Assessment of the meibomian gland dysfunction guided by noncontact meibograph in diabetic patients with hyperlipidemia

Purpose To estimate the role of noninvasive meibograph in the assessment of meibomian gland dysfunction (MGD) in diabetic hyperlipidemia patients after medical treatment. Patients and methods A case–control study of 42 eyes of 42 patients, presented at Ain Shams University clinic between May 2024 and March 2025. The patients are grouped into group I (21 eyes of type 2 diabetes mellitus hyperlipidemia with MGD), group II (21 eyes of nondiabetic with MGD). All patients are assessed clinically by Schirmer test, break-up time, and meibography maps using Sirius CSO topography. All patients are captured and then receive the treatment in the form of vitamin A5000IU and doxycycline 100 mg daily for 6 weeks and reevaluated again by the same parameters and by the same physician. Results In meibography, the meibomian gland dropout before and after the medical treatment showed significant improvement as the amount of change in group I (mean±SD=−5.676±2.405 in group I and −4.829±2.228 in group II; P <0.001), the Schirmer test was significantly improved on both groups but the amount of changes improved more in group I (mean±SD=2.286±0.717 in group I and 1.857±0.727 in group II; P <0.001), while break-up time was increased in values on both groups with mean±SD 2.190±0602 in group I and 2.952±0.740 in group II ( P <0.001). Diabetes mellitus duration is considered the main risk factor that directly correlates with MG dropout. Conclusion The meibograph and other parameters helped in the diagnosis of MGD and dry eye syndrome and proved the good effect of the medical regimen of vitamin A and doxycycline 100 mg for 6 weeks in the treatment of MGD and dry eye syndrome.