Relationship Between Meibomian Gland Loss in Infrared Meibography and Meibum Quality

Abstract Background In this study, to determine the correlation between meibomian gland loss (dropout) and meibum quality, we evaluated the correlation between meibomian gland dropout in the central eight meibomian glands of the eyelid and meibum quality in the same central eight meibomian glands of the eyelid. Methods Ninety nine eyes of 91 patients were included in the study. Dropout at the central eight meibomian glands of eyelids was graded as grade 0,1,2,3 according to the dropout area. The meibum quality was graded as follows: grade 0, no secretion; 1, inspissated/toothpaste consistency, 2: cloudy liquid secretion, and 3: clear liquid secretion. For 68 eyes of 68 patients, correlation analysis between dropout and meibum quality was performed. To precisely analyze the direct correlation between meibomian gland dropout in meibography and meibum quality, we evaluated 31 eyes of 23 patients with focal dropout in meibography. Results The mean meiboscore (±SD) was 1.1±1.1 in the upper eyelids and 0.7±1.0 in the lower eyelids. The mean meibum quality grade (±SD) was 2.3 ±0.9 in the upper eyelids and 1.3±0.6 in the lower eyelids. There was no significant correlation between the meiboscore and the meibum quality grade in the upper ( p =0.445) and lower ( p =0.405) eyelids. Analysis of the direct correlation between meibomian gland dropout in meibography and meibum quality in patients with focal dropout (loss of 1 or 2 adjacent meibomian glands), however, indicated that meibomian glands with dropout secrete little to no meibum. Conclusions Overall, there appeared to be no relationship between meibomian gland dropout and the meibum quality, but more detailed investigation of each meibomian gland alone revealed that meibomian glands with dropout secrete little to no meibum.