In the latest offshoot of the DREAM study, researchers report most meibomian gland (MG) structural features are not associated with the severity of dry eye disease (DED) signs or symptoms.

The cross-sectional investigation used data from the DREAM study, and readers graded MG features in the middle third of the upper and lower lids on infrared meibography images and evaluated associations with signs and symptoms of DED, with adjustment for age and sex.

The investigators also found tortuous glands and a higher composite score for MG features were associated with longer tear break-up times and longer Schirmer test length in the upper eyelid only. Also of note: patients with Sjögren’s syndrome had fewer distorted and ghost glands.

Among 268 patients, no MG features were associated with symptom scores. Among 394 upper eyelids, the researchers found better tear break-up times were associated with more tortuous glands and with higher scores on a composite score of MG features. Longer Schirmer test wetting lengths (0–5, >5–10, and >10mm) were associated with increasing composite scores.

Additionally, the investigators noted patients with Sjögren’s syndrome had fewer distorted MGs (mean 3.4 vs. 4.3) and fewer ghost glands (mean 0.33 vs. 0.89) in the upper lid compared with the other patients.

Daniel E, Pistilli M, Ying GS, et al. Association of meibomian gland morphology with symptoms and signs of dry eye disease in the Dry Eye Assessment and Management (DREAM) study. The Ocular Surface. August 25, 2020. [Epub ahead of print].