Exploring the link between melasma and dry eye disease: insights into Meibomian gland morphology

To evaluate and compare the dry eye parameters and Meibomian gland functions in women diagnosed with melasma and healthy volunteers. In this cross-sectional observational study, the right eyes of 20 female patients diagnosed with melasma (Group 1) and the right eyes of 20 healthy volunteers (Group 2) were included. The presence of dry eye was assessed using the Schirmer-I, Oxford score, Ocular Surface Disease Index (OSDI), and tear break-up time (TBUT). The function of the Meibomian glands was evaluated using the Meibum Score, which classifies meibum content, and the MeiboScore, calculated by meibography. The Schirmer-I, Oxford score, and OSDI score were similar in both groups, with no statistically significant differences observed (p-values > 0.05). TBUT was significantly lower in the melasma group than in the control group ( p = 0.023). The Meibum Score was significantly higher in the melasma group ( p = 0.006). While the upper MeiboScore was similar in both groups, the lower and total MeiboScore were significantly higher in the melasma group ( p = 0.388, 0.011, and 0.020, respectively). No significant correlations were observed between MASI score and ocular surface or meibomian gland parameters. In this cross-sectional study, melasma was associated with shorter TBUT and altered meibomian gland morphology/secretion, findings more consistent with predominantly evaporative tear film instability than with aqueous-deficient dry eye.