The Dry Eye Zone

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Abstract: OMGD treatments & evaluation with confocal

This is kind of an interesting one, studying obstructive meibomian gland disease via confocal microscopy in patients treated with an antiinflammatory or just with unpreserved tears and sodium hyaluronate. Unsurprisingly, the artificial tears really didn't improve anything clinically. Wish there had been some comparison with other treatments.

Graefes Arch Clin Exp Ophthalmol. 2009 Jun;247(6):821-9. Epub 2008 Dec 20.
The evaluation of the treatment response in obstructive meibomian gland disease by in vivo laser confocal microscopy.

Matsumoto Y, Shigeno Y, Sato EA, Ibrahim OM, Saiki M, Negishi K, Ogawa Y, Dogru M, Tsubota K.
Johnson & Johnson Department of Ocular Surface and Visual Optics, Keio University School of Medicine, Tokyo, Japan.

PURPOSE: To evaluate the status of periglandular inflammation, ocular surface and tear function alterations in patients with obstructive meibomian gland disease (OMGD) by in vivo confocal microscopy before and after anti-inflammatory treatment, and to compare the results with patients receiving only topical non-preserved artificial tears and sodium hyaluronate eye drops without anti-inflammatory agents.

METHODS: Thirty-two eyes of 16 OMGD patients receiving anti-inflammatory treatment (treatment group) and 22 eyes of 11 OMGD patients receiving only topical non-preserved artificial tears and sodium hyaluronate eye drops (control group) were recruited in this prospective study. All subjects underwent slit-lamp examinations, tear film break-up time (BUT) measurements, fluorescein and Rose-Bengal stainings, Schirmer test capital I, Ukrainian without anesthesia, transillumination of the lids (meibography), and in vivo laser confocal microscopy of the lids (HRTII-RCM).

RESULTS: The mean BUT, fluorescein staining scores, and inflammatory cell densities observed by in vivo confocal microscopy improved significantly in the group receiving anti-inflammatory treatment (p < 0.05), whereas no significant alterations of these parameters were observed in the group not receiving anti-inflammatory agents (p > 0.05).

CONCLUSIONS: In vivo confocal microscopy was able to effectively demonstrate the treatment responses in patients with OMGD. Inflammatory cell density calculation seems to be a promising new parameter of in vivo confocal microscopy in the evaluation of treatment responses.
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