Psoriasis can affect the morphology of the meibomian glands, setting off a cascade of structural changes associated with meibomian gland dysfunction (MGD), themselves associated with dry eye disease (DED), according to a study published in Anais Brasileiros de Dermatologia.
This prospective-controlled study evaluated DED and MGD in patients with psoriasis, using meibography. In total, 50 participants with psoriasis (mean age 43.4±14.1 years and 26 women, 24 men) and 50 healthy participants (mean age 41.2±8.1 years and 25 women, 25 men) were included.
Physicians administered meibomian gland obstruction examination, irregular lid margin assessment, ocular surface disease index assessment, tear film break-up time test, Schirmer test, and corneal conjunctival fluorescein staining assessment to all participants. They also used meibography to examine both upper and lower lids for meibomian gland loss.
The research team found that MGD (28%), meibomian gland loss (MGL) (29.5%), upper meiboscore (0.61±0.81), lower meiboscore (0.46±0.61), and prevalence of DED (22%) were significantly higher in the psoriasis group compared with the control group (P =.008, P <.001, P =.027, P =.041, P =.044, respectively). They also found a significant association between MGD and psoriasis area severity index (PASI) (P =.015, Odds Ratio =1.211). There was a significant positive association between MGL with PASI (P <.001, r=608) and psoriasis duration (P <.001, r=0.547).
“In this study, 4 of 50 patients (8%) had ocular symptoms,” according to the report. “Periodic ophthalmological examinations should be performed in patients with psoriasis, especially in those who have high PASI scores, regardless of the presence of ocular symptoms, and early diagnosis of the condition gives patients the chance of treatment, improves the patients’ quality of the life.”
Limitations of the study were the relatively small sample size and inability to determine quality changes in the meibum.
Kemeriz F, Tugrul B, Yasar E. Evaluation of ocular psoriasis with meibography. An Bras Dermatol. Published online November 14, 2021. doi:10.1016/j.abd.2021.05.008