Meibomian glands reduced after 3 minutes of intranasal tear neurostimulation

BALTIMORE — Intranasal tear neurostimulation may have a significant effect on meibomian gland morphology, based on research presented at the Association for Research in Vision and Ophthalmology annual meeting.

Nicholas Pondelis, clinical research assistant and ophthalmic photographer at Tufts Medical Center, spoke about the study in an interview with Healio.com/OSN.

“Previous researchers have shown that intranasal tear neurostimulation activates tear production and observed a slight twitch in the eyelid during stimulation, which encouraged our further analysis into goblet cell and meibum release,” he said.

Twelve dry eye subjects were enrolled in the study, with anterior segment OCT meibography performed on the lower eyelids before and after 3 minutes of treatment with the Intranasal Tear Neurostimulator (Allergan).

“Originally the idea was for an implant in the upper nose; instead, Allergan decided on the rechargeable, replaceable pack with the goal of offering affordable relief for these patients,” Pondelis said.

The areas of the meibomian glands were 2,184.76 ± 135.51 µm² before stimulation and 1,933.2 ± 114.82 µm² after stimulation.

The mean change in area was 251.56 ± 10.95 µm², a statistically significant 11.6% reduction, after use of the neurostimulator (P < .001).

The 5.81% reduction in meibomian gland perimeter was also statistically significant (P < .012).

After stimulation, the images showed an increase in brightness at the conjunctival surface and hyporeflective areas at orifices of the meibomian glands.

“We are seeing a reduction in dilation of the glands, which is suggestive of meibum release,” Pondelis said.

The device has the potential to treat all types of dry eye, according to Pondelis.

Sneezing and watery eyes were the reported side effects. – by Abigail Sutton

Reference:

Pondelis N, et al. Intranasal neurostimulator induces morphological changes in meibomian glands in patients with dry eye disease. Presented at: Association for Research in Vision and Ophthalmology annual meeting; May 7-11, 2017; Baltimore.

Disclosure: Pondelis reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.