In Vivo Confocal Microscopy of Meibomian Glands in Contact Lens Wearers
In Vivo Confocal Microscopy of Meibomian Glands in Contact Lens Wearers
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DOI：
10.1167/iovs.11-7427
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发表时间：
2011-07-01
影响因子：
4.4
通讯作者：
Ratiglia, Roberto
中科院分区：
文献类型：
--
作者：
Villani, Edoardo;Ceresara, Gaia;Ratiglia, Roberto
目的。通过体内激光扫描共聚焦显微镜 (LSCM) 评估隐形眼镜佩戴者 (CLW) 睑板腺 (MG) 的形态变化和腺周炎症状态，并研究临床和共聚焦结果之间的相关性。方法。连续招募了 20 名 CLW 和 20 名年龄和性别匹配的对照受试者。每个参与者都完成了眼表疾病指数调查问卷，并接受了全面的眼部检查，包括泪膜破裂时间、荧光素和丽丝胺绿染色以及席默试验。对 MG 进行 LSCM 以确定粘膜皮肤连接上皮的细胞密度、腺泡单位密度和直径、腺孔直径、睑脂分泌反射率以及腺间隙和腺泡壁的不均匀外观。结果。除 Schirmer 检验外，所有临床参数均显示组间存在统计学显着差异（P < 0.01，Mann-Whitney U 检验）。共聚焦数据（曼-惠特尼 U 检验）显示，与对照组相比，CLW 的基底上皮细胞密度显着降低（P < 0.01），腺泡单位直径较小（P < 0.05），腺孔直径较高（P < 0.05），分泌反射率较高（P < 0.01），腺周间隙不均匀性较大（P < 0.05）。佩戴隐形眼镜的持续时间与腺泡单位直径相关（P < 0.05，Spearman）。结论。 LSCM 显示的 MG 形态变化被解释为 MG 脱落、导管阻塞和腺体炎症的迹象。对 CLW 眼表进行全面的 LSCM 评估可以更好地阐明 MG 脱落和眼睑边缘炎症在 CL 引起的干眼发病机制中的作用。 （投资眼科可见科学。2011 年；52：5215-5219）DOI：10.1167/iovs.11-7427
PURPOSE. To evaluate by in vivo laser scanning confocal microscopy (LSCM) the morphologic changes in the meibomian glands (MGs) and the status of periglandular inflammation in contact lens wearers (CLWs) and to investigate the correlations between clinical and confocal findings.METHODS. Twenty CLWs and 20 age-and sex-matched control subjects were consecutively enrolled. Each participant completed an Ocular Surface Disease Index questionnaire and underwent a full eye examination, including tear film break-up time, fluorescein and lissamine green staining, and Schirmer test. LSCM of the MGs were performed to determine the cell density of the mucocutaneous junction epithelium, acinar unit density and diameter, glandular orifice diameters, meibum secretion reflectivity, and inhomogeneous appearance of the glandular interstice and acinar wall.RESULTS. All clinical parameters showed statistically significant differences between groups (P < 0.01, Mann-Whitney U test) except the Schirmer test. Confocal data (Mann-Whitney U test) showed significantly decreased basal epithelial cell density (P < 0.01), lower acinar unit diameters (P < 0.05), higher glandular orifice diameters (P < 0.05), greater secretion reflectivity (P < 0.01), and greater inhomogeneity of the periglandular interstices (P < 0.05) in CLWs compared with controls. The duration of contact lens wear was correlated with the acinar unit diameters (P < 0.05, Spearman).CONCLUSIONS. Morphologic changes in the MGs shown by LSCM were interpreted as signs of MG dropout, duct obstruction, and glandular inflammation. A comprehensive LSCM evaluation of the ocular surface in CLWs could better clarify the role of MG dropout and eyelid margin inflammation on the pathogenesis of CL-induced dry eye. (Invest Ophthalmol Vis Sci. 2011; 52:5215-5219) DOI: 10.1167/iovs.11-7427