Chronic blepharitis: an alternative instrumental method for studying the morphofunctional state of the eyelids

Relevance To confirm the existence of such an alternative and objective method for examining eyelids in chronic blepharitis as laser Doppler flowmetry. Aim To prove the possibility of using laser Doppler flowmetry (LDF) as an alternative method for assessing the morphofunctional state of the eyelids. Material and methods The study included 62 patients (124 eyes) with an established diagnosis of chronic mixed demodectic blepharitis. Patients of the 1st group used a cosmeceutical 2 times a day and a tear substitute 3 times a day for 1.5 months. Patients of the 2nd group used an eyelid care gel 2 times a day and a tear substitute 3 times a day for 1.5 months. In addition to the standard ophthalmological examination, laser Doppler flowmetry and laser scanning confocal microscopy were performed. Dynamic observation was performed after 1.5 and 3 months. Results The eyelids are a thin and complex dynamic structure, the main function of which is to protect the surface of the eye [1]. Chronic blepharitis is one of the most common lesions of the anterior segment of the eye [2]. In the work of N.P. Kintyukhina, the presence of microcirculatory disorders (non-nutritive arterial hyperemia and ischemia) in the eyelids in chronic blepharitis and MGD was established [3]. During the analysis of laser scanning confocal microscopy (LSCM) and laser Doppler flowmetry (LDF) data, a significant inverse correlation was found between the number of inflammatory cells in the tarsal conjunctiva of the eyelids and neurogenic blood flow fluctuations, as well as a strong direct dependence on the level of blood flow shunting. LSCM allows to evaluate the condition of the walls of the acini, their diameter, density, to determine the diameter and degree of keratinization of the mouths of the meibomian glands, the state of the interstitial space [4]. In combination with clinical, functional and instrumental methods of research, LDF of the skin of the eyelids allows with high sensitivity and specificity to identify the onset of the inflammatory process in the eyelids at early stages, as well as to obtain information about the condition of the eyelids in individuals without signs of the disease [5]. Conclusion The obtained results confirm that the laser Doppler flowmetry method can be used for an objective assessment of the condition of the eyelids. The parameters of this method can serve as criteria for choosing pathogenetically substantiated therapy for chronic blepharitis and assessing its effectiveness. Key words: blepharitis; laser Doppler flowmetry; laser scanning confocal microscopy