Clinical Ophthalmology (Nov 2023)
Risk Factors for Meibomian Gland Disease Assessed by Meibography
Abstract
Christine K Kim,1,2 Steven Carter,2,3 Cinthia Kim,2 Tara Shooshani,1,2 Urmi Mehta,2,4 Kailey Marshall,2 Ryan G Smith,1,2,5 Alexander Knezevic,2,6– 8 Kavita Rao,1,2 Olivia L Lee,2 Marjan Farid2 1Department of Ophthalmology, University of California, Irvine, School of Medicine, 1001 Health Sciences Rd, Irvine, CA, 92617, USA; 2Gavin Herbert Eye Institute at University of California, Irvine School of Medicine, 850 Health Sciences Rd, Irvine, CA, 92617, USA; 3Miramar Eye Specialists Medical Group, Ventura, CA, 93003, USA; 4St John’s Episcopal Hospital, Far Rockaway, NY, 11691, USA; 5Pacific Eye Institute, Upland, CA 91786, USA; 6Macy Eye Center, Los Angeles, CA, 90048, USA; 7Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA; 8Jules Stein Eye Institute at University of California, Los Angeles, CA, 90095, USACorrespondence: Christine K Kim, Gavin Herbert Eye Institute at University of California, Irvine School of Medicine, 850 Health Sciences Road, Irvine, CA, 92617, USA, Tel +1 818 279 5029, Email [email protected]: To elucidate risk factors for meibomian gland disease (MGD) and understand associated changes in meibography and in relation to ocular surface disease.Patients and Methods: As part of the standard workup for ocular surface disease at a tertiary academic center, 203 patients received an ocular history and lifestyle questionnaire. The questionnaire included detailed inquiries about ocular health and lifestyle, including makeup use, cosmetic eyelid procedures, screen time, and contact lens habits. Subjects also took the standardized patient evaluation of eye dryness (SPEED) II questionnaire. Meibomian gland (MG) dropout and structural changes were evaluated on meibography and scored by three independent graders using meiboscores. Statistical analysis was conducted to identify significant risk factors associated with MG loss.Results: This retrospective, cross-sectional study included 189 patients (378 eyes) with high-quality images for grading, and the average age was 67 years (77% female). Patients older than 45 years had significantly more dropout than younger patients (p < 0.01). Self-reported eye makeup use did not significantly impact MG loss. Patients with a history of blepharoplasty trended toward higher meiboscores, but the difference was not statistically significant. Self-reported screen time did not affect meiboscores. Contact lens use over 20 years was associated with significant MG loss (p < 0.05). SPEED II scores had no relationship to meiboscores (p = 0.75).Conclusion: Older age is a significant risk factor for MG loss. Any contact lens use over 20 years also impacted MG dropout. Highlighting the incongruence of symptoms to signs, SPEED II scores showed no relationship to the structural integrity of MGs.Keywords: dry eye, meibomian gland dropout, meiboscore, ocular surface disease
