Purpose This study describes the histopathological features of different morphological variants of human meibomian glands (MGs) seen on infrared imaging.
Methods Tarsal plates dissected from seven cadaveric upper eyelids were imaged using infrared meibography, and then studied histopathologically using H&E, peroxisome proliferator-activated receptor gamma (PPARγ, meibocyte differentiation marker) and Ki-67 (cellular proliferation marker) antibody staining. The different morphological characteristics (varying size and shape) of MGs on meibography were correlated with histopathology findings using image analysis software.
Results Of the total 127 glands, the morphological variants observed on meibography based on size were: normal (n=62), short (n=18), severely short (n=6) and dropout (n=12) glands, and on shape were: hooked (n=2), tortuous (n=5), overlapping (n=1), thick (n=15) and fluffy (n=6) glands. Short, hooked, tortuous and overlapping glands had similar acinar and ductal histology as seen in normal glands whereas thick, and fluffy glands had increased acinar diameter. All glands except the severely short type demonstrated normal signs of holocrine secretory activity and normal nuclear and cytoplasmic PPARγ expression. Severely short glands had nil while short glands had reduced Ki-67 proliferation index (3%±1%) as compared with normal and other variants (8%±5.2%). Gland dropout areas showed no evidence of any glandular tissue on histology.
Conclusion Hooked, tortuous and overlapping glands had completely normal glandular histology, whereas severely short glands showed atrophic changes with loss of meibocyte differentiation and cellular proliferation. Dropout areas showed total loss of glandular elements. Further studies are needed to validate and to explore the clinical implications of these findings.
- ocular surface
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Contributors Concept and design of study or acquisition of data or analysis and interpretation of data—SS, GCN and SB. Drafting the article or revising it critically for important intellectual content—SS, GV and SB. Final approval of the version to be published—SS, GV and SB. Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved—SS, GCN, GV and SB.
Funding SS was funded through the Initiative for Dry Eye Amelioration (IDEA) project, a corporate social responsibility grant awarded by Sun Pharmaceutical Industries Private Limited, Mumbai, Maharashtra, India.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.