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Purpose:
To evaluate by in vivo laser scanning confocal microscopy (LSCM) the morphological changes of the Meibomian glands (MGs) and the status of periglandular inflammation in contact lens wearers (CLWs) and to investigate the correlations between clinical and confocal findings.
Methods:
Twenty CLWs and 20 age- and gender-matched control subjects were consecutively enrolled. Each participant completed an Ocular Surface Disease Index questionnaire and underwent a full eye examination, including tear film break-up time, fluorescein and lissamine green staining, and Schirmer test. LSCM of the MGs were performed to determine the cell density of the mucocutaneous junction epithelium, acinar unit density and diameter, glandular orifice diameters, meibum secretion reflectivity, and inhomogeneous appearance of the glandular interstice and acinar wall.
Results:
All clinical parameters showed statistically significant differences between groups (P <0.01, Mann-Whitney U test) except the Schirmer test. Confocal data (Mann-Whitney U test) showed significantly decreased basal epithelium cell density ( P <0.01), lower acinar unit diameters (P <0.05), higher glandular orifice diameters (P <0.05), greater secretion reflectivity (P <0.01), and greater inhomogeneity of the periglandular interstices (P <0.05) in CLWs compared to controls. The duration of contact lens wear was correlated with the acinar unit diameters (P < 0.05, Spearman).
Conclusions:
Morphological changes of the MGs shown by LSCM were interpreted as signs of MG drop-out, duct obstruction, and glandular inflammation. A comprehensive LSCM evaluation of the ocular surface in CLWs could better clarify the role of MG drop-out and eyelid margin inflammation on the pathogenesis of CL-induced dry eye.
To evaluate by in vivo laser scanning confocal microscopy (LSCM) the morphological changes of the Meibomian glands (MGs) and the status of periglandular inflammation in contact lens wearers (CLWs) and to investigate the correlations between clinical and confocal findings.
Methods:
Twenty CLWs and 20 age- and gender-matched control subjects were consecutively enrolled. Each participant completed an Ocular Surface Disease Index questionnaire and underwent a full eye examination, including tear film break-up time, fluorescein and lissamine green staining, and Schirmer test. LSCM of the MGs were performed to determine the cell density of the mucocutaneous junction epithelium, acinar unit density and diameter, glandular orifice diameters, meibum secretion reflectivity, and inhomogeneous appearance of the glandular interstice and acinar wall.
Results:
All clinical parameters showed statistically significant differences between groups (P <0.01, Mann-Whitney U test) except the Schirmer test. Confocal data (Mann-Whitney U test) showed significantly decreased basal epithelium cell density ( P <0.01), lower acinar unit diameters (P <0.05), higher glandular orifice diameters (P <0.05), greater secretion reflectivity (P <0.01), and greater inhomogeneity of the periglandular interstices (P <0.05) in CLWs compared to controls. The duration of contact lens wear was correlated with the acinar unit diameters (P < 0.05, Spearman).
Conclusions:
Morphological changes of the MGs shown by LSCM were interpreted as signs of MG drop-out, duct obstruction, and glandular inflammation. A comprehensive LSCM evaluation of the ocular surface in CLWs could better clarify the role of MG drop-out and eyelid margin inflammation on the pathogenesis of CL-induced dry eye.
Villani E, Ceresara G, Beretta S, Magnani F, Viola F, Ratiglia R.
Source
Universitą degli Studi di Milano. UO Oculistica Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milan, Italy.