Morphological features of the eyelid margin in relation to conjunctival goblet cells and MUC5AC in tear film and clinical tests of dry eye

Abstract

Abstract Purpose This study aimed to investigate the morphological features of eyelid margin in dry eye patients and determine their correlations with conjunctival goblet cells, MUC5AC secretion, and clinical tests of tear film. Methods Patients diagnosed with dry eye disease (DED) were asked to complete the evaluations of symptoms and signs of dry eye, including Ocular Surface Disease Index (OSDI) questionnaire, Lipid layer thickness (LLT), partial blinking (PB) rate, tear-film breakup time (TBUT), Schirmer’s I test (SIt), and meiboscore. Marx line (ML), lid wiper epitheliopathy (LWE), and meibomian orifices (MOs) were used as indicators of morphological features of the eyelid margin. PAS staining of conjunctival goblet cells and MUC5AC measurement of the tear samples were also performed. Results A total of 30 patients diagnosed with DED were included. The ML score was correlated with the SIt. The MOs showed a significant negative correlation with the TBUT and LLT. The LWE was corrected to TBUT and meiboscore, and also associated with decreased conjunctival goblet cell density and MUC5AC concentration in the tear film rather than ML and MOs in the eyelid margin of dry eye patients. The tear MUC5AC concentration had a significant positive correlation with conjunctival goblet cell density. Conclusion The eyelid margin is crucial for maintaining the integrity of tear film and ocular surface. Attracting more attention to the eyelid margin is beneficial to routine clinical practice, and lid wipers could be used to evaluate the secretion of MUC5AC in the tear film secreted by conjunctival goblet cells.