In vivo findings of the bulbar/palpebral conjunctiva and presumed meibomian glands by laser scanning confocal microscopy

OBJECTIVE: To report in vivo laser scanning confocal microscopic findings of the normal human conjunctiva and presumed meibomian glands and to investigate the potential application of this confocal microscope (HRT II Rostock Cornea Module) as a diagnostic device for normal and abnormal ocular surface structures. METHOD: Four healthy volunteers (51-, 49-, 31-, and 30-year-old men) participated in this study. The temporal bulbar conjunctiva, approximately 5 mm away from the limbus, and the upper tarsus conjunctiva of each patient were examined in vivo by a laser confocal microscope. Also, presumed meibomian glands beneath the tarsal conjunctiva were examined. RESULTS: In all subjects, the in vivo laser confocal microscope obtained similar images. In the superficial epithelial cell layer of the bulbar conjunctiva, numerous bright nuclei were observed. We also observed many Langerhans cells with characteristic dendritic morphology and goblet cells with relatively homogeneous brightness in the bulbar conjunctiva. Most interestingly, the palpebral conjunctival epithelium with invaginations or crypts was observed. In addition, weblike structures, presumably meibomian glands, were observed beneath the palpebral conjunctival epithelium. CONCLUSIONS: These results indicate that in vivo laser confocal microscopy can be used not only to visualize the bulbar conjunctiva but the upper tarsus conjunctiva and possibly subconjunctival meibomian glands. Further investigations of conjunctival and meibomian gland pathologies may further elucidate the potential of this device in clinical ophthalmology.     

Efficacy of commercially available topical cyclosporine A 0.05% in the treatment of meibomian gland dysfunction

OBJECTIVE: To investigate the efficacy of topical cyclosporine A 0.05% (tCsA) (Restasis, Allergan Pharmaceuticals) in the treatment of meibomian gland dysfunction (posterior blepharitis). METHODS: Thirty-three patients with symptomatic meibomian gland dysfunction were randomized in a prospective study to either tCsA or placebo (Refresh Plus preservative-free artificial tears), 2 times daily for 3 months. They were evaluated at baseline and at 1, 2, and 3 months for subjective symptoms and objective signs including meibomian gland inclusions, lid margin vascular injection, tarsal telangiectasis, fluorescein staining, tear breakup time, and Schirmer scores. RESULTS: Twenty-six patients completed the study. All patients were tested for ocular symptoms, lid margin vascularity, tarsal telangiectasis, meibomian gland inclusions, tear breakup time, and fluorescein staining. At the 3-month visit, the tCsA group showed a greater improvement in ocular symptoms than the placebo group, but this difference was not statistically significant. At the 3-month visit, several objective examination findings were statistically significantly (P < 0.05) improved in the tCsA group compared with the placebo group. These differences included lid margin vascular injection, tarsal telangiectasis, and fluorescein staining. The most significant finding (P = 0.001) was the greater decrease in the number of meibomian gland inclusions in the tCsA group compared with the placebo group. CONCLUSIONS: Topical CsA may be helpful in the treatment of meibomian gland dysfunction (posterior blepharitis). Topical CsA did not induce an improvement in the symptoms, but it did decrease the number of meibomian gland inclusions in patients with meibomian gland dysfunction.     

Utility of meibography in the evaluation of meibomian glands morphology in normal and diseased eyelids

PurposeTo study the utility of meibography for the morphology of meibomian glands in normal eyelids and in various eyelid diseases.DesignA cross-sectional study.MethodsA newly designed transilluminator, fitting both the upper along with lower eyelids, and an infrared camera were used to obtain video clips of the meibomian glands for 60 asymptomatic subjects with normal eyelid margin. Parameters studied included, ocular surface, Schirmer test, and tear breakup time (TBUT). The meibomian glands of patients with meibomian glands’ abnormality secondary to infectious, inflammatory, malignant, congenital, or post-radiation therapy disease related etiologies were compared with normal patients. Still pictures were extracted from the video clips to evaluate the meibomian glands for gland dropout and gross morphological changes.ResultsIn normal subjects, meibomian glands appeared to be thinner and longer in the upper eye lids than in the lower eye lids. Gland dropout occured with increased age, more in the lower eye lid and in females. Excessive gland drop out (> 75%) was seen in patients with history of trachoma, Stevens Johnson syndrome, severe blepharitis, and post-radiation for orbital tumors. Variable gland drop out was noticed in patients with floppy eyelid syndrome, and blepharitis. In patients with congenital distichiasis, partial or complete gland drop out at the part of the eyelid margins affected by distichiasis was noticed.ConclusionsThe newly designed transilluminator permitted the examination of both upper and lower eye lid meibomian glands with minimal discomfort. Evaluating the anatomical changes involving meibomian glands with meibography may help increase our understanding of the meibomian gland-related diseases, monitor the effects of treatment, and provide helpful information for patient education.     

Meibomian keratoconjunctivitis.

We evaluated, dermatologically and ophthalmologically, 26 patients who had chronic blepharitis (meibomitis); we also investigated 26 age- and sex-matched controls. All of the blepharitic patients had an abnormality of sebaceous gland function ranging from seborrhea sicca to seborrheic dermatitis or acne rosacea, suggesting a generalized sebaceous gland dysfunction that included the meibomian glands. Sebaceous gland abnormalities most frequently involved the cool areas of the face or scalp. Stagnation of the meibomian glands presumably caused a defect in the tear lipid layer; this resulted in an unstable tear film that produced superficial punctate keratopathy. The break-up time was much lower in these patients than in controls. The break-up time returned to normal or super-normal levels when fresh meibomian secretions were expressed into the tear film. The superficial punctate keratopathy had the characteristics of those seen in conditions with a known unstable tear film and not of those experimentally produced by staphylococcus toxin.     

Clinical treatment of ocular demodecosis by lid scrub with tea tree oil

PURPOSE: To report clinical outcome of treating ocular demodecosis by lid scrub with tea tree oil (TTO). METHODS: Retrospective review of clinical results in 11 patients with ocular Demodex who received weekly lid scrub with 50% TTO combined with daily lid hygiene with tea tree shampoo. RESULTS: These 11 patients also had meibomian gland dysfunction (n = 7) manifesting abnormal lipid film with slow lipid film spread, intermittent trichiasis (n = 5), and subjective lash loss (n = 4), suggesting damage to the meibomian glands and lash follicles. In addition, conjunctival inflammation (n = 8) was associated with conjunctivitis (n = 5), conjunctivochalasis (n = 3), findings suspicious for pemphigoid (n = 2), and recurrent pterygium (n = 2). After TTO lid scrub, the Demodex count dropped to 0 for 2 consecutive visits in less than 4 weeks in 8 of 11 patients. Ten of the 11 patients showed different degrees of symptomatic relief and notable reduction of inflammatory signs. Significant visual improvement in 6 of 22 eyes was associated with a stable lipid tear film caused by significant reduction of lipid spread time. Lid scrub with 50% TTO caused notable irritation in 3 patients. CONCLUSION: Demodex potentially causes ocular surface inflammation, meibomian gland dysfunction, and lash abnormalities. Lid scrub with TTO can effectively eradicate ocular Demodex and result in subjective and objective improvements. This preliminary positive result warrants future prospective investigation of Demodex pathogenicity.     

睑板腺功能障碍患者睑缘形态与睑板腺形态学的相关性研究

目的 研究睑板腺功能障碍（MGD）患者睑缘形态与睑板腺形态的相关性。设计 横断面研究。研究对象 2019年北京同仁医院行Lipiflow热脉冲治疗前的MGD患者30例（30眼）。方法 通过眼前节照相技术和Oculus眼表分析仪拍摄睑缘和睑板腺,并依据睑缘形态、睑板腺主体部形态、睑板腺开口和分泌物性状进行分类。睑缘形态分为肥厚、充血、角化和变形;睑板腺主体部形态分为缺失、白色节段、导管膨胀、萎缩、扭曲和分叉;睑板腺开口形态分为圆形、脂帽、脂塞和脂栓。依上述形态进行评分,运用Spearman相关分析研究睑缘形态与睑板腺形态的相关性。主要指标 睑缘及睑板腺形态评分,睑缘及睑板腺形态学相关系数（r）。结果 睑板腺开口形态与分泌物性状之间呈正相关（r=0.590,P=0.001）,睑板腺白色节段与睑板腺开口形态呈正相关（r=0.439,P=0.015）;睑板腺萎缩和分叉与睑板腺的分泌物性状呈负相关（r=-0.349,-0.374;P=0.048,0.042）。在睑缘形态中,睑缘角化的评分与睑缘形态总评分呈正相关,且相关关系最强（r=0.842,P＝0.000）;睑缘角化与睑板腺开口形态改变呈正相关（r=0.517,P=0.003）。在睑板腺形态中,睑板腺白色节段评分与睑板腺总评分呈正相关,且相关关系最强（r=0.535,P＝0.002）。结论 MGD患者睑缘形态与睑板腺形态部分存在相关关系。睑板腺白色节段作为睑板腺主体部的形态评估指标更为合理;睑缘角化作为睑缘的形态评估指标更为合理,且睑缘角化与睑板腺开口的形态改变相关。（眼科, 2020, 29： 355-360）     

Is complete androgen insensitivity syndrome associated with alterations in the meibomian gland and ocular surface?

PURPOSE: This study's purpose was to determine whether complete androgen insensitivity syndrome (CAIS) is associated with alterations in the meibomian gland and ocular surface. METHODS: Individuals with CAIS, as well as age-matched female and male controls, completed questionnaires which assessed dry eye symptoms and underwent slit lamp evaluations of the tear film, tear meniscus, lids and lid margins and conjunctiva. The quality of meibomian gland secretions was also analyzed. RESULTS: Our results demonstrate that CAIS is associated with meibomian gland alterations and a significant increase in dry eye signs and symptoms. Clinical assessment revealed that CAIS women, as compared to controls, had a significant increase in telangiectasia, keratinization, lid erythema and orifice metaplasia of the meibomian glands, and a significant decrease in the tear meniscus and quality of meibomian gland secretions. Questionnaire results showed that dry eye symptoms were increased over twofold in CAIS individuals, as compared to controls, including a significant increase in the sensations of dryness, pain and light sensitivity. CONCLUSION: Our results suggest that androgen insensitivity may promote meibomian gland dysfunction and an increase in the signs and symptoms of dry eye.     

Lid margin keratinization in Stevens-Johnson syndrome: Review of pathophysiology and histopathology

Lid margin keratinization (LMK) is a chronic ocular sequela of Stevens-Johnson syndrome (SJS), which causes lid wiper epitheliopathy and progressive ocular surface damage. The exact etiopathogenesis of LMK, however, remains elusive. This review summarizes the potential pathophysiological mechanisms of LMK and describes its histopathological features. A literature search of articles discussing the pathophysiology of LMK in SJS was performed. The possible pathophysiologic mechanisms contributing to LMK, as identified on the literature review, included loss of the muco-cutaneous junction barrier leading to epidermalization, dyskeratosis involving the meibomian gland orifices, altered lid margin microbiome, and de novo squamous metaplasia of the marginal conjunctival epithelium. Based on these mechanisms, the possible sources of keratinized epithelium at the posterior lid margin in SJS could be the adjacent anterior eyelid skin, hyperkeratinized epithelium from the meibomian gland ductal orifices, or the inflamed marginal conjunctiva. The epithelial, sub-epithelial, and stromal changes seen in keratinized posterior lid margins in SJS patients undergoing mucous membrane grafting were also investigated. The findings revealed keratinizing squamous metaplasia of the posterior lid margin accompanied by subepithelial infiltration of helper T cells predominantly on the conjunctival side. The visible meibomian gland orifices had ductal hyperkeratinization and plugging. These findings support a role for inflammation in the pathogenesis of LMK in SJS. Future research can be directed at delineating the pathways that lead to LMK by studying the changes in the lid margin microbiome, and the molecular mechanisms regulating keratinization in the conjunctiva and the meibomian gland orifices in eyes affected by SJS.     

Classification of chronic blepharitis

Since last thoroughly evaluated over three decades ago, the clinical spectrum of chronic blepharitis has changed. The relative prevalence of Staphylococcus aureus alone or in combination with seborrheic blepharitis has decreased. The relative prevalence has increased of seborrheic blepharitis with or without associated excess meibomian secretions (meibomian seborrhea) or inflammation (meibomitis). Primary meibomitis appears not to be a primarily infectious entity but to represent a facet of generalized sebaceous gland dysfunction and to be found in association with seborrheic dermatitis or acne rosacea. The keratoconjunctivitis found in association with primary meibomitis may be contributed to by the production of bacterial lypolytic exoenzymes that split neutral lipids, resulting in an increased level of free fatty acids in the tears. A frequent finding of keratoconjunctivitis sicca in this patient population, especially the S. aureus group (50%), is of note. Of particular importance is that these entities be recognized as chronic diseases requiring control and ones for which there is no "cure."     

In vivo confocal microscopy of normal conjunctiva and conjunctivitis

PURPOSE: To analyze the appearance of normal conjunctiva and conjunctival inflammation by in vivo confocal microscopy. METHODS: Conjunctiva of 15 normal patients and 21 patients with conjunctivitis including bacterial, papillary, follicular, granulomatous, and cicatrizing disease were analyzed by the Heidelberg retina tomograph (HRTII)/Rostock cornea modul (RCM). RESULTS: Scans of normal bulbar and tarsal conjunctiva corresponded well to the established anatomy except for a prominent, thickened epithelial basement membrane observed by in vivo microscopy. Presumed goblet cells were visible throughout the conjunctival epithelium. Adenoid structures and hair follicles were discernible in the tarsal conjunctiva in vivo. Conjunctival perfusion could be observed directly. Acute and chronic inflammatory cells, conjunctival papillary, and follicular reactions, as well as conjunctival cicatrization, could be discriminated. In a patient with conjunctival granuloma, in vivo confocal microscopy disclosed suture material inside the lesion. CONCLUSION: Confocal microscopy using near-infrared laser light is a useful new tool in the analysis of conjunctival tissue in vivo. It is a valuable aid in the differential diagnosis of conjunctival inflammation and thus may guide therapeutical decisions.     

Age-related morphological changes in lid margin and meibomian gland anatomy.

Meibomian gland dysfunction (MGD) is responsible for recurrent irritative symptoms. Attempts to characterize MGD have largely concentrated on microbial and lipid abnormalities in meibomian gland secretions. Few reports describe histological abnormalities in this disease, and fewer still morphological changes. This article follows a previous study that established a classification for MGD. This was based on morphological changes in the meibomian gland and lid margin. Using this classification, we studied the age-related changes in 80 subjects, between 5 and 87 years of age without ocular disease. The lid margin became thicker after childhood. Lid margin vascularity and cutaneous hyperkeratinization increased with age in both lids, whereas, telangiectasia increased with age in the lower lid and squamous blepharitis and posterior lid margin rounding were more common after 50 years of age in the upper lid. Multiple rows of meibomian gland orifices occurred more frequently in the upper than lower lid, and orifice narrowing and pouting increased with age. No age-related changes in the shape or form of the mucocutaneous function, gland ducts, or acini were found. Meibomian gland secretions were less easily expressed in the elderly. We have attempted to define a normal range of lid morphology in healthy children and adults that we believe to be important for the subsequent definition of lid disease, and in particular, posterior blepharitis.     

活体共聚焦显微镜在睑板腺观察中的应用现状

活体共聚焦显微镜(in vivo confocal microscopy,IVCM)作为一种非侵入性眼部成像技术,可在细胞水平上为角膜、结膜、睑板腺等眼表组织提供高分辨率图像,以显示它们的微观结构特征,在眼表疾病的科研和临床应用中体现出独特的优势。近年来国内外许多学者已逐渐将IVCM引入到睑板腺功能障碍(meibomian gland dysfunction,MGD)及其他睑板腺相关疾病的探究中。因此,本文对IVCM在睑板腺观察中的应用研究及其进展进行总结,以期为临床工作提供参考。     

Meibomian gland dysfunction in chronic blepharitis

We examined 57 patients with symptoms of chronic blepharitis using meibomian gland expression, meibography, tear osmolarity, and the Schirmer's test. We also performed meibography on 20 normal patients free of chronic blepharitis. We found that 42 blepharitis patients (74%) had evidence of meibomian gland loss, whereas only four of 20 normal patients (20%) had any gland dropout. We performed cluster analysis on the data from the patients with blepharitis and found that these patients tended to fall into distinct groups with clinically relevant characteristics. We also found that tear osmolarity correlated positively with gland dropout (+0.413) and negatively with excreta volume (-0.499). This study demonstrates that an objective analysis of meibomian gland function may be used to assess chronic blepharitis and define subsets of blepharitis with measurable differences. It also supports the significance of meibomian gland dysfunction on tear osmolarity and the evaporative state of the eye.     

Giant papillary conjunctivitis and meibomian gland dysfunction blepharitis.

In this prospective pilot study we saw 42 consecutive giant papillary conjunctivitis (GPC) patients (80 eyes), all of whom were found to have some meibomian gland dysfunction blepharitis. Severity of GPC at presentation correlated with severity of meibomian gland dysfunction blepharitis (Kendall's tau b averaged 0.246 across the adjusted statistical analyses). Thirty-two patients (63 eyes) were refit after treating meibomian gland dysfunction blepharitis. Twenty-eight of these patients (55 eyes; 87%) continue to wear contact lenses, maintaining an improvement in GPC (mean follow-up 21 months; range 11-36 months). We hypothesize that meibomian gland dysfunction blepharitis may play a role in the pathogenesis of GPC and suggest that a large, controlled, multi-observer study be performed to further investigate this possible association.     

Primary intraepithelial sebaceous gland carcinoma of the palpebral conjunctiva

Sebaceous gland carcinoma usually arises from meibomian or Zeis glands deep within the eyelid, but it can rarely arise within the conjunctival epithelium without a deep component. We describe a woman with a history of chronic blepharoconjunctivitis unresponsive to topical medications. Examination disclosed confluent papillary hypertrophy of the upper palpebral conjunctiva and deposits of white flaky material. Tarsoconjunctival punch biopsy revealed intraepithelial sebaceous gland carcinoma. Management consisted of frozen section-controlled complete tumor excision with removal of the entire posterior lamella of the right upper eyelid, cryotherapy to the margins, and reconstruction. Histopathologic analysis confirmed primary sebaceous gland carcinoma localized to the conjunctival epithelium without involvement of underlying meibomian or Zeis glands or the caruncle. Patients with unexplained chronic unilateral blepharoconjunctivitis or papillary hypertrophy of the palpebral conjunctiva should be considered for biopsy to rule out neoplasia, even when there is no sign of an underlying eyelid mass.     

Comparative bacteriology of chronic blepharitis.

One hundred and fifteen patients with chronic blepharitis were compared with 47 normal controls. Six clinically distinct groups of blepharitis were observed: staphylococcal; seborrhoeic, alone, with associated staphylococcal superinfection, meibomian seborrhoea, or secondary inflammation of the meibomian glands; and meibomian keratoconjunctivitis (MKC). Staphylococcus aureus was isolated in appreciable frequency from the staphylococcal and the mixed staphylococcal/seborrhoeic groups in contrast to the normal and non-staphylococcal groups. Coagulase-negative Staphylococcus spp., Propionibacterium acnes, and cornyneform bacteria were the most commonly isolated bacteria from the lid for all groups. Cultures of material expressed from the meibomian glands yielded similar organisms but in reduced frequency. Testing of antibiotic susceptibility revealed Staph aureus to be usually sensitive to most commonly used ophthalmic antimicrobials except sulphonamides.     

Association between meibomian gland changes and aging, sex, or tear function

PURPOSE: To study changes in the lid margin and meibomian glands and their association with aging, sex, and tear function. METHODS: We examined 354 eyes in 177 subjects (76 men and 101 women; 21-93 years; mean age, 63.0 +/- 14.3 years) with no ocular symptoms or ocular surface disorders. Anatomic changes in the lid margin were studied using slit-lamp biomicroscopy. Meibomian gland function and morphology were evaluated on the basis of meibum expression and meibography, respectively. Tear function and ocular surface epithelium were assessed with the Schirmer test, by tear film break-up time, and with a fluorescein staining test. RESULTS: Eyes with abnormal lid margin anatomy, hyposecretion of meibum, and meibomian gland dropout were seen in 26 (7.3%), 46 (12.4%), and 68 eyes (18.6%), respectively, with a significant association between each finding and aging (P = <0.0001, 0.0498, and <0.0001, respectively). In patients < or =69 years of age, no significant association was found between meibomian gland-related findings and sex. However, a high incidence of abnormal lid margin and gland dropout was noted in men > or =70 years of age compared with women. No significant association was found between changes in the lid margin and meibomian glands and tear function in patients > or =40 years of age. CONCLUSION: Among symptom-free subjects, we found that changes in the lid margin and meibomian glands were closely related to aging. Among elderly subjects, changes in the anatomic lid margin and meibomian gland morphology were observed more frequently in men than in women. Tear function showed no association with either changes in the lid margin or function of the meibomian glands.     

睑缘炎患者睑板腺形态变化及其与干眼的关系

背景 睑缘炎是一种常见的眼表疾病,常累及睑板腺体,而睑板腺体所分泌的脂质是泪膜的重要组成成分之一.泪膜稳定性的破坏可导致干眼相关症状,可以说睑缘炎是干眼发病的因素之一,但二者之间的关系有待进一步研究. 目的 使用非接触式红外线睑板腺观察仪观察睑缘炎患者睑板腺腺体的形态,并与干眼相关检查进行相关性分析. 方法 采用病例观察的设计方法对睑缘炎患者睑板腺形态改变与干眼症的关系进行研究.选取2010年9月至2011年4月于河南省眼科研究所眼科门诊依据PPP标准诊断为睑缘炎的患者83例83眼,取得患者的知情同意后,在裂隙灯下行眼前节检查睑缘畸形评分、泪液分泌( Schirmer Ⅰ)试验、泪膜破裂时间(BUT)、角膜荧光素染色评分及结膜充血评分,采用泪膜干涉仪行泪膜形态分级,采用非接触式红外线睑板腺摄像仪行睑板腺腺体缺失分级,对睑缘炎睑板腺腺体缺失分级与上述检查结果的关系进行评估.结果 不同年龄组不同性别间睑缘炎的频数分布差异无统计学意义(x2=2.69,P=0.75).睑缘炎患者的睑板腺腺体缺失分级与年龄星弱的正相关(r=0.58,P=0.00),但与性别无明显相关性(r=-0.09,P=0.99);患者睑板腺体缺失与睑缘畸形评分及结膜充血评分均呈弱的正相关(r=0.64,P=0.00;r=0.50,P=0.00);与泪膜影像分级及角膜染色评分均呈弱的正相关(r=0.23,P=0.04;r=0.50,P=0.00),与BUT呈弱的负相关(r=-0.32,P=0.00),但与Schirmer Ⅰ试验结果无明显相关性(r=-0.05,P=0.69).不同年龄组男性和女性的睑板腺缺失分级评分差异无统计学意义(Z=-0.09,P=0.93).结论 睑缘炎可引起蒸发过强型干眼,且患者的睑板腺体随年龄的增长缺失程度加重.非接触式红外线睑板腺观察仪作为一种有效、快速、无刺激地观察睑板腺体形态的仪器,可作为一项常规检查来辅助诊断睑缘炎.     

Oral erythromycin treatment for childhood blepharokeratitis

Blepharokeratitis is a chronic external ocular and adnexal inflammatory condition marked by erythematous and edematous lid margins, lid margin crusting and scaling, meibomian gland inflammation and inspissation, and conjunctival hyperemia. The associated keratitis usually involves the inferior cornea and is characterized by punctate epithelial keratopathy and marginal stromal infiltrates. The inflammation sometimes leads to corneal thinning, scarring, and vascularization. The standard therapy for adult blepharokeratitis includes lid hygiene, topical cortico-steroid preparations, and topical antibiotics. Oral tetracycline and its analogues, doxycycline and minocycline, are used in adults to treat associated meibomian gland dysfunction. Whereas blepharitis is common in children, blepharokeratitis is rare and is often associated with severe ocular and psychosocial morbidity. Treatment of youths may be problematic because of poor compliance with lid hygiene and therapy that includes drops and ointment.(1) Furthermore, the use of tetracycline and its analogues is contraindicated in children aged less than 8 years because it may cause dental enamel abnormalities. Isolated case reports have suggested that erythromycin may be a reasonable alternative to tetracycline in childhood blepharokeratitis.(2,3) We report on the successful treatment of this condition with oral erythromycin in 5 children.     

长波长前节OCT在睑板腺形态检测中的初步应用研究

 目的 探讨长波长（1310 nm）前段相干光断层扫描（AS-OCT）在睑板腺形态检测中的应用价值。设计 前瞻性病例系列。研究对象 19~50岁正常自愿受试者8例（8眼）。方法 对受试者进行非接触红外线睑板腺照相及长波长AS-OCT检查。在睑板腺照相基础上从四个不同位置（睑板腺开口区、近睑板腺开口的腺体分布区、近穹窿部睑板腺区及中央区）进行AS-OCT扫描;利用自行开发“OCT图像增强软件”处理获得的扫描图像,分析睑板腺开口及腺体分布情况。明确睑板腺开口有无阻塞及脂栓形成;使用ImageJ软件半自动模块对睑板腺腺体宽度及距睑结膜位置等相关参数进行定量检测及对比分析。主要指标 睑板腺开口有无阻塞及脂栓形成;睑板腺腺体宽度及距睑结膜位置。结果 长波长AS-OCT在睑板腺开口区扫描线可观察睑板腺开口情况,计算阻塞及脂栓形成的睑板腺开口数量;近睑板腺开口的腺体分布区扫描线可清晰显示横断面睑板腺形态,是了解睑板腺腺体形态的最佳位置。同时发现,睑板腺开口阻塞者其睑板腺缺失面积较大者残存腺体增粗并距睑结膜位置较深。结论 使用长波长AS-OCT可较好地定量检测睑板腺腺体宽度、清昕地观察睑板腺开口阻塞情况,对睑板腺功能障碍的诊断具有潜在应用价值。