Sains Malaysiana 49(4)(2020): 801-808

http://dx.doi.org/10.17576/jsm-2020-4904-09

Meibomian Gland Dropout and Ocular Surface Appearances of Young Adults in Kuala Lumpur

(Kehilangan Kelenjar Meibomian dan Ciri Permukaan Okul Dewasa Muda di Kuala Lumpur)

MOHAMAD HANIF HAJAR MAIDIN¹, BARIAH MOHD-ALI^1*, ZAINORA MOHAMMED¹ & JAMALUDIN MOHAMED²

¹Optometry & Vision Science Programme, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Federal Territory, Malaysia

²Biomedical Science Programme, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Federal Territory, Malaysia

Received: 4 April 2019/Accepted: 6 December 2019

ABSTRACT

Meibomian gland dropout (MGDo) refers to partial or total loss of the acinar tissues which can be detected by meibography. It is possible that MGDo can be associated with lid margin inflammation commonly seen in dry eye (DE) patients. This study evaluated the MGDo and its association with lid margin inflammation in young adults using meibography and lid wiper epitheliopathy (LWE) techniques. Other ocular surface appearance (cornea, conjunctiva and limbus) were also examined. A total of 107 healthy noncontact lens wearers were evaluated (mean age: 23.06 ± 2.63 years old). All subjects were screened with McMonnies Dry Eye Questionnaire (MDEQ) before undergoing clinical investigations using slit-lamp biomicroscope, LWE and meibography. Cornea, conjunctiva and limbus appearances were graded using the Efron grading scale. Following the MDEQ score, 36 subjects were classified as DE (mean 16.49 ± 1.74), and 71 subjects were classified as non-DE (NDE, mean score: 7.23 ± 3.09). The difference in corneal staining between both groups was significant (χ² [1, N = 107] = 18.01, p < 0.05). A total of 70% of subjects had LWE staining which was more apparent in subjects with DE (χ² [1, N = 107] = 13.17, p < 0.01). The meiboscore indicated that 44.85% of subjects had MGDo, with a higher percentage (72.22%) in DE. There were significant differences between meiboscore in both groups (χ² [1, N = 107] = 16.42, p < 0.05). However, there was weak and insignificant correlation between LWE and meiboscore (r_s = 0.14, p = 0.16). Positive correlations were noted between MDEQ and LWE (r_s = 0.49, p < 0.01), MDEQ and corneal staining (r_s = 0.36, p < 0.01) and MDEQ and meiboscore (r_s = 0.24, p < 0.05). The results of this study demonstrated the differences in MGDo, LWE and ocular surface appearances between DE and NDE of the young adults but MGDo was not associated with LWE. Larger number of subjects is needed to confirm these findings. 

Keywords: Adults; conjunctiva; cornea; Meibomian glands

ABSTRAK

Kehilangan kelenjar meibomian (MGDo) merujuk kepada kehilangan sepenuhnya atau sebahagian daripada tisu asinar yang boleh diukur menggunakan meibografi. Terdapat kemungkinan MGDo berkait dengan inflamasi margin kelopak mata yang kerap dilihat dalam kalangan pesakit mata kering (DE). Kajian ini mengkaji hubungan MGDo dengan inflamasi margin kelopak mata populasi dewasa muda menggunakan teknik meibografi dan lid wiper epitheliopathy (LWE). Penampilan permukaan okul yang lain turut dikaji. Seramai 107 bukan pemakai kanta sentuh (min umur: 23.06 ± 2.63 tahun) telah disaring menggunakan soalan kaji selidik McMonnies (MDEQ) sebelum menjalani pemeriksaan klinikal menggunakan lampu celah biomikroskop, lid wiper epitheliopathy (LWE) dan meibografi. Keadaan kornea, konjunktiva dan limbus digred menggunakan skala penggredan Efron. Seramai 36 orang subjek dikelaskan sebagai DE (min skor: 16.49 ± 1.74) dan 71 orang sebagai NDE (min skor: 7.23 ± 3.09). Analisis menunjukkan perbezaan penandaan kornea yang signifikan antara kedua kumpulan (χ² [1, N = 107] = 18.01, p < 0.05). Seramai 70% subjek mempunyai penandaan LWE, lebih jelas pada subjek DE (χ² [1, N = 107] = 13.17, p < 0.01). Meiboscore menunjukkan 44.85% subjek mengalami kekurangan kelenjar, dengan peratusan yang lebih tinggi (72.22%) pada subjek DE. Terdapat perbezaan signifikan meiboscore dalam dua kumpulan kajian (χ² [1, N = 107] = 16.42, p < 0.05), tetapi tiada korelasi didapati antara meiboscore dan LWE (r_s=0.14, p=0.16). Korelasi positif dilihat antara skor MDEQ dan LWE (r_s = 0.49, p < 0.01), skor MDEQ dan penandaan kornea (r_s = 0.36, p < 0.01) dan antara skor MDEQ dan meiboscore (r_s = 0.24, p < 0.05). Keputusan kajian ini menunjukkan perbezaan MGDo, LWE dan penampilan permukaan okul antara DE dan NDE serta tiada hubungan antara MGDo dan LWE. Walau bagaimanapun,  bilangan subjek yang lebih ramai diperlukan untuk mengesahkan hasil kajian ini.

Kata kunci: Dewasa; konjuntiva; kornea; kelenjar meibomian

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*Corresponding author; email: bariah@ukm.edu.my