Meibomian gland dysfunction in patients with Sjögren syndrome.
OBJECTIVE
Changes in the ocular surface of patients with Sjögren syndrome (SS) often are more severe than those in patients with dry eye without SS. This study was conducted to investigate the possible involvement of meibomian gland dysfunction in SS-related ocular surface abnormalities.


METHODS
A nonrandomized, prospective, clinical study.


METHODS
Twenty-seven eyes of 27 consecutive patients with SS (SS group) were studied. Twenty-nine eyes of age- and gender-matched non-SS patients with aqueous tear deficiency (non-SS group) were examined as control subjects.


METHODS
Changes in the ocular surface, tear function, and meibomian gland were examined.


METHODS
Tear evaporation rate, meibomian gland expression, and meibography were measured.


RESULTS
Fluorescein and rose bengal staining scores were significantly higher in the SS group than in the non-SS group (P = 0.0001). Evaporation of tears was increased significantly in the SS group compared with the non-SS group. There were no significant differences in the rate of tear production between the SS and non-SS groups. Meibography showed that 11 (57.9%) of 19 eyes in the SS group had gland dropout (i.e., histologic destruction of meibomian glands) in more than half of the tarsus. The incidence was significantly higher than that in the non-SS group (5 [18.5%] of 27 eyes; P = 0.005).


CONCLUSIONS
The results of this study indicate that destruction of meibomian glands and an increase in tear evaporation often are associated with changes in the ocular surface in patients with SS. Severe ocular surface changes in patients with SS may be attributed, in part, to the meibomian gland dysfunction.
Department of Ophthalmology, Tokyo Dental College, Chiba, Japan.
J
J
Shimazaki
E
E
Goto
M
M
Ono
S
S
Shimmura
K
K
Tsubota
D005141:Eyelid Diseases / Q000150:complications / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D005260:Female; D019793:Fluorescein / Q000378:metabolism; D006801:Humans; D008537:Meibomian Glands / Q000378:metabolism / Q000473:pathology* / Q000503:physiopathology; D008875:Middle Aged; D011446:Prospective Studies; D012395:Rose Bengal / Q000378:metabolism; D012859:Sjogren's Syndrome / Q000150:complications* / Q000378:metabolism / Q000503:physiopathology; D013666:Tears / Q000378:metabolism
D012395:Rose Bengal; D019793:Fluorescein