A Study of the Correlation between Meibomian Gland Dysfunction and the Occurrence of Dry Eye with Sjögren's Syndrome

GAO Xiaojuan; LAI Xiaolan; CHEN Renli

doi:10.3639/j.issn.2095-3097.2024.11.016

Abstract：Objective To investigate the correlation between meibomian gland dysfunction and the occurrence of dry eye associated with Sjögren's syndrome..Methods A total of 106 patients with Sjögren's syndrome accompanied by dry eye,who were admitted to Ningde Municipal Hospital Affiliated to Ningde Normal University from February 2020 to October 2023,were selected as the observation group.Meanwhile,another 106 patients with dry eye but without Sjögren's syndrome during the same period were selected as the control group.The meibomian gland function and clinical indicators were detected.The serum immu-noglobulin(Ig)A,IgM,and IgG levels were measured by immunoturbidimetric assay.Spearman's correlation analysis was used to analyze the correlations among meibomian gland function indicators,clinical indicators,and immunoglobulins.Multivariate Logis-tic regression analysis was performed to identify the influencing factors of Sjögren's syndrome with dry eye.The receiver operating characteristic(ROC)curve was plotted to evaluate the diagnostic value of meibomian gland dysfunction for Sjögren's syndrome with dry eye.Results In the observation group,the scores of Ocular Surface Disease Index(OSDI),Fluorescein Staining(FL),im-munoglobulin A(IgA),IgM,IgG,eyelid margin changes,meibomian gland secretion ability,meibomian gland secretion character-istics,and meibomian gland loss were significantly higher than those in the control group(P<0.05),while the scores of Tear Break-Up Time(BUT)and Schirmer I Test(sIt)were significantly lower than those in the control group(P<0.05).The meibomian gland function indicators were positively correlated with OSDI,FL,IgA,IgM,and IgG(P<0.05),and negatively correlated with BUT and sIt(P<0.05).Multivariate Logistic regres-sion analysis revealed that OSDI,FL,IgA,IgM,IgG,and meibomian gland function indicators were all risk factors for Sjögren's syndrome with dry eye(P<0.05),while BUT and sIt were protective factors(P<0.05).According to the ROC curve,the area under the curve(AUC)of the com-bined diagnosis of four scores(eyelid margin changes,meibomian gland secretion ability,meibomian gland secretion characteristics,and meibomian gland loss)for patients with Sjögren's syndrome with dry eye was 0.962.The combined diagnosis of the four was superior to individual diagnoses(Z=2.641,Z=2.302,Z=2.218,Z=2.896,all P<0.05).Conclusion Meibomian gland dysfunction is closely related to the occurrence of dry eye asso-ciated with Sjöjen's syndrome.