Evaluation of the Relationship Between Rosacea Cutaneous Subtype and Meibography Findings

Abstract

Objective: Acne rosacea (AR) is a chronic inflammatory skin disease that can cause serious ocular complications. This study was designed to evaluate dry eye disease (DED) and meibomian gland dysfunction (MGD) in AR patients and to investigate the relationship between the cutaneous subtype of AR and ocular involvement. Materials and Methods: This study included 67 participants with AR and 50 healthy individuals. Patients diagnosed with 3 cutaneous subtypes were examined: erythematotelangiectatic rosacea (ETR), papulopustular rosacea (PPR), and phymatous rosacea (PR). An ophthalmatological examination was performed that included an evaluation of lid margin alterations due to meibomian gland (MG) obstruction, Ocular Surface Disease Index assessment, tear film break-up time testing, Schirmer testing, and a corneal conjunctival fluorescein staining assessment. Meibography was used to evaluate the upper and lower lids for MG loss. Results: Findings in the AR group revealed MGD in 45.5% and DED in 28.1%. The meibomian gland loss rate (MGLR) was 38.7 +/- 16.9% and the meibomian gland loss grade (MGLG) was 1.57 +/- 0.82%. The rate of MGLR and MGLG was significantly greater in the AR group than in the control group (p<0.001). PPR was seen in 59.7% of the 67 patients, ETR in 29.9%, and PR in 13.4%. A comparison of the MGD, MGLR, MGLG, and presence of DED in the 3 cutaneous subtype groups yielded statistically insignificant results. Conclusion: AR can affect MG morphology, which may result in MGD or DED. Though we did not find a significant difference in the ocular findings by subgroup, ocular involvement is a recognized risk in AR. Ophthalmologists and dermatologists should cooperate in the evaluation of AR patients. Additional studies to further examine the effects in subtype groups are recommended.