Epidemiology of Meibomian Gland Dysfunction in Elderly Population
To study the epidemiology of meibomian gland dysfunction (MGD) in an elderly, predominantly male population.
Patients with normal eyelid, conjunctival, and corneal anatomy were prospectively recruited from the Miami Veterans Affairs eye clinic. Patients underwent a complete ocular surface examination, including dry eye questionnaires (dry eye questionnaire 5 (DEQ5) and ocular surface disease index (OSDI)) and tear assessments (osmolarity, tear break up time (TBUT), corneal staining, Schirmer’s strips with anesthesia). The main outcome measures were the correlations between meibomian gland (MG) parameters and local (dry eye) and systemic (demographics) factors. The studied MG parameters were eyelid vascularity and meibum quality; a score of ≥2 in either parameter was considered abnormal.
Mean age of the 118 patients was 65 (SD=11); 86% were male and 62% had at least one abnormal MG parameter (vascularity 22% (n=26),abnormal quality 58%(n=68)). MG abnormalities were weakly associated with each other (r=0.19, p=0.51) and not at all with dry eye symptoms (r=0.007-0.17,p>0.05 for all). Some MG parameters were associated with some dry eye signs (osmolarity with vascularity, OD only r=-0.2, p=0.03, TBUT with both vascularity and meibum quality, both eyes r=-0.25-0.35, p<0.05, Schirmer with vascularity, OD only r=-0.2 (p=0.03). Corneal staining was not associated with MG parameters. Demographically, white patients were more likely to have abnormal vascularity than non-whites (35% (n=23) versus 2.5% (n=1) and 15% (n=2) for blacks and others respectively, (p < 0.0005)). Ethnicity and age did not correlate with MG parameters.
MGD is a frequent finding in an elderly, predominantly male population with racial differences noted in the frequency of abnormal eyelid vascularity but not in MG quality.