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CİLT ROZASEASINDA MEİBOMİAN BEZLERİN DEĞERLENDİRİLMESİ

Year 2021, Volume: 28 Issue: 4, 621 - 626, 30.12.2021
https://doi.org/10.17343/sdutfd.962200

Abstract

Amaç
Cilt rozaseası olan hastalarda gözyaşı fonksiyonlarını
ve Meibomian bezlerin durumunu değerlendirmek.
Gereç ve Yöntem
Cilt rozaseası olan 38 hasta (çalışma grubu) ile 30
sağlıklı gönüllü bireyin (kontrol grubu) sağ gözleri
değerlendirildi. Oküler yüzey hastalık indeksi (OSDI)
skoru hesaplandıktan sonra sırasıyla gözyaşı ozmolariteleri
ve gözyaşı kırılma zamanları (T-BUT) ölçülüp
ve Schirmer testi yapıldı. Alt ve üst kapaktaki meibomian
bezler Sirius ön segment analiz sistemi ile meibografi
yapılarak değerlendirildi.
Bulgular
Gruplar arasında yaş ve cinsiyet açısından istatistiksel
olarak anlamlı fark saptanmadı (p>0.05). OSDI
skoru, gözyaşı ozmolaritesi ve Schirmer değerleri
açısından gruplar arasında istatistiksel olarak anlamlı
fark saptanmadı (tümü için p>0.05). Çalışma grubunun
T-BUT değerlerinin kontrol grubuna göre anlamlı
olarak daha kısa olduğu tespit edildi (p <0.01). Rozasea
ve kontrol grubunda üst göz kapağında meibmian
bezlerdeki kayıp oranının ortanca değerleri sırası ile
%18.00 (çeyrekler arası aralık [ÇAA]: %8.10-27.75)
ve %14.60 (ÇAA: %7.95-25.30) iken alt göz kapağı
meibografisinde bu değerler sırası ile %15.00 (ÇAA:
%9.37-25.90) ve %11.15 (ÇAA: %5.60-19.70) idi.
Hem alt hem de üst göz kapağında meibomian bezlerdeki
kayıp oranı açısından gruplar arasında istatiksel
olarak anlamlı bir fark saptanmadı (sırasıyla,
p=0.39 ve p=0.18).
Sonuç
Cilt rozaseası olan hastalarda daha yüksek oranda
meibomian bez kaybı gözlenmesine rağmen, bu istatistiksel
olarak kontrol grubundan farklı değildi. Buna
rağmen bu hastalarda gözyaşı instabilitesi olduğu
saptandı.

References

  • 1. Steinhoff M, Schauber J, Leyden JJ. New insights into rosacea pathophysiology: a review of recent findings. J Am Acad Dermatol 2013;69:5–26.
  • 2. Gallo RL, Granstein RD, Kang S, Mannis M, Steinhoff M, Tan J, Thiboutot D. Standard classification and pathophysiology of rosacea: The 2017 update by the National Rosacea Society Expert Committee. J Am Acad Dermatol 2018;78:148-155.
  • 3. Spoendlin J, Voegel JJ, Jick SS, Meier CR. A study on the epidemiology of rosacea in the U.K. Br J Dermatol 2012;167:598- 605.
  • 4. Webster G, Schaller M. Ocular rosacea: a dermatologic perspective. J Am Acad Dermatol 2013;69:42–43.
  • 5. Crawford GH, Pelle MT, James WD. Rosacea: I. Etiology, pathogenesis, and subtype classification. J Am Acad Dermatol 2004;51:327–341.
  • 6. Awais M, Anwar MI, Iftikhar R, Iqbal Z, Shehzad N, Akbar B. Rosacea—the ophthalmic perspective. Cutan Ocul Toxicol 2015;34:161-166.
  • 7. Blount BW, Pelletier AL. Rosacea: a common, yet commonly overlooked, condition. Am Fam Physician 2002;66:435-440.
  • 8. Vieira AC, Höfling-Lima AL, Mannis MJ. Ocular rosacea-a review. Arq Bras Oftalmol 2012;75:363–369.
  • 9. Oltz M, Check J. Rosacea and its ocular manifestations. Optometry 2011;82:92–103.
  • 10. Wilkin J, Dahl M, Detmar M, Drake L, Liang MH, Odom R, Powell F. Standard classification of rosacea: Report of the National Rosacea Society Expert Committee on the classification and staging of rosacea. J Am Acad Dermatol 2004;50:907-912.
  • 11. Ghanem VC, Mehra N, Wong S, Mannis MJ. The prevalence of ocular signs in acne rosacea: comparing patients from ophthalmology and dermatology clinics. Cornea 2003;22:230-233.
  • 12. Dursun Altınörs D, Asena L. Systemic Diseases and Dry Eye. MN Oftalmoloji 2016;23:53-59.
  • 13. Knop E, Knop N, Millar T, Obata H, Sullivan DA. The international workshop on meibomian gland dysfunction: report of the subcommittee on anatomy, physiology, and pathophysiology of the meibomian gland. Invest Ophthalmol Vis Sci 2011; 52:1938-1978.
  • 14. Arita R, Itoh K, Inoue K, Amano S. Noncontact infrared meibography to document age-related changes of the meibomian glands in a normal population. Ophthalmology 2008;115:911–915.
  • 15. Palamar M, Değirmenci C, Ertam I, Yağci A. Evaluation of dry eye and meibomian gland dysfunction with meibography in patients with rosacea. Cornea 2015;34:497–499.
  • 16. Holmes AD. Potential role of microorganisms in the pathogenesis of rosacea. J Am Acad Dermatol 2013;69:1025–1032.
  • 17. Müftüoglu İK, Aydın Akova Y. Clinical Findings, Follow-up and Treatment Results in Patients with Ocular Rosacea. Turk J Ophthalmol 2016;46:1-6.
  • 18. Evren Ö, Karci AA, Orhan İ, Artüz F, Tamer U, Sener B, Gürsel E. Tear Film Function and Lipid Composition of Meibomian Glands. Turk J Ophthalmol 2006;36:450-456.
  • 19. Alvarenga LS, Mannis MJ. Ocular rosacea. Ocul Surf 2005;3:41–58.
  • 20. Adil MY, Xiao J, Olafsson J, Chen X, Lagali NS, Ræder S, Utheim ØA, Dartt DA, Utheim TP. Meibomian Gland Morphology Is a Sensitive Early Indicator of Meibomian Gland Dysfunction. Am J Ophthalmol 2019;200:16-25.
  • 21. Machalińska A, Zakrzewska A, Markowska A, Safranow K, Wiszniewska B, Parafiniuk M, Machaliński B. Morphological and Functional Evaluation of Meibomian Gland Dysfunction in Rosacea Patients. Curr Eye Res 2016;41:1029-1034.
  • 22. Lee WJ, Jung JM, Lee YJ, et al. Histopathological Analysis of 226 Patients With Rosacea According to Rosacea Subtype and Severity. Am J Dermatopathol 2016; 38: 347-352.
  • 23. Liang H, Randon M, Michee S, Tahiri R, Labbe A, Baudouin C. In vivo confocal microscopy evaluation of ocular and cutaneous alterations in patients with rosacea. Br J Ophthalmol 2017;101:268-2674.
  • 24. Schaller M, Almeida LM, Bewley A, Cribier B, Dlova NC, Kautz G, Mannis M, Oon HH, Rajagopalan M, Steinhoff M, Thiboutot D, Troielli P, Webster G, Wu Y, van Zuuren E, Tan J. Rosacea treatment update: recommendations from the global ROSacea COnsensus (ROSCO) panel. Br J Dermatol. 2017;176:465- 471.
  • 25. Andrade FMX, Picosse FR, Cunha LPD, Valente CM, Bezerra FM, Miot H, Bagatin E, Freitas D. Ocular surface changes in the treatment of rosacea: comparison between low-dose oral isotretinoin and doxycycline. Arq Bras Oftalmol. 2020;83:109-112.
  • 26. Holzchuh FG, Hida RY, Moscovici BK, Villa Albers MB, Santo RM, Kara-José N, Holzchuh R. Clinical treatment of ocular Demodex folliculorum by systemic ivermectin. Am J Ophthalmol. 2011;151:1030-1034.e1.
  • 27. Sobolewska B, Doycheva D, Deuter CM, Schaller M, Zierhut M. Efficacy of Topical Ivermectin for the Treatment of Cutaneous and Ocular Rosacea. Ocul Immunol Inflamm. 2020:1-5. Epub ahead of print. PMID: 32255398.
  • 28. Ozek D, Evren Kemer Ö, Artüz F. Assessment of Tear Functions in Patients with Acne Rosacea without Meibomian Gland Dysfunction. Ocul Immunol Inflamm 2019;27:632-635.
  • 29. Topcu-Yilmaz P, Atakan N, Bozkurt B, Irkec M, Aban D, Mesci L, Tezcan I. Determination of tear and serum inflammatory cytokines in patients with rosacea using multiplexbead technology. Ocul Immunol Inflamm 2013;21:351-359.

EVALUATION OF MEIBOMIAN GLANDS IN CUTANEOUS ROSACEA

Year 2021, Volume: 28 Issue: 4, 621 - 626, 30.12.2021
https://doi.org/10.17343/sdutfd.962200

Abstract

Objective
To evaluate tear functions and Meibomian glands’
status in patients with cutaneous rosacea.
Material and Methods
Right eyes of 38 patients with cutaneous rosacea
(study group) and 30 healthy volunteers (control
group) were evaluated. After Ocular Surface Disease
Index (OSDI) score was calculated, tear osmolarity
and tear break-up time (T-BUT) were measured, and
the Schirmer test was applied respectively. Meibomian
glands in the lower and upper eyelids were evaluated
by meibography using the Sirius anterior segment
analysis system.
Results
No statistically significant difference was detected
between the groups in respect of age and gender
(p>0.05). No statistically significant difference was
determined between the groups in respect of the
OSDI score, tear osmolarity, and Schirmer test values
(p>0.05 for all). The T-BUT values of the study group
were detected to be significantly shorter than those
of the control group (p<0.01). The median values
of meibomian gland loss rate in the upper eyelid
of the rosacea and control groups were 18.00%
(Interquartile range [IQR]: 8.10-27.75%) and 14.60%
(IQR: 7.95-25.30%) respectively, while these values
in the lower eyelid meibography, were 15.00% (IQR:
9.37-25.90%) and 11.15% (IQR: 5.60-19.70%)
respectively. No statistically significant difference was
determined between the groups in terms of loss of
meibomian glands in both the upper and lower eyelids
(p=0.39 and p=0.18, respectively).
Conclusion
Although a higher rate of loss of meibomian glands
was observed in patients with cutaneous rosacea, this
was not statistically different from the control group.
However, tear instability was detected in these patients.

References

  • 1. Steinhoff M, Schauber J, Leyden JJ. New insights into rosacea pathophysiology: a review of recent findings. J Am Acad Dermatol 2013;69:5–26.
  • 2. Gallo RL, Granstein RD, Kang S, Mannis M, Steinhoff M, Tan J, Thiboutot D. Standard classification and pathophysiology of rosacea: The 2017 update by the National Rosacea Society Expert Committee. J Am Acad Dermatol 2018;78:148-155.
  • 3. Spoendlin J, Voegel JJ, Jick SS, Meier CR. A study on the epidemiology of rosacea in the U.K. Br J Dermatol 2012;167:598- 605.
  • 4. Webster G, Schaller M. Ocular rosacea: a dermatologic perspective. J Am Acad Dermatol 2013;69:42–43.
  • 5. Crawford GH, Pelle MT, James WD. Rosacea: I. Etiology, pathogenesis, and subtype classification. J Am Acad Dermatol 2004;51:327–341.
  • 6. Awais M, Anwar MI, Iftikhar R, Iqbal Z, Shehzad N, Akbar B. Rosacea—the ophthalmic perspective. Cutan Ocul Toxicol 2015;34:161-166.
  • 7. Blount BW, Pelletier AL. Rosacea: a common, yet commonly overlooked, condition. Am Fam Physician 2002;66:435-440.
  • 8. Vieira AC, Höfling-Lima AL, Mannis MJ. Ocular rosacea-a review. Arq Bras Oftalmol 2012;75:363–369.
  • 9. Oltz M, Check J. Rosacea and its ocular manifestations. Optometry 2011;82:92–103.
  • 10. Wilkin J, Dahl M, Detmar M, Drake L, Liang MH, Odom R, Powell F. Standard classification of rosacea: Report of the National Rosacea Society Expert Committee on the classification and staging of rosacea. J Am Acad Dermatol 2004;50:907-912.
  • 11. Ghanem VC, Mehra N, Wong S, Mannis MJ. The prevalence of ocular signs in acne rosacea: comparing patients from ophthalmology and dermatology clinics. Cornea 2003;22:230-233.
  • 12. Dursun Altınörs D, Asena L. Systemic Diseases and Dry Eye. MN Oftalmoloji 2016;23:53-59.
  • 13. Knop E, Knop N, Millar T, Obata H, Sullivan DA. The international workshop on meibomian gland dysfunction: report of the subcommittee on anatomy, physiology, and pathophysiology of the meibomian gland. Invest Ophthalmol Vis Sci 2011; 52:1938-1978.
  • 14. Arita R, Itoh K, Inoue K, Amano S. Noncontact infrared meibography to document age-related changes of the meibomian glands in a normal population. Ophthalmology 2008;115:911–915.
  • 15. Palamar M, Değirmenci C, Ertam I, Yağci A. Evaluation of dry eye and meibomian gland dysfunction with meibography in patients with rosacea. Cornea 2015;34:497–499.
  • 16. Holmes AD. Potential role of microorganisms in the pathogenesis of rosacea. J Am Acad Dermatol 2013;69:1025–1032.
  • 17. Müftüoglu İK, Aydın Akova Y. Clinical Findings, Follow-up and Treatment Results in Patients with Ocular Rosacea. Turk J Ophthalmol 2016;46:1-6.
  • 18. Evren Ö, Karci AA, Orhan İ, Artüz F, Tamer U, Sener B, Gürsel E. Tear Film Function and Lipid Composition of Meibomian Glands. Turk J Ophthalmol 2006;36:450-456.
  • 19. Alvarenga LS, Mannis MJ. Ocular rosacea. Ocul Surf 2005;3:41–58.
  • 20. Adil MY, Xiao J, Olafsson J, Chen X, Lagali NS, Ræder S, Utheim ØA, Dartt DA, Utheim TP. Meibomian Gland Morphology Is a Sensitive Early Indicator of Meibomian Gland Dysfunction. Am J Ophthalmol 2019;200:16-25.
  • 21. Machalińska A, Zakrzewska A, Markowska A, Safranow K, Wiszniewska B, Parafiniuk M, Machaliński B. Morphological and Functional Evaluation of Meibomian Gland Dysfunction in Rosacea Patients. Curr Eye Res 2016;41:1029-1034.
  • 22. Lee WJ, Jung JM, Lee YJ, et al. Histopathological Analysis of 226 Patients With Rosacea According to Rosacea Subtype and Severity. Am J Dermatopathol 2016; 38: 347-352.
  • 23. Liang H, Randon M, Michee S, Tahiri R, Labbe A, Baudouin C. In vivo confocal microscopy evaluation of ocular and cutaneous alterations in patients with rosacea. Br J Ophthalmol 2017;101:268-2674.
  • 24. Schaller M, Almeida LM, Bewley A, Cribier B, Dlova NC, Kautz G, Mannis M, Oon HH, Rajagopalan M, Steinhoff M, Thiboutot D, Troielli P, Webster G, Wu Y, van Zuuren E, Tan J. Rosacea treatment update: recommendations from the global ROSacea COnsensus (ROSCO) panel. Br J Dermatol. 2017;176:465- 471.
  • 25. Andrade FMX, Picosse FR, Cunha LPD, Valente CM, Bezerra FM, Miot H, Bagatin E, Freitas D. Ocular surface changes in the treatment of rosacea: comparison between low-dose oral isotretinoin and doxycycline. Arq Bras Oftalmol. 2020;83:109-112.
  • 26. Holzchuh FG, Hida RY, Moscovici BK, Villa Albers MB, Santo RM, Kara-José N, Holzchuh R. Clinical treatment of ocular Demodex folliculorum by systemic ivermectin. Am J Ophthalmol. 2011;151:1030-1034.e1.
  • 27. Sobolewska B, Doycheva D, Deuter CM, Schaller M, Zierhut M. Efficacy of Topical Ivermectin for the Treatment of Cutaneous and Ocular Rosacea. Ocul Immunol Inflamm. 2020:1-5. Epub ahead of print. PMID: 32255398.
  • 28. Ozek D, Evren Kemer Ö, Artüz F. Assessment of Tear Functions in Patients with Acne Rosacea without Meibomian Gland Dysfunction. Ocul Immunol Inflamm 2019;27:632-635.
  • 29. Topcu-Yilmaz P, Atakan N, Bozkurt B, Irkec M, Aban D, Mesci L, Tezcan I. Determination of tear and serum inflammatory cytokines in patients with rosacea using multiplexbead technology. Ocul Immunol Inflamm 2013;21:351-359.
There are 29 citations in total.

Details

Primary Language English
Subjects Surgery
Journal Section Research Articles
Authors

Ersin Muhafiz 0000-0002-8281-8767

Seray Aslan 0000-0001-8514-9450

Hasan Ali Bayhan 0000-0002-3364-6890

Emine Çölgeçen 0000-0001-9651-6068

Canan Gürdal 0000-0002-5312-378X

Publication Date December 30, 2021
Submission Date July 4, 2021
Acceptance Date September 29, 2021
Published in Issue Year 2021 Volume: 28 Issue: 4

Cite

Vancouver Muhafiz E, Aslan S, Bayhan HA, Çölgeçen E, Gürdal C. EVALUATION OF MEIBOMIAN GLANDS IN CUTANEOUS ROSACEA. Med J SDU. 2021;28(4):621-6.

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