Evaluation of the Ocular Surface, Conjunctival Impression Cytology and Meibomian Gland Dropout in Patients with Familial Mediterranean Fever

Abstract

Purpose. - Familial Mediterranean fever (FMF) is an idiopathic disease with chronic inflammation. We aimed to determine the changes caused by the chronic inflammatory nature of FMF on the ocular surface, meibomian glands (MG), and conjunctiva via conjunctival impression cytology (CIC). Material-method. - Forty-two FMF patients with a mean age of 11.93 +/- 3.92 years and 36 control patients with a mean age of 11.83 +/- 3.38 years were included in the study. Ocular surface anomalies of the patients were evaluated using Schirmer II, TBUT and OSDI. MG function (meibum quality), morphology (meiboography), and CIC were evaluated. Results. - Although there was a significant difference between the groups in terms of Schirmer II and TBUT, OSDI scores did not significantly differ (P = 0.022, 0.010, and 0.099 respectively), and no significant dry eye sign was observed in either group. There was significant difference between the groups in terms of the percent area of MG dropout, MG density, meiboscore( P = 0.020, 0.023, and 0.031 respectively), but no significant difference was observed in relation to MG quality (P = 0.650). Although conjunctival impression cytology was of a higher grade in the patients with FMF according to Nelson's classification, no significant difference was observed between the groups (P = 0.109). Conclusion. - Although there was a decrease in the number of MGs in FMF patients, no significant deterioration was observed in conjunctival cytology. In these patients, tear film stability may deteriorate in particular. Clinicians should be aware of the possibility of ocular surface disease secondary to MG dropout in patients with FMF. (c) 2021 Elsevier Masson SAS. All rights reserved.