Severe meibomian gland dysfunction linked to tear film instability in TED

Dry eye symptoms observed in treatment-naive thyroid eye disease (TED) predominantly manifest as evaporative dry eye disease, according to a study. The severity of meibomian gland dysfunction (MGD) in the lower eyelid and the presence of lagophthalmos appear to be strongly correlated with tear film instability in patients with treatment-naive TED.

In this cross-sectional study has shed light on the connection between meibomian gland dysfunction (MGD), 152 eyes from 76 patients with TED, and 93 eyes from 61 healthy individuals serving as controls, were evaluated.

The findings revealed significant differences between patients with TED and the control group. TED eyes exhibited higher scores in the ocular surface disease index, tear meniscus height, lipid layer thickness, and corneal punctate epithelial erosions, while non-invasive tear break-up time was shorter, and meibomian gland dropout (meiboscore) was worse (P < 0.05).

In addition, eyes with TED demonstrated increased exophthalmos, longer margin reflex distances of the upper and lower eyelids (MRD1 and MRD2), elevated lateral flare, and lagophthalmos.

Through multivariate analysis, the study identified 2 key factors associated with tear film instability in TED patients: lagophthalmos (β = -1.13, 95%CI: -2.08, -0.18) and severe MGD in the lower eyelid (β = -5.01, 95%CI = -7.59, -2.43).

Reference
Liao X, Lai KKH, Aljufairi FMAA, et al. Ocular Surface Changes in Treatment-Naive Thyroid Eye Disease. J Clin Med. 2023;12(9):3066. doi: 10.3390/jcm12093066. PMID: 37176507; PMCID: PMC10179143.