title: Regional Differences in Tear Film Stability and Meibomian Glands in Patients With Aqueous-Deficient Dry Eye.
abstract: OBJECTIVE
  To noninvasively investigate regional differences in tear film stability and meibomian glands in patients with aqueous-deficient dry eye.
  
  
  METHODS
  Forty-nine dry eyes and 31 normal eyes were analyzed. A corneal topographer with a tear film scanning function was used for noninvasive tear film break-up time (NI-TFBUT) measurements and meibomian gland observations. The NI-TFBUT values and location of the first tear film break-up point were recorded in four quadrants. Meibomian gland loss was graded for each eyelid using meiboscores. Lid margin abnormality was scored from zero to four according to the number of existing abnormalities. The NI-TFBUT values and meiboscores were compared between two groups, and regional differences in NI-TFBUT values and meiboscores were analyzed. Also, the correlation between the NI-TFBUT and ocular surface examination results were investigated.
  
  
  RESULTS
  The NI-TFBUT values and meiboscores were significantly lower and higher, respectively, for the dry eye group than for the normal group. In the dry eye group, the occurrence rate for first tear film break-up was the highest in the inferior nasal quadrant, and the mean meiboscore was significantly higher for the upper eyelids than for the lower eyelids. The NI-TFBUT and lid margin abnormality scores showed a weak negative correlation, and the NI-TFBUT values and meiboscores showed no correlation.
  
  
  CONCLUSIONS
  Compared to normal eyes, aqueous-deficient dry eyes show significant regional differences in tear film stability and meibomian glands. Considering these regional differences, the overall observation of the ocular surface, including both upper and lower eyelids, will aid clinicians in understanding this condition better.
authors.affiliation: Department of Ophthalmology (S.K., C.I., H.F., Y.O., T.S., N.M., K.N.), Osaka University Graduate School of Medicine, Suita, Osaka, Japan; and Research & Development Division (C.I.), Rohto Pharmaceutical Co., Ltd., Kyoto, Japan.
authors.forename: Shizuka
authors.initials: S
authors.lastname: Koh
authors.forename: Chikako
authors.initials: C
authors.lastname: Ikeda
authors.forename: Hisataka
authors.initials: H
authors.lastname: Fujimoto
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Oie
authors.forename: Takeshi
authors.initials: T
authors.lastname: Soma
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Maeda
authors.forename: Kohji
authors.initials: K
authors.lastname: Nishida
mesh_terms: D000368:Aged; D019781:Corneal Topography / Q000295:instrumentation* / Q000379:methods*; D003941:Diagnostic Techniques, Ophthalmological / Q000592:standards; D015352:Dry Eye Syndromes / Q000175:diagnosis / Q000503:physiopathology*; D005260:Female; D015590:Fluorophotometry / Q000379:methods; D006801:Humans; D008297:Male; D008537:Meibomian Glands / Q000473:pathology*; D008875:Middle Aged; D013666:Tears / Q000000981:diagnostic imaging* / Q000378:metabolism