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      Morphology and Function of Meibomian Glands and Other Tear Film Parameters in Junior High School Students

      research-article
      , MD * , , , MD, PhD , , , , MD , § , , MD, PhD ,
      Cornea
      Cornea
      meibomian gland, tear film, meibography, adolescence

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          Abstract

          Purpose:

          We measured tear film parameters, including the morphology and function of meibomian glands, in junior high school students at 15 years of age.

          Methods:

          A total of 111 eyes of 111 students (56 males and 55 females) were enrolled in the study. The ocular symptom score (0–14), after-school study time, lipid layer thickness (LLT) of the tear film, partial blink rate, lid margin abnormalities (0–4), tear film breakup time, corneal and conjunctival epithelial damage (fluorescein staining score, 0–9), meiboscore as determined by noncontact meibography (0–6), Schirmer test value, and meibum grade (0–3) were determined. The relationships between parameters were evaluated with the Spearman correlation coefficient (ρ).

          Results:

          The meiboscore was 2.8 ± 1.2, and the meibum grade was 1.8 ± 1.2. The meiboscore significantly correlated with the meibum grade (ρ = 0.272, P = 0.004), Schirmer test value (ρ = −0.220, P = 0.021), and LLT (ρ = −0.264, P = 0.005). The breakup time significantly correlated with LLT (ρ = 0.261, P = 0.006), meibum grade (ρ = −0.338, P < 0.001), and fluorescein staining score (ρ = −0.214, P = 0.025). The partial blink rate significantly correlated with the Schirmer test value (ρ = −0.240, P = 0.011). The meiboscore ( P < 0.001) and meibum grade ( P = 0.032) were significantly greater in males than in females.

          Conclusions:

          The morphology and function of meibomian glands are altered even at 15 years of age, with the changes being more prominent in males than in females.

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          Most cited references42

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          The international workshop on meibomian gland dysfunction: report of the subcommittee on anatomy, physiology, and pathophysiology of the meibomian gland.

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            Prevalence of dry eye syndrome among US women.

            Dry eye syndrome (DES) is believed to be one of the most common ocular problems in the United States (US), particularly among older women. However, there are few studies describing the magnitude of the problem in women and how this may vary with demographic characteristics. Cross-sectional prevalence survey. we surveyed 39,876 US women participating in the Women's Health Study about a history of diagnosed DES and dry eye symptoms. we defined DES as the presence of clinically diagnosed DES or severe symptoms (both dryness and irritation constantly or often). We calculated the age-specific prevalence of DES and adjusted the overall prevalence to the age distribution of women in the US population. We used logistic regression to examine associations between DES and other demographic factors. The prevalence of DES increased with age, from 5.7% among women or = 75 years old. The age-adjusted prevalence of DES was 7.8%, or 3.23 million women aged > or = 50 in the US. Compared with Whites, Hispanic (odds ratio [OR] = 1.81, confidence interval [CI] = 1.18-2.80) and Asian (OR = 1.77, CI = 1.17-2.69) women were more likely to report severe symptoms, but not clinically diagnosed DES. There were no significant differences by income (P([trend]) =.78), but more educated women were less likely to have DES (P([trend]) =.03). Women from the South had the highest prevalence of DES, though the magnitude of geographic differences was modest. Dry eye syndrome leading to a clinical diagnosis or severe symptoms is prevalent, affecting over 3.2 million American women middle-aged and older. Although the condition is more prevalent among older women, it also affects many women in their 40s and 50s. Further research is needed to better understand DES and its impact on public health and quality of life.
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              Distribution of aqueous-deficient and evaporative dry eye in a clinic-based patient cohort: a retrospective study.

              To evaluate in a general clinic-based cohort of patients with dry eye disease (DED) the distribution of patients with aqueous-deficient or evaporative subtype of DED. Schirmer tests and meibomian gland dysfunction (MGD) (Foulks-Bron scoring) were evaluated in both eyes of 299 normal subjects and DED patients (218 women and 81 men) across 10 sites in the European Union and the United States. Using the more severe measurement of the 2 eyes, subjects were considered to have pure aqueous-deficient dry eye (ADDE) with Schirmer values of 5 and Schirmer values of ≥7 mm. Subjects were placed into the mixed (hybrid) category if they exhibited both a low Schirmer value of 5. Of the 224 subjects classified with DED using an objective, composite, disease severity scale, 159 were classified into 1 of 3 categories: 79 were classified with only MGD, whereas only 23 were classified as purely aqueous deficient, and 57 showed evidence of both MGD and aqueous deficiency. Overall, 86% of these qualified DED patients demonstrated signs of MGD. The remaining 65 patients showed evidence of DED through other clinical signs, without overt evidence of MGD or ADDE, possibly because of the inherent variability of these signs. The proportion of subjects exhibiting signs of evaporative dry eye resulting from MGD far outweighs that of subjects with pure ADDE in a general clinic-based patient cohort.
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                Author and article information

                Journal
                Cornea
                Cornea
                cornea
                Cornea
                Cornea
                0277-3740
                1536-4798
                14 June 2017
                August 2017
                : 36
                : 8
                : 922-926
                Affiliations
                [* ]Mizoguchi Eye Clinic, Sasebo, Nagasaki, Japan;
                []Lid and Meibomian Gland Working Group (LIME), Tokyo, Japan;
                []Itoh Clinic, Saitama, Japan;
                [§ ]Omiya Hamada Eye Clinic, Saitama, Japan; and
                []Division of Cornea and Ocular Surface, Ohshima Eye Hospital, Fukuoka, Japan.
                Author notes
                Reprints: Reiko Arita, MD, PhD, Department of Ophthalmology, Itoh Clinic, 626-11 Minami-Nakano, Minumaku, Saitama 337-0042, Japan (e-mail: ritoh@ 123456za2.so-net.ne.jp ).
                Article
                CORNEA-D-17-00136 00005
                10.1097/ICO.0000000000001252
                5499970
                28628504
                f01b5db0-199a-47af-a125-c9581761427f
                Copyright © 2017 The Author(s). Published by Wolters Kluwer Health, Inc.

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

                History
                : 08 February 2017
                : 12 April 2017
                : 16 April 2017
                Categories
                Clinical Science
                Custom metadata
                TRUE

                meibomian gland,tear film,meibography,adolescence
                meibomian gland, tear film, meibography, adolescence

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