ArticleDer Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft2009
[Meibomian glands : part IV. Functional interactions in the pathogenesis of meibomian gland dysfunction (MGD)].
Article in Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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Who cites it
22 citing papers in PubMed, 58 citations in OpenAlex.
- Efficacy of a 0.05% cyclosporine a topical nanoemulsion in dry eyes with obstructive meibomian gland dysfunction.Japanese journal of ophthalmology · 2022Trial
- Pharmacological, Natural and Emerging Therapies for Meibomian Gland Dysfunction: A Review.Drugs · 2026Review
- Deletion of Fgfr2 in Ductal Basal Epithelium With Tamoxifen Induces Obstructive Meibomian Gland Dysfunction.Investigative ophthalmology & visual science · 2024Article
- Ductal Hyperkeratinization and Acinar Renewal Abnormality: New Concepts on Pathogenesis of Meibomian Gland Dysfunction.Current issues in molecular biology · 2023Article
- In vivo confocal microscopy assessment of meibomian glands microstructure in patients with Graves' orbitopathy.BMC ophthalmology · 2021Article
- Article
- The cornea in keratoconjunctivitis sicca.Experimental eye research · 2020Review
- Deficiency in Acyl-CoA:Wax Alcohol Acyltransferase 2 causes evaporative dry eye disease by abolishing biosynthesis of wax esters.FASEB journal : official publication of the Federation of American Societies for Experimental Biology · 2020Article
- Diagnostic Test Efficacy of Meibomian Gland Morphology and Function.Scientific reports · 2019Article
- Hypoxia: A breath of fresh air for the meibomian gland.The ocular surface · 2019Article
- The prevalence of meibomian gland dysfunction, tear film and ocular surface parameters in an Austrian dry eye clinic population.Acta ophthalmologica · 2018Article
- The Effect of Solithromycin, a Cationic Amphiphilic Drug, on the Proliferation and Differentiation of Human Meibomian Gland Epithelial Cells.Current eye research · 2018Article
- The function and morphology of Meibomian glands in patients with thyroid eye disease: a preliminary study.BMC ophthalmology · 2018Article
- Eyelid cleansing with ointment for obstructive meibomian gland dysfunction.Japanese journal of ophthalmology · 2017Article
- Dissecting lipid metabolism in meibomian glands of humans and mice: An integrative study reveals a network of metabolic reactions not duplicated in other tissues.Biochimica et biophysica acta · 2016Article
- Revisiting the vicious circle of dry eye disease: a focus on the pathophysiology of meibomian gland dysfunction.The British journal of ophthalmology · 2016Review
- [Testosterone reduces the expression of keratinization-promoting genes in murine Meibomian glands].Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft · 2013Article
- Activities of autonomic neurotransmitters in Meibomian gland tissues are associated with menopausal dry eye.Neural regeneration research · 2012Article
- Association of contact lens-related allergic conjunctivitis with changes in the morphology of meibomian glands.Japanese journal of ophthalmology · 2012Article
- Changes in gene expression in human meibomian gland dysfunction.Investigative ophthalmology & visual science · 2011Article
Corrections and comments
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Authors and funding
2 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Obstructive dysfunction of the meibomian glands (MGD) is surprisingly frequent in the general population and increases with age. Clinically, the focus is mainly on the consequences at the ocular surface in the sense of an evaporative dry eye syndrome. However, in addition, chronic obstruction of the meibomian glands also leads to degeneration of the secretory gland tissue which can result in a secondary hyposecretion even if the primary obstruction is later resolved by therapeutic approaches.Important influencing factors in the pathogenesis of obstructive MGDs and their interaction during the progression of the disease are systematically analyzed and displayed in a flow diagram. Age, hormonal disturbances and environmental influences, such as contact lenses, as well as qualitative alterations in the composition of the meibomian oil (meibum) lead to hyperkeratinization of the ductal epithelium and increased viscosity of the meibum which result, either alone or in combination, in obstruction of the duct and orifice. This leads to a lack of meibum on the lid margin and tear film with downstream hyperevaporative dry eye syndrome. At the same time, obstruction leads to a stasis of meibum inside the meibomian gland with increased pressure and resulting dilatation of the ducts and in atrophy of the acini with rarefaction of the secretory meibocytes and gland dropout. Stasis can also increase the growth of commensal bacteria, their production of oil degrading enzymes (lipases) and release of toxic mediators. These factors can, in return, act as self-enforcing feedback loops in the sense of vicious circles that aggravate the primary hyperkeratinization and compositional disturbance of meibum and can hence lead to a progressive MGD.
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