title: Association between meibomian gland changes and aging, sex, or tear function.
abstract: OBJECTIVE
  To study changes in the lid margin and meibomian glands and their association with aging, sex, and tear function.
  
  
  METHODS
  We examined 354 eyes in 177 subjects (76 men and 101 women; 21-93 years; mean age, 63.0 +/- 14.3 years) with no ocular symptoms or ocular surface disorders. Anatomic changes in the lid margin were studied using slit-lamp biomicroscopy. Meibomian gland function and morphology were evaluated on the basis of meibum expression and meibography, respectively. Tear function and ocular surface epithelium were assessed with the Schirmer test, by tear film break-up time, and with a fluorescein staining test.
  
  
  RESULTS
  Eyes with abnormal lid margin anatomy, hyposecretion of meibum, and meibomian gland dropout were seen in 26 (7.3%), 46 (12.4%), and 68 eyes (18.6%), respectively, with a significant association between each finding and aging (P = <0.0001, 0.0498, and <0.0001, respectively). In patients < or =69 years of age, no significant association was found between meibomian gland-related findings and sex. However, a high incidence of abnormal lid margin and gland dropout was noted in men > or =70 years of age compared with women. No significant association was found between changes in the lid margin and meibomian glands and tear function in patients > or =40 years of age.
  
  
  CONCLUSIONS
  Among symptom-free subjects, we found that changes in the lid margin and meibomian glands were closely related to aging. Among elderly subjects, changes in the anatomic lid margin and meibomian gland morphology were observed more frequently in men than in women. Tear function showed no association with either changes in the lid margin or function of the meibomian glands.
authors.affiliation: Department of Ophthalmology, Tokyo Dental College, Chiba, Japan. seika@poh.osaka-med.ac.jp
authors.forename: Seika
authors.initials: S
authors.lastname: Den
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Shimizu
authors.forename: Tsunehiko
authors.initials: T
authors.lastname: Ikeda
authors.forename: Kazuo
authors.initials: K
authors.lastname: Tsubota
authors.forename: Shigeto
authors.initials: S
authors.lastname: Shimmura
authors.forename: Jun
authors.initials: J
authors.lastname: Shimazaki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D004847:Epithelial Cells / Q000378:metabolism; D005260:Female; D019793:Fluorescein / Q000378:metabolism; D005456:Fluorescent Dyes / Q000378:metabolism; D006801:Humans; D008297:Male; D008537:Meibomian Glands / Q000502:physiology*; D008875:Middle Aged; D011446:Prospective Studies; D012737:Sex Factors; D013194:Staining and Labeling / Q000379:methods; D013666:Tears / Q000502:physiology*
chemical_list: D005456:Fluorescent Dyes; D019793:Fluorescein