Evidence map›Paper›PMID 26781133›Full record

ReviewThe British journal of ophthalmology2016

Revisiting the vicious circle of dry eye disease: a focus on the pathophysiology of meibomian gland dysfunction.

Christophe Baudouin, Elisabeth M Messmer, Pasquale Aragona, Gerd Geerling, Yonca A Akova, José Benítez-del-Castillo, Kostas G Boboridis, Jesús Merayo-Lloves, Maurizio Rolando, Marc Labetoulle

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PubMed Full text at PMC Publisher
In one paragraph

Review in The British journal of ophthalmology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 249 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
249citing papers in PubMed, 8 pooled it
31.8field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

249 citing papers in PubMed, 8 syntheses or guidelines pooled it, 497 citations in OpenAlex.

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  8. Intense pulsed light for meibomian gland dysfunction: a systematic review and meta-analysis.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2021
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  10. Effect of OTX-101 0.09% ciclosporin solution on clinical signs of dry eye disease in patients with moderate-to-severe corneal damage: a post-hoc analysis of randomized clinical trials.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2026
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189 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 9 institutions in 10 countries.

Christophe BaudouinQuinze-Vingts National Ophthalmology Hospital, University Versailles St Quentin en Yvelines, Versailles, France UPMC Univ Paris 06, UMR_S 968, Institut de la Vision, Paris, France.
Elisabeth M MessmerDepartment of Ophthalmology, Ludwig Maximilian University, Munich, Germany.
Pasquale AragonaInstitute of Ophthalmology, University of Messina, Messina, Italy.ORCID http://orcid.org/0000-0002-9582-9799
Gerd GeerlingDepartment of Ophthalmology, University Hospital Düsseldorf, Heinrich-Heine University, Düsseldorf, Germany.
Yonca A AkovaDepartment of Ophthalmology, Bayindir Hospital, Ankara, Turkey.
José Benítez-del-CastilloSan Carlos University Hospital, Complutense University, Madrid, Spain.
Kostas G BoboridisDepartment of Ophthalmology, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Jesús Merayo-LlovesUniversity of Oviedo and Fernández-Vega Ophthalmological Institute, Oviedo, Spain.
Maurizio RolandoDepartment of Neuroscience, Ophthalmology, and Genetics, University of Genoa, Genoa, Italy.
Marc LabetoulleOphthalmology Department, Bicêtre University Hospital, Le Kremlin-Bicêtre, France.
Aristotle University of Thessaloniki · GRBayındır Hastanesi · TRBicêtre Hospital · FRDüsseldorf University Hospital · DEFernández-Vega Ophthalmological Institute · ESInstitut de la Vision · FRLudwig-Maximilians-Universität München · DEPediatrics and Genetics · USUniversity of Messina · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Meibomian gland dysfunction (MGD) is the most frequent cause of dry eye disease (DED). Eyelid inflammation, microbial growth, associated skin disorders as well as potentially severe corneal complications culminate to make MGD a complex multifactorial disorder. It is probable that MGD is a heterogeneous condition arising from any combination of the following five separate pathophysiological mechanisms: eyelid inflammation, conjunctival inflammation, corneal damage, microbiological changes and DED resulting from tear film instability. The pathogenesis of both MGD and DED can be described in terms of a 'vicious circle': the underlying pathophysiological mechanisms of DED and MGD interact, resulting in a double vicious circle. The MGD vicious circle is self-stimulated by microbiological changes, which results in increased melting temperature of meibum and subsequent meibomian gland blockage, reinforcing the vicious circle of MGD. Meibomian gland blockage, dropout and inflammation directly link the two vicious circles. MGD-associated tear film instability provides an entry point into the vicious circle of DED and leads to hyperosmolarity and inflammation, which are both a cause and consequence of DED. Here we propose a new pathophysiological scheme for MGD in order to better identify the pathological mechanisms involved and to allow more efficient targeting of therapeutics. Through better understanding of this scheme, MGD may gain true disease status rather than being viewed as a mere dysfunction.

Indexed as

Dry Eye SyndromesEyelid DiseasesHumansMeibomian GlandsCorneaInflammationOcular surfaceTearsTreatment Medical

Identifiers

PMID26781133
PMCPMC4789719
OpenAlexW2289895447

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.