Overall, there does not appear to be an association between meibomian gland dropout and meibum quality, according to a study published in BMC Ophthalmology. In patients with focal dropout (loss of 1 or 2 adjacent meibomian glands), however, a detailed look at each individual gland revealed that meibomian glands with dropout secrete little to no meibum.

Researchers enrolled 91 participants with dry eye (eyes, 99; 73% women; median age, 58 years) in the analysis. The dropout out of the meibomian glands according to area and meibum quality were graded on a numeric scale from 0 to 3 (0, no secretion; 1, inspissated/ toothpaste consistency; 2, cloudy liquid consistency; 3, clear liquid consistency). Patients were stratified according to whether they had focal dropout (n=23; eyes, 31) or did not have focal dropout (n=68; eyes, 68). A correlation analysis between gland dropout and meibomian quality was performed based on data from 68 eyes. 

In participants who did not have focal dropout, median meibomian score was 1.0 in the upper eyelids and 0.0 in the lower eyelids. The median meibum quality grade was 3.0 (clear liquid secretion) in the upper eyelids and 1.0 (inspissated/toothpaste consistency) in the lower eyelids. No significant correlation was noted between meiboscore and meibum quality in either the upper (P =.746) or lower (P =.551) eyelids. 


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In patients with focal dropout 84% did not secrete meibum. A total of 4 eyes secreted a normal volume of meibum and 1 secreted an excess of meibum. Meibum quality grades were 1 or 2 in the eyes that did secrete meibum. 

The study authors state that physicians may underestimate the clinical value of infrared meibography due to a seeming lack of association between meibography and meibum quality. 

“The present study revealed no significant correlation between meibomian gland dropout in meibography and meibum quality in the central 8 meibomian glands of the upper and lower eyelids,” according to the researchers. “Analysis of the direct correlation between meibomian gland dropout in meibography and meibum quality in patients with focal dropout (loss of 1 or 2 adjacent meibomian glands), however, indicated that meibomian glands with dropout secrete little to no meibum.”

Study limitations include failure to calculate the sample size before the study, the strict inclusion of patients with dry eye, and analysis of only the central meibomian glands.

Reference

Ha M, Oh S-E, Whang W-J, et al. Relationship between meibomian gland loss in infrared meibography and meibum quality in dry eye patients. BMC Ophthalmol. Published online July 4, 2022. doi:10.1186/s12886-022-02509-5