Novel investigation and management options for meibomian gland dysfunction related to dry eye disease
Keywords:
meibomian gland dysfunction, dry eye, treatment modalities, investigationAbstract
Meibomian gland dysfunction (MGD) is mostly encountered in the ophthalmology clinic. It is an important cause of evaporative dry eye, which has significant adverse effects on quality of life. The traditional treatments of MGD consist of warm compresses and eyelid hygiene, as well as antibiotics and anti-inflammatory agents to improve the obstructed meibum. Despite the numerous treatment options for MGD, it remains difficult to completely relieve signs and symptoms. Novel treatment options, including intraductal probing, thermal pulsation, and intense pulsed light therapy, are emerging. This review article summarizes the pathogenesis, pathophysiology, diagnosis, and treatment, including current emerging technology options, of MGD.
References
Geerling G, Baudouin C, Aragona P, et al. Emerging strategies for the diagnosis and treatment of meibomian gland dysfunction: Proceedings of the OCEAN group meeting. Ocul Surf. 2017;15(2):179-192. https://doi.org/10.1016/j.jtos.2017.01.006
Giannaccare G, Taroni L, Senni C, Scorcia V. Intense Pulsed Light Therapy In The Treatment Of Meibomian Gland Dysfunction: Current Perspectives. Clin Optom. 2019;11:113-126. https://doi.org/10.2147/OPTO.S217639
Arita R, Fukuoka S. Non-pharmaceutical treatment options for meibomian gland dysfunction. Clin Exp Optom. Published online January 13, 2020. https://doi.org/10.1111/cxo.13035
Amano S. Meibomian Gland Dysfunction: Recent Progress Worldwide and in Japan. Invest Ophthalmol Vis Sci. 2018;59(14):DES87-DES93. https://doi.org/10.1167/iovs.17-23553
Lam PY, Shih KC, Fong PY, et al. A Review on Evidence-Based Treatments for Meibomian Gland Dysfunction. Eye Contact Lens. 2020;46(1):3-16. https://doi.org/10.1097/ICL.0000000000000680
Nelson JD, Shimazaki J, Benitez-del-Castillo JM, et al. The International Workshop on Meibomian Gland Dysfunction: Report of the Definition and Classification Subcommittee. Invest Ophthalmol Vis Sci. 2011;52(4):1930-1937. https://doi.org/10.1167/iovs.10-6997b
Matsumoto Y, Shigeno Y, Sato EA, et al. The evaluation of the treatment response in obstructive meibomian gland disease by in vivo laser confocal microscopy. Graefes Arch Clin Exp Ophthalmol Albrecht Von Graefes Arch Klin Exp Ophthalmol. 2009;247(6):821-829. https://doi.org/10.1007/s00417-008-1017-y
Finis D, Hayajneh J, König C, Borrelli M, Schrader S, Geerling G. Evaluation of an Automated Thermodynamic Treatment (LipiFlow®) System for Meibomian Gland Dysfunction: A Prospective, Randomized, Observer-Masked Trial. Ocul Surf. 2014;12(2):146-154. https://doi.org/10.1016/j.jtos.2013.12.001
Arita R, Morishige N, Shirakawa R, Sato Y, Amano S. Effects of Eyelid Warming Devices on Tear Film Parameters in Normal Subjects and Patients with Meibomian Gland Dysfunction. Ocul Surf. 2015;13(4):321-330. https://doi.org/10.1016/j.jtos.2015.04.005
Maskin SL, Alluri S. Intraductal meibomian gland probing: background, patient selection, procedure, and perspectives. Clin Ophthalmol. 2019;13:1203-1223. https://doi.org/10.2147/OPTH.S183174
Sik Sarman Z, Cucen B, Yuksel N, Cengiz A, Caglar Y. Effectiveness of Intraductal Meibomian Gland Probing for Obstructive Meibomian Gland Dysfunction. Cornea. 2016;35(6):721-724. https://doi.org/10.1097/ICO.0000000000000820
Huang X, Qin Q, Wang L, Zheng J, Lin L, Jin X. Clinical results of Intraductal Meibomian gland probing combined with intense pulsed light in treating patients with refractory obstructive Meibomian gland dysfunction: a randomized controlled trial. BMC Ophthalmol. 2019;19(1):211. https://doi.org/10.1186/s12886-019-1219-6
Qiao J, Yan X. Emerging treatment options for meibomian gland dysfunction. Clin Ophthalmol Auckl NZ. 2013;7:1797-1803. https://doi.org/10.2147/OPTH.S33182
Lane SS, DuBiner HB, Epstein RJ, et al. A new system, the LipiFlow, for the treatment of meibomian gland dysfunction. Cornea. 2012;31(4):396-404. https://doi.org/10.1097/ICO.0b013e318239aaea
Arita R, Mizoguchi T, Fukuoka S, Morishige N. Multicenter Study of Intense Pulsed Light Therapy for Patients With Refractory Meibomian Gland Dysfunction. Cornea. 2018;37(12):1566-1571. https://doi.org/10.1097/ICO.0000000000001687
Dell SJ, Gaster RN, Barbarino SC, Cunningham DN. Prospective evaluation of intense pulsed light and meibomian gland expression efficacy on relieving signs and symptoms of dry eye disease due to meibomian gland dysfunction. Clin Ophthalmol Auckl NZ. 2017;11:817-827. https://doi.org/10.2147/OPTH.S130706
Choi M, Han SJ, Ji YW, et al. Meibum Expressibility Improvement as a Therapeutic Target of Intense Pulsed Light Treatment in Meibomian Gland Dysfunction and Its Association with Tear Inflammatory Cytokines. Sci Rep. 2019;9(1). https://doi.org/10.1038/s41598-019-44000-0
Yin Y, Liu N, Gong L, Song N. Changes in the Meibomian Gland After Exposure to Intense Pulsed Light in Meibomian Gland Dysfunction (MGD) Patients. Curr Eye Res. 2018;43(3):308-313. https://doi.org/10.1080/02713683.2017.1406525
Craig JP, Chen Y-H, Turnbull PRK. Prospective trial of intense pulsed light for the treatment of meibomian gland dysfunction. Invest Ophthalmol Vis Sci. 2015;56(3):1965-1970. https://doi.org/10.1167/iovs.14-15764
Vora GK, Gupta PK. Intense pulsed light therapy for the treatment of evaporative dry eye disease. Curr Opin Ophthalmol. 2015;26(4):314-318. https://doi.org/10.1097/ICU.0000000000000166
Albietz JM, Schmid KL. Intense pulsed light treatment and meibomian gland expression for moderate to advanced meibomian gland dysfunction. Clin Exp Optom. 2018;101(1):23-33. https://doi.org/10.1111/cxo.12541
Zhang L, Su Z, Zhang Z, Lin J, Li D-Q, Pflugfelder SC. Effects of Azithromycin on Gene Expression Profiles of Proinflammatory and Anti-inflammatory Mediators in the Eyelid Margin and Conjunctiva of Patients With Meibomian Gland Disease. JAMA Ophthalmol. 2015;133(10):1117-1123. https://doi.org/10.1001/jamaophthalmol.2015.2326
De Benedetti G, Vaiano AS. Oral azithromycin and oral doxycycline for the treatment of Meibomian gland dysfunction: A 9-month comparative case series. Indian J Ophthalmol. 2019;67(4):464-471. https://doi.org/10.4103/ijo.IJO_1244_17
Perry HD, Doshi-Carnevale S, Donnenfeld ED, Solomon R, Biser SA, Bloom AH. Efficacy of commercially available topical cyclosporine A 0.05% in the treatment of meibomian gland dysfunction. Cornea. 2006;25(2):171-175. https://doi.org/10.1097/01.ico.0000176611.88579.0a
Macsai MS. The role of omega-3 dietary supplementation in blepharitis and meibomian gland dysfunction (an AOS thesis). Trans Am Ophthalmol Soc. 2008;106:336-356.
Arita R, Kawashima M, Ito M, Tsubota K. Clinical safety and efficacy of vitamin D3 analog ointment for treatment of obstructive meibomian gland dysfunction. BMC Ophthalmol. 2017;17(1):84. https://doi.org/10.1186/s12886-017-0482-7
Arita R, Suehiro J, Haraguchi T, et al. Topical diquafosol for patients with obstructive meibomian gland dysfunction. Br J Ophthalmol. 2013;97(6):725-729. https://doi.org/10.1136/bjophthalmol-2012-302668
Amano S, Inoue K. Effect of topical 3% diquafosol sodium on eyes with dry eye disease and meibomian gland dysfunction. Clin Ophthalmol Auckl NZ. 2017;11:1677-1682. https://doi.org/10.2147/OPTH.S148167
Holland EJ, Luchs J, Karpecki PM, et al. Lifitegrast for the Treatment of Dry Eye Disease: Results of a Phase III, Randomized, Double-Masked, Placebo-Controlled Trial (OPUS-3). Ophthalmology. 2017;124(1):53-60. https://doi.org/10.1016/j.ophtha.2016.09.025
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