New Indicator of Children's Excessive Electronic Screen Use and Factors in Meibomian Gland Atrophy.
- 2021
CONCLUSIONS: Children's excessive electronic-screen-use is associated with severe-meibomian-gland-atrophy. Further research is needed to establish formal electronic-screen-use limits based on meibography-grade and evaluate correlation of autoimmune-disease-biomarker-positivity in children with severe-meibomian-gland-atrophy. Copyright (c) 2021. Published by Elsevier Inc. DESIGN: Retrospective cross-sectional study METHODS: Children (6-17years) presenting at clinical practice December 2016-2017 were evaluated for >=grade 2 MGA versus age-matched-controls with insignificant atrophy (=grade 2 atrophy, >=1eyelid on validated, 4-point, ImageJ-scale: 0(normal)-3(severe)). Autoimmune-disease-biomarker-positivity was assessed in 16 severe-meibomian-gland-atrophy-cases after found relevant in 1 case. PURPOSE: To evaluate the association of children's daily-electronic-screen-use with severe meibomian-gland-atrophy (MGA). RESULTS: 172 children were evaluated. Patients with known meibomian-gland-atrophy causes or poor-quality meibographies were excluded. 41 met inclusion criteria (mean-age, 11years; 49% female): 17 cases had severe-meibomian-gland-atrophy; 24 controls had insignificant gland-atrophy. All severe-meibomian-gland-atrophy cases had ocular symptoms/signs of dry-eye-disease including corneal neovascularization (29%), best-corrected-visual-acuity loss (41%), and central corneal neovascularization (14%). No controls had significant dry-eye symptoms/signs. Controls had lower/"better" meibogrades versus cases (p<0.01). In severe-meibomian-gland-atrophy cases, 86% reported >=4hours of daily-electronic-screen-use; 50% reported >=8hours. No controls exceeded 2hours. Increased electronic-screen-use was positively associated with increased/"worse" meibogrades (Odds-Ratio: 2.74; 95%CI, 1.39-5.41). In 16 severe-meibomian-gland-atrophy cases, 62.5% tested positive for autoimmune-biomarker(s) though none had systemic-symptoms: 18.8% Rheumatoid-Factor; 6.25% SSA/SSB; 31.3% early Sjogren's-syndrome-biomarkers; 6.25% ANA-positive/RF-negative. Autoimmune-disease-biomarker-positivity was not significantly associated with severe-meibomian-gland-atrophy vs controls (p=0.34, right-eye; p=0.71, left-eye).