Journal of Shandong University (Health Sciences) ›› 2024, Vol. 62 ›› Issue (6): 65-70.doi: 10.6040/j.issn.1671-7554.0.2024.0207

• Clinical Medicine • Previous Articles    

Abnormalities of morphology and function of meibomian gland and their effects on tear film in patients with systemic lupus erythematosus

KANG Suifang1, WANG Yingxue2, ZHANG Qichen1, WANG Zhilun2, YIN Zhe2, XIAO Juan3, CHEN Guoling1   

  1. 1. Department of Ophthalmology;
    2. Department of Rheumatology;
    3. Department of Hospital Infection Management, The Second Hospital of Shandong University, Jinan 250033, Shandong, China
  • Published:2024-07-15

Abstract: Objective To observe the abnormalities of morphology and function of meibomian gland and their effects on tear film in systemic lupus erythematosus(SLE)patients. Methods Eighty-two eyes of 41 SLE patients were recruited as SLE group and 52 eyes of 26 healthy volunteers were recruited as control group. The grade of meibomian gland dropout was evaluated by Keratograph 5M ocular surface analyzer, the tear film lipid layer thickness(TFLLT)was measured by LipiView interferometer, the dynamic tear film objective scatter index(OSI)was measured by the double-pass Optical Quality Analysis System(OQAS II). The eyelid margin, meibomian gland secretion, fluorescein breakup time(FBUT)and fluorescein cornea staining(FCS)were observed under slit lamp microscope. Schirmer Ⅰ test(SⅠt)was conducted using standard Schirmer paper strip. The correlations between meibomian gland parameters and tear film function were assessed by Spearman rank correlation analysis. Results Compared with the control group, the meibomian gland dropout score(MGDS), meibomian gland secretion score(MGSS), eyelid margin score(EMS), dynamic tear film OSI and FCS were higher, while FBUT and TFLLT were lower in SLE group(all P<0.05). There was no significant difference in the SⅠt between SLE group and control group(P>0.05). MGDS, MGSS, and EMS were negatively correlated with FBUT(rMGDS=-0.335, rMGSS=-0.424, rEMS=-0.318, P<0.05), while MGDS was positively correlated with dynamic tear film OSI(r=0.254, P<0.05). Conclusion Abnormalities in the morphology and function of meibomian glands can be caused by SLE, leading to decreased TFLLT and tear film stability.

Key words: Systemic lupus erythematosus, Autoimmune disease, Meibomian gland, Tear film, Ocular surface disease

CLC Number: 

  • R771.3
[1] Kiriakidou M, Ching CL. Systemic lupus erythematosus[J]. Ann Intern Med, 2020, 172(11): ITC81-ITC96.
[2] Fatoye F, Gebrye T, Mbada C. Global and regional prevalence and incidence of systemic lupus erythematosus in low-and-middle income countries: a systematic review and meta-analysis[J]. Rheumatol Int, 2022, 42(12): 2097-2107.
[3] 亚洲干眼协会中国分会, 海峡两岸医药卫生交流协会眼科学专业委员会眼表与泪液病学组, 中国医师协会眼科医师分会眼表与干眼学组. 中国干眼专家共识:免疫性疾病相关性干眼(2021年)[J]. 中华眼科杂志, 2021, 57(12): 898-907. Chinese Branch of the Asian Dry Eye Society, Ocular Surface and Tear Film Diseases Group of Ophthalmology Committee of Cross-Strait Medicine Exchage Association, Ocular Surface and Dry Eye Group of Chinese Ophthalmologist Association. Chinese expert consensus on dry eye: dry eye related to immunologic diseases(2021)[J]. Chinese Journal of Ophthalmology, 2021, 57(12): 898-907.
[4] Dias-Santos A, Tavares Ferreira J, Pinheiro S, et al. Ocular involvement in systemic lupus erythematosus patients: a paradigm shift based on the experience of a tertiary referral center[J]. Lupus, 2020, 29(3): 283-289.
[5] Li YX, Ou SK, Lin SJ, et al. Meibomian gland alteration in patients with systemic lupus erythematosus[J]. Lupus, 2022, 31(4): 407-414.
[6] Yılmaz Tu gan B, Sönmez HE, ?瘙塁ahin N, et al. Analysis of meibomian glands in juvenile systemic lupus erythematosus patients without dry eye symptoms and signs[J]. Jpn J Ophthalmol, 2023, 67(1): 32-37.
[7] Aringer M, Costenbader K, Daikh D, et al. 2019 European League Against Rheumatism/American College of Rheumatology classification criteria for systemic lupus erythematosus[J]. Ann Rheum Dis, 2019, 78(9): 1151-1159.
[8] 亚洲干眼协会中国分会, 海峡两岸医药卫生交流协会眼科学专业委员会眼表与泪液病学组, 中国医师协会眼科医师分会眼表与干眼学组. 中国睑板腺功能障碍专家共识:诊断和治疗(2023年)[J]. 中华眼科杂志, 2023, 59(11): 880-887.
[9] Amano S, Shimazaki J, Yokoi N, et al. Meibomian gland dysfunction clinical practice guidelines[J]. Jpn J Ophthalmol, 2023, 67(4): 448-539.
[10] Whitcher JP, Shiboski CH, Shiboski SC, et al. A simplified quantitative method for assessing keratoconjunctivitis sicca from the Sjögrens Syndrome International Registry[J]. Am J Ophthalmol, 2010, 149(3): 405-415.
[11] 亚洲干眼协会中国分会, 海峡两岸医药卫生交流协会眼科学专业委员会眼表与泪液病学组, 中国医师协会眼科医师分会眼表与干眼学组. 中国睑板腺功能障碍专家共识:定义和分类(2023年)[J]. 中华眼科杂志, 2023, 59(4): 256-261. Chinese Branch of the Asian Dry Eye Society, Ocular Surface and Tear Film Diseases Group of Ophthalmology Committee of Cross-Straits Medicine Exchange Association, Ocular Surface and Dry Eye Group of Chinese Ophthalmologist Association. Chinese expert consensus on meibomian gland dysfunction: definition and classification(2023)[J]. Chinese Journal of Ophthalmology, 2023, 59(4): 256-261.
[12] Shan HM, Liu WH, Li YY, et al. The autoimmune rheumatic disease related dry eye and its association with retinopathy[J]. Biomolecules, 2023, 13(5): 724. doi:10.3390/biom13050724.
[13] Adil MY, Xiao JX, Olafsson J, et al. Meibomian gland morphology is a sensitive early indicator of meibomian gland dysfunction[J]. Am J Ophthalmol, 2019, 200: 16-25. doi:10.1016/j.ajo.2018.12.006.
[14] 张京京, 陈国玲, 鲍印磊, 等. Oculus Keratograph分析仪评估睑板腺功能障碍患者的眼表情况[J]. 山东大学学报(医学版), 2020, 58(6): 87-91. ZHANG Jingjing, CHEN Guoling, BAO Yinlei, et al. Oculus Keratograph in the evaluation of ocular surface in patients with meibomian gland dysfunction[J]. Journal of Shandong University(Health Sciences), 2020, 58(6): 87-91.
[15] Arita R, Mori N, Shirakawa R, et al. Meibum color and free fatty acid composition in patients with meibomian gland dysfunction[J]. Invest Ophthalmol Vis Sci, 2015, 56(8): 4403-4412.
[16] Gupta PK, Periman LM, Lain E, et al. Meibomian gland dysfunction: a dermatological perspective on pathogenesis and treatment outlook[J]. Clin Ophthalmol, 2021, 15: 4399-4404. doi:10.2147/OPTH.S327407.
[17] Willcox MDP, Argüeso P, Georgiev GA, et al. TFOS DEWS II tear film report[J]. Ocul Surf, 2017, 15(3): 366-403.
[18] Arita R, Fukuoka S, Morishige N. New insights into the lipid layer of the tear film and meibomian glands[J]. Eye Contact Lens, 2017, 43(6): 335-339.
[19] Lee JM, Jeon YJ, Kim KY, et al. Ocular surface analysis: a comparison between the LipiView® II and IDRA®[J]. Eur J Ophthalmol, 2021, 31(5): 2300-2306.
[20] Gu ZY, Lu QY, Zhang A, et al. Analysis of ocular surface characteristics and incidence of dry eye disease in systemic lupus erythematosus patients without secondary sjögrens syndrome[J]. Front Med, 2022, 9: 833995. doi:10.3389/fmed.2022.833995.
[21] Tseng CH, Tai YH, Hong CT, et al. Systemic lupus erythematosus and risk of dry eye disease and corneal surface damage: a population-based cohort study[J]. Int J Environ Res Public Health, 2023, 20(5): 3776.
[22] 王佳慧, 刘学勤. 全球近10年干眼相关生活质量研究: 基于VOSviewer和CiteSpace的文献计量学及可视化分析[J]. 山东大学耳鼻喉眼学报, 2024, 38(2): 61-72. WANG Jiahui, LIU Xueqin. A global study on quality of life related to dry eye in the last ten years: bibliometrics and visualization analysis through VOSviewer and CiteSpace[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(2): 61-72.
[23] Wu MF, Gao H, Zhao LJ, et al. Real dynamic assessment of tear film optical quality for monitoring and early prevention of dry eye[J]. Medicine, 2020, 99(31): e21494. doi:10.1097/MD.0000000000021494.
[24] 吴艳, 陈月芹, 闫峰, 等. 系统性红斑狼疮患者泪膜损伤及客观视觉质量改变的研究[J]. 医学研究生学报, 2018, 31(2): 163-168. WU Yan, CHEN Yueqin, YAN Feng, et al. Systemic lupus erythematosus affects the tear film and objective visual quality of the patient[J]. Journal of Medical Postgraduates, 2018, 31(2): 163-168.
[25] 亚洲干眼协会中国分会, 海峡两岸医药卫生交流协会眼科学专业委员会眼表与泪液病学组, 中国医师协会眼科医师分会眼表与干眼学组. 中国干眼专家共识:检查和诊断(2020年)[J]. 中华眼科杂志, 2020, 56(10): 741-747.
[26] 李威, 张斌. 优化脉冲光联合睑板腺按摩治疗睑板腺功能障碍的临床效果观察[J]. 山东大学耳鼻喉眼学报, 2021, 35(2): 105-109. LI Wei, ZHANG Bin. Effects of optimal pulse technology combined with meibomian gland massage to treat meibomian gland dysfunction[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(2): 105-109.
[1] ZHANG Qichen, KANG Suifang, YIN Chuanjie, XIAO Juan, MA Guangfeng, CAO Yuan, CHEN Guoling. Effects of intense pulsed light on the meibomian gland and tear film lipid layer in patients with lipid deficiency dry eye disease [J]. Journal of Shandong University (Health Sciences), 2024, 62(4): 54-60.
[2] CHENG Xuan, YANG Fan, PAN Zhenglun. Systemic lupus erythematosus, antiphospholipid syndrome with cerebral venous sinus thrombosis: a case report and literature review [J]. Journal of Shandong University (Health Sciences), 2022, 60(6): 70-74.
[3] KONG Linxiaoyu, SUN Shuzhen, YU Lichun, JIA Mengwen. Analysis of 5-year survival rate and prognosis in 188 children with systemic lupus erythematosus [J]. Journal of Shandong University (Health Sciences), 2022, 60(12): 69-76.
[4] GUO Yunfei, SHU Qiang. Role of immunosuppressants in rheumatic disease-associated recurrent spontaneous abortion [J]. Journal of Shandong University (Health Sciences), 2021, 59(8): 38-43.
[5] ZHANG Jingjing, CHEN Guoling, BAO Yinlei, MA Guangfeng. Oculus Keratograph in the evaluation of ocular surface in patients with meibomian gland dysfunction [J]. Journal of Shandong University (Health Sciences), 2020, 58(6): 87-91.
[6] WANG Baihui, SONG Yanjun, ZHANG Shuaiqing, ZUO Xiuli, WANG Qing, ZHANG Aijun, LI Ruyuan. Three cases of amyloidosis with diarrhea as the first symptom and literature review [J]. Journal of Shandong University (Health Sciences), 2020, 58(5): 93-97.
[7] XU Daxia, HOU Nan, LI Xiaofeng, WANG Chuang, KONG Meng, JIAO Guangjun, CHEN Yunzhen. Relevance between bone metabolism of glucocorticoid-induced osteoporosis and duration of glucocorticoid treatment [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(5): 103-107.
[8] DU Jinge, CHEN Hui, YANG Xiaorong, LÜ Ming. Meta-analysis of the association between the STAT4 rs7574865 polymorphism and systemic lupus erythematosus [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(5): 95-102.
[9] MA Zhenzhen, SUN Hongsheng, YANG Qingrui. Changes and clinical significance of serum adipokines in systemic lupus erythematosus [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(4): 86-90.
[10] SUN Hao, WANG Chunjuan, WANG Ge, WANG Baojie, GUO Shougang. Neuromyelitis optica spectrum disorders with common non-organ-specific autoantibodies [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(10): 50-54.
[11] CHEN Hong-mei1, ZHUO Jian2. Changes and influencing factors of the tear film after phacoemulsification [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2011, 49(4): 133-.
[12] QU Yunyun, MA Chunyan, ZHU Min, LIU Xiaowen, SUN Xinping, XU Jie, ZHAO Yueran. Effects of immune complexes on monocytemacrophages [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2010, 48(4): 54-58.
[13] WANG Zi-e,CHE Zhi-xiang,WU Hao,FENG Rong-jie,LIU Yi-qing,SHAO Song,CUI Xiang-fa,CHEN Guo-jian,LU Zhi-ming. Relationship between the oestrogen receptor α gene polymorphisms and the Th1/Th2 cytokine drift in systemic lupus erythematosus [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2008, 46(11): 1087-1091.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!