Optimization of therapeutic approaches for meibomian gland dysfunction in women of reproductive age with dry eye disease
DOI:
https://doi.org/10.31288/Ukr.j.ophthalmol.20265512Keywords:
dry eye disease, meibomian gland dysfunction, vitamin D deficiency, tear film stability, fertile-aged women, LacryDiag, oral vitamin D supplementationAbstract
Objective. To evaluate the clinical effectiveness of oral vitamin D supplementation as an adjunct to conventional therapy in reproductive-aged women with meibomian gland dysfunction (MGD)-associated dry eye disease (DED) and vitamin D deficiency by assessing changes in serum 25-hydroxyvitamin D levels, tear film stability, lipid layer thickness, tear meniscus height, meibomian gland morphology, and ocular surface function.
Materials and Methods. This prospective comparative study included 60 women (120 eyes) of reproductive age diagnosed with MGD-associated DED. Forty patients with confirmed vitamin D deficiency were allocated into two treatment groups: Group I received oral vitamin D supplementation combined with preservative-free artificial tears, whereas Group II received preservative-free artificial tears alone. Twenty women with normal vitamin D levels comprised Group III (control group) and received preservative-free artificial tears. Ocular surface evaluation includes non-invasive tear breakup time (NIBUT), lipid layer thickness (LLT), tear meniscus height (TMH), and meibography using the LacryDiag® ocular surface analyzer (Quantel Medical, France). Serum 25-hydroxyvitamin D concentrations were measured at baseline and after three months of treatment.
Results. Combination therapy with oral vitamin D supplementation resulted in significantly greater improvement in tear film stability, LLT, TMH, and meibomian gland morphology compared with artificial tears alone (p < 0.05). The greatest clinical improvement was observed in patients with mild-to-moderate MGD. Patients receiving vitamin D supplementation also demonstrated a marked reduction in dry eye symptoms and better restoration of ocular surface function than those treated with artificial tears alone.
Conclusion. Personalized correction of vitamin D deficiency based on serum 25-hydroxyvitamin D levels represents an important pathogenetic component in the treatment of MGD-associated DED in women of reproductive age. The addition of oral vitamin D to preservative-free artificial tears significantly improves tear film stability, meibomian gland function, and clinical symptoms, particularly in mild-to-moderate disease. This approach may provide an effective strategy for optimizing DED management.
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