EVAPORATİF KURU GÖZ HASTALIĞI OLUŞUMUNDA MEİBOMİUS BEZ HASTALIĞININ VE NÖROMEDİYATÖRLERİN ROLÜ
Bilgiç, Ahmet Alp
Bilgiç, Ahmet Alp
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The aim of this study is to evaluate the effects of visual display terminal (VDT) work and meibomian gland dysfunction (MGD) on the ocular surface and their association with dry eye disease. In addition, the comparison of the changes with VDT work and changes with MGD were evaluated and the relationship between these changes and tear cytokine levels and Substance P (SP) levels were evaluated. 17 patients with more than 4 hr/day VDT work, 17 patienst with more than 4 hr/day VDT work and with MGD, 26 patients with less than 4 hr/day VDT work and with MGD who admitted to our clinic and a sex and age matched control group of 20 patients who had no history of any ocular disease except refractive errors were enrolled. VDT work duration were examined, ocular surface and tear functions were evaluated with; OSDI (Ocular surface disease index) questionnaire, tear breakup time (TBUT) assesment, Fluorescein and Lissamine staining of the ocular surface, Schirmer test, MGD staging with meibography, in vivo confocal microscopy (IVCM) measurement and corneal sensitivity measurement with Cochet-Bonnet. GM- CSF, G-CSF, IFN-α, IFN-γ, IL-1β, IL-1RA, IL-2, IL-2R, IL-4, IL-5, IL-6, IL-7, IL-8, IL-10, IL-12, IL-13, IL-15, IL-17, TNF-α, MCP-1, IP-10, MIG, RANTES, Eotaksin, MIP-1α, MIP-1β, EGF, FGF, HGF ve VEGF levels in tears were examined with Luminex and SP levels in tears were examined with ELISA. In VDT work group and in MGD group, OSDI score was higher (p<0,001), corneal flourescein and lissamine staining was increased (p=0,029), TBUTs were shorter (p<0,001). The difference of Schirmer test was not significant between groups. The difference of IVCM measurements was not significant between the groups but nerve tortuosity was increased in the group who is with MGD and had less than 4 hr/day VDT work. Corneal sensitivity measurements were not significantly different between groups. In dry eye groups tear IL-6 levels was higher than control group (p=0,006). Tear SP levels had no significant difference between the groups (p=0,265). There was a weak positive correlation between VDT work time and OSDI score (p=0,014), also between VDT work time and SP levels (p=0,011). In conclusion; prolongation of VDT work time was seen to cause changes in ocular surface and tear film. It was also seen that MGD with VDT work did not exacerbate ocular surface findings and symptoms. It was considered that there was no significant inflammatory response on the ocular surface in the evaporative dry eye developing in the presence of VDT work or mild to moderate MGD.