The Role of Eyelid Margin Vascularity in Meibomian Gland Dysfunction Diagnosis and Management

This review investigates the diagnostic and prognostic significance of telangiectatic meibomian gland dysfunction (MGD), as well as potential therapeutic approaches. A thorough scientific literature search was conducted using various databases. Studies focusing on eyelid vascular changes in MGD published between 2010 and 2024 were reviewed. Paper selection was based on their contribution to the understanding of the pathophysiology, diagnosis, and management of the disease. Ocular surface inflammation, oxidative stress, and cytokine activity are the main molecular pathways involved in the pathophysiology of MGD, which leads to increased eyelid margin vascularity. Newer imaging techniques, especially swept-source optical coherence tomography angiography (SS-OCTA), have enabled quantification and objective visualization of this pathology. Additionally, the classification of MGD into telangiectatic and non-telangiectatic forms aids in treatment customization. Promising treatments targeting vascular abnormalities, such as intense pulsed light (IPL), anti-vascular endothelial growth factor (VEGF) agents, and cyclosporine, have emerged to improve meibomian gland function and reduce inflammation. Eyelid margin vascularity is an important biomarker for the diagnosis and management of MGD. With improved imaging techniques and targeted treatments, clinicians can more precisely evaluate disease severity and offer more effective interventions. Further research is needed to standardize diagnostic criteria, customize treatment protocols, and investigate new therapeutic targets for clinical management.