Noncontact Meibography Detects Changes in Meibomian Glands in the Aging Process in a Normal Population and Patients with Meibomian Gland Dysfunction

Purpose: To examine, using our novel technique of noncontact meibography, morphological changes in meibomian glands associated with aging and sex in a normal population and in patients with obstructive meibomian gland dysfunction (oMGD) and seborrheic meibomian gland dysfunction (sMGD). Participants: Two hundred thirty-six healthy volunteers [M:F, 114:122; mean age (range), 41.2 +/- 23.1 (4-98) years] and patients with oMGD or sMGD. Methods: Lid margin and ocular surface were examined by slit lamp. The meibomian glands were observed with noncontact meibography and scored using meiboscore. Partial or complete loss of meibomian glands was scored for each eyelid from grade 0 (no loss of meibomian glands) to grade 3 (lost area more than two thirds total area of meibomian glands). Results: Significant positive correlations were noted between age and meiboscore in total subjects (R = 0.428; P < 0.0001), in men (R = 0.462; P < 0.0001), and in women (R = 0.418; P < 0.0001). There was a significant positive correlation between age and score of lid margin abnormalities (R = 0.538; P < 0.0001). Meiboscore was significantly correlated with the score of lid margin abnormalities (R = 0.359; P < 0.0001). In oMGD, changes in meibomian glands such as dropout and shortening were observed. In sMGD, no change in meibomian glands was detected. Conclusions: Changes in meibomian glands increased with age in a normal population. In oMGD, morphologic changes in meibomian glands were observed. In sMGD, no morphologic changes in meibomian glands were detected.