.: ORİJİNAL ARAŞTIRMA
Evaluation of Dry Eye and Meibomian Gland Dysfunction with Meibography in Pseudoexfoliation Syndrome
Psödoeksfoliasyon Sendromunda Kuru Göz ve Meibomian Bez Disfonksiyonunun Meibografi ile Değerlendirilmesi
Turkiye Klinikleri J Ophthalmol. 2020;29(4):271-7
doi: 10.5336/ophthal.2020-73348
Makale Dili: EN
Tam Metin
ABSTRACT
Objectives: To evaluate morphological changes caused by pseudoexfoliation (PEX) syndrome in meibomian glands with meibography. Material and Methods: 39 individuals with PEX syndrome and 42 individuals without PEX syndrome were included in the study. Meibomian glands, tear-film break-up time, tear volume and subjective symptoms of the study and control groups were evaluated with followings, respectively: meibography, non-invasive keratographic tear film break-up time (NIKBUT), Schirmer 1 test with anesthesia, ocular surface disease index (OSDI) questionnaire. Results: Schirmer 1 and NIKBUT values were found to be significantly lower in the participants with PEX syndrome compared to the control group (p<0.001, p=0.012; respectively). But the OSDI index and total meibograde values were found to be significantly higher in the PEX syndrome group compared to the control group (p=0.002, p<0.001; respectively). Additionally, in the PEX syndrome group, a negative correlation was determined between total meibograde value and NIKBUT value (r:-0.673; p=0.001) and a positive correlation was determined between total meibograde value and OSDI index score value (r: 0.515; p<0.001). No statistically significant correlation was determined between total meibograde value and Schirmer 1 value (p=0.847). Conclusion: PEX syndrome affects the ocular surface adversely. Causing the meibomian gland dropout by this syndrome is also among the mechanisms of this adverse effect. This condition should be considered for the diagnosis and treatment approach of dry eye disease in patients with PEX syndrome.
Keywords: Exfoliation syndrome; dry eye syndromes; meibomian glands
Objectives: To evaluate morphological changes caused by pseudoexfoliation (PEX) syndrome in meibomian glands with meibography. Material and Methods: 39 individuals with PEX syndrome and 42 individuals without PEX syndrome were included in the study. Meibomian glands, tear-film break-up time, tear volume and subjective symptoms of the study and control groups were evaluated with followings, respectively: meibography, non-invasive keratographic tear film break-up time (NIKBUT), Schirmer 1 test with anesthesia, ocular surface disease index (OSDI) questionnaire. Results: Schirmer 1 and NIKBUT values were found to be significantly lower in the participants with PEX syndrome compared to the control group (p<0.001, p=0.012; respectively). But the OSDI index and total meibograde values were found to be significantly higher in the PEX syndrome group compared to the control group (p=0.002, p<0.001; respectively). Additionally, in the PEX syndrome group, a negative correlation was determined between total meibograde value and NIKBUT value (r:-0.673; p=0.001) and a positive correlation was determined between total meibograde value and OSDI index score value (r: 0.515; p<0.001). No statistically significant correlation was determined between total meibograde value and Schirmer 1 value (p=0.847). Conclusion: PEX syndrome affects the ocular surface adversely. Causing the meibomian gland dropout by this syndrome is also among the mechanisms of this adverse effect. This condition should be considered for the diagnosis and treatment approach of dry eye disease in patients with PEX syndrome.
Keywords: Exfoliation syndrome; dry eye syndromes; meibomian glands
ÖZET
Amaç: Psödoeksfoliasyon sendromunun (PES) meibomian bezlerinde yaptığı morfolojik değişiklikleri meibografi ile değerlendirmek. Gereç ve Yöntemler: PES'li 39 ve PES'i olmayan 42 kontrol grubu katılımcı çalışmaya alındı. Çalışma ve kontrol grubunun meibomian bezleri (MB), gözyaşı kırılma zamanı, gözyaşı miktarı ve subjektif semptomları, meibografi, noninvaziv keratografik gözyaşı kırılma zamanı (NİKGKZ), anestezili Schirmer 1 test ve oküler yüzey hastalık indeksi (OYHİ) ile değerlendirildi. Bulgular: Schirmer 1 ve NİKGKZ düşüklüğü PES grubunda kontrol grubuna göre istatistiksel olarak anlamlı idi (sırasıyla; p<0.001; p=0.012). OYHİ ve toplam meibograde değerleri yüksekliği ise PES grubunda kontrol grubuna göre istatistiksel olarak anlamlı idi (sırasıyla p=0.002; p<0.001). Ayrıca PES grubunda toplam meibograde değeri ile NİKGKZ değeri arasında negatif (r:-0.673; p=0.001), OYHİ değeri arasında ise pozitif (r: 0.515; p=0.001) korelasyon saptandı. Yine bu grupta toplam meibograde değeri ile Schirmer 1 testi değeri arasında anlamlı bir korelasyon saptanmadı (p=0.847). Sonuç: PES oküler yüzeyi olumsuz olarak etkilemektedir. Bu olumsuz etkilerin nedenleri arasında meibomian bez kaybı da vardır. Klinisyenler PES'lu hastalarda kuru göz teşhis ve tedavisine yaklaşımda bu durumu dikkate almalıdır.
Anahtar Kelimeler: Eksfoliasyon sendromu; kuru göz sendromları; meibomian bezler
Amaç: Psödoeksfoliasyon sendromunun (PES) meibomian bezlerinde yaptığı morfolojik değişiklikleri meibografi ile değerlendirmek. Gereç ve Yöntemler: PES'li 39 ve PES'i olmayan 42 kontrol grubu katılımcı çalışmaya alındı. Çalışma ve kontrol grubunun meibomian bezleri (MB), gözyaşı kırılma zamanı, gözyaşı miktarı ve subjektif semptomları, meibografi, noninvaziv keratografik gözyaşı kırılma zamanı (NİKGKZ), anestezili Schirmer 1 test ve oküler yüzey hastalık indeksi (OYHİ) ile değerlendirildi. Bulgular: Schirmer 1 ve NİKGKZ düşüklüğü PES grubunda kontrol grubuna göre istatistiksel olarak anlamlı idi (sırasıyla; p<0.001; p=0.012). OYHİ ve toplam meibograde değerleri yüksekliği ise PES grubunda kontrol grubuna göre istatistiksel olarak anlamlı idi (sırasıyla p=0.002; p<0.001). Ayrıca PES grubunda toplam meibograde değeri ile NİKGKZ değeri arasında negatif (r:-0.673; p=0.001), OYHİ değeri arasında ise pozitif (r: 0.515; p=0.001) korelasyon saptandı. Yine bu grupta toplam meibograde değeri ile Schirmer 1 testi değeri arasında anlamlı bir korelasyon saptanmadı (p=0.847). Sonuç: PES oküler yüzeyi olumsuz olarak etkilemektedir. Bu olumsuz etkilerin nedenleri arasında meibomian bez kaybı da vardır. Klinisyenler PES'lu hastalarda kuru göz teşhis ve tedavisine yaklaşımda bu durumu dikkate almalıdır.
Anahtar Kelimeler: Eksfoliasyon sendromu; kuru göz sendromları; meibomian bezler
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