=2.03, p=0.027； P <0.05).Conclusion:1.Eyelid neovascularization grading score and Palpebral hyperemia gradingscore in MGD patients were higher than those in non-MGD patients, which can betaken as referent indicator for meibomian gland dysfunction. Highereyelid neovascularization grading score in elderly MGD patients was associated withhigher score of meibomian gland secretion score and meibomian gland grading scorewhile it has no significant effects on meibomian gland secretion ability, tear break-uptime, Schirmer test and corneal fluorescein staining results.2.Tear break-up time, Schirmer test and corneal fluorescein staining in elderlyMGD patients were higher than those in non-MGD patients which might be of certainvalue. Meibomian gland opening and loss of meibomian gland does not changesignificantly following increase of age.3. The prevalence rate of MGD increased following the increase of age in elderlypopulation and it showed no significant difference in different genders. The irrational symptoms in elderly MGD patients were stronger than that in non-MGD patients. |
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