Assessment of meibomian gland dysfunction and dry eye disease by using novel noninvasive ocular surface analyzer in people with type 2 diabetes

Abstract

Objective: To assess meibomian gland dysfunction (MGD) and dry eye disease in people with type 2 diabetes using a novel noninvasive ocular surface analyzer. Materials and Methods: This prospective study was conducted in the Ophthalmology Department, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi, from June to December 2020. MGD is defined as increased lipids and proteins in the meibomian glands, leading to increased severity of dry eye disease symptoms. People with type 2 diabetes underwent an ocular surface examination; lipid layer thickness, noninvasive breakup time, tear meniscus height, grading of meibomian gland loss, and expression of meibum by a noninvasive analyzer. MGD was graded based on minimal to mild, moderate, and marked symptoms and divided into four subtypes. Result: A total of 46 diabetic subjects, 24 (52.2%) were males and 22 (47.8%) were females, with a median age of 55 (50–67.5) and 48 (41.5–55.25) years. Most of the subjects had mild gland opening for both the right and the left eye (50% and 54.3%). MGD score 1 was found in 12 (26.7%) and 11 (24.4%) subjects for the right and the left eye, respectively. Score 2 was observed mostly in the right eye 32 (71.1%) while score 3 was more frequent in the left eye 27 (60%). Notably, the conjunctival and ciliary levels were predominantly normal. Conclusion: Most of the participants had moderate to severe loss of the meibomian gland in both eyes.

Keywords

• diabetes; dry eye; first breakup point; meibomian gland dysfunction; tear film