Changes of meibomian glands in patients with type 2 diabetes mellitus
Author:
Corresponding Author:

Wei-Yun Shi. Shandong Eye Hospital, Shandong Eye Institute, No. 372 Jingsi Road, Jinan 250021, Shandong Province, China. weiyunshi@163.com

  • Article
  • | |
  • Metrics
  • |
  • Reference [25]
  • |
  • Related
  • | | |
  • Comments
    Abstract:

    AIM: To investigate the morphological changes of meibomian glands in patients with type 2 diabetes mellitus (DM). METHODS: Of 118 eyes (118 patients) with type 2 DM (DM group) and 100 eyes of 100 control subjects (control group) were enrolled. After completing an ocular surface disease index (OSDI) questionnaire, the non-invasive tear film break-up time (NI-BUT) and the structure of the meibomian glands (MGs, meibography) were assessed by the Keratograph 5M system. Partial or complete loss of MG was scored for each eyelid from grade 0 (no loss) to grade 3 (lost area was >2/3 of the total MG area), which were also examined by laser scanning confocal microscopy (LSCM). The primary outcomes were meibomian gland acinar unit density (MGAUD), meibomian gland acinar longest diameter (MGALD) and meibomian gland acinar shortest diameter (MGASD). RESULTS: Compared with control group, the OSDI was significantly higher in DM group (Z=-5.916; P<0.001), while the NI-BUT was significantly lower (Z=-7.765; P<0.001). Keratograph showed that there were more MGs dropout in DM group than that in control group. The meiboscore was significantly higher in DM group compared with control group (Z=-3.937; P<0.001). LSCM revealed that there were cytological alterations of MGs in DM group compared with control group, which included enlargement of MG acinar units and decreased in density of MG acinar units. Specifically, there were lower MGAUD, larger MGALD and MGASD in DM group than control group (Z=-10.120, -9.4442, -7.771; P<0.001). CONCLUSION: Compared with the normal control participants, the patients with type 2 DM had more unstable tear films and severe symptoms of dry eye. Using Keratograph 5M system and LSCM, we found that the patients with type 2 DM had more significant morphological and cytological changes and dysfunction in MGs.

    Reference
    1 Najafi L, Malek M, Valojerdi AE, Khamseh ME, Aghaei H. Dry eye disease in type 2 diabetes mellitus; comparison of the tear osmolarity test with other common diagnostic tests: a diagnostic accuracy study using STARD standard. J Diabetes Metab Disord 2015;14:39.
    2 Wang Y, Dong N, Wu H. Meibomian gland morphology study progression. Zhonghua Yan Ke Za Zhi 2014;50(4):299-302.
    3 Craig JP, Tomlinson A. Importance of the lipid layer in human tear film stability and evaporation. Optom Vis Sci 1997;74(1):8-13.
    4 Palamar M, Degirmenci C, Ertam I, Yagci A. Evaluation of dry eye and meibomian gland dysfunction with meibography in patients with rosacea. Cornea 2015;34(5):497-499.
    5 Schiffman RM, Christianson MD, Jacobsen G, Hirsch JD, Reis BL. Reliability and validity of the ocular surface disease index. Arch Ophthalmol 2000;118(5):615-621.
    6 Feng Y, Gao Z, Feng K, Qu H, Hong J. Meibomian gland dropout in patients with dry eye disease in China. Curr Eye Res 2014;39(10):965-972.
    7 Hong J, Sun X, Wei A, Cui X, Li Y, Qian T, Wang W, Xu J. Assessment of tear film stability in dry eye with a newly developed keratograph. Cornea 2013;32(5):716-721.
    8 Johnson ME, Murphy PJ. The effect of instilled fluorescein solution volume on the values and repeatability of TBUT measurements. Cornea 2005;24(7):811-817.
    9 Menzies KL, Srinivasan S, Prokopich CL, Jones L. Infrared imaging of meibomian glands and evaluation of the lipid layer in Sjogren's syndrome patients and nondry eye controls. Invest Ophthalmol Vis Sci 2015;56(2):836-841.
    10 Srinivasan S, Menzies K, Sorbara L, Jones L. Infrared imaging of meibomian gland structure using a novel keratograph. Optom Vis Sci 2012;89(5):788-794.
    11 Abdelfattah NS, Dastiridou A, Sadda SR, Lee OL. Noninvasive imaging of tear film dynamics in eyes with ocular surface disease. Cornea 2015;34 Suppl 10:S48-52.
    12 Arita R, Itoh K, Inoue K, Amano S. Noncontact infrared meibography to document age-related changes of the meibomian glands in a normal population. Ophthalmology 2008;115(5):911-915.
    13 Finis D, Ackermann P, Pischel N, Konig C, Hayajneh J, Borrelli M, Schrader S, Geerling G. Evaluation of meibomian gland dysfunction and local distribution of meibomian gland atrophy by non-contact infrared meibography. Curr Eye Res 2015;40(10):982-989.
    14 Ibrahim OM, Matsumoto Y, Dogru M, Adan ES, Wakamatsu TH, Goto T, Negishi K, Tsubota K. The efficacy, sensitivity, and specificity of in vivo laser confocal microscopy in the diagnosis of meibomian gland dysfunction. Ophthalmology 2010;117(4):665-672.
    15 Matsumoto Y, Sato EA, Ibrahim OM, Dogru M, Tsubota K. The application of in vivo laser confocal microscopy to the diagnosis and evaluation of meibomian gland dysfunction. Mol Vis 2008;14:1263-1271.
    16 Matsumoto Y, Shigeno Y, Sato EA, Ibrahim OM, Saiki M, Negishi K, Ogawa Y, Dogru M, Tsubota K. The evaluation of the treatment response in obstructive meibomian gland disease by in vivo laser confocal microscopy. Graefes Arch Clin Exp Ophthalmol 2009;247(6):821-829.
    17 Misra SL, Patel DV, McGhee CN, Pradhan M, Kilfoyle D, Braatvedt GD, Craig JP. Peripheral neuropathy and tear film dysfunction in type 1 diabetes mellitus. J Diabetes Res 2014;2014:848659.
    18 Seifart U, Strempel I. The dry eye and diabetes mellitus. Ophthalmologe 1994;91(2):235-239.
    19 Rocha EM, Wickham LA, da Silveira LA, Krenzer KL, Yu FS, Toda I, Sullivan BD, Sullivan DA. Identification of androgen receptor protein and 5alpha-reductase mRNA in human ocular tissues. Br J Ophthalmol 2000;84(1):76-84.
    20 Sullivan DA, Sullivan BD, Ullman MD, Rocha EM, Krenzer KL, Cermak JM, Toda I, Doane MG, Evans JE, Wickham LA. Androgen influence on the meibomian gland. Invest Ophthalmol Vis Sci 2000;41(12):3732-3742.
    21 Corona G, Mannucci E, Petrone L, Schulman C, Balercia G, Fisher AD, Chiarini V, Forti G, Maggi M. A comparison of NCEP-ATPIII and IDF metabolic syndrome definitions with relation to metabolic syndrome-associated sexual dysfunction. J Sex Med 2007;4(3):789-796.
    22 Chung CW, Tigges M, Stone RA. Peptidergic innervation of the primate meibomian gland. Invest Ophthalmol Vis Sci 1996;37(1):238-245.
    23 Song XJ, Li DQ, Farley W, Luo LH, Heuckeroth RO, Milbrandt J, Pflugfelder SC. Neurturin-deficient mice develop dry eye and keratoconjunctivitis sicca. Invest Ophthalmol Vis Sci 2003;44(10):4223-4229.
    24 Knop E, Knop N, Millar T, Obata H, Sullivan DA. The international workshop on meibomian gland dysfunction: report of the subcommittee on anatomy, physiology, and pathophysiology of the meibomian gland. Invest Ophthalmol Vis Sci 2011;52(4):1938-1978.
    25 Sagdik HM, Ugurbas SH, Can M, Tetikoglu M, Ugurbas E, Ugurbas SC, Alpay A, Ucar F. Tear film osmolarity in patients with diabetes mellitus. Ophthalmic Res 2013;50(1):1-5.
    Related
    Cited by
    Comments
    Comments
    分享到微博
    Submit
Get Citation

Tao Yu, Wei-Yun Shi, Ai-Ping Song,/et al.Changes of meibomian glands in patients with type 2 diabetes mellitus. Int J Ophthalmol, 2016,9(12):1740-1744

Copy
Share
Article Metrics
  • Abstract:
  • PDF:
  • HTML:
  • Cited by:
Publication History
  • Received:June 08,2016
  • Revised:August 19,2016
  • Online: December 07,2016