The evaluation of the treatment response in obstructive meibomian gland disease by in vivo laser confocal microscopy.
OBJECTIVE
To evaluate the status of periglandular inflammation, ocular surface and tear function alterations in patients with obstructive meibomian gland disease (OMGD) by in vivo confocal microscopy before and after anti-inflammatory treatment, and to compare the results with patients receiving only topical non-preserved artificial tears and sodium hyaluronate eye drops without anti-inflammatory agents.


METHODS
Thirty-two eyes of 16 OMGD patients receiving anti-inflammatory treatment (treatment group) and 22 eyes of 11 OMGD patients receiving only topical non-preserved artificial tears and sodium hyaluronate eye drops (control group) were recruited in this prospective study. All subjects underwent slit-lamp examinations, tear film break-up time (BUT) measurements, fluorescein and Rose-Bengal stainings, Schirmer test capital I, Ukrainian without anesthesia, transillumination of the lids (meibography), and in vivo laser confocal microscopy of the lids (HRTII-RCM).


RESULTS
The mean BUT, fluorescein staining scores, and inflammatory cell densities observed by in vivo confocal microscopy improved significantly in the group receiving anti-inflammatory treatment (p < 0.05), whereas no significant alterations of these parameters were observed in the group not receiving anti-inflammatory agents (p > 0.05).


CONCLUSIONS
In vivo confocal microscopy was able to effectively demonstrate the treatment responses in patients with OMGD. Inflammatory cell density calculation seems to be a promising new parameter of in vivo confocal microscopy in the evaluation of treatment responses.
Matsumoto
Yukihiro
Y
Johnson & Johnson Department of Ocular Surface and Visual Optics, Keio University School of Medicine, Tokyo, Japan.
Shigeno
Yuta
Y
Sato
Enrique Adan
EA
Ibrahim
Osama M A
OM
Saiki
Megumi
M
Negishi
Kazuno
K
Ogawa
Yoko
Y
Dogru
Murat
M
Tsubota
Kazuo
K
D000284:Administration, Oral; D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001762:Blepharitis / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D004359:Drug Therapy, Combination; D005260:Female; D005469:Fluorometholone / Q000627:therapeutic use; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D006820:Hyaluronic Acid / Q000627:therapeutic use*; D008297:Male; D008537:Meibomian Glands / Q000187:drug effects* / Q000473:pathology / Q000503:physiopathology; D018613:Microscopy, Confocal; D008875:Middle Aged; D008911:Minocycline / Q000627:therapeutic use; D015242:Ofloxacin / Q000627:therapeutic use; D009883:Ophthalmic Solutions / Q000627:therapeutic use*; D011446:Prospective Studies; D013666:Tears / Q000502:physiology; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D005938:Glucocorticoids; D009883:Ophthalmic Solutions; D006820:Hyaluronic Acid; D015242:Ofloxacin; D008911:Minocycline; D005469:Fluorometholone