Abstract
PURPOSE: To investigate the morphological characteristics of the meibomian glands (MGs) in children with allergic conjunctivitis (AC)-related dry eye (DE). METHODS: Children with a clinical diagnosis of seasonal allergic conjunctivitis (SAC) and perennial allergic conjunctivitis (PAC) were recruited. Age- and sex-matched children without a history of allergy or dry eye were recruited as controls. All participants completed the 5-item Dry Eye Questionnaire (DEQ-5) and ocular surface examination, including assessment of the tear meniscus height (TMH), noninvasive tear breakup time (NIBUT), and morphology of the upper lower MGs by noncontact infrared meibography (Oculus Keratograph 5M). Receiver operating characteristic (ROC) curve analysis was performed to determine the predictive value of the morphological characteristics of the MGs for AC-related DE. RESULTS: Sixty-two children with AC (31 with DE and 31 without DE) and 33 healthy children were enrolled in the study. The mean age was 7.67 (ranging from 5-13.5) years. More morphological changes were observed in the upper eyelids of AC children with DE than in healthy children. No morphological feature difference was found between AC children without DE and healthy children. ROC curve analysis showed that the morphological characteristics with good predictive value for DE were shortened upper eyelid MGs (AUC=0.72, P<0.001) and hooked upper eyelid MGs (AUC=0.71, P<0.001). CONCLUSION: The grading of MG morphology according to the DREAM Study may be a valuable predictor for AC-related DE in children.