[Sustained effects of sodium hyaluronate solution on tear film stability evaluated by Tear Stability Analysis System].

PURPOSE: To investigate the sustained effects of sodium hyaluronate solution (HA) on tear film stability using a Tear Stability Analysis System (TSAS), a method enabling quantitative evaluation of tear film stability. METHODS: Eighteen eyes of 18 normal subjects (N group) and 21 eyes of 21 dry eye patients (D group) were examined. Dry eye was diagnosed by the 2006 diagnostic criteria. In each subject, artificial tears (AT), 0.1% sodium hyaluronate solution (H 01) or 0.3% sodium hyaluronate solution (H 03) were instilled into both eyes, and tear film stability in the right eye before and 1, 5, 15, 30, 60 and 120 minutes after instillation was compared using a break up index (BUI: 0-100), the TSAS's index of tear film stability. RESULTS: N group: In both the AT and H 01 subgroups, no significant change was found in the BUI ratios (BUI after instillation/before instillation) at any point during the 120 minute period after instillation. However, in the H 03 subgroup, the BUI ratio temporarily decreased to 0.650 one minute after H 03 instillation (p = 0.0038). D group: In the AT subgroup, the BUI ratio significantly increased to 1.568 five minutes after AT instillation (p = 0.0259), but began to decrease 15 minutes after instillation and returned to the initial value 30 minutes after instillation. In the H 01 subgroup, the BUI ratio significantly increased to 1.531 five minutes after H 01 instillation (p = 0.0087), and was maintained at 1.347 120 minutes after instillation (p = 0.0088). In the H 03 subgroup, the BUI ratio rose to 1.544 15 minutes after H 03 instillation (p = 0.0009), and was maintained at high levels of 1.413 30 minutes after (p = 0.0122), 1.629 60 minutes after (p = 0.0008), and 1.407 120 minutes after instillation (p = 0.0008). CONCLUSION: The current study confirms that both 0.1 and 0.3% sodium hyaluronate solution effectively improve tear film stability in dry eyes for up to two hours after instillation.

Presence of adipose differentiation-related protein in rat meibomian gland cells.

Adipose differentiation-related protein (ADRP) is an intrinsic lipid storage protein found in lipid droplets of different type of cells. ADRP has been recognized to be a specific marker of lipid accumulation and a marker of differentiated adipocytes. The purpose of this study was to determine whether ADRP was present in the cells of the meibomian gland. The expression of the mRNA of ADRP was determined by RT-PCR and Northern blot analysis of the meibomian gland and other rat tissues. A newly generated polyclonal antibody against rat ADRP was used for Western blot analysis and immunohistochemical staining to determine whether ADRP was expressed in the rat meibomian gland. Meibomian gland acinar cells were isolated to determine when ADRP was expressed during cell differentiation in vitro. Northern blot analysis and Western analysis showed that ADRP was expressed in the meibomian gland. Immunoreactivity to ADRP was observed in the lobules of acinar cells in the meibomian gland, and was preferentially located adjacent the vacuolated cytoplasm. In culture, the meibocytes began to store lipid droplets in the cytoplasm as they became confluent, and the immunoreactivity for ADRP was found at the margins of the oil droplets. Our results suggest that ADRP can serve as a new marker for the identification of differentiated meibocytes containing lipid droplets.

Marx line: fluorescein staining line on the inner lid as indicator of meibomian gland function.

PURPOSE: To determine whether the location of a fluorescein-stained line, the Marx line (ML), which runs along the inner eyelid, is correlated with meibomian gland function. DESIGN: Prospective observational case series. METHODS: After applying fluorescein dye solution to the eye, the ML score was calculated for the outer, middle, and inner thirds of the lower eyelid margin. ML scoring was as follows: 0, entirely on the conjunctival side of the meibomian orifices (MOs); 1, part of the ML touches the MOs; 2, ML runs through all of the MOs; and 3, ML runs on the eyelid-margin side of the MOs. Correlations were calculated between the total ML score and age for 251 randomly recruited subjects without acute ocular surface diseases, and between age and the ML score for the three regions of the lower eyelid. Correlations between the regional ML score and the meibographic score, and the meibomian gland secretion score were also determined. The total ML scores of 15 subjects without meibomian gland dysfunction (MGD) were compared with 15 age-matched patients with MGD. RESULTS: The three regions of the lower eyelid had significantly different ML scores. Strong correlations were found between the ML score and age, the meibographic score, and the meibomian gland secretion score. The total ML score of MGD group was significantly higher than that of the non-MGD group. CONCLUSIONS: The strong correlation between the ML score and the meibomian gland scores indicates that the ML score can be used as a simple and rapid screening score for meibomian gland function.