Lower-eyelid meibography findings across angiography-defined coronary artery disease severity.

CLINICAL RELEVANCE: Cardiometabolic disease and its treatments can influence ocular surface health. Describing ocular surface features in populations with systemic vascular disease may help generate hypotheses for future studies, but current evidence is insufficient to support changes in cardiovascular screening, optometric triage, dry eye treatment, or patient management.

BACKGROUND

Links between systemic vascular disease burden and meibomian gland morphology have been suggested, but evidence is limited in cohorts where coronary artery disease severity is defined by coronary angiography.

METHODS

This single-centre retrospective observational study included patients aged 50 to 80 years who underwent coronary angiography between January 2023 and January 2026 and had lower-eyelid meibography and non-invasive tear break-up time measurements within a ± 90-day window. When more than one record was available, the closest measurement to angiography was analysed (right eye only). Outcomes were meibomian gland loss, meiboscore and non-invasive tear break-up time. An age- and sex-adjusted linear regression model evaluated associations with meibomian gland loss; broader adjustment was not feasible.

RESULTS

Eighty-eight patients were analysed (no coronary artery disease, 22; one to two vessel disease, 38; three-vessel disease or greater, 28). Meibomian gland loss differed between groups (median [interquartile range] 23.4 [12.8], 31.3 [19.4] and 47.5 [13.9], respectively; all pairwise comparisons significant). Meiboscore findings were less consistent, and non-invasive tear break-up time did not differ significantly. In the age- and sex-adjusted model, crude angiographic grouping and female sex were associated with lower-eyelid meibomian gland loss.

CONCLUSION

This highly selected retrospective cohort showed an age- and sex-adjusted association between crude angiographic coronary artery disease grouping and lower-eyelid meibomian gland loss, whereas non-invasive tear break-up time did not differ between groups. These preliminary findings should not be interpreted as evidence that isolated lower-eyelid structural gland loss directly reflects tear film instability, mechanistic vascular injury, systemic screening value, or clinical practice relevance.