Comparison of meibomian gland morphology in patients with evaporative dry eye versus healthy subjects.

There is no conclusive information regarding the impact of meibomian gland (MG) morphology in tear film physiology and disease. We present a retrospective and observational clinical study that investigated the prevalence of anatomical and morphological MG alterations between patients with evaporative dry eye disease and healthy controls, and the correlation between these alterations and common clinical parameters used during meibomian gland disease evaluation. Retrospective chart review of patients with evaporative dry eye and healthy individuals. The inclusion criteria for healthy subjects included an OSDI (Ocular Surface Disease Index) score of <12 points, non-invasive tear film break-up time (NIKBUT) > 10 sec, and absence of ocular surface staining (any type of dry eye was excluded). Patients with evaporative dry eye were selected based on the International Workshop on Meibomian Gland Dysfunction criteria. Demographic data, OSDI questionnaire, meibomian gland characteristics, ocular surface staining, non-invasive tear film break-up time, and infrared meibography were analyzed. Descriptive statistics and linear and logistical regression were used to evaluate the correlation between the clinical parameters and MG morphology. 75 eyes of 75 subjects were studied with a mean age of 40.68±18.43 (56% women), 42 (56%) subjects presented dry eyes and 33 (44%) were healthy controls. 90.7% of the subjects presented a morphological alteration in the upper lid and only 44% in the lower lid. We did not find significant differences in MG alterations in the upper lid between healthy and dry-eye subjects. Patients with evaporative dry eye presented MG alterations in the lower lid more frequently than healthy subjects (54.8 vs 30.3%; p=0.03). However, the presence of shortened glands was the only MG alteration that was more prevalent in the lower lid in dry-eye patients than in healthy subjects (p <0.05). In the studied population, subjects with evaporative dry eye presented more alterations in the lower lid than healthy subjects, and meibomian-gland shortening was the most common morphological alteration in patients with dry eye. This is a 2021 ARVO Annual Meeting abstract.