title: Meibomian Gland Alteration in Patients with Primary Chronic Dacryocystitis: An In vivo Confocal Microscopy Study.
abstract: OBJECTIVE
  To evaluate meibomian gland (MG) alterations in patients with primary chronic dacryocystitis (PCD) by in vivo confocal microscopy (IVCM), and to correlate the finding with clinical presentation.
  
  
  METHODS
  Twenty-eight eyes with the diagnosis of PCD and their contralateral unaffected eyes were studied and compared with 27 normal controls. All subjects completed an Ocular Surface Disease Index questionnaire (OSDI) and underwent slit-lamp biomicroscopy examination, tear break-up time (BUT) measurements, fluorescein staining, Schirmer test I, and an IVCM examination of the MG. IVCM parameters, including the MG acinar unit density (MGAUD), periglandular inflammatory cell density (ICD), MG acinar unit longest diameter (MGALD), and MG acinar unit shortest diameter (MGASD) and their correlation with clinical data were analyzed.
  
  
  RESULTS
  The mean MG expressibility scores, BUT values, and staining scores were significantly worse in eyes with PCD compared with the contralateral clinically unaffected eyes and controls (p < 0.05). A significant decrease in MGAUD was observed in PCD eyes compared with the controls and the contralateral clinically unaffected eyes. Conversely, the mean ICD and MGASD values were significantly higher in the PCD eyes. There were no significant differences in mean MGALD value between the PCD eyes and the contralateral clinically unaffected eyes. In addition, there were significant changes in the IVCM parameters in the contralateral unaffected eyes compared with the controls, including MGAUD, ICD, MGALD, and MGASD. All IVCM parameters showed a strong, significant correlation with MG dropout grades, MG expressibility, fluorescein staining scores, and OSDI values (all p < 0.05).
  
  
  CONCLUSIONS
  Patients with unilateral PCD demonstrated significant changes in MG as compared with the contralateral clinically unaffected eyes and controls. The MG function should be closely observed in these patients.
authors.affiliation: Department of Ophthalmology and Visual Science, Eye, and ENT Hospital, Shanghai Medical College, Fudan University , Shanghai , P.R. China .
authors.forename: Jiaxu
authors.initials: J
authors.lastname: Hong
authors.forename: Zhiqiang
authors.initials: Z
authors.lastname: Yu
authors.forename: Xinhan
authors.initials: X
authors.lastname: Cui
authors.forename: Tingting
authors.initials: T
authors.lastname: Qian
authors.forename: Qihua
authors.initials: Q
authors.lastname: Le
authors.forename: Anji
authors.initials: A
authors.lastname: Wei
authors.forename: Zuguo
authors.initials: Z
authors.lastname: Liu
authors.forename: Xinghuai
authors.initials: X
authors.lastname: Sun
authors.forename: Sophie X
authors.initials: SX
authors.lastname: Deng
authors.forename: Jianjiang
authors.initials: J
authors.lastname: Xu
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002452:Cell Count; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D003607:Dacryocystitis / Q000150:complications* / Q000175:diagnosis; D005141:Eyelid Diseases / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006801:Humans; D007767:Lacrimal Duct Obstruction / Q000209:etiology; D008297:Male; D008537:Meibomian Glands / Q000473:pathology*; D018613:Microscopy, Confocal; D008875:Middle Aged; D011446:Prospective Studies; D013194:Staining and Labeling / Q000379:methods; D011795:Surveys and Questionnaires; D013666:Tears / Q000737:chemistry
keywords: Confocal microscopy; meibomian gland; primary chronic dacryocystitis