Is Complete Androgen Insensitivity Syndrome Associated with Alterations in the Meibomian Gland and Ocular Surface?

  title={Is Complete Androgen Insensitivity Syndrome Associated with Alterations in the Meibomian Gland and Ocular Surface?},
  author={Jennifer Marie Cermak and Kathleen L. Krenzer and Rose M. Sullivan and Mohamad R. Dana and David A. Sullivan},
Purpose. This study's purpose was to determine whether complete androgen insensitivity syndrome (CAIS) is associated with alterations in the meibomian gland and ocular surface. Methods. Individuals with CAIS, as well as age-matched female and male controls, completed questionnaires which assessed dry eye symptoms and underwent slit lamp evaluations of the tear film, tear meniscus, lids and lid margins and conjunctiva. The quality of meibomian gland secretions was also analyzed. Results. Our… 

Tear film impairment and meibomian gland loss in patients with polycystic ovary syndrome

Tear film stability impaired in patients with PCOS was indicated and this impairment was accompanied by the loss of MG, which play a key role in tear film stability.

Morphological Changes of Meibomian Glands in Men With Benign Prostate Hyperplasia.

BPH was associated with meibomian gland loss and instability of the tear film as well as with the presence of androgenic alopecia.

Does endogenous serum oestrogen play a role in meibomian gland dysfunction in postmenopausal women with dry eye?

It is suggested that MG dysfunction underpins dry eye symptoms in non-Sjögren's dry eye in postmenopausal women and oestrogen plays a role through its effect on meibum secretion.

Changes in gene expression in human meibomian gland dysfunction.

It is demonstrated that MGD is accompanied by multiple changes in gene expression in the meibomian gland, including the upregulation of genes encoding small proline-rich proteins and S100 calcium-binding proteins, which suggest that keratinization plays an important role in the pathogenesis of MGD.

Effects of age and dysfunction on human meibomian glands.

These results indicate that aging human meibomian glands show decreased meibocyte differentiation and cell cycling that is associated with the development of MGD, and suggest that altered PPARγ signaling may lead to acinar atrophy and development of an age-related hyposecretory MGD.

[Meibomian glands : part III. Dysfunction - argument for a discrete disease entity and as an important cause of dry eye].

  • E. KnopN. Knop F. Schirra
  • Medicine
    Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
  • 2009
Careful investigation of the eyelids and lid margins with eversion, if necessary, should therefore be performed in every case of a wetting defect, notably before fitting contact lenses.

[Meibomian glands : part IV. Functional interactions in the pathogenesis of meibomian gland dysfunction (MGD)].

  • E. KnopN. Knop
  • Medicine
    Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
  • 2009
Age, hormonal disturbances and environmental influences, such as contact lenses, as well as qualitative alterations in the composition of the meibomian oil (meibum) lead to hyperkeratinization of the ductal epithelium and increased viscosity ofThe meibum which result, either alone or in combination, in obstruction of theduct and orifice.

The international workshop on meibomian gland dysfunction: report of the subcommittee on the epidemiology of, and associated risk factors for, MGD.

Although the etiology of MGD may differ from that of aqueous-deficient dry eye disease (which is due to insufficient lacrimal gland production), the two conditions share many clinical features, including symptoms of ocular surface irritation and visual fluctuation, altered tear film stability, and potential ocularsurface compromise.



Effect of androgen deficiency on the human meibomian gland and ocular surface.

The results demonstrate that patients taking antiandrogen treatment had a significant increase in the frequency of appearance of tear film debris, an abnormal tear film meniscus, irregular posterior lid margins, conjunctival tarsal injection, and orifice metaplasia of the meibomian glands.

Impact of androgen deficiency on the lipid profiles in human meibomian gland secretions.

Whether androgen deficiency, such as that occurring during aging in both sexes, complete androgen insensitivity syndrome (CAIS), the use of anti-androgen therapy and Sjogren’s syndrome (SS), is associated with significant changes in the fatty acid patterns of neutral and polar lipids in meibomian gland secretions is examined.

Does androgen insufficiency cause lacrimal gland inflammation and aqueous tear deficiency?

It is shown that androgen treatment suppresses inflammation and stimulates the function of lacrimal glands in mouse models of Sjögren's syndrome, and androgen insufficiency alone does not cause Lacrimal gland inflammation, a SJögren’s syndrome-like pathology in lacrima tissue, or aqueous tear deficiency in nonautoimmune animals and humans.

Are women with Sjögren's syndrome androgen-deficient?

The results show that women with SS are androgen-deficient, and the overall findings could not be attributed to the use of oral contraceptives or hormone replacement therapy, because the concentrations of 5-diol, DHEA, DHT, ADT-G and 3a- diol-G were also decreased in patients with SS compared to levels in control women who were not taking exogenous estrogens.

Age-Related Morphological Changes in Lid Margin and Meibomian Gland Anatomy

A normal range of lid morphology in healthy children and adults is attempted, believed to be important for the subsequent definition of lid disease, and in particular, posterior blepharitis.

Androgen influence on the meibomian gland.

The findings show that the meibomian gland is an androgen target organ and that androgens influence the lipid profile within this tissue, however, the extent to which androgens regulate the production of these lipids and whether this action may impact tear film stability remain to be determined.

Ocular surface changes and discomfort in patients with meibomian gland dysfunction.

Meibomian gland dysfunction is a major cause of ocular surface abnormalities and ocular discomfort and the rate of tear production was increased more in the gland dropout group than in the non-MGD group.

Lacrimal Gland, Tear Film, and Dry Eye Syndromes

The Dohlman Conference Address: Understanding Dry Eye Syndrome K.Claes H.D. Tsubota.

Meibomian gland disease. Classification and grading of lid changes

A comprehensive classification and grading scheme of meibomian gland disease is presented, supporting the observations with illustrations.