Observational studyEye (London, England)2015
In vivo detection of clinically non-apparent ocular surface inflammation in patients with meibomian gland dysfunction-associated refractory dry eye symptoms: a pilot study.
Observational study in Eye (London, England), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed, 37 citations in OpenAlex.
- Sutureless Dehydrated Amniotic Membrane (Omnigen) Application Using a Specialised Bandage Contact Lens (OmniLenz) for the Treatment of Dry Eye Disease: A 6-Month Randomised Control Trial.Medicina (Kaunas, Lithuania) · 2024Trial
- Stage-dependent alterations in corneal epithelium, stromal keratocyte density, and subbasal nerve plexus in keratoconus: an in vivo confocal microscopy study.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2026Article
- Use of in vivo confocal microscopy in suspected Acanthamoeba keratitis: a 12-year real-world data study at a Swedish regional referral center.Journal of ophthalmic inflammation and infection · 2024Article
- Quantitative Assessment of Lid Margin Vascularity Using Swept-Source Optical Coherence Tomography Angiography.Translational vision science & technology · 2024Article
- The Yin and Yang of non-immune and immune responses in meibomian gland dysfunction.The ocular surface · 2024Article
- Alkali burn injury model of meibomian gland dysfunction in mice.International journal of ophthalmology · 2024Article
- In Vivo Confocal Microscopy in Different Types of Dry Eye and Meibomian Gland Dysfunction.Journal of clinical medicine · 2022Review
- Relationships between activated dendritic cells and dry eye symptoms and signs.The ocular surface · 2021Article
- Can in vivo confocal microscopy differentiate between sub-types of dry eye disease? A review.Clinical & experimental ophthalmology · 2021Review
- A Review of Imaging Biomarkers of the Ocular Surface.Eye & contact lens · 2020Review
- Objective optical assessment of tear-film quality dynamics in patients with meibomian gland dysfunction and aqueous-deficient dry eye optical quality changes in different dry eye subtypes.Indian journal of ophthalmology · 2019Article
- Intraductal meibomian gland probing: background, patient selection, procedure, and perspectives.Clinical ophthalmology (Auckland, N.Z.) · 2019Article
- Clinically Relevant Immune-Cellular Metrics of Inflammation in Meibomian Gland Dysfunction.Investigative ophthalmology & visual science · 2018Article
- TFOS DEWS II pain and sensation report.The ocular surface · 2017Review
- In Vivo Confocal Microscopy of Corneal Nerves in Health and Disease.The ocular surface · 2017Review
- Revisiting the vicious circle of dry eye disease: a focus on the pathophysiology of meibomian gland dysfunction.The British journal of ophthalmology · 2016Review
- In Vivo Laser Scanning Confocal Microscopy of Human Meibomian Glands in Aging and Ocular Surface Diseases.BioMed research international · 2016Review
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
Abstract
purposeThe utility of in vivo confocal microscopy (IVCM) in the investigation of palpebral conjunctival and corneal inflammation in patients with meibomian gland dysfunction (MGD)-associated refractory dry eye symptoms following gland expression, despite objective clinical improvement.
methodsA retrospective, observational pilot study was conducted evaluating five patients with MGD-associated refractory dry eye symptoms and three control groups: symptomatic untreated MGD patients (n=3), treatment-responsive MGD patients with improved symptoms (n=3) and asymptomatic healthy normals (n=11). Ocular surface disease index (OSDI) scores, tear break-up time (TBUT), the number of meibomian glands yielding liquid secretion (MGYLS), palpebral conjunctival epithelial and substantia propria immune cell (EIC, SIC), and corneal dendritic cell (DC) densities were measured.
resultsDespite clinical improvement (TBUT: 6.4±1.2 s to 10.1±2.1 s, P=0.03; MGYLS: 3.5±0.8 glands to 7.0±1.1 glands, P=0.13) and a normal clinical examination post treatment, MGD patients remained symptomatic. IVCM revealed increased immune cells in the palpebral conjunctiva (refractory MGD EIC=592.6±110.1 cells/mm2 untreated MGD EIC=522.6±104.7 cells/mm2, P=0.69; responsive MGD EIC=194.9±119.4 cells/mm2, P<0.01; normals EIC=123.7±19.2 cells/mm2, P< 0.001), but not the cornea (refractory MGD DC=60.9±28.3 cells/mm2; normals DC=25.9±6.3 cells/mm2; P=0.43). EIC did not correlate with TBUT (Rs=-0.26, P=0.33). OSDI scores correlated with both EIC (Rs=0.76, P<0.001) and TBUT (Rs=-0.69, P<0.01) but not SIC. Intraglandular immune cells were also seen.
conclusionMGD-associated refractory symptoms and the symptom-sign disparity may be explained by clinically non-apparent, active inflammation of the palpebral conjunctiva as detected by IVCM. These patients may benefit from anti-inflammatory therapy.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.