The ocular surface · 2019
Ocular surface assessment and morphological alterations in meibomian glands with meibography in obstructive sleep apnea Syndrome.
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Karaca Irmak, Yagci Ayse, Palamar Melis, Tasbakan Mehmet Sezai, Basoglu Ozen K
Аннотация
PURPOSE: To evaluate ocular surface and Meibomian glands morphology of patients with obstructive sleep apnea syndrome (OSAS).
MATERIALS AND METHODS: Based on polysomnography, 36 eyes of 36 patients with severe OSAS (Group 1, apnea-hypopnea index (AHI) ≥30/h) and 24 eyes of 24 patients with primary snoring or mild OSAS (Group 2, AHI<15/h) were enrolled. Detailed eye examination along with ocular surface staining (fluorescein, 2%) according to Oxford scale, tear film break-up time (t-BUT), Schirmer 1 test, ocular surface disease index (OSDI) scoring, and evaluation of upper and lower eyelid Meibomian glands using infrared filter of slit-lamp biomicroscope were performed. In addition to grading Meibomian gland drop-out, the presence morphologic alterations such as Meibomian gland duct distortion, thinning and dilatation were also assessed.
RESULTS: The mean ages were 50.8 ± 8.3 (range, 35-68) and 47.9 ± 10.5 (range, 27-69) in Group 1 and Group 2, respectively (p = 0.616). Best-corrected visual acuity, Schirmer 1 test, Oxford scale and OSDI scores, and lower meiboscores did not differ significantly between groups. In Group 1, average t-BUT was lower (p = 0.003), upper and total (upper + lower) meiboscores were higher as compared to Group 2 (p < 0.05). The frequency of Meibomian gland duct distortion, thinning and dilatation were also significantly greater in Group 1 (p < 0.05).
CONCLUSION: Morphological changes, in addition to Meibomian glands dropout were significant in severe OSAS patients as demonstrated objectively with meibography. Schirmer 1 and t-BUT tests were in favor of evaporative type dry eye syndrome, which also support Meibomian gland alterations in severe OSAS patients.
MATERIALS AND METHODS: Based on polysomnography, 36 eyes of 36 patients with severe OSAS (Group 1, apnea-hypopnea index (AHI) ≥30/h) and 24 eyes of 24 patients with primary snoring or mild OSAS (Group 2, AHI<15/h) were enrolled. Detailed eye examination along with ocular surface staining (fluorescein, 2%) according to Oxford scale, tear film break-up time (t-BUT), Schirmer 1 test, ocular surface disease index (OSDI) scoring, and evaluation of upper and lower eyelid Meibomian glands using infrared filter of slit-lamp biomicroscope were performed. In addition to grading Meibomian gland drop-out, the presence morphologic alterations such as Meibomian gland duct distortion, thinning and dilatation were also assessed.
RESULTS: The mean ages were 50.8 ± 8.3 (range, 35-68) and 47.9 ± 10.5 (range, 27-69) in Group 1 and Group 2, respectively (p = 0.616). Best-corrected visual acuity, Schirmer 1 test, Oxford scale and OSDI scores, and lower meiboscores did not differ significantly between groups. In Group 1, average t-BUT was lower (p = 0.003), upper and total (upper + lower) meiboscores were higher as compared to Group 2 (p < 0.05). The frequency of Meibomian gland duct distortion, thinning and dilatation were also significantly greater in Group 1 (p < 0.05).
CONCLUSION: Morphological changes, in addition to Meibomian glands dropout were significant in severe OSAS patients as demonstrated objectively with meibography. Schirmer 1 and t-BUT tests were in favor of evaporative type dry eye syndrome, which also support Meibomian gland alterations in severe OSAS patients.