Psoriasis Exacerbates Meibomian Gland Loss, Tear Film Instability

Psoriasis may lead to a greater rate of meibomian gland loss (MGL) and tear film instability, according to research published in Photodiagnosis and Photodynamic Therapy. Anti-tumor necrosis factor alpha (anti-TNF-α) use, Psoriasis Area and Severity Index (PASI) score, patient age, and corneal parameters are important considerations when treating patients with psoriasis, the report suggests.

Researchers enrolled 100 patients including individuals with psoriasis (n=50; 44% women; mean age, 39.56 years) and 50 age- and sex-matched control group participants (50% women, mean age, 39.22 years) in a prospective, controlled, cross-sectional study to evaluate corneal topography in patients with psoriasis. All participants underwent noninvasive tear break-up time (NIBUT), meibography, keratometry, and higher-order corneal aberration (HOA) assessments at a single center between January and June 2021. 

Psoriatic evaluation included determining PASI score, disease severity, and systemic drug use (anti-TNF-α) among participants with psoriasis. 

Participants with psoriasis had lower NIBUT (8.64 vs 14.10 seconds; P <.001) and a higher MGL rate (33.92% vs 21.83%; P <.001) compared with individuals in the control group. No significant differences were noted between groups in terms of corneal HOAs.

Patients with psoriasis who used anti-TNF-α drugs experienced greater MGL rates compared with individuals with psoriasis who did not use them. The PASI score was negatively associated with NIBUT values (r, -0.296; P =.037).

“Changes to the ocular surface and meibomian gland are observed more frequently in psoriasis patients than in healthy individuals,” according to researchers. “Ocular surface disorder and MGL should be monitored regularly to prevent the devastating effects of ocular surface changes in psoriasis patients; moreover, ocular surface disorder and MGD should be treated when necessary.” 

Study limitations include the cross-sectional nature and the lack of long-term follow-up.