Meibomian Gland Dropout, not Distortion, Can Distinguish Dry Eyes from Normal Eyes in Contact Lens Wearers

ABSTRACT

Purpose

To examine the effectiveness of using meibomian gland (MG) dropout and distortion for dry eye disease (DED) diagnosis in a young population with long-term contact lens (CL) wear.

Methods

Seventy-three CL-wearers and 68 non-CL-wearers (20–28 years old) participated in the study. The diagnosis of DED was based on an ocular surface disease index ≥ 13, and a noninvasive breakup time < 10 seconds or positive corneal fluorescein staining. The MG dropout and distortion in each subject were quantified with non-invasive meibography. Receiver operating characteristic (ROC) curves were created to evaluate the effectiveness of using MG dropout and distortion to determine the presence of DED in CL-wearers and non-CL-wearers.

Results

In non-CL-wearers, the MG distortion was significantly higher in DED subjects than in normal subjects (3.83 ± 1.81 versus 1.59 ± 1.04). In CL-wearers, MG distortion was not significantly different (5.12 ± 4.11 versus 5.51 ± 3.15 in normal and DED subjects respectively). The area under the ROC curve (AUC) for MG distortion was 0.783 in the non-CL-wearers, but 0.507 in CL-wearers. In non-CL-wearers, MG dropout was significantly higher in DED subjects than in normal subjects (0.22 ± 0.08 versus 0.15 ± 0.06). In CL-wearers, MG dropout was also significantly higher in DED subjects than in normal subjects (0.29 ± 0.11 versus 0.22 ± 0.08). The AUC for MG dropout used to classify DED was 0.740 in the non-CL-wearers and 0.715 in CL-wearers.

Conclusions

MG dropout was effective in distinguishing subjects with DED from normal subjects in both CL wearers and non-CL wearers. MG distortion can only distinguish DED subjects from normal ones in non-CL wearers, but not in CL wearers.

KEYWORDS:

• Dry eye
• contact lens
• meibomian gland
• diagnosis
• meibography

Summary statement

This study indicates that meibomian gland dropout and distortion are associated with dry eye disease differently in a unique population: young people with long-term contact lens wear.

While meibomian gland dropout is effective in distinguishing the subjects with dry eye from the normal ones, meibomian gland distortion cannot distinguish DED subjects from normal subjects.

Declaration of interest

The authors have no conflicts of interest to disclose.

Additional information

Funding

This work was supported by [National Nature Science Foundation of China] grant number [81770901], Tianjin Clinical Key Discipline Project (TJLCZDXKQ012) and [Science Committee Nature Science Foundation of Tianjin] grant number [17ZXHLSY00070].