Investigation of Meibomian Gland Function and Dry Eye Disease in Patients with Graves’ Ophthalmopathy †
Abstract
:1. Introduction
2. Experimental Section
2.1. Patients
2.2. Ocular Surface Examination
2.3. Criteria for Dry Eye Diagnosis
2.4. Criteria for Diagnosis of Meibomian Gland Dysfunction
2.5. Examination for Graves’ Ophthalmopathy
2.6. Assessment of Subjective Symptoms, Self-Reported via a Questionnaire
2.7. Statistical Analysis
3. Results
3.1. Ocular Surface Examination
3.2. Examination for Graves’ Ophthalmopathy
3.3. Representative Cases
3.3.1. Case 1
3.3.2. Case 2
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Parameter | Patients with GO (n = 19) |
---|---|
Clinical parameters | |
Duration of GO, months | 52.9 ± 21.5 |
Active GO, n (CAS ≥ 4) | 1 |
Smokers, n (%) | 8 (42.1) |
Thyroid function | |
Hyperthyroidism, n | 18 |
Hypothyroidism, n | 1 |
Euthyroidism, n | 0 |
Ophthalmologic parameter | |
Severity of GO, mild n, (%) | 10/19 (52.6) |
Moderate n (%) | 9/19 (47.4) |
Proptosis (>15 mm) n, mm, (%) | 38/38, 18.8 ± 1.8, (100) |
Eyelid retraction, n (%) | 4/38 (10.5) |
Palpebral fissure height (>7 mm) n, mm, (%) | 33/38, 9.0 ± 2.0 (91.7) |
Eyelid swelling, n (%) | 22/38 (57.9) |
Engorgement of the levator muscle, n (%) | 30/38 (78.9) |
Engorgement of the extra ocular muscle, n (%) | 17/38 (44.7) |
Swelling of the lacrimal gland, n (%) | 28/38 (73.7) |
Parameter | Patients with GO (n = 19) | Normal Participants (n = 14) | p Value |
---|---|---|---|
Mean age, years (mean ± SD) | 44.0 ± 10.0 | 44.6 ± 2.2 | p = 0.6 |
Male, n | 2 | 0 | p = 0.4 |
Ocular surface examination | |||
Lid margin abnormalities, n | 19 | ||
Vasculitis, n | 19 | 2 | p = 0.000 |
Fluorescein score | 0.6 ± 0.8 | 0.3± 0.5 | p = 0.4 |
TBUT, s | 4.7 ± 3.2 | 7.1 ± 1.6 | p = 0.000 |
SLK, n | 0 | 0 | - |
Schirmer’s test, mm | 10.5 ± 8.8 | 9.2 ± 3.5 | p = 0.5 |
Meibum score | 1.6 ± 0.5 | 0.3 ± 0.5 | p = 0.000 |
Meibography | |||
Meiboscores | |||
Upper lid | 1.0 ± 0.6 | 0.3 ± 0.5 | p = 0.002 |
Lower lid | 0.9 ± 0.6 | 0.4 ± 0.5 | p = 0.07 |
Total meiboscores | 1.9 ± 1.1 | 0.7 ± 0.8 | p = 0.001 |
Abnormalities of central part, n | 12 | 0 | p = 0.000 |
DEQS | 35.2 ± 28.3 | 4.3 ± 1.3 | p = 0.000 |
Meibography | Engorgement | Swelling | |||||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Fluorescein | Lid margin Vasculitis | Schirmer‘s Test (mm) | Meiboscore | Abnormalities Central Part | |||||||||||||||||||||
Age | Sex | Eye | Score | TBUT (s) | Upper Lid | Lower Lid | Meibum Grade | Upper Lid | Lower Lid | Total | Upper Lid | Lower Lid | DEQS | CAS | GO Severity | Disease Duration | Proptosis | Palpebral Fissure | Levator Muscle | Extra-Ocular Muscles | Lacrimal Gland | Eyelid Swelling | Lid Retraction | ||
1 | 53 | F | R | 1 | 6 | 1 | 1 | 2 | 1 | 2 | 2 | 4 | 1 | 0 | 25 | 0 | 2 | 60 | 19 | 7 | 1 | 0 | 1 | 1 | 0 |
L | 1 | 6 | 1 | 1 | 2 | 1 | 2 | 0 | 2 | 1 | 0 | 18 | 8 | 1 | 0 | 1 | 1 | 0 | |||||||
2 | 56 | F | R | 2 | 6 | 1 | 1 | 23 | 2 | 1 | 0 | 1 | 1 | 0 | 55 | 5 | 2 | 53 | 19 | 8 | 1 | 0 | 1 | 1 | 0 |
L | 3 | 4 | 1 | 1 | 13 | 2 | 1 | 0 | 1 | 0 | 0 | 18 | 10 | 1 | 1 | 1 | 1 | 0 | |||||||
3 | 41 | F | R | 0 | 4 | 0 | 1 | 9 | 2 | 0 | 0 | 0 | 0 | 0 | 60 | 2 | 1 | 58 | 18 | 8 | 1 | 0 | 1 | 0 | 0 |
L | 0 | 4 | 1 | 1 | 9 | 2 | 0 | 0 | 0 | 0 | 0 | 17 | 9 | 1 | 1 | 1 | 0 | 0 | |||||||
4 | 38 | F | R | 0 | 4 | 1 | 1 | 6 | 1 | 2 | 1 | 3 | 0 | 0 | 55 | 0 | 2 | 60 | 20 | 8 | 1 | 0 | 1 | 1 | 0 |
L | 0 | 3 | 1 | 1 | 4 | 1 | 2 | 1 | 3 | 0 | 0 | 21 | 9 | 1 | 0 | 1 | 1 | 0 | |||||||
5 | 47 | F | R | 1 | 2 | 1 | 1 | 0 | 2 | 0 | 1 | 1 | 1 | 1 | 56.7 | 0 | 1 | 24 | 16 | 10 | 0 | 0 | |||
L | 1 | 2 | 1 | 1 | 4 | 2 | 0 | 1 | 1 | 1 | 0 | 16 | 9 | 0 | 0 | ||||||||||
6 | 38 | F | R | 0 | 3 | 1 | 1 | 19 | 1 | 1 | 1 | 2 | 0 | 0 | 11.6 | 2 | 2 | 60 | 19 | 8 | 1 | 0 | 1 | 1 | 0 |
L | 0 | 4 | 1 | 1 | 17 | 1 | 1 | 0 | 1 | 0 | 0 | 22 | 12 | 1 | 0 | 1 | 1 | 0 | |||||||
7 | 42 | F | R | 0 | 2 | 1 | 1 | 2 | 1 | 1 | 1 | 2 | 1 | 0 | 16.6 | 0 | 1 | 24 | 19 | 8 | 0 | 0 | 0 | 0 | 0 |
L | 0 | 2 | 1 | 1 | 0 | 1 | 1 | 2 | 3 | 1 | 0 | 18 | 10 | 0 | 0 | 0 | 0 | 0 | |||||||
8 | 28 | F | R | 1 | 0 | 1 | 1 | 3 | 1 | 1 | 0 | 1 | 1 | 1 | 26.7 | 2 | 2 | 48 | 20 | 11 | 1 | 1 | 1 | 1 | 1 |
L | 1 | 0 | 1 | 0 | 2 | 1 | 1 | 0 | 1 | 1 | 1 | 19 | 11 | 1 | 1 | 1 | 1 | 1 | |||||||
9 | 48 | F | R | 0 | 4 | 1 | 1 | 0 | 2 | 2 | 1 | 3 | 1 | 0 | 23.3 | 0 | 1 | 60 | 18 | 10 | 1 | 0 | 1 | 0 | 0 |
L | 0 | 4 | 1 | 1 | 1 | 2 | 1 | 1 | 2 | 1 | 0 | 18 | 9 | 1 | 0 | 1 | 0 | 0 | |||||||
10 | 39 | F | R | 2 | 8 | 1 | 1 | 11 | 2 | 1 | 1 | 2 | 0 | 0 | 30 | 1 | 2 | 7 | 19 | 10 | 1 | 1 | 0 | 1 | 0 |
L | 2 | 5 | 1 | 1 | 12 | 2 | 1 | 1 | 2 | 0 | 0 | 19 | 11 | 1 | 1 | 0 | 1 | 0 | |||||||
11 | 44 | F | R | 1 | 4 | 1 | 1 | 6 | 2 | 1 | 1 | 2 | 1 | 0 | 20 | 1 | 1 | 65 | 18 | 6 | 0 | 0 | 0 | 0 | 0 |
L | 1 | 3 | 1 | 1 | 11 | 2 | 1 | 1 | 2 | 1 | 0 | 19 | 8 | 0 | 0 | 0 | 0 | 0 | |||||||
12 | 39 | M | R | 0 | 5 | 1 | 1 | 17 | 1 | 1 | 0 | 1 | 1 | 1 | 21.7 | 1 | 1 | 75 | 18 | 9 | 1 | 0 | 1 | 0 | 0 |
L | 0 | 5 | 1 | 1 | 11 | 1 | 1 | 0 | 1 | 1 | 0 | 18 | 9 | 1 | 0 | 1 | 0 | 0 | |||||||
13 | 67 | F | R | 0 | 5 | 1 | 1 | 14 | 2 | 2 | 1 | 3 | 1 | 0 | 35.7 | 0 | 1 | 72 | 18 | 8 | 1 | 1 | 1 | 0 | 0 |
L | 0 | 5 | 1 | 1 | 12 | 2 | 1 | 1 | 2 | 0 | 0 | 17 | 8 | 1 | 1 | 1 | 0 | 0 | |||||||
14 | 29 | F | R | 0 | 5 | 1 | 1 | 20 | 1 | 0 | 0 | 0 | 1 | 0 | 3.3 | 1 | 1 | 24 | 18 | 7 | 1 | 0 | 1 | 1 | 0 |
L | 0 | 3 | 1 | 1 | 14 | 1 | 0 | 0 | 0 | 0 | 0 | 19 | 9 | 1 | 1 | 1 | 1 | 0 | |||||||
15 | 48 | M | R | 0 | 3 | 1 | 1 | 14 | 2 | 1 | 1 | 2 | 1 | 0 | 58.9 | 2 | 2 | 64 | 23 | 9 | 1 | 1 | 1 | 0 | 0 |
L | 0 | 3 | 1 | 1 | 15 | 2 | 1 | 1 | 2 | 0 | 0 | 21 | 9 | 1 | 1 | 1 | 0 | 0 | |||||||
16 | 27 | F | R | 1 | 5 | 1 | 1 | 12 | 2 | 1 | 3 | 4 | 0 | 0 | 10 | 1 | 2 | 48 | 22 | 12 | 1 | 1 | 1 | 1 | 0 |
L | 0 | 1 | 1 | 22 | 2 | 1 | 3 | 4 | 0 | 0 | 23 | 12 | 1 | 1 | 1 | 1 | 0 | ||||||||
17 | 56 | F | R | 1 | 3 | 1 | 1 | 3 | 2 | 1 | 3 | 4 | 0 | 0 | 8.3 | 1 | 2 | 55 | 18 | 8 | 1 | 1 | 1 | 1 | 0 |
L | 1 | 2 | 1 | 1 | 3 | 2 | 1 | 2 | 3 | 0 | 0 | 20 | 8 | 1 | 1 | 1 | 1 | 1 | |||||||
18 | 38 | F | R | 0 | 6 | 1 | 1 | 35 | 1 | 1 | 1 | 2 | 0 | 0 | 91.7 | 1 | 1 | 8 | 16 | 6 | 1 | 1 | 1 | 1 | 1 |
L | 0 | 7 | 1 | 1 | 35 | 1 | 1 | 1 | 2 | 1 | 0 | 16 | 7 | 1 | 1 | 1 | 1 | 0 | |||||||
19 | 52 | F | R | 0 | 3 | 1 | 1 | 4 | 2 | 2 | 1 | 3 | 1 | 0 | 58.9 | 0 | 1 | 96 | 17 | 8 | 1 | 0 | 0 | 1 | 0 |
L | 0 | 5 | 1 | 1 | 13 | 1 | 2 | 1 | 3 | 1 | 0 | 16 | 8 | 1 | 0 | 0 | 1 | 0 |
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Inoue, S.; Kawashima, M.; Arita, R.; Kozaki, A.; Tsubota, K. Investigation of Meibomian Gland Function and Dry Eye Disease in Patients with Graves’ Ophthalmopathy. J. Clin. Med. 2020, 9, 2814. https://doi.org/10.3390/jcm9092814
Inoue S, Kawashima M, Arita R, Kozaki A, Tsubota K. Investigation of Meibomian Gland Function and Dry Eye Disease in Patients with Graves’ Ophthalmopathy. Journal of Clinical Medicine. 2020; 9(9):2814. https://doi.org/10.3390/jcm9092814
Chicago/Turabian StyleInoue, Sachiko, Motoko Kawashima, Reiko Arita, Ai Kozaki, and Kazuo Tsubota. 2020. "Investigation of Meibomian Gland Function and Dry Eye Disease in Patients with Graves’ Ophthalmopathy" Journal of Clinical Medicine 9, no. 9: 2814. https://doi.org/10.3390/jcm9092814