The correlation between meibomian gland abnormalities and obstructive sleep apnea-hypopnea syndrome
LIU Mu,GAO Yingying,ZHAO Huaxuan,ZENG Mingfan,CHEN Xiaoyang
Department of Ophthalmology, the Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, China; 2. Department of Respiratory, the Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, China
Objective To discuss the relationship between meibomian gland abnormalities and tear film stability in patients with obstructive sleep apnea-hypopnea syndrome. Methods In a descriptive study from November 2013 to June 2014, 63 patients (126 eyes) who were diagnosed with obstructive sleep apnea-hypopnea syndrome (OSAHS) were recruited. Healthy individuals (n=44; 88 eyes) who were seeking physical examinations served as the control group. Personal information, clinical history, and the ocular surface disease index (OSDI) were recorded. All eyes were assessed by slit lamp examination, tear break-up time (BUT), noncontact infrared meibography, and meibomian gland inspection. The prevalence of meibomian gland dropout and distortion in OSAHS patients was compared with controls. Results The prevalence of meibomian gland dropout in the control and different OSAHS groups (mild, moderate, and severe) was 12/88(14%), 7/18(39%), 14/30(47%), and 53/78(68%), respectively. The difference was statistically significant (χ²=50.62, P＜0.01). The meibography scores of the mild, moderate, and severe OSAHS group and the control group were 2.29±1.25, 2.29±0.91, 2.64±1.18, and 1.50±0.67, respectively. The difference was statistically significant. The prevalence of meibomian gland distortion in the control and different OSAHS groups (mild, moderate, and severe) was 8/88(9%), 6/18(33%), 12/30(40%), 49/78(63%), respectively. The difference was statistically significant (χ²=51.96, P＜0.01). Meibomian gland orifices were plugged in 32 eyes in the control group (32/88, 36%) and in 87 eyes in the OSAHS group (87/126, 69%). The difference was significant (χ²=22.42, P＜0.01). Meibomian abnormalities were present in 34 eyes in the control group (34/88, 39%) and in 91 eyes in the OSAHS group (91/126, 72%). The difference between the two groups were statistically significant (χ²=27.26, P＜0.01). Conclusion Compared to the general population, OSAHS patients have a less stable tear film, and they are more likely to develop meibomian gland atrophy or morphological abnormality. Morphological abnormality of the meibomian gland is correlated with the severity of OSAHS.
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