title: Morphological changes in the meibomian glands of patients with phlyctenular keratitis: a multicenter cross-sectional study.
abstract: BACKGROUND
  Phlyctenular keratitis is a hypersensitivity reaction of the cornea, and a complication of eyelid margin disease in children and young adults. In this study, we compared the morphology of the meibomian glands in eyelids between phlyctenular keratitis patients and healthy young adults, using noncontact meibography.
  
  
  METHODS
  The study included 16 eyes of 13 patients diagnosed with phlyctenular keratitis and 17 eyes of 17 healthy volunteers. Slit-lamp observations of the cornea and eyelid were performed on all subjects. The morphology of the meibomian glands was scored using non-contact meibography (meiboscore). The meiboscore in worse eye was used in bilateral phlyctenular keratitis.
  
  
  RESULTS
  All eyes with phlyctenular keratitis, but not normal controls, showed corneal nodules, neovascularization, and superficial punctate keratopathy. The mean meiboscore in phlyctenular keratitis patients (upper lid: 2.9 ± 0.3, lower lid: 2.7 ± 0.5) was significantly higher than in controls (upper lid: 0.4 ± 0.6, lower lid: 0.1 ± 0.3).
  
  
  CONCLUSIONS
  Noncontact meibography enabled visualization of meibomian gland loss in phlyctenular keratitis patients, suggesting a relationship between abnormalities of the meibomian glands in young individuals and the pathogenesis of phlyctenular keratitis.
authors.affiliation: LIME (Lid and Meibomian gland) working group, Tokyo, Japan. t-suzuki@m.ehime-u.ac.jp.|Department of Ophthalmology, Ehime University, Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan. t-suzuki@m.ehime-u.ac.jp.
authors.forename: Takashi
authors.initials: T
authors.lastname: Suzuki
authors.affiliation: LIME (Lid and Meibomian gland) working group, Tokyo, Japan.|Department of Ophthalmology, Yamaguchi University, Graduate School of Medicine, Ube, Japan.
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Morishige
authors.affiliation: LIME (Lid and Meibomian gland) working group, Tokyo, Japan.|Department of Ophthalmology, University of Tokyo School of Medicine, Tokyo, Japan.|Department of Ophthalmology, Itoh Clinic, Saitama, Japan.
authors.forename: Reiko
authors.initials: R
authors.lastname: Arita
authors.affiliation: LIME (Lid and Meibomian gland) working group, Tokyo, Japan.|Department of Ophthalmology, Osaka University Graduate School of Medicine, Suita, Japan.
authors.forename: Shizuka
authors.initials: S
authors.lastname: Koh
authors.affiliation: LIME (Lid and Meibomian gland) working group, Tokyo, Japan.|Department of Visual Sciences, Division of Ophthalmology, Nihon University School of Medicine, Tokyo, Japan.
authors.forename: Tohru
authors.initials: T
authors.lastname: Sakimoto
authors.affiliation: LIME (Lid and Meibomian gland) working group, Tokyo, Japan.|Department of Ophthalmology, University of Tokyo School of Medicine, Tokyo, Japan.
authors.forename: Rika
authors.initials: R
authors.lastname: Shirakawa
authors.affiliation: Miyata Eye Hospital, Miyakonojo, Japan.
authors.forename: Kazunori
authors.initials: K
authors.lastname: Miyata
authors.affiliation: Department of Ophthalmology, Ehime University, Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Ohashi
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002648:Child; D016510:Corneal Neovascularization / Q000473:pathology; D003430:Cross-Sectional Studies; D005141:Eyelid Diseases / Q000175:diagnosis / Q000473:pathology*; D005260:Female; D006801:Humans; D007634:Keratitis / Q000473:pathology*; D008297:Male; D008537:Meibomian Glands / Q000473:pathology*; D055815:Young Adult
keywords: Meibography; Meibomian glands; Meibomitis; Phlyctenular keratitis