title: Evaluation of the adhesive properties of the cornea by means of optical coherence tomography in patients with meibomian gland dysfunction and lacrimal tear deficiency.
abstract: OBJECTIVE
  The aim was to determine the influence of meibomian gland dysfunction (MGD) and aqueous tear deficiency dry eye (ADDE) on the adhesive properties of the central cornea by means of optical coherence tomography (OCT), and to investigate the relationship between corneal adhesiveness and classical tear tests, as well as the reliability of results, in these lacrimal functional unit disorders.
  
  
  METHODS
  Prospective, case-control study.
  
  
  METHODS
  Twenty-eight patients with MGD and 27 patients with ADDE were studied. A group of 32 healthy subjects of similar age and gender distribution served as a control group. The adhesive properties of the anterior corneal surface were measured by OCT, based on the retention time of adhesion marker above it, in all participants.
  
  
  RESULTS
  An excellent (≥5 minutes), borderline (within 3-5 minutes), fair (within 1-3 minutes) and poor (<1 minute) values of corneal adhesiveness were found, respectively, in 0%, 7.1%, 64.3% and 28.6% of MGD, in 0%, 7.4%, 63% and 29.6% of ADDE, and in 31.3%, 65.6%, 3.1% and 0% of healthy patients. The differences in time of corneal adhesiveness between MGD and healthy patients, as well as between ADDE and healthy patients, were found to be statistically significant (p<0.001; p<0.001; respectively). Conversely, no statistical significant differences between MGD and ADDE were found (p = 0.952). Data analysis revealed a statistically significant correlation between corneal adhesiveness and clinical tests of dry eye, as well as an excellent degree of inter-rater reliability and reproducibility for OCT measurements (p<0.001).
  
  
  CONCLUSIONS
  ADDE and MGD share similar abnormalities on OCT imaging. Decreased adhesive properties of the anterior cornea were identified as a common feature of MGD and ADDE. This simple OCT approach may provide new clues into the mechanism and evaluation of dry eye syndrome.
authors.affiliation: Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy.
authors.forename: Pietro Emanuele
authors.initials: PE
authors.lastname: Napoli
authors.affiliation: Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Coronella
authors.affiliation: Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy.
authors.forename: Giovanni Maria
authors.initials: GM
authors.lastname: Satta
authors.affiliation: Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy.
authors.forename: Maria Silvana
authors.initials: MS
authors.lastname: Galantuomo
authors.affiliation: Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Fossarello
mesh_terms: D000328:Adult; D000368:Aged; D003315:Cornea / Q000473:pathology* / Q000503:physiopathology; D015352:Dry Eye Syndromes / Q000150:complications / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007765:Lacrimal Apparatus / Q000473:pathology* / Q000503:physiopathology; D008297:Male; D008537:Meibomian Glands / Q000503:physiopathology*; D008875:Middle Aged; D041623:Tomography, Optical Coherence