Zusammenfassung
Das ölige Sekret (Meibum) der Meibom-Drüsen bildet die oberflächliche Lipidschicht des präokulären Tränenfilms und vermindert die Verdunstung der wässrigen Phase. Meibum ist eine komplexe Mischung aus verschiedenen Lipiden sowie kleineren Anteilen von Proteinen und weiteren Bestandteilen der sekretorischen Meibozyten, die bei Körpertemperatur ein klares Öl bilden. Seine Komposition und Funktion sind noch teilweise ungeklärt, speziell die Interaktion der wasserunlöslichen apolaren Lipide mit polaren, partiell wasserlöslichen Lipiden und möglicherweise Proteinen, die zusammen die Verbindung mit der unterliegenden wässrigen Tränenphase herstellen. Meibum wird innerhalb der Drüsen durch den Druck der kontinuierlichen Sekretion sowie durch Muskelkräfte des M. orbicularis oculi und des Riolan-Muskels beim Lidschlag transportiert. Nach der Freisetzung auf den hinteren Lidrand, gelangt das Öl aus dem Lidrandreservoir auf den Tränenmeniskus und wird bei jeder Lidöffnung als dünne Schicht auf dem präokularen Tränenfilm ausgezogen. Beim Lidschluss wird es wieder zusammengeschoben, wobei immer ein kleiner Teil der Lipidschicht des Tränenfilms erneuert wird. Meibum hat auch eine Barrierefunktion gegen das Auslaufen der Tränen über die innere Lidkante und gegen das Eindringen des Hautfettes (Sebum) vom freien Lidrand.
Abstract
The oily secretion (meibum) of the Meibomian glands forms the superficial layer of the pre-ocular tear film and reduces evaporation of the aqueous phase. Meibum is a complex mixture of various lipids and minor protein components as well as other components of the secretory meibocytes, which form a clear liquid at body temperature. The exact composition and functions of meibum are still partly unknown, in particular the interaction of the water insoluble non-polar lipids with the polar, partly water soluble, lipids and potentially with proteins, which altogether interact to maintain the connection with the underlying aqueous tear phase. Meibum is transported within the gland by the force of secretory pressure from continuous secretion and by muscular action of the orbicularis muscle and Riolans muscles during blinking. After delivery of meibum onto the posterior lid margin the oil moves from the posterior lid margin reservoir onto the tear meniscus and is pulled as a thin layer onto the pre-ocular tear film every time the lid opens. During lid closure it is compressed and a small part is continuously renewed. Meibum also has a barrier function against the spillage of tears over the inner border of the lid and against the entry of skin lipids (sebum) from the free lid margin.
Literatur
Andrews JS (1970) Human tear film lipids. I. Composition of the principal non- polar component. Exp Eye Res 10:223–227
Blackie CA, Korb DR (2009) Recovery time of an optimally secreting meibomian gland. Cornea 28:293–297
Blackie CA, Solomon JD, Greiner JV et al (2008) Inner eyelid surface temperature as a function of warm compress methodology. Optom Vis Sci 85:675–683
Brewitt H, Kaercher TM, Rüfer F (2008) Trockenes Auge und Blepharitis. Klin Monatsbl Augenheilkd 225:R15–R36
Bron AJ (1988) Eyelid secretions and the prevention and production of disease. Eye 2:164–171
Bron AJ, Benjamin L, Snibson GR (1991) Meibomian gland disease. Classification and grading of lid changes. Eye 5:395–411
Bron AJ, Tiffany JM (1998) The meibomian glands and tear film lipids. Structure, function, and control. Adv Exp Med Biol 438:281–295
Bron AJ, Tiffany JM (2003) The tear film lipid layer forms a pleated sheet on eye closure. Ophthalmic Res 35 (Suppl 1):112
Bron AJ, Tiffany JM (2004) The contribution of meibomian disease to dry eye. Ocul Surf 2:149–165
Bron AJ, Tiffany JM, Gouveia SM et al (2004) Functional aspects of the tear film lipid layer. Exp Eye Res 78:347–360
Butovich IA, Uchiyama E, Di Pascuale MA, McCulley JP (2007) Liquid chromatography-mass spectrometric analysis of lipids present in human meibomian gland secretions. Lipids 42:765–776
Butovich IA, Millar TJ, Ham BM (2008) Understanding and analyzing meibomian lipids. A Review. Curr Eye Res 33:405–420
Chew CK, Hykin PG, Jansweijer C et al (1993) The casual level of meibomian lipids in humans. Curr Eye Res 12:255–259
Chew CK, Jansweijer C, Tiffany JM et al (1993) An instrument for quantifying meibomian lipid on the lid margin: the Meibometer. Curr Eye Res 12:247–254
Collins MJ, Iskander DR, Saunders A et al (2006) Blinking patterns and corneal staining. Eye Contact Lens 32:287–293
Cope C, Dilly PN, Kaura R, Tiffany JM (1986) Wettability of the corneal surface: a reappraisal. Curr Eye Res 5:777–785
Craig JP, Blades K, Patel S (1995) Tear lipid layer structure and stability following expression of the meibomian glands. Ophthalmic Physiol Opt 15:569–574
Dana MR (2004) Corneal antigen-presenting cells: diversity, plasticity, and disguise the cogan lecture. Invest Ophthalmol Vis Sci 45:722–727
Foulks GN, Bron AJ (2003) Meibomian gland dysfunction: a clinical scheme for description, diagnosis, classification, and grading. Ocul Surf 1:107–126
Gilbard JP, Rossi SR, Heyda KG (1989) Tear film and ocular surface changes after closure of the meibomian gland orifices in the rabbit. Ophthalmology 96:1180–1186
Glasgow BJ, Abduragimov AR, Gasymov OK, Yusifov TN (2002) Tear lipocalin: structure, function and molecular mechanisms of action. Adv Exp Med Biol 506:555–565
Goto E, Yagi Y, Matsumoto Y, Tsubota K (2002) Impaired functional visual acuity of dry eye patients. Am J Ophthalmol 133:181–186
Goto E, Endo K, Suzuki A et al (2003) Tear evaporation dynamics in normal subjects and subjects with obstructive meibomian gland dysfunction. Invest Ophthalmol Vis Sci 44:533–539
Gouveia SM, Tiffany JM (2005) Human tear viscosity: an interactive role for proteins and lipids. Biochim Biophys Acta 1753:155–163
Green-Church KB, Nichols KK, Kleinholz NM et al (2008) Investigation of the human tear film proteome using multiple proteomic approaches. Mol Vis 14:456–470
Greiner JV, Glonek T, Korb DR et al (1996) Phospholipids in meibomian gland secretion. Ophthalmic Res 28:44–49
Greiner JV, Glonek T, Korb DR, Leahy CD (1996) Meibomian gland phospholipids. Curr Eye Res 15:371–375
Harrison WW, Begley CG, Liu H et al (2008) Menisci and fullness of the blink in dry eye. Optom Vis Sci 85:706–714
Haworth KM, Nichols JJ, Thangavelu M et al (2009) Examination of human meibum collection and extraction techniques. Invest Ophthalmol Vis Sci 50:2544
Henriquez AS, Korb DR (1981) Meibomian glands and contact lens wear. Br J Ophthalmol 65:108–111
Holly FJ (1973) Formation and stability of the tear film. Int Ophthalmol Clin 13:73–96
Holly FJ (1973) Formation and rupture of the tear film. Exp Eye Res 15:515–525
Hykin PG, Bron AJ (1992) Age-related morphological changes in lid margin and meibomian gland anatomy. Cornea 11:334–342
Isenberg SJ, Del Signore M, Chen A, Wei J (2002) The lipid layer and stability of tears in human newborns. Adv Exp Med Biol 506:401–404
Isreb MA, Greiner JV, Korb DR et al (2003) Correlation of lipid layer thickness measurements with fluorescein tear film break-up time and Schirmer’s test. Eye 17:79–83
Kaercher T, Brewitt H (2004) Blepharitis. Ophthalmologe 101:1135–1147
Kaercher T, Honig D, Mobius D (1993) Brewster angle microscopy. A new method of visualizing the spreading of Meibomian lipids. Int Ophthalmol 17:341–348
Kaercher T, Mobius D, Welt R (1992) Biophysical characteristics of the Meibomian lipid layer under in vitro conditions. Int Ophthalmol 16:167–176
Kaercher T, Mobius D, Welt R (1994) Biophysical behaviour of the infant Meibomian lipid layer. Int Ophthalmol 18:15–19
King-Smith PE, Fink BA, Hill RM et al (2004) The thickness of the tear film. Curr Eye Res 29:357–368
King-Smith PE, Fink BA, Nichols JJ et al (2009) The contribution of lipid layer movement to tear film thinning and breakup. Invest Ophthalmol Vis Sci 50:2747–2756
Knop E, Knop N (2003) Augen-assoziiertes lymphatisches Gewebe (EALT) durchzieht die Augenoberfläche kontinuierlich von der Tränendrüse bis in die ableitenden Tränenwege. Ophthalmologe 100:929–942
Knop E, Knop N (2005) Influence of the Eye-associated Lymphoid Tissue (EALT) on inflammatory ocular surface disease. Ocul Surf 3:S180–S186
Knop E, Knop N (2009) Conjunctiva immune surveillance. In: Dartt DA, Edelhauser HF (eds) Encyclopedia of the Eye. Elsevier, Oxford
Knop E, Knop N, Brewitt H (2003) Das trockene Auge als komplexe Fehlregulation der funktionellen Anatomie der Augenoberfläche. Neue Impulse zum Verständnis des trockenen Auges. Ophthalmologe 100:917–928
Knop E, Knop N, Claus P (2008) Local production of secretory IgA in the eye-associated lymphoid tissue (ealt) of the normal human ocular surface. Invest Ophthalmol Vis Sci 49:2322–2329
Korb DR, Donald R, Korb OD (2008) Interview. Ocul Surf 6:56–58
Korb DR, Baron DF, Herman JP et al (1994) Tear film lipid layer thickness as a function of blinking. Cornea 13:354–359
Korb DR, Blackie CA (2008) Meibomian gland diagnostic expressibility: correlation with dry eye symptoms and gland location. Cornea 27:1142–1147
Korb DR, Greiner JV (1994) Increase in tear film lipid layer thickness following treatment of meibomian gland dysfunction. Adv Exp Med Biol 350:293–298
Korb DR, Henriquez AS (1980) Meibomian gland dysfunction and contact lens intolerance. J Am Optom Assoc 51:243–251
Korb DR, Herman JP, Greiner JV et al (2005) Lid wiper epitheliopathy and dry eye symptoms. Eye Contact Lens 31:2–8
Lemp M, Holly FJ, Shuzo I, Dohlman C (1970) The precorneal tear film. 1. Factors in spreading and maintaining a continuous tear film over the corneal surface. Arch Ophthalmol 83:89–94
Linton RG, Curnow DH, Riley WJ (1961) The meibomian glands: an investigation into the secretion and some aspects of the physiology. Br J Ophthalmol 45:718–723
Mathers WD (1993) Ocular evaporation in meibomian gland dysfunction and dry eye. Ophthalmology 100:347–351
Mathers WD, Lane JA (1998) Meibomian gland lipids, evaporation, and tear film stability. Adv Exp Med Biol 438:349–360
McCulley JP, Shine W (1997) A compositional based model for the tear film lipid layer. Trans Am Ophthalmol Soc 95:79–88
McCulley JP, Shine WE (2001) The lipid layer: the outer surface of the ocular surface tear film. Biosci Rep 21:407–418
McDermott AM, Perez V, Huang AJ et al (2005) Pathways of corneal and ocular surface inflammation: a perspective from the Cullen symposium. Ocul Surf 3:S131–S138
McDonald JE (1968) Surface phenomena of tear films. Trans Am Ophthalmol Soc 66:905–939
Mishima S, Maurice D (1961) The oily layer of the tear film and evaporation from the corneal surface. Exp Eye Res 1:39–45
Nagymihalyi A, Dikstein S, Tiffany JM (2004) The influence of eyelid temperature on the delivery of meibomian oil. Exp Eye Res 78:367–370
Nagyova B, Tiffany JM (1999) Components responsible for the surface tension of human tears. Curr Eye Res 19:4–11
Nicolaides N, Kaitaranta JK, Rawdah TN et al (1981) Meibomian gland studies: comparison of steer and human lipids. Invest Ophthalmol Vis Sci 20:522–536
Norn M (1985) Meibomian orifices and Marx’s line. Studied by triple vital staining. Acta Ophthalmol (Copenh) 63:698–700
Norn M (1987) Expressibility of meibomian secretion. Relation to age, lipid precorneal film, scales, foam, hair and pigmentation. Acta Ophthalmol (Copenh) 65:137–142
Norn MS (1979) Semiquantitative interference study of fatty layer of precorneal film. Acta Ophthalmol (Copenh) 57:766–774
Olami Y, Zajicek G, Cogan M et al (2001) Turnover and migration of meibomian gland cells in rats‘ eyelids. Ophthalmic Res 33:170–175
Purslow C, Wolffsohn JS (2005) Ocular surface temperature: a review. Eye Contact Lens 31:117–123
Shimazaki J, Sakata M, Tsubota K (1995) Ocular surface changes and discomfort in patients with meibomian gland dysfunction. Arch Ophthalmol 113:1266–1270
Shine WE, McCulley JP (1991) The role of cholesterol in chronic blepharitis. Invest Ophthalmol Vis Sci 32:2272–2280
Shine WE, McCulley JP (2003) Polar lipids in human meibomian gland secretions. Curr Eye Res 26:89–94
Siemasko KF, Gao J, Calder VL et al (2008) In vitro expanded CD4+CD25+Foxp3+ regulatory t cells maintain a normal phenotype and suppress immune-mediated ocular surface inflammation. Invest Ophthalmol Vis Sci 49(12):5434–5440
Stern ME, Pflugfelder SC (2004) Inflammation in dry eye. Ocul Surf 2:124–130
Sullivan DA, Yamagami H, Liu M et al (2002) Sex steroids, the meibomian gland and evaporative dry eye. Adv Exp Med Biol 506:389–399
Tiffany JM (1978) Individual variations in human meibomian lipid composition. Exp Eye Res 27:289–300
Tiffany JM (1979) The meibomian lipids of the rabbit. I. Overall composition. Exp Eye Res 29:195–202
Tiffany JM (1985) The role of meibomian secretion in the tears. Trans Ophthalmol Soc U K 104:396–401
Tiffany JM (1986) Refractive index of meibomian and other lipids. Curr Eye Res 5:887–889
Tiffany JM (1987) The lipid secretion of the meibomian glands. Adv Lipid Res 22:1–62
Tiffany JM (1995) Physiological functions of the meibomian glands. Prog Retin Eye Res 14:47–74
Tiffany JM, Dart JKG (1981) Normal and abnormal functions of meibomian secretion. R Soc Med Int Congr Symp Ser 40:1061–1064
Tiffany JM, Marsden RG (1986) The influence of composition on physical properties of meibomian secretion. The preocular tear film in health, disease and contact lens wear. Dry Eye Institute, Lubbock TX, pp 597–604
Tiffany JM, Nagyova B (2002) The role of lipocalin in determining the physical properties of tears. Adv Exp Med Biol 506:581–585
Torens S, Berger E, Stave J, Guthoff R (2000) Darstellung der Mikroarchitektur und Dynamik der Aufreißphänomene des präkornealen Tränenfilms mit Hilfe der Laser-Rastermikroskopie. Ophthalmologe 97:635–639
Tsai PS, Evans JE, Green KM et al (2006) Proteomic analysis of human meibomian gland secretions. Br J Ophthalmol 90(3):372–377
Yokoi N, Bron AJ, Tiffany JM, Kinoshita S (2000) Reflective meniscometry: a new field of dry eye assessment. Cornea 19:S37–S43
Yokoi N, Takehisa Y, Kinoshita S (1996) Correlation of tear lipid layer interference patterns with the diagnosis and severity of dry eye. Am J Ophthalmol 122:818–824
Interessenkonflikt
Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Knop, E., Knop, N. & Schirra, F. Meibom-Drüsen. Ophthalmologe 106, 884–892 (2009). https://doi.org/10.1007/s00347-009-2019-9
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00347-009-2019-9