Perimenopausal syndrome (PMS) which changes in physiology, pathology and hormone levels, brings a series of ocular and systemic health problems, such as dry eye, meibomian gland dysfunction (MGD), obesity, coronary heart disease and osteoporosis etc.
This study aimed to examine the changes of the ocular surface and the meibomian glands in PMS-MGD patients.
A case-control study was performed from January to August 2015 in the Affiliated Hospital of the Armed Police College.Forty-two patients with PMS-MGD were included in this study.Ocular surface disease index (OSDI) questionnaire was carried out to assess the ocular surface symptoms, and the ocular surface examination, dry-eye related tests and morphological and functional examinations of meibomian gland as well as the detect of serum sex hormone levels were conducted under the informed consent.
Compared with the control group, the serum follicle-stimulating hormone (FSH), luteinizing hormone (LH) and estradiol 2 (E2) were significantly higher in the PMS-MGD group (t=55.217, 76.769, -46.358, all at P<0.01). The scores of OSDI were 25.00(18.00, 32.00) and 1.00(1.00, 2.00) in the PMS-MGD group and the control group, respectively, showing significant difference between them (Z=-8.043, P<0.05). According to the severity of ocular surface symptoms by the analysis of OSDI questionnaire, foreign body sensation was dominant and then was blurred vision, photophobia and eye acid, vision loss in turn.Watching TV aggravated symptoms in 16 patients (38.10%), computer or ATM aggravated symptoms in 10 subjects (23.81%), reading aggravated symptoms in 6 subjects (14.29%), driving at night aggravated symptoms in 4 subjects (9.52%), winding worse symptoms in 4 subjects (9.52%), dry environment worsen symptoms in 14 subjects (33.33%), air conditioning environment worsen symptoms in 16 subjects (38.10%). The corneal fluorescent staining score of the PMS-MGD group was significantly higher than that of control group (P<0.05), and BUT was less than that of control group (t=-10.276, P<0.05). All four MGD parameters (eyelid margin scores, meibomian gland scores, meibomian gland secretion scores, and meibomian gland dropout scores) in the PMS-MGD group were significantly higher than those of the control group (Z=-7.258, -6.517, -6.195, -6.973, P<0.005). There was not statistical significance in SⅠt test between the two groups (P>0.005).
PMS-MGD patients occur the morphology and functional changes, leading to the ocular surface symptoms, and foreign body sensation, watching TV and air conditioning aggravates the symptoms.