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Purpose : To examine the morphological changes in meibomian glands using noncontact infrared meibography in patients with ocular lymphoma undergoing radiotherapy.
To investigate complications of external beam radiotherapy and find out correlation between morphological changes in meibomian gland and other factors associated with ocular surface and tear film abnormality.
Methods : The study was designed in prospective manner with 53 of 43 patients who were diagnosed as ocular adnexal MALT lymphoma and treated primarily with radiation therapy from July 2015 to May 2017. An infrared meibography was used to obtain pictures of meibomian glands in upper and lower eyelids for 53 subjects before the radiation and 1, 3, 6 months after the radiation therapy. The morphological changes in meibomian glands were evaluated by meibograde. The symptoms and complications of radiation were inquired from individual patients. In addition, evaluation of lid margin abnormalities, OSDI, tear film break-up time, schirmer test, and corneal surface changes were carried out before and after the radiation therapy.
Results : The meibograde of pre-radiation was 0.44 ± 0.39 in upper eyelids and 0.56 ± 0.74 in lower eyelids. After the radiation therapy, meibograde changed to 2.06 ± 0.60 in in upper eyelids and 3.25 ± 1.11 in lower eyelids and this increase in meibograde showed statistical significance. The most common complication the patients complained of was dryness of their eyes. There were also statistically significant changes in lid margin abnormalities, OSDI, tear film break-up time, and corneal surface stain after the radiation. Among these factors, morphological changes in meibomin glands were significantly correlated with lid margin abnormality and tear film break-up
Conclusion : Meibography can detect post-irradiation changes in meibomian glands. Infrared meibography may be a useful and patient-friendly method tool for evaluation of ocular complications after orbital irradiation such as dry eye disease along with BUT and OSDI.
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