Caracterización de la función y morfología de las glándulas de Meibomio en distintas poblaciones
Justification The aim of this doctoral thesis is to develop an objective method of analysis and to characterize the morphology of the meibomian glands (MG) in different populations. A decrease in relative humidity increases the signs and symptoms of dry eye disease (DED), for this reason the effect...
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| Tipo de recurso: | tesis doctoral |
| Estado: | Versión publicada |
| Fecha de publicación: | 2023 |
| País: | España |
| Institución: | Universidad de Valladolid |
| Repositorio: | UVaDOC. Repositorio Documental de la Universidad de Valladolid |
| OAI Identifier: | oai:uvadoc.uva.es:10324/60999 |
| Acceso en línea: | https://doi.org/10.35376/10324/60999 https://uvadoc.uva.es/handle/10324/60999 |
| Access Level: | acceso abierto |
| Palabra clave: | Ojo seco Optometry Optometría 3201.09 Oftalmología |
| Sumario: | Justification The aim of this doctoral thesis is to develop an objective method of analysis and to characterize the morphology of the meibomian glands (MG) in different populations. A decrease in relative humidity increases the signs and symptoms of dry eye disease (DED), for this reason the effect of an adverse environmental exposure on the treatment of EOS has also been evaluated. Hypothesis Meibomian gland morphology changes with age and in different ocular conditions, and analysis of these changes may be useful in the evaluation of the diagnosis and treatment of such conditions. Objectives 1. To characterize the morphology of the Meibomian glands in healthy subjects, defining reference intervals. 2. To evaluate Meibomian gland morphology in subjects with dry eye disease. 3. To evaluate Meibomian gland morphology in subjects undergoing hematopoietic cell transplantation. 4. To evaluate the effect of treatment for Meibomian gland dysfunction under controlled environmental conditions. Characterization of MG Reference intervals (RI) for Meibomian gland morphology in healthy subjects. Length, euclidean distance between MG ends, width and tortuosity are age dependent. The number of MG, number of segments, deviation from vertical and global MG area do not depend on either age or sex. The superior MG area is age- and sex-dependent. Meibomian gland morphology in subjects with dry eye disease 66.7% subjects with DED were classified as 'normal' and 33.3% as 'non -normal'. The non-normal group had more symptoms and worse MG function than the normal group. Effect of hematopoietic cell transplantation on the MG Subjects undergoing hematopoietic cell transplantation had a greater degree of MG loss in the lower eyelid than control subjects. The length was less in subjects in the transplantation group in both eyelids. After transplantation, the degree of loss increased in the upper eyelid, MG area decreased in both eyelids, length increased in both eyelids, and tortuosity in the lower eyelid also increased. Effect of thermal pulsation treatment in patients with meibomian gland dysfunction under controlled environmental conditions MG function improved at all visits after treatment. Symptoms decreased one year after treatment. Tear film lipid layer thickness decreased under the adverse condition. The degree of anterior blepharitis decreased at 6 and 12 months. Corneal staining decreased at all visits. Conjunctival staining decreased at 6 and 12 months. Conclusions 1. It is possible to quantify and calculate reference intervals of different properties of the Meibomian glands considering the influence of age and sex, being able to be useful to describe ocular surface alterations. 2. It is possible to apply the defined indices and reference intervals to classify Meibomian gland morphology in subjects with dry eye, being able to detect cases with worse Meibomian gland function and more symptoms when ocular signs are equal. 3. Subjects undergoing hematopoietic cell transplantation could suffer an increased degree of Meibomian gland loss after transplantation. 4. A single treatment session leads to an objective and subjective improvement of the lacrimal functional unit under controlled environmental conditions and its effects last up to one year after treatment. |
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