title: Meibomian gland dysfunction in Graves' orbitopathy.
abstract: OBJECTIVE
  To examine morphologic changes in the meibomian glands associated with patients with Graves' orbitopathy (GO) using a novel meibography imaging system, and to evaluate its correlation with GO clinical manifestations.
  
  
  METHODS
  Retrospective, observational case series.
  
  
  METHODS
  Fifty-one GO patients and 31 normal control participants.
  
  
  METHODS
  This retrospective study examined 51 GO patients and 31 normal control participants. The structure of the meibomian gland was assessed using the meibography imaging system. All of the participants completed the Ocular Surface Disease Index (OSDI) questionnaire. The tear film break-up time (BUT) was measured. The palpebral fissure height, exophthalmos, and eyelid retraction were also assessed.
  
  
  RESULTS
  The meibography score, tear film BUT, and OSDI indicated statistically significant differences between the GO and normal groups: The tear film BUT was shorter and the OSDI and meibography score were higher in the GO patient group. There was a significant negative correlation between the meibography score and the tear film BUT in GO patients (r = -.503 and p < .001). In the multivariable linear regression analysis, the meibography score of the GO patients had a positive association with exophthalmos and palpebral fissure height.
  
  
  CONCLUSIONS
  Compared with the normal control participants, GO patients had more unstable tear films and severe symptoms of dry eye. Using the meibography system, the authors found that GO patients had a higher prevalence of obstructive type meibomian gland dysfunction and changes in meibomian glands increased, with proptosis and lid fissure widening.
authors.affiliation: Department of Ophthalmology, Soonchunhyang University College of Medicine, Bucheon.
authors.forename: Young Shin
authors.initials: YS
authors.lastname: Kim
authors.affiliation: Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul.
authors.forename: Ae Young
authors.initials: AY
authors.lastname: Kwak
authors.affiliation: Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul.
authors.forename: Sang Yeul
authors.initials: SY
authors.lastname: Lee
authors.affiliation: Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul.
authors.forename: Jin Sook
authors.initials: JS
authors.lastname: Yoon
authors.affiliation: Department of Ophthalmology, Soonchunhyang University College of Medicine, Bucheon; Yonsei University Graduate School of Medicine, Seoul, Korea.. Electronic address: ysyat01@naver.com.
authors.forename: Sun Young
authors.initials: SY
authors.lastname: Jang
mesh_terms: D000328:Adult; D005141:Eyelid Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D049970:Graves Ophthalmopathy / Q000150:complications* / Q000175:diagnosis; D064368:Healthy Volunteers; D006801:Humans; D008297:Male; D008537:Meibomian Glands / Q000473:pathology*; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013666:Tears / Q000737:chemistry