Application Of Infrared Photography Combined With IVCM In The Study Of Meibomian Gland Morphology In Patients With MGD

Objective:Infrared photographic technique combined with in vivo confocal microscopy to observe the morphology of meibomian glands in patients with meibomian gland dysfunction,and to explore the diagnostic value of IVCM in meibomian gland dysfunction.Method :In a case-control study,infrared photographic techniques combined with IVCM were used to observe the morphology of the meibomian glands in patients with mild meibomian gland dysfunction and healthy individuals.30 patients(30 eyes)who were admitted to our hospital from April 2018 to October 2018 were diagnosed with meibomian gland dysfunction(diagnostic criteria refer to the domestic 2017 MGD consultation expert consensus),healthy subjects 17 cases(17 eyes)were used as the control group.Both groups were observed in the left eye.Patients in the MGD group were asked to fill out a questionnaire before the examination.All the enrollees(MGD group,healthy group)were subjected to OSDI score,schirmer I test,ocular surface comprehensive analyzer(tear-film break-up time,tear meniscus height,meibomian gland photography)and meibomian gland IVCM examination.The IVCM examination mainly focused on the meibomian glands of the nasal,central and temporal iliac crests and the proximal temporal iliac crest,focusing on the meibomian gland opening,the acinar gland morphology and inflammatory cell infiltration.The t-test of two independent samples was used to compare the measurement parameters of the two groups.Result:The difference of OSDI score and NITBUTavg between the two groups was statistically significant(P<0.05).There was no significant difference in STI and TMH between the two groups(P>0.05).The glandular gland deletion score in the MGD group was significantly higher than that in the healthy group(P<0.05).The rate ofupper and lower meibomian gland loss in MGD group was higher than that in healthy group,and the difference was statistically significant(P<0.05).IVCM-related results:There was no difference in the diameter and opening area of the meibomian gland in the MGD group compared with the healthy group(P>0.05).The longest diameter of the meibomian glandular acinus,the shortest diameter of the acinus,the acinar area and the inflammatory cell density were higher than the healthy group.acinar area and inflammatory cell density of meibomian glandular acinus were higher than those of healthy group.The difference between the two groups was statistically significant(P<0.05).The density of acinar gland in the MGD group was lower than that in the healthy group,and the difference was statistically significant(P<0.05).Conclusion:1.Infrared photography technology and IVCM have the advantages of non-invasive and reproducible.The combined application can more comprehensively observe the morphology of the meibomian gland and help us explain the pathophysiological process of MGD.2.IVCM can perform microscopic observation of meibomian gland structure from cytological level.Axillary gland axonal expansion,acinar atrophy,acinar fibrosis and acinar inflammatory cell infiltration are important markers of MGD.3.IVCM has a certain significance for the early diagnosis of mild MGD.