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Morphologic evaluation of meibomian glands in chronic graft-versus-host disease using in vivo laser confocal microscopy.

Ban Y, Ogawa Y, Ibrahim OM, Tatematsu Y, Kamoi M, Uchino M, Yaguchi S, Dogru M, Tsubota K - Mol. Vis. (2011)

Bottom Line: Clinical findings of the lid margin were obtained.Tear dynamics, ocular surface vital staining, meibography, and MG expressibility were also examined.Data were compared between the 2 groups using the unpaired t and Mann-Whitney tests.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, School of Medicine, Keio University, Tokyo, Japan.

ABSTRACT

Purpose: To evaluate the morphological changes of the meibomian glands (MGs) using in vivo laser confocal microscopy (CM) in dry eye (DE) patients with chronic graft-versus-host disease (cGVHD).

Methods: Seventeen eyes from 9 patients with a diagnosis of DE associated with cGVHD (DE/cGVHD group; 6 males, 3 females; median 50.5 years) and 16 eyes of 8 hematopoietic stem cell transplantation (HSCT) recipients without DE (non-DE/non-cGVHD group; 5 males, 3 females; median 47.0 years) were enrolled. CM was used to investigate the MG and MG acinar unit density (MGAUD), MG acinar longest diameter (MGALD), MG acinar shortest diameter (MGASD), and the fibrosis grade. Clinical findings of the lid margin were obtained. Tear dynamics, ocular surface vital staining, meibography, and MG expressibility were also examined. Data were compared between the 2 groups using the unpaired t and Mann-Whitney tests.

Results: The mean MGAUD value was significantly lower in the DE/cGVHD group than in the non-DE/non-cGVHD group (p=0.01, 57.8±38.3 glands/mm(2), 88.8±26.6 glands/mm(2), respectively), and the mean MGALD and MGASD were significantly shorter in the DE/cGVHD group than in the non-DE/non-cGVHD group (p=0.0018, 37.3±24.4 μm and 60.4±11.8 μm, p=0.0106, 17.7±11.8 μm and 26.6±6.03 μm, respectively). The mean fibrosis grade was significantly higher in the DE/cGVHD group than the non-DE/non-cGVHD group (p<0.0001, 1.39±0.71 grade, 0.06±0.25 grade, respectively). Clinical findings in the lid margin, tear dynamics, and ocular surface findings were significantly worse in the DE/cGVHD group than in the non-DE/non-cGVHD group.

Conclusions: CM clearly depicted the morphological changes of the MG in the DE/cGVHD group, and revealed the severity of the meibomian gland dysfunction. Patients with severe DE after HSCT showed atrophic MG and excessive fibrosis.

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Related in: MedlinePlus

Meibomian gland images observed by noncontact infrared meibography. A, C: DE/cGVHD group, 57 year-old male (Case 1; Table1). Note the numerous meibomian gland dropouts. B, D: Non-DE/Non-cGVHD group, 28-year-old male (Case 2; Table2) No loss of meibomian glands was observed in the patient who did not develop DE after HSCT. UL=Upper, Left, LL=Lower, Left.
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f1: Meibomian gland images observed by noncontact infrared meibography. A, C: DE/cGVHD group, 57 year-old male (Case 1; Table1). Note the numerous meibomian gland dropouts. B, D: Non-DE/Non-cGVHD group, 28-year-old male (Case 2; Table2) No loss of meibomian glands was observed in the patient who did not develop DE after HSCT. UL=Upper, Left, LL=Lower, Left.

Mentions: The numerous meibomian gland dropouts were observed by using noncontact infrared meibography from a 57-year-old male (Case 1; Table 1) in the DE/cGVHD group (Figure 1A,C). In contrast, there was no loss of MG in a 28-year old male (Case 2; Table 2) who did not develop DE after HSCT in the non-DE/non-cGVHD group (Figure 1B,D). The mean meibomian gland dropout grade was significantly higher (1.41±0.80 grade) in the DE/cGVHD group than in the non-DE/non-cGVHD group (0.50±0.52 grade; p=0.0014; Table 3).


Morphologic evaluation of meibomian glands in chronic graft-versus-host disease using in vivo laser confocal microscopy.

Ban Y, Ogawa Y, Ibrahim OM, Tatematsu Y, Kamoi M, Uchino M, Yaguchi S, Dogru M, Tsubota K - Mol. Vis. (2011)

Meibomian gland images observed by noncontact infrared meibography. A, C: DE/cGVHD group, 57 year-old male (Case 1; Table1). Note the numerous meibomian gland dropouts. B, D: Non-DE/Non-cGVHD group, 28-year-old male (Case 2; Table2) No loss of meibomian glands was observed in the patient who did not develop DE after HSCT. UL=Upper, Left, LL=Lower, Left.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3198483&req=5

f1: Meibomian gland images observed by noncontact infrared meibography. A, C: DE/cGVHD group, 57 year-old male (Case 1; Table1). Note the numerous meibomian gland dropouts. B, D: Non-DE/Non-cGVHD group, 28-year-old male (Case 2; Table2) No loss of meibomian glands was observed in the patient who did not develop DE after HSCT. UL=Upper, Left, LL=Lower, Left.
Mentions: The numerous meibomian gland dropouts were observed by using noncontact infrared meibography from a 57-year-old male (Case 1; Table 1) in the DE/cGVHD group (Figure 1A,C). In contrast, there was no loss of MG in a 28-year old male (Case 2; Table 2) who did not develop DE after HSCT in the non-DE/non-cGVHD group (Figure 1B,D). The mean meibomian gland dropout grade was significantly higher (1.41±0.80 grade) in the DE/cGVHD group than in the non-DE/non-cGVHD group (0.50±0.52 grade; p=0.0014; Table 3).

Bottom Line: Clinical findings of the lid margin were obtained.Tear dynamics, ocular surface vital staining, meibography, and MG expressibility were also examined.Data were compared between the 2 groups using the unpaired t and Mann-Whitney tests.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, School of Medicine, Keio University, Tokyo, Japan.

ABSTRACT

Purpose: To evaluate the morphological changes of the meibomian glands (MGs) using in vivo laser confocal microscopy (CM) in dry eye (DE) patients with chronic graft-versus-host disease (cGVHD).

Methods: Seventeen eyes from 9 patients with a diagnosis of DE associated with cGVHD (DE/cGVHD group; 6 males, 3 females; median 50.5 years) and 16 eyes of 8 hematopoietic stem cell transplantation (HSCT) recipients without DE (non-DE/non-cGVHD group; 5 males, 3 females; median 47.0 years) were enrolled. CM was used to investigate the MG and MG acinar unit density (MGAUD), MG acinar longest diameter (MGALD), MG acinar shortest diameter (MGASD), and the fibrosis grade. Clinical findings of the lid margin were obtained. Tear dynamics, ocular surface vital staining, meibography, and MG expressibility were also examined. Data were compared between the 2 groups using the unpaired t and Mann-Whitney tests.

Results: The mean MGAUD value was significantly lower in the DE/cGVHD group than in the non-DE/non-cGVHD group (p=0.01, 57.8±38.3 glands/mm(2), 88.8±26.6 glands/mm(2), respectively), and the mean MGALD and MGASD were significantly shorter in the DE/cGVHD group than in the non-DE/non-cGVHD group (p=0.0018, 37.3±24.4 μm and 60.4±11.8 μm, p=0.0106, 17.7±11.8 μm and 26.6±6.03 μm, respectively). The mean fibrosis grade was significantly higher in the DE/cGVHD group than the non-DE/non-cGVHD group (p<0.0001, 1.39±0.71 grade, 0.06±0.25 grade, respectively). Clinical findings in the lid margin, tear dynamics, and ocular surface findings were significantly worse in the DE/cGVHD group than in the non-DE/non-cGVHD group.

Conclusions: CM clearly depicted the morphological changes of the MG in the DE/cGVHD group, and revealed the severity of the meibomian gland dysfunction. Patients with severe DE after HSCT showed atrophic MG and excessive fibrosis.

Show MeSH
Related in: MedlinePlus