{
  "abstract": "Meibomian gland (MG) dysfunction impairs the tear film lipid layer, which is critical for preventing aqueous evaporation and maintaining tear film stability. While a LipiView® II-reported mean lipid layer thickness (LLT) of ≥100 nm indicates a high- or ceiling-range device output rather than a calibrated absolute LLT, mean LLT alone may overlook clinically relevant information about the dynamic behavior of the tear film. This study aimed to evaluate whether qualitative variability in 20-s LipiView® II dynamic LLT traces is associated with MG morphology and ocular surface findings in eyes with device-reported high-range LLT values. In this retrospective, cross-sectional study, we analyzed 20-s dynamic LipiView® II recordings from eyes that were initially measured to have a mean LLT of ≥100 nm. Two masked observers classified LLT pattern variability as high or low based on predefined criteria. Clinical and demographic differences between the high- and low-variability groups were assessed statistically. Out of 85 eyes, 58 (68.2%) and 27 (31.8%) exhibited high- and low-variability, respectively. The high-variability group demonstrated markedly elevated meiboscores compared to the low-variability group, indicating a greater degree of MG dropouts (p = 0.042). Besides elevated meiboscores, patients in the high-variability group suffered from substantially worse dry eye disease (DED) symptoms, a trend toward higher corneal and conjunctival staining scores, and significantly increased blinking frequency (p < 0.05). Qualitative evaluation of LLT revealed increased meiboscores, greater severity of DED symptoms, and increased blinking frequency even in eyes with device-reported high-range mean LLT. LLT pattern analysis may warrant evaluation as an adjunctive approach for the early detection and targeted management of MG dysfunction-related evaporative DED.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Ophthalmology, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea",
    "Department of Ophthalmology, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea",
    "Department of Ophthalmology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea",
    "Itoh Clinic, Saitama, Japan",
    "Department of Ophthalmology, Keio University, Tokyo, Japan"
  ],
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  "author_total": 9,
  "authors": [
    {
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        0
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      "name": "Jiyoung Emily Lee"
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      "name": "Dong-Kyu Kim"
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      "name": "Hye Yeon Yoon"
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        3
      ],
      "name": "Woong-Joo Whang"
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    {
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        4
      ],
      "name": "Ho Sik Hwang"
    },
    {
      "name": "Hyun-Seung Kim"
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    {
      "name": "Reiko Arita"
    },
    {
      "name": "Eun Chul Kim"
    },
    {
      "name": "Kyung-Sun Na"
    }
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  "bibtex": "https://research.draconitic.com/paper/34mbgvnvc859t.bib",
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  "doi": "10.1371/journal.pone.0357020",
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  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
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  "pdf_url": "https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0357020&type=printable",
  "pmcid": null,
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  "published": "2026-09-15",
  "publisher": "Public Library of Science",
  "ris": "https://research.draconitic.com/paper/34mbgvnvc859t.ris",
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    {
      "first_seen": "2026-10-30T12:17:49Z",
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  "title": "Qualitative analysis and clinical implications of lipid layer thickness variability: A retrospective, cross-sectional study",
  "title_text": "Qualitative analysis and clinical implications of lipid layer thickness variability: A retrospective, cross-sectional study",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:49Z",
  "url": "https://research.draconitic.com/paper/34mbgvnvc859t",
  "venue": "PLOS One",
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