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Natesan S, Boddu SHS, Krishnaswami V, Shahwan M. The Role of Nano-ophthalmology in Treating Dry Eye Disease. Pharm Nanotechnol 2020; 8:258-289. [PMID: 32600244 DOI: 10.2174/2211738508666200628034227] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 03/24/2020] [Accepted: 05/07/2020] [Indexed: 11/22/2022]
Abstract
Dry eye disease (DED) is a common multifactorial disease linked to the tears/ocular surface leading to eye discomfort, ocular surface damage, and visual disturbance. Antiinflammatory agents (steroids and cyclosporine A), hormonal therapy, antibiotics, nerve growth factors, essential fatty acids are used as treatment options of DED. Current therapies attempt to reduce the ocular discomfort by producing lubrication and stimulating gland/nerve(s) associated with tear production, without providing a permanent cure for dry eye. Nanocarrier systems show a great promise to revolutionize drug delivery in DED, offering many advantages such as site specific and sustained delivery of therapeutic agents. This review presents an overview, pathophysiology, prevalence and etiology of DED, with an emphasis on preclinical and clinical studies involving the use of nanocarrier systems in treating DED. Lay Summary: Dry eye disease (DED) is a multifactorial disease associated with tear deficiency or excessive tear evaporation. There are several review articles that summarize DED, disease symptoms, causes and treatment approaches. Nanocarrier systems show a great promise to revolutionize drug delivery in DED, offering many advantages such as site specific and sustained delivery of therapeutic agents. Very few review articles summarize the findings on the use of nanotherapeutics in DED. In this review, we have exclusively discussed the preclinical and clinical studies of nanotherapeutics in DED therapy. This information will be attractive to both academic and pharmaceutical industry researchers working in DED therapeutics.
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Affiliation(s)
- Subramanian Natesan
- Department of Pharmaceutical Technology, University College of Engineering, BIT Campus, Anna University, Tiruchirappalli, Tamil Nadu, India
| | - Sai H S Boddu
- Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates
| | - Venkateshwaran Krishnaswami
- Department of Pharmaceutical Technology, University College of Engineering, BIT Campus, Anna University, Tiruchirappalli, Tamil Nadu, India
| | - Moyad Shahwan
- Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates
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102
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Inubushi S, Kawaguchi H, Mizumoto S, Kunihisa T, Baba M, Kitayama Y, Takeuchi T, Hoffman RM, Tanino H, Sasaki R. Oncogenic miRNAs Identified in Tear Exosomes From Metastatic Breast Cancer Patients. Anticancer Res 2020; 40:3091-3096. [PMID: 32487603 DOI: 10.21873/anticanres.14290] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 04/18/2020] [Accepted: 05/05/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Exosomes are produced by normal and cancer cells. Exosomes are found in the serum of cancer patients and have been used for diagnosis and prognosis. Recently tears from non-cancer patients have been found to contain exosomes. In the present report we describe tears from advanced breast-cancer patients. MATERIALS AND METHODS We found oncogenic miRNAs in the exosomes isolated from tear fluids obtained from five patients with metastatic breast cancer and compared them with tear exosomes form eight healthy volunteers. RESULTS Tear exosomes had a significantly higher quantity of exosome markers than serum exosomes (CD9, CD63). Tear exosomes were subjected to quantitative reverse-transcription polymerase reaction (qRT-PCR), and western blot analysis to elucidate the status of miRNAs, previously reported in serum from patients with metastatic breast cancer. qRT-PCR and western-blot analysis revealed that breast-cancer-specific miR-21 and miR-200c were highly expressed in tear exosomes from metastatic breast cancer patients in contrast to tear exosomes from healthy volunteers. CONCLUSION Tear exosomes can be a potential source of diagnostic and prognostic biomarkers for metastatic breast cancer, and possibly other cancers or diseases.
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Affiliation(s)
- Sachiko Inubushi
- Division of Radiation Oncology, Kobe University Graduate School of Medicine, Hyogo, Japan.,AntiCancer Inc, San Diego, CA, U.S.A.,Department of Surgery, University of California, San Diego, CA, U.S.A
| | - Hiroki Kawaguchi
- Division of Radiation Oncology, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Sachiko Mizumoto
- Division of Breast and Endocrine Surgery Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Tomonari Kunihisa
- Division of Breast and Endocrine Surgery Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Motoi Baba
- Division of Breast and Endocrine Surgery Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Yukiya Kitayama
- Graduate School of Engineering, Medical Device Fabrication Engineering Center, Graduate School of Engineering, Kobe University, Hyogo, Japan
| | - Toshifumi Takeuchi
- Graduate School of Engineering, Medical Device Fabrication Engineering Center, Graduate School of Engineering, Kobe University, Hyogo, Japan
| | - Robert M Hoffman
- AntiCancer Inc, San Diego, CA, U.S.A.,Department of Surgery, University of California, San Diego, CA, U.S.A
| | | | - Ryohei Sasaki
- Division of Radiation Oncology, Kobe University Graduate School of Medicine, Hyogo, Japan
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103
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Affiliation(s)
- Vishal Jhanji
- Ophthalmology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - James Chodosh
- Ophthalmology, Massachusetts Eye and Ear, Howe Laboratory, Harvard Medical School, Boston, Massachusetts, USA
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104
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Laihia J, Järvinen R, Wylęgała E, Kaarniranta K. Disease aetiology-based design of multifunctional microemulsion eye drops for moderate or severe dry eye: a randomized, quadruple-masked and active-controlled clinical trial. Acta Ophthalmol 2020; 98:244-254. [PMID: 31579987 PMCID: PMC7216857 DOI: 10.1111/aos.14252] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 09/06/2019] [Indexed: 01/14/2023]
Abstract
PURPOSE To assess the safety and efficacy of multi-ingredient sacha inchi microemulsion (SIME) eye drops designed to target (1) tear film instability, (2) tear hyperosmolarity, and (3) ocular surface damage and inflammation in moderate or severe dry eye. METHODS This randomized, quadruple-masked, active-controlled parallel study in 64 adult patients comprised three parts. Part 1 (n = 3): one eye was treated with SIME for one day. Part 2 (n = 9): randomized eyes were treated with SIME and 0.2% hyaluronic acid (HA) control eye drops 3 times a day for 10 days. Part 3 (n = 26 + 26): randomized treatment was applied on both eyes 3 times a day for 30 days. OSDI change was tested for superiority of SIME over HA. Ocular assessments were performed at baseline and after the last dose. RESULTS Both treatments were well tolerated without adverse device effects. Tear film break-up time (p = 0.0025) and ocular protection index (p = 0.0026; change vs. HA, p = 0.047) increased significantly with SIME after 30 days. Tear osmolarity decreased more in SIME than in the HA group and significantly with both eye drops in hyperosmolar subgroups. Corneal (p = 0.014) and nasal conjunctival staining (p = 0.043) were reduced with SIME in per-protocol patients (n = 24). Conjunctival (p = 0.001) and lid redness (p = 0.012) decreased with SIME in all patients (n = 26). Symptoms decreased by about 25 OSDI units with both treatments (p < 0.0001) and with nonsignificant difference between treatments. CONCLUSIONS Sacha inchi microemulsion (SIME) proved safe and efficacious in improving each aetiologic factor for dry eye as revealed through objective tests. Hyperosmolar stress dominating blink cycles must be disrupted by biophysical protection of the ocular surface to facilitate resolution of cellular damage and inflammation, and relief of ocular symptoms.
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Affiliation(s)
| | | | - Edward Wylęgała
- Department of OphthalmologyDistrict Railway Hospital KatowiceKatowicePoland,II School of Medicine with the Division of Dentistry in ZabrzeMedical University of SilesiaKatowicePoland
| | - Kai Kaarniranta
- Department of OphthalmologyInstitute of Clinical MedicineUniversity of Eastern FinlandKuopioFinland,Department of OphthalmologyKuopio University HospitalKuopioFinland
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105
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Abstract
Purpose: In early 2020, the World Health Organization declared the outbreak of the disease COVID-19, caused by a new variant of coronavirus 2019-nCoV as a global pandemic. The government of India ordered a nationwide lockdown for 21 days, limiting movement of people as a preventive measure. This survey was designed and conducted during the lockdown period to assess its effect on ophthalmic practice and patient care in India. Methods: An online survey was sent across to practicing Indian ophthalmologists across through various social media platforms. All valid responses were tabulated and analyzed. Results: A total of 1260 ophthalmologists responded to the survey. Most of the respondents (775/1260; 61.5%) were in private practice and 14.8% (187/1260) were affiliated to ophthalmic institutes. At the time of taking the survey, 72.5% of the respondents (913/1260) were not seeing any patients due to the lockdown. Of those who were still examining patients, 82.9% (287/347) were only seeing emergency cases, based on their own clinical judgement. The proportion of ophthalmologists in ophthalmic institutes, government and municipal hospitals (126/253;49.8%) who were still seeing patients was significantly higher (P < 0.0001) than those in private practice (174/775;22.4%). Apart from emergencies such as trauma, retinal detachment, and endophthalmitis (81.8%), other surgeries that were still being performed included intravitreal injections (9.1%) and cataract surgeries (5.9%). Approximately, 77.5% (976/1260) of the respondents had begun telephonic/e-mail/video consultations or consultations over social media applications since the lockdown began. In addition, 59.1% (745/1260) felt that ophthalmologists were potentially at a higher risk of contracting COVID-19 compared to other specialties while examining patients. When asked about the resumption of practice upon easing off of the restrictions, 57.8% (728/1260) of the respondents said they were unsure of when to resume elective surgeries; furthermore, 62.8% (791/1260) were unsure about the preferred screening strategy or precautionary approach prior to resuming surgeries and were awaiting guidelines. Conclusion: Our survey shows that majority of ophthalmologists in India were not seeing patients during the COVID-19 lockdown, with near-total cessation of elective surgeries. Emergency services were still being attended to by 27.5% of ophthalmologists who responded. A large proportions of ophthalmologists had switched over to telephonic advice or other forms of telemedicine to assist patients. Most of the responding ophthalmologists were unclear about when and how to resume surgeries upon easing off of the COVID-19 related restrictions. Regulatory bodies should take note of this and issue appropriate guidelines regarding the same.
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Affiliation(s)
- Akshay Gopinathan Nair
- Aditya Jyot Eye Hospital, Wadala; Advanced Eye Hospital and Institute, A Unit of Agarwal's Eye Hospital; Aayush Eye Clinic, A Unit of Agarwal's Eye Hospital, Chembur, Mumbai, Maharashtra, India
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106
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Miyamoto M, Sassa T, Sawai M, Kihara A. Lipid polarity gradient formed by ω-hydroxy lipids in tear film prevents dry eye disease. eLife 2020; 9:53582. [PMID: 32252890 PMCID: PMC7138607 DOI: 10.7554/elife.53582] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 03/10/2020] [Indexed: 12/11/2022] Open
Abstract
Meibum lipids form a lipid layer on the outermost side of the tear film and function to prevent water evaporation and reduce surface tension. (O-Acyl)-ω-hydroxy fatty acids (OAHFAs), a subclass of these lipids, are thought to be involved in connecting the lipid and aqueous layers in tears, although their actual function and synthesis pathway have to date remained unclear. Here, we reveal that the fatty acid ω-hydroxylase Cyp4f39 is involved in OAHFA production. Cyp4f39-deficient mice exhibited damaged corneal epithelium and shortening of tear film break-up time, both indicative of dry eye disease. In addition, tears accumulated on the lower eyelid side, indicating increased tear surface tension. In Cyp4f39-deficient mice, the production of wax diesters (type 1ω and 2ω) and cholesteryl OAHFAs was also impaired. These OAHFA derivatives show intermediate polarity among meibum lipids, suggesting that OAHFAs and their derivatives contribute to lipid polarity gradient formation for tear film stabilization.
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Affiliation(s)
- Masatoshi Miyamoto
- Laboratory of Biochemistry, Faculty of Pharmaceutical Sciences, Hokkaido University, Sapporo, Japan
| | - Takayuki Sassa
- Laboratory of Biochemistry, Faculty of Pharmaceutical Sciences, Hokkaido University, Sapporo, Japan
| | - Megumi Sawai
- Laboratory of Biochemistry, Faculty of Pharmaceutical Sciences, Hokkaido University, Sapporo, Japan
| | - Akio Kihara
- Laboratory of Biochemistry, Faculty of Pharmaceutical Sciences, Hokkaido University, Sapporo, Japan
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107
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Yu Y, Qi B, Liang X, Wang Z, Wang J, Liu W. Intraoperative iatrogenic retinal breaks in 23-gauge vitrectomy for stage 3 and stage 4 idiopathic macular holes. Br J Ophthalmol 2020; 105:93-96. [PMID: 32217539 DOI: 10.1136/bjophthalmol-2019-315579] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 02/28/2020] [Accepted: 03/10/2020] [Indexed: 11/03/2022]
Abstract
AIMS To investigate characteristics of intraoperative iatrogenic retinal breaks in 23-gauge vitrectomy for idiopathic macular hole and classify the breaks based on their causes to analyse the risk factors. METHODS This retrospective study enrolled patients with stage 3 or 4 idiopathic macular hole who underwent 23-gauge vitrectomy in Beijing Tongren Hospital from July 2015 to August 2018. The intraoperative iatrogenic retinal breaks were classified into three types: by induction of posterior vitreous detachment (type 1), by peripheral vitreous cutting (type 2) and by others (type 3). The types, incidence and distribution of the breaks were analysed, and all clinical features were compared between eyes with and without the breaks. RESULTS A total of 364 eyes from 341 patients were recruited. Twenty-five breaks from 24 eyes (6.6%) were encountered, 52% (13/25) of which distributed in the superior region. Type 1 and type 2 breaks contributed 52% (13/25) and 44% (11/25) to all, respectively. Eyes with stage 3 and stage 4 holes showed no significant differences in incidence or distribution in type 2 breaks. No breaks occurred on the surface of lattice degenerations. All clinical features showed no significant differences between eyes with and without the breaks. CONCLUSION Distribution of intraoperative iatrogenic retinal breaks shows no preference for the superior or inferior region. Induction of posterior vitreous detachment and traction from peripheral vitreous cutting are major causes of the breaks, which classify them into two main types. The presence of lattice may not be one of the risk factors if treated properly.
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Affiliation(s)
- Yanping Yu
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Biying Qi
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Xida Liang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Zengyi Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Jing Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Wu Liu
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
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108
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Dalton MF, Siepker CL, Maboni G, Sanchez S, Rissi DR. Ocular and Lacrimal Gland Lesions in Naturally Occurring Rabies of Domestic and Wild Mammals. Vet Pathol 2020; 57:409-417. [PMID: 32202218 DOI: 10.1177/0300985820911458] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Investigations describing the ocular and lacrimal gland lesions associated with rabies are sparse. Here we characterize the pathological changes and distribution of rabies viral antigen in the eye, optic nerve, and lacrimal gland of 18 rabies cases from different mammalian species. Histology and immunohistochemistry for rabies virus, CD3, CD20, and Iba1 were performed on tissue sections of eye, optic nerve, and lacrimal gland. Polymerase chain reaction (PCR) for rabies was performed on all cases, including 7 formalin-fixed, paraffin-embedded (FFPE) and 11 frozen tissue samples of eye and lacrimal gland. Pathological changes in the eye consisted of retinal necrosis (12/18 cases) with occasional viral inclusions within ganglion cells (8/12 cases). Immunohistochemically, viral antigen was detected within the nerve fiber layer, ganglion cells, and inner plexiform layer in all 12 cases with retinal lesions and in 2 cases with no retinal lesions, as well as optic nerve (6/18 cases) and lacrimal gland epithelium (3/18 cases). CD3+ T lymphocytes were present in the retina (11/18 cases), optic nerve (2/18 cases), and lacrimal gland (11/18 cases). No CD20+ B lymphocytes or Iba1+ macrophages were detected. PCR for rabies virus was positive in 9 of 11 frozen samples but in only 2 of 7 FFPE samples. Five samples that were negative for rabies by PCR were positive by immunohistochemistry, and 2 samples were negative by both tests. These results provide evidence that rabies virus infection extends to the eye, likely via the ocular nerve, and that the lacrimal gland might be a source of viral infection.
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Affiliation(s)
- Martha F Dalton
- Department of Pathology, University of Georgia College of Veterinary Medicine, Athens, GA, USA
| | - Chris L Siepker
- Department of Pathology, University of Georgia College of Veterinary Medicine, Athens, GA, USA
| | - Grazieli Maboni
- Athens Veterinary Diagnostic Laboratory, University of Georgia College of Veterinary Medicine, Athens, GA, USA
| | - Susan Sanchez
- Athens Veterinary Diagnostic Laboratory, University of Georgia College of Veterinary Medicine, Athens, GA, USA.,Department of Infectious Diseases, University of Georgia College of Veterinary Medicine, Athens, GA, USA
| | - Daniel R Rissi
- Department of Pathology, University of Georgia College of Veterinary Medicine, Athens, GA, USA.,Athens Veterinary Diagnostic Laboratory, University of Georgia College of Veterinary Medicine, Athens, GA, USA
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109
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110
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Rodriguez-Smith J, Yeh S, Angeles-Han S. Improving quick and accurate diagnosis of childhood JIA-uveitis from a pediatric rheumatology perspective. Expert Rev Ophthalmol 2020; 15:101-109. [PMID: 32313548 PMCID: PMC7170263 DOI: 10.1080/17469899.2020.1739521] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 03/04/2020] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Juvenile idiopathic arthritis (JIA) is the most common pediatric rheumatic disease associated with uveitis. JIA-associated uveitis (JIA-U) is typically asymptomatic, chronic, and can lead to sight-threatening complications. This review will provide approaches to improve the diagnosis and outcomes of children with JIA-U. AREAS COVERED We will provide updates on risk factors for uveitis onset and ocular complications, improvements in the ophthalmic screening schedule for uveitis detection, and potential strategies to advance the diagnosis and monitoring of JIA-U using advanced ophthalmic imaging and diagnostic equipment and laboratory biomarkers. EXPERT OPINION There is a lack of high-quality research in JIA-U and few randomized controlled trials, underscoring the urgent need for further studies in this population. Early uveitis diagnosis combined with timely and appropriate treatment can improve visual outcomes. Improved knowledge of uveitis pathogenesis, risk factors for uveitis onset, measurement of uveitis outcomes, and optimal treatment are crucial.
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Affiliation(s)
- Jackeline Rodriguez-Smith
- Cincinnati Children's Hospital Medical Center, Division of Rheumatology, 3333 Burnett Avenue, Cincinnati, Ohio 45229-3026, United States
| | - Steven Yeh
- Emory Eye Center, Department of Ophthalmology, Atlanta, Georgia 30322-1013, United States
| | - Sheila Angeles-Han
- Cincinnati Children's Hospital Medical Center, Division of Rheumatology, 3333 Burnett Avenue, Cincinnati, Ohio 45229-3026, United States
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111
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Teo ZL, Chu C, Tong L. Severe dysfunctional tear syndrome patients and resolution of central corneal staining: retrospective cohort study. Br J Ophthalmol 2020; 104:1669-1675. [PMID: 32152143 DOI: 10.1136/bjophthalmol-2019-315573] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 01/28/2020] [Accepted: 02/19/2020] [Indexed: 11/03/2022]
Abstract
PURPOSE Severe dry eye is widely prevalent yet difficult to treat. This study aims to evaluate for improvement in epithelial status and the risk factors for lack of improvement in a cohort of patients in Singapore with severe dry eye. METHODS We retrospectively identified 1712 patients with severe dry eye (≥grade 3 Delphi) in at least one eye, referred to a tertiary centre dry eye clinic from 2006 to 2017. We included patients with central corneal staining grade of ≥2 at referral and minimum follow-up duration of 6 months (n=407). An epithelial staining grade of <2 at the last visit was considered a significantly improved outcome. RESULTS The mean follow-up duration was 4.0±2.4 years, with 88.0% (358/407) of patients achieving significant improvement. Various treatment modalities including topical corticosteroids (32.4%), cyclosporine (52.8%) and punctal plugs (24.1%) were used. Risk factors for non-improvement of staining grade include autoimmune disease (OR 3.2, 95% CI: 1.7 to 6.1), rheumatoid arthritis (RA) (OR 3.4 (1.8 to 6.6)), graft-versus-host disease (GVHD) (OR 3.4 (1.0 to 11.7)), reduced baseline Schirmer's test (OR 2.1 (1.2 to 3.9)) and reduced tear break up time (OR 2.0 (1.0 to 3.8)). On multivariate analyses, RA and GVHD were still significant risk factors. Gender, age and meibum viscosity were not significantly associated with epithelial staining grade improvement. CONCLUSIONS Overall, a high rate of corneal epithelial improvement was achieved. Nevertheless, there is an unmet need for more effective measures to reduce epitheliopathy in severe dry eye, especially in patients with systemic immune-mediated disease.
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Affiliation(s)
- Zhen Ling Teo
- Ocular Surface Research Group, Singapore Eye Research Institute, Singapore.,Department of Ophthalmology, Singapore National Eye Centre, Singapore
| | - Clarisse Chu
- Ocular Surface Research Group, Singapore Eye Research Institute, Singapore
| | - Louis Tong
- Ocular Surface Research Group, Singapore Eye Research Institute, Singapore .,Department of Ophthalmology, Singapore National Eye Centre, Singapore.,Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Ophthalmology & Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore
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112
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Fodor M, Vitályos G, Losonczy G, Hassan Z, Pásztor D, Gogolák P, Kolozsvári BL. Tear Mediators NGF along with IL-13 Predict Keratoconus Progression. Ocul Immunol Inflamm 2020; 29:1090-1101. [PMID: 32130054 DOI: 10.1080/09273948.2020.1716024] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Purpose: To find immunomediator combinations which could sensitively indicate keratoconus progression.Methods: Tear samples of 42 patients with keratoconus were collected at baseline and at the end of a one-year follow-up. The concentrations of 13 mediators were measured by CBA. Based on Pentacam HR examination, eyes were divided into a non-progressive and a progressive group.Results: At the end of the follow-up, significant differences were observed in the release of IFNγ, IL-13, IL-17A, CCL5, MMP-13 and PAI-1 between the two groups. Changes in five Pentacam parameters correlated positively with changes in IFNγ, IL-13, IL-17A, CXCL8, CCL5, TIMP-1 and t-PA. We found that tear level of IL-13 in combination with NGF can predict the progression of keratoconus with 100% specificity and 80% sensitivity.Conclusion: The findings of our longitudinal study may underscore the importance of NGF and IL-13 tear levels in the prediction of keratoconus progression.
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Affiliation(s)
- Mariann Fodor
- Department of Ophthalmology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Géza Vitályos
- Department of Orthodontics, Faculty of Dentistry, University of Debrecen, Debrecen, Hungary
| | - Gergely Losonczy
- Department of Ophthalmology, Zuyderland Hospital, Eyescan BV, Sittard, The Netherlands
| | - Ziad Hassan
- Orbident Refractive Surgery and Medical Center, Debrecen, Hungary
| | - Dorottya Pásztor
- Department of Ophthalmology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Péter Gogolák
- Department of Immunology, University of Debrecen, Debrecen, Hungary
| | - Bence Lajos Kolozsvári
- Department of Ophthalmology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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113
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Sitovs A, Voiko L, Kustovs D, Kovalcuka L, Bandere D, Purvina S, Giorgi M. Pharmacokinetic profiles of levofloxacin after intravenous, intramuscular and subcutaneous administration to rabbits ( Oryctolagus cuniculus). J Vet Sci 2020; 21:e32. [PMID: 32233138 PMCID: PMC7113567 DOI: 10.4142/jvs.2020.21.e32] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 01/20/2020] [Accepted: 01/22/2020] [Indexed: 01/05/2023] Open
Abstract
Levofloxacin pharmacokinetic profiles were evaluated in 6 healthy female rabbits after intravenous (I/V), intramuscular (I/M), or subcutaneous (S/C) administration routes at a single dose of 5 mg/kg in a 3 × 3 cross-over study. Plasma levofloxacin concentrations were detected using a validated Ultra Performance Liquid Chromatography method with a fluorescence detector. Levofloxacin was quantifiable up to 10 h post-drug administration. Mean AUC0-last values of 9.03 ± 2.66, 9.07 ± 1.80, and 9.28 ± 1.56 mg/h*L were obtained via I/V, I/M, and S/C, respectively. Plasma clearance was 0.6 mL/g*h after I/V administration. Peak plasma concentrations using the I/M and S/C routes were 3.33 ± 0.39 and 2.91 ± 0.56 μg/mL. Bioavailability values, after extravascular administration were complete, - 105% ± 27% (I/M) and 118% ± 40% (S/C). Average extraction ratio of levofloxacin after I/V administration was 7%. Additionally, levofloxacin administration effects on tear production and osmolarity were evaluated. Tear osmolarity decreased within 48 h post-drug administration. All 3 levofloxacin administration routes produced similar pharmacokinetic profiles. The studied dose is unlikely to be effective in rabbits; however, it was calculated that a daily dose of 29 mg/kg appears effective for I/V administration for pathogens with MIC < 0.5 μg/mL.
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Affiliation(s)
- Andrejs Sitovs
- Department of Pharmacology, Riga Stradins University, Riga, LV-1007, Latvia.
| | - Laura Voiko
- Clinical Institute, Faculty of Veterinary Medicine, University of Life Sciences and Technologies, Jelgava, LV-3001, Latvia
| | - Dmitrijs Kustovs
- Department of Pharmacology, Riga Stradins University, Riga, LV-1007, Latvia
| | - Liga Kovalcuka
- Clinical Institute, Faculty of Veterinary Medicine, University of Life Sciences and Technologies, Jelgava, LV-3001, Latvia
| | - Dace Bandere
- Department of Pharmaceutical Chemistry, Riga Stradins University, Riga, LV-1007, Latvia
| | - Santa Purvina
- Department of Pharmacology, Riga Stradins University, Riga, LV-1007, Latvia
| | - Mario Giorgi
- Department of Veterinary Sciences, University of Pisa, Pisa 56126, Italy
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114
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van Roeyen I, Riem MME, Toncic M, Vingerhoets AJJM. The Damaging Effects of Perceived Crocodile Tears for a Crier's Image. Front Psychol 2020; 11:172. [PMID: 32132947 PMCID: PMC7040244 DOI: 10.3389/fpsyg.2020.00172] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Accepted: 01/23/2020] [Indexed: 11/13/2022] Open
Abstract
Emotional tears are uniquely human and play an essential role in the communication of distress in adults. Several studies have shown that individuals are more willing to offer emotional support and help a person in tears. Preliminary evidence suggests that this greater willingness to provide support is mediated via perceived warmth and helplessness. Moreover, tearful individuals are regarded as more reliable and honest. In the current study, we examined whether people can reliably distinguish genuine and fake crying, and what the consequences for the further evaluation of the crier are. A total of 202 participants (73 men, 129 women) were exposed to brief movie clips of genuine and fake crying adults and were asked to assess the criers. Results show that women were slightly better at identifying fake and genuine crying. How the crying was perceived subsequently seemed to have a strong influence on the further evaluation of the "crier." Criers qualified as pretenders were perceived as significantly more manipulative, less reliable, less warm, and less competent. Further, the respondents felt less connected with the perceived pretenders, who also were less welcomed as friends, colleagues, neighbors, and babysitter. They were additionally qualified as significantly less fit for "reliable" professions (judge, teacher, police officer, scientist, and physician). In contrast, the ratings of their fitness for "unreliable" professions (banker, CEO, journalist, real estate salesman, and politician) yielded a significant difference in only one video clip (and contrary to expectations). Our findings thus indicate that the subjective labeling of crying as fake is associated with a significantly less positive perception of the "crying" person, regardless of whether the crying is actually fake or genuine. The qualification of tears as crocodile tears thus seems to affect the crier's image strongly negatively.
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Affiliation(s)
- Inge van Roeyen
- Center of Research on Psychological and Somatic Disorders, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands
| | - Madelon M E Riem
- Center of Research on Psychological and Somatic Disorders, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands.,Clinical Child and Family Studies, VU University Amsterdam, Amsterdam, Netherlands
| | - Marko Toncic
- Department of Psychology, University of Rijeka, Rijeka, Croatia
| | - Ad J J M Vingerhoets
- Center of Research on Psychological and Somatic Disorders, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands
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115
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Edman MC, Janga SR, Kakan SS, Okamoto CT, Freire D, Feigenbaum D, Lew M, Hamm-Alvarez SF. Tears - more to them than meets the eye: why tears are a good source of biomarkers in Parkinson's disease. Biomark Med 2020; 14:151-163. [PMID: 32064896 DOI: 10.2217/bmm-2019-0364] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Tears are a known source of biomarkers for both ocular and systemic diseases with particular advantages; specifically, the noninvasiveness of sample collection and a unique and increasingly better-defined protein composition. Here, we discuss our rationale for use of tears for discovery of biomarkers for Parkinson's disease (PD). These reasons include literature supporting changes in tear flow and composition in PD, and the interconnections between the ocular surface system and neurons affected in PD. We highlight recent data on the identification of tear biomarkers including oligomeric α-synuclein, associated with neuronal degeneration in PD, in tears of PD patients and discuss possible sources for its release into tears. Challenges and next steps for advancing such biomarkers to clinical usage are highlighted.
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Affiliation(s)
- Maria C Edman
- Department of Ophthalmology and Roski Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Srikanth R Janga
- Department of Ophthalmology and Roski Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Shruti Singh Kakan
- Department of Ophthalmology and Roski Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA.,Department of Pharmacology and Pharmaceutical Sciences, School of Pharmacy, University of Southern California, Los Angeles, CA 90033, USA
| | - Curtis T Okamoto
- Department of Pharmacology and Pharmaceutical Sciences, School of Pharmacy, University of Southern California, Los Angeles, CA 90033, USA
| | - Daniel Freire
- Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Danielle Feigenbaum
- Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Mark Lew
- Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Sarah F Hamm-Alvarez
- Department of Ophthalmology and Roski Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA.,Department of Pharmacology and Pharmaceutical Sciences, School of Pharmacy, University of Southern California, Los Angeles, CA 90033, USA
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116
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Peart DJ, Walshe IH, Sweeney EL, James E, Henderson T, O'Doherty AF, McDermott AM. The effect of acute exercise on environmentally induced symptoms of dry eye. Physiol Rep 2020; 8:e14262. [PMID: 31997577 PMCID: PMC6989563 DOI: 10.14814/phy2.14262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 09/17/2019] [Accepted: 09/17/2019] [Indexed: 11/24/2022] Open
Abstract
The purpose of this study was to investigate the effects of acute exercise on environmentally induced symptoms of dry eye. Twelve participants without dry eye disease volunteered to complete three experimental visits in a randomized order; (1) control condition seated for 1 h at a relative humidity (RH) of 40% (CONT), (2) dry condition seated for 1 h at a RH of 20% (DRY), and (3) exercise condition seated for 40 min followed by 20 min of cycling exercise at a RH of 20% (EXER). Tear volume, tear matrix metalloproteinase 9 (MMP-9), perception of dry eye symptoms (frequency and severity), core temperature, and ocular surface temperature (OST) were measured at the end of each exposure. The perception of dry eye frequency and MMP-9 concentration were significantly higher in DRY compared to CONT (P < 0.012), with no differences in EXER compared to CONT. The results suggest that an acute bout of exercise may attenuate symptoms of environmentally induced dry eye, and warrant further research.
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Affiliation(s)
- Daniel J. Peart
- Department of Sport, Exercise and RehabilitationNorthumbria UniversityNewcastle‐upon‐TyneUnited Kingdom
| | - Ian H. Walshe
- Department of Sport, Exercise and RehabilitationNorthumbria UniversityNewcastle‐upon‐TyneUnited Kingdom
| | - Emma L. Sweeney
- Department of Sport, Exercise and RehabilitationNorthumbria UniversityNewcastle‐upon‐TyneUnited Kingdom
| | - Emily James
- Department of Sport, Exercise and RehabilitationNorthumbria UniversityNewcastle‐upon‐TyneUnited Kingdom
| | - Thomas Henderson
- Department of Sport, Exercise and RehabilitationNorthumbria UniversityNewcastle‐upon‐TyneUnited Kingdom
| | - Alasdair F. O'Doherty
- Department of Sport, Exercise and RehabilitationNorthumbria UniversityNewcastle‐upon‐TyneUnited Kingdom
| | - Alison M. McDermott
- Department of Applied SciencesNorthumbria UniversityNewcastle‐upon‐TyneUnited Kingdom
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117
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Dantam J, Subbaraman LN, Jones L. Adhesion of Pseudomonas aeruginosa, Achromobacter xylosoxidans, Delftia acidovorans, Stenotrophomonas maltophilia to contact lenses under the influence of an artificial tear solution. Biofouling 2020; 36:32-43. [PMID: 31973583 DOI: 10.1080/08927014.2019.1710832] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 12/25/2019] [Accepted: 12/27/2019] [Indexed: 06/10/2023]
Abstract
Corneal infection is a devastating sight-threatening complication that is associated with contact lens (CL) wear, commonly caused by Pseudomonas aeruginosa. Lately, Achromobacter xylosoxidans, Delftia acidovorans, and Stenotrophomonas maltophilia have been associated with corneal infection. This study investigated the adhesion of these emerging pathogens to CLs, under the influence of an artificial tear solution (ATS) containing a variety of components commonly found in human tears. Two different CL materials, etafilcon A and senofilcon A, either soaked in an ATS or phosphate buffered saline, were exposed to the bacteria. Bacterial adhesion was investigated using a radio-labeling technique (total counts) and plate count method (viable counts). The findings from this study revealed that in addition to P. aeruginosa, among the emerging pathogens evaluated, A. xylosoxidans showed an increased propensity for adherence to both CL materials and S. maltophilia showed lower viability. ATS influenced the viable counts more than the total counts on CLs.
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Affiliation(s)
- Jaya Dantam
- Centre for Ocular Research & Education, School of Optometry & Vision Science, University of Waterloo, Waterloo, Canada
| | - Lakshman N Subbaraman
- Centre for Ocular Research & Education, School of Optometry & Vision Science, University of Waterloo, Waterloo, Canada
| | - Lyndon Jones
- Centre for Ocular Research & Education, School of Optometry & Vision Science, University of Waterloo, Waterloo, Canada
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118
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Asbell P, Messmer E, Chan C, Johnson G, Sloesen B, Cook N. Defining the needs and preferences of patients with dry eye disease. BMJ Open Ophthalmol 2019; 4:e000315. [PMID: 31909189 PMCID: PMC6936476 DOI: 10.1136/bmjophth-2019-000315] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 09/04/2019] [Accepted: 11/09/2019] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE Dry eye disease is a multifactorial chronic disease, leading to ocular discomfort and visual disturbance with a substantial impact on quality of life. Therefore, the patient's perspective should be taken into account early in the drug development process. We have developed a step-by-step methodology based on the self-explicated conjoint approach to assess the needs and preferences of patients with moderate-to-severe dry eye disease. METHODS AND ANALYSIS Following a literature review and social media listening (step 0), qualitative phone call interviews were conducted with 12 patients (step 1). Patients' responses underwent content analysis and were coded, quantified and displayed as charts. Based on the emerging trends and attributes identified as relevant in steps 0 and 1, a quantitative online questionnaire was designed and conducted with 160 patients across four countries (step 2). RESULTS The online questionnaire was rated as easy/very easy to understand by 60% of respondents, 62% rated the survey as easy/very easy to complete and 71% rated it as interesting/very interesting. Treatment satisfaction was the most important aspect for patients, and the three most relevant attributes were as follows (with the most important indexed to 100%): 'treatment effectiveness on symptoms of dry eyes' (100%), 'frequency of treatment use' (96%) and 'how the treatment works' (95%). CONCLUSION Our methodology was well received by patients, and the results will help inform future clinical trial development and discussions with health technology assessment bodies and regulators on unmet needs and product attributes that are of most value to patients with dry eye disease.
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Affiliation(s)
- Penny Asbell
- Ophthalmology, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Elisabeth Messmer
- Department of Ophthalmology, Ludwig Maximilians University, Munich, Germany
| | - Colin Chan
- Central Clinical School, University of Sydney, Sydney Medical School, Sydney, New South Wales, Australia
| | | | | | - Nigel Cook
- Global Patient Access, Novartis Pharma, Basel, Switzerland
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119
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Nakayama T, Watanabe A, Rajak S, Yamanaka Y, Sotozono C. Congenital nasolacrimal duct obstruction continues trend for spontaneous resolution beyond first year of life. Br J Ophthalmol 2019; 104:1161-1163. [PMID: 31676597 DOI: 10.1136/bjophthalmol-2019-314980] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 09/25/2019] [Accepted: 10/21/2019] [Indexed: 11/04/2022]
Abstract
PURPOSE To investigate spontaneous resolution of congenital nasolacrimal duct obstruction (CNLDO) beyond 12 months of age in Japanese infants. METHODS Retrospective, observational case series. We retrospectively reviewed the clinical records of patients diagnosed with CNLDO beyond 12 months of age at Kyoto Prefectural University Hospital, Kyoto, Japan. This study involved 155 cases of CNLDO in 133 Japanese infants diagnosed with CNLDO. All patients chose intervention with either dacryoendoscopic guided probing and stenting or conservative management. The proportion and age of patients who had spontaneous CLNDO resolution were analysed. RESULTS The patients were divided into two groups: (1) 62 patients with 70 obstructed nasolacrimal ducts (45%) in whom spontaneous resolution occurred and (2) 71 patients with 85 obstructed nasolacrimal ducts (55%) who underwent dacryoendoscopic guided probing and stenting. The mean age of spontaneous resolution was 17.8±5.3 months (range: 12.0-35.4 months). Dacryoendoscopic guided probing and stenting were successful in 83/85 (97.6%) of cases. CONCLUSIONS Spontaneous resolution of CNLDO can occur in 45% of infants over the age of 12 months. Dacryoendoscopic guided stenting also has high success rates in this patient group, and both treatment options can be proposed to caregivers.
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Affiliation(s)
- Tomomichi Nakayama
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Akihide Watanabe
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | | | - Yukito Yamanaka
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Chie Sotozono
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
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120
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Reneker LW, Irlmeier RT, Shui YB, Liu Y, Huang AJW. Histopathology and selective biomarker expression in human meibomian glands. Br J Ophthalmol 2019; 104:999-1004. [PMID: 31585964 PMCID: PMC7361036 DOI: 10.1136/bjophthalmol-2019-314466] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 09/09/2019] [Accepted: 09/21/2019] [Indexed: 12/17/2022]
Abstract
Background/aims Meibomian gland dysfunction (MGD) is the most common form of evaporative dry eye disease, but its pathogenesis is poorly understood. This study examined the histopathological features of meibomian gland (MG) tissue from cadaver donors to identify potential pathogenic processes that underlie MGD in humans. Methods Histological analyses was performed on the MGs in the tarsal plates dissected from four cadaver donors, two young and two old adults, including a 36-year-old female (36F) and three males aged 30, 63 and 64 years (30M, 63M and 64M). Results The MGs of 36F displayed normal anatomy and structure, whereas the MGs of 30M showed severe ductal obstruction with mild distortion. The obstruction was caused by increased cytokeratin levels in association with hyperproliferation, but not hyperkeratinisation. In two older males, moderate to severe MG atrophy was noted. Cell proliferation was significantly reduced in the MG acini of the two older donors as measured by Ki67 labelling index (6.0%±3.4% and 7.9%±2.8% in 63M and 64M, respectively) when compared with that of the two younger donors (23.2%±5.5% and 16.9%±4.8% in 30M and 36F, respectively) (p<0.001). The expression patterns of meibocyte differentiation biomarkers were similar in the older and younger donors. Conclusion Our histopathological study, based on a small sample size, suggests potentially distinct pathogenic mechanisms in MGD. In the young male adult, hyperproliferation and aberrant differentiation of the central ductal epithelia may lead to the obstruction by overproduced cytokeratins. In contrast, in older adults, decreased cell proliferation in acinar basal epithelia could be a contributing factor leading to MG glandular atrophy.
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Affiliation(s)
- Lixing W Reneker
- Department of Ophthalmology, University of Missouri School of Medicine, Columbia, Missouri, USA
| | - Rebecca T Irlmeier
- Department of Ophthalmology, University of Missouri School of Medicine, Columbia, Missouri, USA
| | - Ying-Bo Shui
- Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Ying Liu
- Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Andrew J W Huang
- Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, Missouri, USA
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121
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Hamm-Alvarez SF, Janga SR, Edman MC, Feigenbaum D, Freire D, Mack WJ, Okamoto CT, Lew MF. Levels of oligomeric α-Synuclein in reflex tears distinguish Parkinson's disease patients from healthy controls. Biomark Med 2019; 13:1447-1457. [PMID: 31552762 DOI: 10.2217/bmm-2019-0315] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: Due to active engagement of sensory and afferent nerve fibers in reflex tearing which could be affected in Parkinson's disease (PD), we tested reflex tears as a source of potential PD biomarkers. Patients & methods: Reflex tears collected from 84 PD and 84 age- and sex-equivalent healthy controls (HC) were used to measure levels of oligomeric α-Syn (α-SynOligo), total α-Syn (α-SynTotal), CCL2, DJ-1, lactoferrin and MMP9. Results: α-synOligo (p < 0.0001), CCL2 (p = 0.003) and lactoferrin (p = 0.002) were significantly elevated in PD patient tears relative to HC tears. Tear flow was significantly lower in PD relative to HC (p = 0.001). Conclusion: Reflex tears are a potential source for detection of characteristic changes in PD patients.
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Affiliation(s)
- Sarah F Hamm-Alvarez
- Department of Ophthalmology & Roski Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA.,Department of Pharmacology & Pharmaceutical Sciences, School of Pharmacy, University of Southern California, Los Angeles, CA 90033, USA
| | - Srikanth R Janga
- Department of Ophthalmology & Roski Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Maria C Edman
- Department of Ophthalmology & Roski Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Danielle Feigenbaum
- Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Daniel Freire
- Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Wendy J Mack
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Curtis T Okamoto
- Department of Pharmacology & Pharmaceutical Sciences, School of Pharmacy, University of Southern California, Los Angeles, CA 90033, USA
| | - Mark F Lew
- Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
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Di Y, Zhao XY, Ye JJ, Li B, Ma N. Fundus manifestations and HIV viral loads of AIDS patients before and after HAART. Int J Ophthalmol 2019; 12:1438-1443. [PMID: 31544040 DOI: 10.18240/ijo.2019.09.11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 06/21/2019] [Indexed: 12/22/2022] Open
Abstract
AIM To investigate the fundus manifestations and human immunodeficiency virus (HIV) viral loads of acquired immune deficiency syndrome (AIDS) patients before and after highly active antiretroviral therapy (HAART). METHODS This retrospective study included 21 AIDS patients (42 eyes) who presented to the Department of Ophthalmology, Peking Union Medical College Hospital, from 2007 to 2011. Among the patients, 16 showed a good response to HAART, 3 presented drug resistance and 2 were pre-HAART. All patients underwent comprehensive ophthalmic examinations. The HIV viral loads and the CD4+ T-cell counts were also determined. RESULTS The best-corrected visual acuity (BCVA) of 38 eyes (19 patients) was improved, and cytomegalovirus retinitis (CMVR) in 5 eyes (3 patients) regressed after HAART. Furthermore, 16 patients treated with effective HAART had decreased plasma HIV viral loads (<78 copies/mL) and increased CD4+ T-cell counts (343±161 cells/µL, P<0.005), but the HIV viral load in tears was still detected at 2404 copies/mL. The CD4+ T-cell count was lower in the CMVR group than in the non-CMVR group (P=0.022), but the HIV viral load in the tears was not significantly different between the two groups (P=0.439). CONCLUSION Most patients with AIDS show a good viral response with a decreased HIV viral load and an increased CD4+ T-cell count in plasma after HAART. However, the HIV viral load remain quite high in the tear samples. Based on our results, we suggest that AIDS patients undergo long-term HAART that should not be interrupted.
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Affiliation(s)
- Yu Di
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Xin-Yu Zhao
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Jun-Jie Ye
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Bing Li
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Nan Ma
- Department of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
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123
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Zygula A, Kosinski P, Wielgos M. Saliva, hair, tears, and other biological materials obtained non-invasively for diagnosis in pregnancy: a literature review. Ginekol Pol 2019; 90:475-481. [PMID: 31482552 DOI: 10.5603/gp.2019.0082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Accepted: 07/28/2019] [Indexed: 11/25/2022] Open
Abstract
As medical technology evolves, clinicians are increasingly choosing relatively painless non-invasive methods of patientdiagnosis and treatment. There are two principles behind this: greater patient comfort and lower cost. Tears, hair, saliva,urine, and faeces can replace blood for diagnosis. The varied constituents in these biological materials can serve as biomarkersfor the detection of both local and systemic diseases. In this paper, we review a range of diagnostic techniques - allusing biological material obtained via non-invasive procedure - for detecting medical conditions in pregnant women.PubMed, Medline, Embase, and the Cochrane Library were searched from January 1996 until December 2018. Forty sevenstudies were included: thirty-five original articles, nine reviews and three meta-analysis.Analysis showed that saliva, hair, tears, and other biological material - obtained via non-invasive methods - may serveas clinically informative biomarkers. These biomarkers may be used for: toxicology, psychological studies, disease detection,biomonitoring, and drug abuse. The analysis of tears, hair, saliva, urine, and faeces is a safe, noninvasive and usefuldiagnostic tool within groups of pregnant women, but further investigation is necessary to fully realize the promise ofthese novel diagnostic tools.
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Affiliation(s)
- Aleksandra Zygula
- 1st Chair and Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland.
| | - Przemyslaw Kosinski
- 1st Chair and Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | - Miroslaw Wielgos
- 1st Chair and Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
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Rossi C, Cicalini I, Cufaro MC, Agnifili L, Mastropasqua L, Lanuti P, Marchisio M, De Laurenzi V, Del Boccio P, Pieragostino D. Multi-Omics Approach for Studying Tears in Treatment-Naïve Glaucoma Patients. Int J Mol Sci 2019; 20:ijms20164029. [PMID: 31426571 PMCID: PMC6721157 DOI: 10.3390/ijms20164029] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 08/13/2019] [Accepted: 08/14/2019] [Indexed: 12/20/2022] Open
Abstract
Primary open-angle glaucoma (POAG) represents the leading cause of irreversible blindness worldwide and is a multifactorial, chronic neurodegenerative disease characterized by retinal ganglion cell and visual field loss. There are many factors that are associated with the risk of developing POAG, with increased intraocular pressure being one of the most prevalent. Due to the asymptomatic nature of the disease, the diagnosis of POAG often occurs too late, which necessitates development of new effective screening strategies for early diagnosis of the disease. However, this task still remains unfulfilled. In order to provide further insights into the pathophysiology of POAG, we applied a targeted metabolomics strategy based on a high-throughput screening method for the determination of tear amino acids, free carnitine, acylcarnitines, succinylacetone, nucleosides, and lysophospholipids in naïve to therapy glaucomatous patients and normal controls. Also, we conducted proteomic analyses of the whole lacrimal fluid and purified extracellular vesicles obtained from POAG patients and healthy subjects. This multi-omics approach allowed us to conclude that POAG patients had lower levels of certain tear amino acids and lysophospholipids compared with controls. These targeted analyses also highlighted the low amount of acetylcarnitine (C2) in POAG patient which correlated well with proteomics data. Moreover, POAG tear proteins seemed to derive from extracellular vesicles, which carried a specific pro-inflammatory protein cargo.
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Affiliation(s)
- Claudia Rossi
- Center for Advanced Studies and Technology (CAST), University ''G. d'Annunzio'' of Chieti-Pescara, 66100 Chieti, Italy
- Department of Medical, Oral and Biotechnological Sciences, University ''G. d'Annunzio'' of Chieti-Pescara, 66100 Chieti, Italy
| | - Ilaria Cicalini
- Center for Advanced Studies and Technology (CAST), University ''G. d'Annunzio'' of Chieti-Pescara, 66100 Chieti, Italy
- Department of Medicine and Aging Science, "G. d'Annunzio" University of Chieti-Pescara, 66100 Chieti, Italy
| | - Maria Concetta Cufaro
- Center for Advanced Studies and Technology (CAST), University ''G. d'Annunzio'' of Chieti-Pescara, 66100 Chieti, Italy
- Department of Pharmacy, University ''G. d'Annunzio'' of Chieti-Pescara, 66100 Chieti, Italy
| | - Luca Agnifili
- Department of Medicine and Aging Science, "G. d'Annunzio" University of Chieti-Pescara, 66100 Chieti, Italy
- Opthalmic Clinic, Ss Annunziata Hospital, 66100 Chieti, Italy
| | - Leonardo Mastropasqua
- Department of Medicine and Aging Science, "G. d'Annunzio" University of Chieti-Pescara, 66100 Chieti, Italy
- Opthalmic Clinic, Ss Annunziata Hospital, 66100 Chieti, Italy
| | - Paola Lanuti
- Department of Medicine and Aging Science, "G. d'Annunzio" University of Chieti-Pescara, 66100 Chieti, Italy
| | - Marco Marchisio
- Department of Medicine and Aging Science, "G. d'Annunzio" University of Chieti-Pescara, 66100 Chieti, Italy
| | - Vincenzo De Laurenzi
- Center for Advanced Studies and Technology (CAST), University ''G. d'Annunzio'' of Chieti-Pescara, 66100 Chieti, Italy
- Department of Medical, Oral and Biotechnological Sciences, University ''G. d'Annunzio'' of Chieti-Pescara, 66100 Chieti, Italy
| | - Piero Del Boccio
- Center for Advanced Studies and Technology (CAST), University ''G. d'Annunzio'' of Chieti-Pescara, 66100 Chieti, Italy
- Department of Pharmacy, University ''G. d'Annunzio'' of Chieti-Pescara, 66100 Chieti, Italy
| | - Damiana Pieragostino
- Center for Advanced Studies and Technology (CAST), University ''G. d'Annunzio'' of Chieti-Pescara, 66100 Chieti, Italy.
- Department of Medical, Oral and Biotechnological Sciences, University ''G. d'Annunzio'' of Chieti-Pescara, 66100 Chieti, Italy.
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125
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Murugesan V, Dwivedi R, Saini M, Gupta V, Dada T, Vivekanandhan S. Tear neuromediators in eyes on chronic topical antiglaucoma therapy with and without BAK preservatives. Br J Ophthalmol 2019; 105:141-148. [PMID: 31383648 DOI: 10.1136/bjophthalmol-2019-314234] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Revised: 06/18/2019] [Accepted: 07/19/2019] [Indexed: 11/03/2022]
Abstract
PURPOSE To evaluate tear neuropeptides (NPs) (vasoactive intestinal peptide (VIP), neuropeptide Y (NPY), calcitonin gene-related peptide (CGRP), substance P (SP), nerve growth factor (NGF)) in chronic ocular topical hypotensive therapy with and without benzalkonium chloride (BAK) preservative. METHODS A comparative, open label, cross-sectional study of patients using antiglaucoma medications for >6 months with BAK (group I), without BAK (group II) and controls was done. Tear NPs (ELISA), ocular surface evaluation tests (tear breakup time (TBUT), Schirmer's test, corneal and conjunctival staining score) and confocal central corneal subbasal nerve fibre layer (SBNFL) imaging was done. RESULTS Of 153 eyes evaluated, group 1 (82 eyes (41 patients; mean age 48±14.5 years)) and group 2 (71 eyes (36 patients; mean age 43.11±15 years)) were on therapy for a mean duration of 10.05±2.0 and 9.67±2.3 months, respectively. Tear analysis showed elevated SP and NGF (p<0.01); decreased CGRP (p=0.03), VIP and NPY (p<0.01) compared with controls (n=30, mean age 29.33±5.7 years). Tear NP levels (SP (p=0.1), NGF (p=0.33), CGRP (p=1), VIP (p=0.87), NPY (p=0.83)) and SBNFL (p=0.09) were comparable in both groups. There was no correlation seen between tear NP levels and clinical tests and SBNFL. CONCLUSION Our study analysis points towards altered tear NP levels in eyes on chronic topical hypotensive therapy in comparison with controls with no significant difference in tear NP levels and central corneal SBNFL density between the BAK preservative and BAK-free antiglaucoma therapy.
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Affiliation(s)
- Vanathi Murugesan
- Dr R P Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Delhi, India
| | - Roopa Dwivedi
- Dr R P Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Delhi, India
| | - Manu Saini
- Dr R P Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Delhi, India
| | - Viney Gupta
- Dr R P Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Delhi, India
| | - Tanuj Dada
- Dr R P Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Delhi, India
| | - S Vivekanandhan
- Neurobiochemistry Lab, C N Centre, All India Institute of Medical Sciences, New Delhi, India
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126
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Sedlak L, Zych M, Wojnar W, Wyględowska-Promieńska D. Effect of Topical Prostaglandin F2α Analogs on Selected Oxidative Stress Parameters in the Tear Film. Medicina (Kaunas) 2019; 55:medicina55070366. [PMID: 31336766 PMCID: PMC6681209 DOI: 10.3390/medicina55070366] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 07/05/2019] [Accepted: 07/09/2019] [Indexed: 01/07/2023]
Abstract
Background and Objectives: Topically administered antiglaucoma medications, especially those containing benzalkonium chloride (BAC), may cause local adverse effects and compromise ocular surface. The aim of the study was to assess the effect of topical prostaglandin F2α analogs (PGAs): preservative-free latanoprost, BAC-preserved latanoprost, preservative-free tafluprost, and BAC-preserved bimatoprost, on selected oxidative stress parameters in the tear film. Materials and Methods: The patients were divided into five groups: group C (n = 25) control group—subjects who did not use topical antiglaucoma medications, group L (n = 22)—patients using topical preservative-free latanoprost, group L+BAC (n = 25)—patients using topical BAC-preserved latanoprost, group T (n = 19)—patients using topical preservative-free tafluprost, and group B+BAC (n = 17)—patients using topical BAC-preserved bimatoprost. The oxidative stress markers in the tear film samples were evaluated: total protein (TP) concentration, advanced oxidation protein products (AOPP) content, total sulfhydryl (-SH) groups content, the activity of superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx), as well as Total Oxidant Status (TOS), Total Antioxidant Response (TAR), and Oxidative Stress Index (OSI). Results: The TP concentrations in the groups L, L+BAC, and B+BAC were statistically significantly higher in comparison with group C. The SOD and CAT activities in the groups L+BAC and B+BAC were statistically significantly higher when compared to group C. As compared to group C, AOPP and TOS were statistically significantly higher in all the study groups. OSI was found to be statistically significantly higher in the groups L+BAC, T, and B+BAC in comparison with group C. Conclusion: Use of topical PGAs by the patients with ocular hypertension or primary open-angle glaucoma is associated with increased oxidative stress in the tear film which is additionally exacerbated by the presence of BAC in the formulation.
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Affiliation(s)
- Lech Sedlak
- Department of Ophthalmology, School of Medicine in Katowice, Medical University of Silesia in Katowice, 40-514 Katowice, Poland.
- Department of Ophthalmology, Kornel Gibiński University Clinical Center, Medical University of Silesia in Katowice, 40-514 Katowice, Poland.
| | - Maria Zych
- Department of Pharmacognosy and Phytochemistry, School of Pharmacy with the Division of Laboratory Medicine, Medical University of Silesia in Katowice, 41-200 Sosnowiec, Poland
| | - Weronika Wojnar
- Department of Pharmacognosy and Phytochemistry, School of Pharmacy with the Division of Laboratory Medicine, Medical University of Silesia in Katowice, 41-200 Sosnowiec, Poland
| | - Dorota Wyględowska-Promieńska
- Department of Ophthalmology, School of Medicine in Katowice, Medical University of Silesia in Katowice, 40-514 Katowice, Poland
- Department of Ophthalmology, Kornel Gibiński University Clinical Center, Medical University of Silesia in Katowice, 40-514 Katowice, Poland
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127
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Hamm-Alvarez SF, Okamoto CT, Janga SR, Feigenbaum D, Edman MC, Freire D, Shah M, Ghanshani R, Mack WJ, Lew MF. Oligomeric α-synuclein is increased in basal tears of Parkinson's patients. Biomark Med 2019; 13:941-952. [PMID: 31262201 DOI: 10.2217/bmm-2019-0167] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Aim: Secretion of proteins into basal tears of Parkinson's disease (PD) patients may be altered by changes in nerve function. Materials & methods: Oligomeric α-SynOligo and total α-SynTotal, CCL-2, DJ-1, LF and MMP-9 were measured in basal tears from 93 PD patients and 82 age- and sex-equivalent healthy controls. Results: α-SynTotal was decreased (p = 0.0043), whereas α-SynOligo (p < 0.0001) and the ratio of α-SynOligo/α-SynTotal (p < 0.0001) were increased in basal tears from PD patients compared with healthy controls. Area under receiver-operating curves of α-SynOligo and α-SynOligo/α-SynTotal contents were 0.70 (95% confidence limits: 0.621-0.774) and 0.72 (95% confidence limits: 0.642-0.792). Conclusion: PD patient basal tears may contain biomarkers that can be assayed noninvasively and inexpensively.
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Affiliation(s)
- Sarah F Hamm-Alvarez
- Department of Ophthalmology & Roski Eye Institute, Keck School of Medicine, Los Angeles, CA 90033-6103, USA.,Department of Pharmacology & Pharmaceutical Sciences, School of Pharmacy, Los Angeles, CA 90033-6103, USA
| | - Curtis T Okamoto
- Department of Pharmacology & Pharmaceutical Sciences, School of Pharmacy, Los Angeles, CA 90033-6103, USA
| | - Srikanth R Janga
- Department of Ophthalmology & Roski Eye Institute, Keck School of Medicine, Los Angeles, CA 90033-6103, USA
| | - Danielle Feigenbaum
- Department of Neurology, Keck School of Medicine, Los Angeles, CA 90033-6103, USA
| | - Maria C Edman
- Department of Ophthalmology & Roski Eye Institute, Keck School of Medicine, Los Angeles, CA 90033-6103, USA
| | - Daniel Freire
- Department of Neurology, Keck School of Medicine, Los Angeles, CA 90033-6103, USA
| | - Mihir Shah
- Department of Ophthalmology & Roski Eye Institute, Keck School of Medicine, Los Angeles, CA 90033-6103, USA
| | - Raveena Ghanshani
- Department of Ophthalmology & Roski Eye Institute, Keck School of Medicine, Los Angeles, CA 90033-6103, USA.,Department of Neurology, Keck School of Medicine, Los Angeles, CA 90033-6103, USA
| | - Wendy J Mack
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033-6103, USA
| | - Mark F Lew
- Department of Neurology, Keck School of Medicine, Los Angeles, CA 90033-6103, USA
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128
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Reed LI, Matari Y, Wu M, Janaswamy R. Emotional Tears: An Honest Signal of Trustworthiness Increasing Prosocial Behavior? Evol Psychol 2019; 17:1474704919872421. [PMID: 31455105 PMCID: PMC10299780 DOI: 10.1177/1474704919872421] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 08/05/2019] [Indexed: 11/16/2022] Open
Abstract
How do our emotional tears affect the way we are treated? We tested whether tears, paired with either a neutral or a sad facial expression, elicited prosocial behavior among perceivers. Participants viewed a video clip depicting a confederate partner with or without tears displaying either a neutral or sad facial expression before making a behavioral decision in one of two economic games. In a Trust game (Experiment 1), participants who played the role of the investor were more likely to share an endowment after viewing a confederate trustee with tears (paired with either a neutral or a sad facial expression) in comparison to a confederate trustee without tears. However, in a Dictator game (Experiment 2), participants who played the role of allocator were no more likely to share an endowment after viewing a confederate recipient with tears (paired with either a neutral or sad facial expression) in comparison to a confederate recipient without tears. Taken together, these findings suggest that tears increase prosocial behavior by increasing trustworthiness as opposed to generally increasing other-regarding altruistic tendencies.
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Affiliation(s)
- Lawrence Ian Reed
- Department of Psychology, New York University,
NY, USA
- Department of Psychiatry, McLean Hospital,
Harvard Medical School, Boston, MA, USA
| | - Yanal Matari
- Department of Psychology, New York University,
NY, USA
| | - Molly Wu
- Department of Psychology, New York University,
NY, USA
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129
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Hümmert MW, Wurster U, Bönig L, Schwenkenbecher P, Sühs KW, Alvermann S, Gingele S, Skripuletz T, Stangel M. Investigation of Oligoclonal IgG Bands in Tear Fluid of Multiple Sclerosis Patients. Front Immunol 2019; 10:1110. [PMID: 31164889 PMCID: PMC6534077 DOI: 10.3389/fimmu.2019.01110] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 05/01/2019] [Indexed: 11/17/2022] Open
Abstract
Background: Oligoclonal IgG bands (OCB) in the cerebrospinal fluid (CSF) represent a typical marker for inflammation in multiple sclerosis (MS) patients and have a predictive and diagnostic value in patients with a first suspected demyelinating event. The detection in tears remains controversial but some reports suggested a replacement of CSF analysis by OCB detection in tears. We aimed to investigate the value of OCB detection in tears systematically in patients with MS. Methods: Tears of 59 patients with suspected or diagnosed MS were collected with Schirmer filter paper strips. Tear IgG was purified by affinity chromatography with protein G. After isoelectric focusing in polyacrylamide gels OCB detection was performed with direct silver staining. Paired triplets of CSF, serum, and tears were analyzed. For comparison purposes we additionally used other tear collection methods (flush procedure and plastic capillary tubes) or detection techniques (Immunoblotting). Clinical and paraclinical parameters are provided. Results: IgG collection in tears was most reliable by using Schirmer strips. Thirteen patients had to be excluded due to insufficient sample material. Tear specific proteins that interfered with OCB detection were successfully eliminated by IgG purification. The concordance of OCB in tears and CSF of all investigated MS patients was 39% with a high rate of only marginal pattern in tears. Five patients demonstrated restricted bands in tears, neither detectable in CSF nor serum. Occurrence of OCB in tears was significantly associated with pathological visual evoked potentials (P = 0.0094) and a history of optic neuritis (P = 0.0258). Conclusion: Due to the limited concordance, high rate of samples with insufficient material, and the unknown origin of tear IgG we cannot recommend that tear OCB detection may replace CSF OCB detection in MS patients. The detection of unique OCB in tears might offer new insights in ophthalmological diseases.
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Affiliation(s)
- Martin W Hümmert
- Departement of Neurology, Clinical Neuroimmunology and Neurochemistry, Hannover Medical School, Hannover, Germany
| | - Ulrich Wurster
- Departement of Neurology, Clinical Neuroimmunology and Neurochemistry, Hannover Medical School, Hannover, Germany
| | - Lena Bönig
- Departement of Neurology, Clinical Neuroimmunology and Neurochemistry, Hannover Medical School, Hannover, Germany
| | - Philipp Schwenkenbecher
- Departement of Neurology, Clinical Neuroimmunology and Neurochemistry, Hannover Medical School, Hannover, Germany
| | - Kurt-Wolfram Sühs
- Departement of Neurology, Clinical Neuroimmunology and Neurochemistry, Hannover Medical School, Hannover, Germany
| | - Sascha Alvermann
- Departement of Neurology, Clinical Neuroimmunology and Neurochemistry, Hannover Medical School, Hannover, Germany
| | - Stefan Gingele
- Departement of Neurology, Clinical Neuroimmunology and Neurochemistry, Hannover Medical School, Hannover, Germany
| | - Thomas Skripuletz
- Departement of Neurology, Clinical Neuroimmunology and Neurochemistry, Hannover Medical School, Hannover, Germany
| | - Martin Stangel
- Departement of Neurology, Clinical Neuroimmunology and Neurochemistry, Hannover Medical School, Hannover, Germany
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130
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Farhangi M, Diel RJ, Buse DC, Huang AM, Levitt RC, Sarantopoulos CD, Felix ER, Galor A. Individuals with migraine have a different dry eye symptom profile than individuals without migraine. Br J Ophthalmol 2019; 104:260-264. [PMID: 31040130 DOI: 10.1136/bjophthalmol-2018-313471] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 03/28/2019] [Accepted: 04/03/2019] [Indexed: 01/03/2023]
Abstract
BACKGROUND Many individuals with migraine report symptoms of dry eye (DE). However, it is not known whether DE profiles are similar between individuals with and without migraine. To bridge this gap, we evaluated symptoms and signs of DE, including symptoms suggestive of nerve dysfunction, in a large group of individuals with DE symptoms, and compared profiles between individuals with migraine and those without migraine or headache. METHODS Prospective cross-sectional study of individuals with DE symptoms seen at the Miami VA. RESULTS Of 250 individuals, 31 met International Classification of Headache Disorders criteria for migraine based on a validated screen. Individuals with migraine were significantly younger (57 vs 62 years) and more likely to be female (26% vs 6%) than controls. Individuals with migraine had more severe DE symptoms and ocular pain compared with controls (mean Ocular Surface Disease Index 53.93 ± 21.76 vs 36.30 ± 22.90, p=0.0001; mean Neuropathic Pain Symptom Inventory modified for the Eye 39.39 ± 23.33 vs 21.86 ± 20.17, p=0.0001). The difference in symptom profile occurred despite similar ocular surface parameters between the groups. CONCLUSIONS Individuals with migraine had a different DE symptom yet a similar DE sign profile when compared with controls without migraine. This suggests that DE symptoms in individuals with migraine may be driven by nerve dysfunction as opposed to ocular surface abnormalities.
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Affiliation(s)
- Monika Farhangi
- Bascom Palmer Eye Institute, University of Miami, Miami, Florida, USA
| | - Ryan J Diel
- Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals & Clinics, Iowa City, Iowa, USA
| | - Dawn C Buse
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA
| | | | - Roy C Levitt
- Department of Anesthesiology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | | | - Elizabeth R Felix
- Physical Medicine & Rehabilitation, University of Miami, Miami, Florida, USA.,Miami Veterans Administration Medical Center, Miami, Florida, USA
| | - Anat Galor
- Bascom Palmer Eye Institute, University of Miami, Miami, Florida, USA .,Miami Veterans Administration Medical Center, Miami, Florida, USA
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131
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Kuo MT, Fang PC, Chao TL, Chen A, Lai YH, Huang YT, Tseng CY. Tear Proteomics Approach to Monitoring Sjögren Syndrome or Dry Eye Disease. Int J Mol Sci 2019; 20:ijms20081932. [PMID: 31010136 PMCID: PMC6514553 DOI: 10.3390/ijms20081932] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 04/12/2019] [Accepted: 04/17/2019] [Indexed: 02/05/2023] Open
Abstract
Sjögren syndrome (SS) or dry eye disease (DED) is one of the most complicated ocular surface diseases. The goal of this study is to elucidate the relationship of the changes in clinical indices of tear film (TF) homeostasis with respect to tear components to allow for SS-DED monitoring and avoid stably controlled SS-DED patients from re-entering a vicious cycle. This prospective case-control study compared stable SS-DED patients with non-SS-DED control from several aspects, including clinical indices for TF homeostasis, 2 DED diagnostic biomarkers (MMP-9 and lactoferrin), and the proteome of flush tears. Compared with non-SS-DED controls, stably controlled SS-DED subjects had less tear secretion and higher ocular surface inflammation, a higher concentration ratio of tear MMP-9/lactoferrin, a more diverse tear proteome, and lower spectral intensities of lipocalin-1, lacritin, and prolactin-inducible protein among the abundant tear proteins. For stable SS-DED patients, the concentration ratio of tear MMP-9/lactoferrin and the corrected lipocalin-1 signal was positively correlated with ocular inflammation and TF stability, respectively. MMP-9 released from stressed ocular surface epithelium and lipocalin-1 secreted from the energetic lacrimal gland are two tear biomarkers responding well to TF homeostasis. The tear proteomics approach through flush tears is a promising method for monitoring SS-DED patients with a standardized sampling procedure and lactoferrin-corrected analysis.
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Affiliation(s)
- Ming-Tse Kuo
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan.
| | - Po-Chiung Fang
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan.
| | - Tsai-Ling Chao
- Department of Laboratory Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan.
| | - Alexander Chen
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan.
| | - Yu-Hsuan Lai
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan.
| | - Yu-Ting Huang
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan.
| | - Chia-Yi Tseng
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan.
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132
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Sacchetti M, Lambiase A, Schmidl D, Schmetterer L, Ferrari M, Mantelli F, Allegretti M, Garhoefer G. Effect of recombinant human nerve growth factor eye drops in patients with dry eye: a phase IIa, open label, multiple-dose study. Br J Ophthalmol 2019; 104:127-135. [PMID: 30944103 PMCID: PMC6922013 DOI: 10.1136/bjophthalmol-2018-312470] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 02/19/2019] [Accepted: 03/09/2019] [Indexed: 11/04/2022]
Abstract
BACKGROUND Dry eye disease (DED) affects more than 14% of the elderly population causing decrease of quality of life, high costs and vision impairment. Current treatments for DED aim at lubricating and controlling inflammation of the ocular surface. Development of novel therapies targeting different pathogenic mechanisms is sought-after. The aim of this study is to evaluate safety and efficacy of recombinant human nerve growth factor (rhNGF) eye drops in patients with DED. METHODS Forty consecutive patients with moderate to severe DED were included in a phase IIa, prospective, open label, multiple-dose, clinical trial to receive rhNGF eye drops at 20 µg/mL (Group 1: G1) or at 4 µg/mL (Group 2: G2) concentrations, two times a day in both eyes for 28 days (NCT02101281). The primary outcomes measures were treatment-emerged adverse events (AE), Symptoms Assessment in Dry Eye (SANDE) scale, ocular surface staining and Schirmer test. RESULTS Of 40 included patients, 39 completed the trial. Both tested rhNGF eye drop concentrations were safe and well tolerated. Twenty-nine patients experienced at least one AE (14 in G1 and 15 in G2), of which 11 had at least 1 related AE (8 in G1 and 3 in G2). Both frequency and severity of DED symptoms and ocular surface damage showed significant improvement in both groups, while tear function improved only in G1. CONCLUSIONS The data of this study indicate that rhNGF eye drops in both doses is safe and effective in improving symptoms and signs of DED. Randomised clinical trials are ongoing to confirm the therapeutic benefit of rhNGF in DED. TRIAL REGISTRATION NUMBER NCT02101281.
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Affiliation(s)
- Marta Sacchetti
- Department of Sense Organs, University Sapienza of Rome, Rome, Italy
| | | | - Doreen Schmidl
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Leopold Schmetterer
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | | | | | | | - Gerhard Garhoefer
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
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133
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Cicalini I, Rossi C, Pieragostino D, Agnifili L, Mastropasqua L, di Ioia M, De Luca G, Onofrj M, Federici L, Del Boccio P. Integrated Lipidomics and Metabolomics Analysis of Tears in Multiple Sclerosis: An Insight into Diagnostic Potential of Lacrimal Fluid. Int J Mol Sci 2019; 20:E1265. [PMID: 30871169 DOI: 10.3390/ijms20061265] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 03/07/2019] [Accepted: 03/08/2019] [Indexed: 01/08/2023] Open
Abstract
Metabolomics based on mass spectrometry represents an innovative approach to characterize multifactorial diseases, such as multiple sclerosis (MuS). To date, the most important biomarker source for MuS diagnosis is the cerebrospinal fluid. However, an important goal for research is to identify new molecules in more easily accessible biological fluids. A very interesting biofluid in MuS is represented by tears, considered as an intermediate fluid between the cerebrospinal fluid and serum. In this work, we developed a merged strategy for the analysis of lipids containing choline by Liquid Chromatography coupled to Tandem Mass Spectrometry (LC-MS/MS), as well as for the targeted analysis of free carnitine, acylcarnitines and aminoacids by direct infusion mass spectrometry. Samples for both metabolomics and lipidomics approaches were obtained in a single extraction procedure from tears of patients affected by MuS and healthy controls. Tear lipidomics showed 30 phospholipids significantly modulated and, notably, many sphingomyelins resulted lower in MuS. Moreover, the metabolomics approach carried out both on tears and serum highlighted the diagnostic potential of specific aminoacids and acylcarnitines. In conclusion, the metabolic profiling of tears appears to reflect the pathological conditions of the central nervous system, suggesting that the molecular repository of tears can be considered as a source of potential biomarkers for MuS.
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134
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Salazar A, Casanova-Méndez I, Pacheco-Quito M, Velázquez-Soto H, Ayala-Balboa J, Graue-Hernández EO, Serafín-López J, Jiménez-Martínez MC. Low Expression of IL-10 in Circulating Bregs and Inverted IL-10/TNF-α Ratio in Tears of Patients with Perennial Allergic Conjunctivitis: A Preliminary Study. Int J Mol Sci 2019; 20:ijms20051035. [PMID: 30818819 PMCID: PMC6429471 DOI: 10.3390/ijms20051035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Revised: 02/12/2019] [Accepted: 02/22/2019] [Indexed: 12/18/2022] Open
Abstract
Allergic conjunctivitis (AC) is one of the most common ophthalmological disorders seen in clinical practice. Growing evidence from recent years suggests that a subset of IL-10-expressing B cells is involved in inflammatory allergic diseases. In this study, we aimed to evaluate the potential involvement of blood Bregs cells in perennial allergic conjunctivitis (PAC), and interleukins (IL)-1β, IL-6, IL-8, IL-10, and IL-12, and tumor necrosis factor (TNF)-α, were measured in tear samples and compared with healthy controls (HC) using flow cytometry. Non-significant differences in CD19+IL-10+ cell frequency between PAC patients and healthy controls (HC) were observed. Nevertheless, when we analyzed the mean fluorescence intensity (MFI) of IL-10 on CD19+CD38Lo/Med/Hi-gated cells, we observed a significant decrease in MFI in all Bregs subsets in PAC patients. Additionally, tear cytokines showed 2.8 times lower levels of IL-10 than TNF-α in PAC patients when compared to HC. Our findings demonstrate an immunological dysregulation in patients with allergic conjunctivitis, characterized by the low expression of IL-10 in circulating CD19+CD38+ Bregs subsets and an inverted tear IL-10/TNF-α ratio, promoting a local pro-inflammatory microenvironment. These findings highlight the novel pathologic changes involved in ocular allergic diseases. Understanding systemic and local mechanisms will aid the design of immunomodulating therapeutics at different levels.
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Affiliation(s)
- Alberto Salazar
- Departamento de Inmunología, ENCB, Instituto Politécnico Nacional, 11340 Ciudad de México, Mexico.
- Department of Immunology and Research Unit, Institute of Ophthalmology "Conde de Valenciana Foundation", 06800 Mexico City, Mexico.
| | - Israel Casanova-Méndez
- Department of Immunology and Research Unit, Institute of Ophthalmology "Conde de Valenciana Foundation", 06800 Mexico City, Mexico.
| | - Michele Pacheco-Quito
- Cornea and Refractive Surgery Department, Institute of Ophthalmology "Conde de Valenciana Foundation", 06800 Mexico City, Mexico.
| | - Henry Velázquez-Soto
- Department of Immunology and Research Unit, Institute of Ophthalmology "Conde de Valenciana Foundation", 06800 Mexico City, Mexico.
| | - Julio Ayala-Balboa
- Department of Immunology and Research Unit, Institute of Ophthalmology "Conde de Valenciana Foundation", 06800 Mexico City, Mexico.
| | - Enrique O Graue-Hernández
- Cornea and Refractive Surgery Department, Institute of Ophthalmology "Conde de Valenciana Foundation", 06800 Mexico City, Mexico.
| | - Jeanet Serafín-López
- Departamento de Inmunología, ENCB, Instituto Politécnico Nacional, 11340 Ciudad de México, Mexico.
| | - María C Jiménez-Martínez
- Department of Immunology and Research Unit, Institute of Ophthalmology "Conde de Valenciana Foundation", 06800 Mexico City, Mexico.
- Department of Biochemistry, Faculty of Medicine, National Autonomous University of Mexico. P.O. Box 70159, 04510 Mexico City, Mexico.
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Tamhane M, Cabrera-Ghayouri S, Abelian G, Viswanath V. Review of Biomarkers in Ocular Matrices: Challenges and Opportunities. Pharm Res 2019; 36:40. [PMID: 30673862 DOI: 10.1007/s11095-019-2569-8] [Citation(s) in RCA: 86] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 01/07/2019] [Indexed: 02/05/2023]
Abstract
Biomarkers provide a powerful and dynamic approach to improve our understanding of the mechanisms underlying ocular diseases with applications in diagnosis, disease modulation or for predicting and monitoring of clinical response to treatment. Defined as measurable indicator of normal or pathological processes, biomarker evaluation has been used extensively in drug development within clinical settings to better comprehend effectiveness of treatment in ocular diseases. Biomarkers in the eye have the advantage of access to multiple ocular matrices via minimally invasive methods. Repeat sampling for biomarker assessment has enabled reproducible objective measures of disease process or biological responses to a drug treatment. This review describes the usage of biomarkers with respect to four commonly sampled ocular matrices in clinic: tears, conjunctiva, aqueous humor and vitreous. Issues that affect the evaluation of biomarkers are discussed along with opportunities to leverage biomarkers such that ultimately, they can be used for customized targeted therapy.
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136
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Lai YT, Cerquinho RG, Perez MM, Alves BDCA, Pereira EC, Azzalis LA, Junqueira VBC, Soares LR, Fonseca FLA. Determination of vitamin D in tears of healthy individuals by the electrochemiluminescence method. J Clin Lab Anal 2019; 33:e22830. [PMID: 30666714 PMCID: PMC6528589 DOI: 10.1002/jcla.22830] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 11/12/2018] [Accepted: 11/27/2018] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Vitamin D is a fat-soluble steroid hormone which can be converted into various forms and is of extreme physiological importance to our body. However, its functions and local metabolic pathways in some organs, such as the eye, have not yet been well studied. We aimed to verify the correlation between vitamin D levels in blood and tear fluid and the possibility of using tear fluid as a biological material for monitoring eye disorders in the future. METHODS The electrochemiluminescence method was used to examine blood and tear samples collected with Schirmer test strips from 21 individuals without ocular disease. RESULTS At the 95% confidence interval, mean tear fluid vitamin D = 37.8 ± 3.6 ng/mL, which is higher than the serum level, with a mean of 30.3 ± 7.7 ng/mL; Lin's concordance correlation coefficient = -0.018 (-0.174; 0.139), Pearson's coefficient = -0.070, and the Bland-Altman coefficient = -11.12 (-30.40; 8.16). Results were obtained using the program Stata version 11.0. CONCLUSION It is possible to determine vitamin D levels in tear fluid using the electrochemiluminescence method, and as the results do not correlate with blood, there is possibility of using tear fluid as a biological matrix for detection of vitamin D, which may increase the possibilities of new studies in eye disorders.
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Affiliation(s)
- Yu Tsun Lai
- Laboratório de Análises Clínicas da Faculdade de Medicina do ABC, Santo André, Brazil
| | | | - Matheus Moreira Perez
- Laboratório de Análises Clínicas da Faculdade de Medicina do ABC, Santo André, Brazil
| | | | - Edimar Cristiano Pereira
- Departamento de Ciências Farmacêuticas da Universidade Federal de São Paulo (UNIFESP), Diadema, Brazil
| | - Ligia Ajaime Azzalis
- Departamento de Ciências Farmacêuticas da Universidade Federal de São Paulo (UNIFESP), Diadema, Brazil
| | | | | | - Fernando Luiz Affonso Fonseca
- Laboratório de Análises Clínicas da Faculdade de Medicina do ABC, Santo André, Brazil.,Departamento de Ciências Farmacêuticas da Universidade Federal de São Paulo (UNIFESP), Diadema, Brazil
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Leonardi A, Messmer EM, Labetoulle M, Amrane M, Garrigue JS, Ismail D, Sainz-de-la-Maza M, Figueiredo FC, Baudouin C. Efficacy and safety of 0.1% ciclosporin A cationic emulsion in dry eye disease: a pooled analysis of two double-masked, randomised, vehicle-controlled phase III clinical studies. Br J Ophthalmol 2019; 103:125-131. [PMID: 29545413 PMCID: PMC6317444 DOI: 10.1136/bjophthalmol-2017-311801] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 02/14/2018] [Accepted: 02/20/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND/AIM To assess the treatment effect of 0.1% ciclosporin A cationic emulsion (CsA CE) versus vehicle on signs/symptoms of dry eye disease (DED) in various subgroups (moderate-to-severe DED/severe DED/Sjögren's syndrome (SS)/SS with severe DED). METHODS Pooled data were analysed from two similar phase III studies: SICCANOVE (moderate-to-severe DED) and SANSIKA (severe DED with severe keratitis). In both studies, patients aged ≥18 years received CsA CE 0.1% (n=395) or vehicle (n=339) once daily for 6 months. A composite responder efficacy endpoint (corneal fluorescein staining-Ocular Surface Disease Index (CFS-OSDI) at month 6) was used to evaluate the efficacy of CsA CE in alleviating signs/symptoms of DED (response defined as improvement of ≥2 grades in CFS and ≥30% in OSDI (baseline to month 6)). Human leucocyte antigen-DR (HLA-DR) conjunctival expression was used as a biomarker of ocular surface inflammation. RESULTS CsA CE-treated patients were significantly more likely to be CFS-OSDI responders than vehicle-treated patients in the overall (OR 1.66, 95% CI 1.11 to 2.50; P=0.015), severe DED (1.80, 1.04 to 3.19; P=0.038) and SS with severe DED (3.37, 1.20 to 11.19; P=0.030) populations. The difference was not significant for CsA CE versus vehicle for the overall Sjögren's population (OR 1.77, CI 0.89 to 3.66; P=0.109). CsA CE also significantly reduced median HLA-DR expression versus vehicle at 6 months (P=0.002). CONCLUSION Pooled phase III data indicate CsA CE produced significant improvement in signs/symptoms versus vehicle in patients with moderate-to-severe DED (especially in those with severe keratitis), including patients with SS with severe DED.
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Affiliation(s)
- Andrea Leonardi
- Department of Neuroscience, Ophthalmology Unit, University of Padua, Padua, Italy
| | - Elisabeth M Messmer
- Department of Ophthalmology, Ludwig-Maximilian University of Munich, Munich, Germany
| | - Marc Labetoulle
- Department of Ophthalmology, Bicêtre Hospital, APHP, Paris-Sud University, Le Kremlin Bicêtre, France
| | | | | | | | - Maite Sainz-de-la-Maza
- Institute Clinic of Ophthalmology, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain
| | - Francisco C Figueiredo
- Department of Ophthalmology, Royal Victoria Infirmary, Newcastle University, Newcastle upon Tyne, UK
| | - Christophe Baudouin
- Quinze-Vingts National Ophthalmology Hospital, Paris, France
- Vision Institute, INSERM UMRS968, CNRS UMR7210, UPMC University, Paris, France
- University of Versailles Saint-Quentin en Yvelines, Versailles, France
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138
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Abstract
Objectives It is often hard to reach a definitive diagnosis of congenital alacrima because of the difficultly in proving the lack of lacrimal tissue. We report here the distinct tear protein profile in presumed congenital alacrima. Patients and methods A 13-year-old girl with presumed congenital alacrima and 15 healthy volunteers aged 23–35 years were included in this study. Tears were collected using Schirmer strips, and tear protein analyses were performed. Tear samples were collected from the patient with alacrima before and after surgical punctal occlusion of both the upper and lower puncta, and tear protein extract was fractionated using HPLC. Lactoferrin and albumin concentrations in the tears were separately determined using ELISA. Results The chromatogram in the patient greatly differed from that in normal subjects with low concentrations of secretory IgA, lipocalin-1, and lysozyme. ELISA results indicated that the tear fluid in the patient contained a high concentration of albumin but a minimal concentration of lactoferrin. Punctal occlusion improved the ocular surface findings, but major lacrimal protein concentrations remained low and tear albumin concentrations further increased. Conclusion The tear protein profile of a patient with presumed congenital alacrima greatly differed from that of normal subjects. Tear protein analysis may be useful in making a diagnosis of congenital alacrima and in assessing the efficacy and mechanism of punctal occlusion.
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Affiliation(s)
- Shigeharu Yaginuma
- Department of Ophthalmology, Kyorin University School of Medicine, Tokyo 181-8611, Japan,
| | - Yoko Akune
- Division for Vision Research, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo 152-8902, Japan
| | - Chika Shigeyasu
- Department of Ophthalmology, Kyorin University School of Medicine, Tokyo 181-8611, Japan, .,Division for Vision Research, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo 152-8902, Japan
| | - Yoji Takano
- Department of Ophthalmology, Kawasaki Municipal Ida Hospital, Kawasaki 211-0035, Japan
| | - Masakazu Yamada
- Department of Ophthalmology, Kyorin University School of Medicine, Tokyo 181-8611, Japan,
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139
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Shinzawa M, Dogru M, Den S, Ichijima T, Higa K, Kojima T, Seta N, Nomura T, Tsubota K, Shimazaki J. Epidermal Fatty Acid-Binding Protein: A Novel Marker in the Diagnosis of Dry Eye Disease in Sjögren Syndrome. Int J Mol Sci 2018; 19:E3463. [PMID: 30400384 DOI: 10.3390/ijms19113463] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Revised: 10/23/2018] [Accepted: 10/27/2018] [Indexed: 12/17/2022] Open
Abstract
Purpose: Sjögren syndrome (SS) is a chronic inflammatory autoimmune disease of the lacrimal and salivary glands. This study compared the concentrations of epidermal fatty-acid binding protein (E-FABP) in the saliva, serum, and tears of SS patients with dry eye and dry mouth, with those of healthy adults to investigate the usefulness of E-FABP as a diagnostic marker for SS. Design: Prospective, observational case series. Participants: The subjects were 11 new patients with untreated Sjogren syndrome and 12 healthy control individuals. Methods: The diagnosis of SS was in accordance with the Ministry of Health, Labour and Welfare (Japan) Diagnostic Criteria (1999). Saliva, serum, and tear specimens were collected during internal medicine, dental, and ophthalmological examinations. The ophthalmological tests included the Dry Eye-related Quality of life Score (DEQS), tear break-up time (BUT), vital staining with fluorescein (FS) and lissamine green (LG), and the Schirmer test-1. The E-FABP concentration in the tears, saliva, and serum was measured by enzyme-linked immunosorbent assay (ELISA). Main outcome measure: The E-FABP concentrations were compared between patients and controls. Results: There were significant differences between the patient and healthy control groups in all ophthalmological test results. There were no significant differences between the groups in the E-FABP concentrations in the saliva (p = 0.1513) or the serum (p = 0.4799), but the E-FABP concentration in the tears significantly differed between groups. The E-FABP concentration in tears tended to be significantly lower in patients with SS (mean, 323.5 ± 325.6 pg/mL) than healthy control subjects (mean, 4076 pg/mL; p = 0.0136). The E-FABP concentration in tears significantly correlated with the results of dry eye parameters. Conclusion: The E-FABP concentration in tears appears to be related to ocular surface epithelial damage and tear stability and may be a promising novel biomarker in the diagnosis of SS.
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140
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Vagge A, Ferro Desideri L, Nucci P, Serafino M, Giannaccare G, Lembo A, Traverso CE. Congenital Nasolacrimal Duct Obstruction (CNLDO): A Review. Diseases 2018; 6:E96. [PMID: 30360371 DOI: 10.3390/diseases6040096] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 10/16/2018] [Accepted: 10/17/2018] [Indexed: 12/03/2022] Open
Abstract
Congenital nasolacrimal duct obstruction (CNLDO) is a common condition causing excessive tearing or mucoid discharge from the eyes, due to blockage of the nasolacrimal duct system. Nasolacrimal duct obstruction affects as many as 20% children aged <1 year worldwide and is often resolved without surgery. Available treatment options are conservative therapy, including observation, lacrimal sac massage and antibiotics, and invasive therapy. Observation, combined with conservative options, seems to be the best option in infants aged <1 year. Meanwhile, in children aged >1 year, nasolacrimal probing successfully addresses most obstructions. However, the most favorable timing for probing remains controversial. To alleviate persistent epiphora and mucous drainage that is refractory to probing, repeat probing, silicone tube intubation, balloon catheter dilation or dacryocystorhinostomy can be considered as available treatment options. Our review aims to provide an update to CNDO management protocols.
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141
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Kadic DTN, Minshall GJ, Wright IM. Surgical management of marginal tears/avulsions of the suspensory ligament branches in 29 Thoroughbred racehorses. Equine Vet J 2018; 51:310-315. [PMID: 30206960 DOI: 10.1111/evj.13020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 09/06/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Suspensory ligament branch injuries are common in horses. Most of these injuries are grouped together and considered as a single pathologic entity. OBJECTIVES To report a specific injury of the abaxial margin of the suspensory ligament branches and to report its surgical management and outcome. STUDY DESIGN Retrospective case series. METHODS All horses with suspensory ligament branch injuries over a 9-year period (2007-2015) were identified. Horses with injuries which, on ultrasonographic examination, appeared to have defects in the abaxial margin of the suspensory ligament branch, that were subsequently confirmed during surgery were selected. RESULTS Twenty-nine cases fulfilled the inclusion criteria with a specific lesion location on the abaxial margin of the suspensory ligament branch. Nineteen horses raced successfully after surgery, nine returned to training but failed to race and one was lost to follow-up. MAIN LIMITATIONS The absence of a comparable population of non-surgically managed horses in this study means that the contribution of removing torn tissue cannot confidently be assessed. CONCLUSIONS The location and morphology of injuries described in this study is consistent, which suggests aetiopathogenic commonality. This case series suggests this type of injury has an identity of its own, differs from other types of suspensory ligament branch injuries and represents a previously undescribed subgroup.
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Affiliation(s)
- D T N Kadic
- Newmarket Equine Hospital, Newmarket, Suffolk, UK
| | - G J Minshall
- Newmarket Equine Hospital, Newmarket, Suffolk, UK
| | - I M Wright
- Newmarket Equine Hospital, Newmarket, Suffolk, UK
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142
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Miyake H, Mori N, Mano H, Imanaka T, Nakamura M. Development of a highly sensitive and reliable enzyme-linked immunosorbent assay for MUC5AC in human tears extracted from Schirmer strips. Clin Ophthalmol 2018; 12:1571-1580. [PMID: 30214141 PMCID: PMC6120569 DOI: 10.2147/opth.s170552] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Purpose Reliable measurement of MUC5AC in human tears is essential for elucidation of the pathophysiological role of MUC5AC in dry eye disease. The purpose of this study was to develop a sensitive and reliable method for measurement of MUC5AC in human tear samples extracted from Schirmer strips by modifying a commercially available ELISA. Methods MUC5AC was extracted from Schirmer strips containing human tears by PBS with various concentrations of polysorbate 20. The extracts were treated with neuraminidase A to cleave the sialic acids in MUC5AC. An ELISA plate was blocked to prevent nonspecific binding. The rate of extraction of MUC5AC from Schirmer strips, linearity of dilution, limit of quantification, calibration range, and intra-assay and inter-assay reproducibility were examined. Results MUC5AC was extracted using polysorbate 20 in a concentration-dependent manner. Extraction was more efficient at 37°C than at 25°C. The signal-to-noise ratio of the assay was dramatically increased by treatment with neuraminidase A. Treatment with a blocking reagent before incubation produced good linearity of dilution. The inter-assay and intra-assay coefficients of variation were ≤16.6%. The relative error was within 13%. Conclusion We developed an efficient method for extraction of MUC5AC from Schirmer strips and a highly sensitive, reliable assay for MUC5AC in human tear samples using a commercially available ELISA kit. This method will aid in our understanding of the pathophysiology of dry eye, assessment of the effects of treatment in daily practice, and selection of appropriate therapeutic agents for patients.
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Affiliation(s)
- Hideki Miyake
- Research and Development Division, Santen Pharmaceutical Co., Ltd., Osaka, Japan,
| | - Naoto Mori
- Research and Development Division, Santen Pharmaceutical Co., Ltd., Osaka, Japan,
| | - Hidetoshi Mano
- Research and Development Division, Santen Pharmaceutical Co., Ltd., Osaka, Japan,
| | - Takahiro Imanaka
- Research and Development Division, Santen Pharmaceutical Co., Ltd., Osaka, Japan,
| | - Masatsugu Nakamura
- Research and Development Division, Santen Pharmaceutical Co., Ltd., Osaka, Japan,
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143
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Garcia da Fonseca RM, Evrard L, Rabba S, Salciccia A, Busoni V. Dynamic flexion/extension and non-weight bearing ultrasonography is helpful for identifying manica flexoria tears in horses. Vet Radiol Ultrasound 2018; 60:65-74. [PMID: 30121953 DOI: 10.1111/vru.12675] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 04/12/2018] [Accepted: 06/01/2018] [Indexed: 11/26/2022] Open
Abstract
Lesions of the manica flexoria are a tenoscopic finding in horses with digital flexor tendon sheath tenosynovitis. This retrospective case series study describes the ultrasonographic findings in seven horses admitted for digital flexor tendon sheath swelling associated with lameness and tenoscopic confirmation of a manica flexoria tear. Six horses had a partial manica flexoria tear, one a complete rupture. The ultrasonographic examination included a static examination on the weight and non-weight bearing limb and a dynamic limb assessment during flexion and extension. The main ultrasonographic finding at the static weight bearing examination in horses with a partial tear was an asymmetrical appearance of the manica flexoria at the level of the junction with the lateral border of the superficial digital flexor tendon, or an incomplete visualization of the manica flexoria in case of complete rupture. The split edges of the completed ruptured manica flexoria were seen floating in the synovial fluid at the examination in flexion. In six of seven cases, the superficial digital flexor tendon slid abnormally relative to the deep digital flexor tendon, during flexion/extension movements, with medial displacement of the superficial digital flexor tendon, appearance of an anechoic gap between the flexor tendons or reduced superficial digital flexor tendon sliding. Because ultrasonographic diagnosis of the manica flexoria tear is considered challenging, detection of these ultrasonographic features is helpful to increase the likelihood of identifying manica flexoria tears prior to tenoscopy. Authors recommend static ultrasonographic examination of the manica flexoria using a flexed limb position and dynamic ultrasonographic examination using flexion and extension positioning for horses with suspected digital sheath injury.
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Affiliation(s)
| | - Laurence Evrard
- Department of Clinical Sciences of Companion Animals and Equids, Diagnostic Imaging Section - Faculty of Veterinary Medicine - University of Liège, Liège, Belgium
| | - Silvia Rabba
- Department of Diagnostic Imaging, Instituto Veterinario di Novara, Granozzo con Monticello, Italy
| | - Alexandra Salciccia
- Department of Clinical Sciences of Companion Animals and Equids, Diagnostic Imaging Section - Faculty of Veterinary Medicine - University of Liège, Liège, Belgium
| | - Valeria Busoni
- Department of Clinical Sciences of Companion Animals and Equids, Diagnostic Imaging Section - Faculty of Veterinary Medicine - University of Liège, Liège, Belgium
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144
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Abstract
PURPOSE Leukocytes accumulate in the eye with sleep, but little is known about the presence or absence of leukocytes in awake, open eye tears. This study sought to compare normal and dry eye subjects for daily variation in open eye leukocyte composition. MATERIALS AND METHODS Ten normal subjects and nine dry eye subjects were enrolled. Subjects were trained for self-collection of tear samples using an ocular surface wash with 5 mL of phosphate buffered saline per eye. Subjects performed washes at awakening, between 8 and 9 am, between 11 am and 12 pm, and between 4 pm and 5 pm on four separate days. Leukocytes were isolated from the wash and were counted with a cell counter before staining with an anti-CD45 antibody and viability stain. Stained leukocytes were then analyzed via flow cytometry. Side scatter characteristics were used to distinguish granulocytes from lymphocytes. Results were interpreted both by time of wash as well as time from awakening. RESULTS At awakening, dry eye subjects had approximately twice as many recovered leukocytes and had a statistically significantly higher granulocyte-to-lymphocyte ratio as compared to normals. Leukocytes were rapidly cleared from the eye with a significant decrease in leukocyte counts at the 8 am time point as compared to awakening. Leukocyte counts across all open eye time points appeared to be consistent, with no differences between normal and dry eye subjects. CONCLUSIONS There is a low level, constitutively expressed population of leukocytes in the open eye tears of normal and dry eye subjects. Higher levels of granulocytes in dry eye disease subjects warrants further investigation into this population of cells, and their role in homeostasis and dysregulation.
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Affiliation(s)
- Cameron K Postnikoff
- a School of Optometry , University of Alabama at Birmingham , Birmingham , Alabama , USA
| | - Carrie Huisingh
- a School of Optometry , University of Alabama at Birmingham , Birmingham , Alabama , USA
| | - Gerald McGwin
- a School of Optometry , University of Alabama at Birmingham , Birmingham , Alabama , USA
| | - Kelly K Nichols
- a School of Optometry , University of Alabama at Birmingham , Birmingham , Alabama , USA
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145
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Tong L, Htoon HM, Hou A, Acharya RU, Tan JH, Wei QP, Lim P. Acupuncture and herbal formulation compared with artificial tears alone: evaluation of dry eye symptoms and associated tests in randomised clinical trial. BMJ Open Ophthalmol 2018; 3:e000150. [PMID: 30123846 PMCID: PMC6093252 DOI: 10.1136/bmjophth-2018-000150] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 05/11/2018] [Accepted: 05/11/2018] [Indexed: 11/17/2022] Open
Abstract
Objective Dry eye is a common disease with great health burden and no satisfactory treatment. Traditional Chinese medicine, an increasingly popular form of complementary medicine, has been used to treat dry eye but studies have been inconclusive. To address this issue, we conducted a randomised investigator-masked study which included the robust assessment of disease mechanisms. Methods and analysis Eligible participants (total 150) were treated with artificial tear (AT) alone, with added eight sessions of acupuncture (AC) or additional daily oral herb (HB) over a month. Results Participants treated with AC were more likely to respond symptomatically than those on AT (88% vs 72%, p=0.039) with a difference of 16% (95% CI: 0.18 to 31.1). The number-to-treat with AC to achieve response in one person was 7 (3 to 157). Participants in the AC group also had reduced conjunctival redness (automatic grading with Oculus keratograph) compared with AT (p=0.043) and reduced tear T helper cell (Th1)-cytokine tumour necrosis factor α (p=0.027) and Th2-cytokine interleukin 4 concentrations (p=0.038). AC was not significantly superior to AT in other outcomes such as tear osmolarity, tear evaporation rates, corneal staining and tear break-up times. No significant adverse effects were encountered. HB was not significantly different in the primary outcome from AT (80% vs 72%, p=0.26). Conclusions AC is safe and provides additional benefit in mild to moderate dry eye up to 1 month, compared with ATs alone. Treatment is associated with demonstrable molecular evidence of reduced inflammation. Provided that suitably qualified practitioners are available to implement standardised treatment, AC may be recommended as adjunctive therapy to AT. Trial registration number ClinicalTrials.gov (NCT02219204)registered on 14 August 2014.
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Affiliation(s)
- Louis Tong
- Singapore Eye Research Institute, Singapore.,Singapore National Eye Centre, Singapore.,Duke-NUS Graduate Medical School, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Hla Myint Htoon
- Singapore Eye Research Institute, Singapore.,Duke-NUS Graduate Medical School, Singapore
| | - Aihua Hou
- Singapore Eye Research Institute, Singapore.,Duke-NUS Graduate Medical School, Singapore
| | - Rajendra Udyavara Acharya
- Ngee Ann Polytechnic, Singapore.,Department of Biomedical Engineering, SIM University, Singapore.,Department of Biomedical Engineering, University of Malaya, Kuala Lumpur, Malaysia
| | - Jen-Hong Tan
- Singapore Eye Research Institute, Singapore.,Singapore National Eye Centre, Singapore.,Duke-NUS Graduate Medical School, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Ngee Ann Polytechnic, Singapore.,Department of Biomedical Engineering, SIM University, Singapore.,Department of Biomedical Engineering, University of Malaya, Kuala Lumpur, Malaysia.,Beijing University of Chinese Medicine, Beijing, China.,Singapore Chung Hwa Medical Institution, Singapore
| | - Qi-Ping Wei
- Beijing University of Chinese Medicine, Beijing, China
| | - Pat Lim
- Singapore Chung Hwa Medical Institution, Singapore
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146
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Koh S, Tung CI, Inoue Y, Jhanji V. Effects of tear film dynamics on quality of vision. Br J Ophthalmol 2018; 102:1615-1620. [PMID: 29907632 DOI: 10.1136/bjophthalmol-2018-312333] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 05/15/2018] [Accepted: 05/26/2018] [Indexed: 11/04/2022]
Abstract
The precorneal tear film is maintained by blinking and exhibits different phases in the tear cycle. The tear film serves as the most anterior surface of the eye and plays an important role as a first refractive component of the eye. Alterations in tear film dynamics may cause both vision-related and ocular surface-related symptoms. Although the optical quality associated with the tear film dynamics previously received little attention, objective measurements of optical quality using wavefront sensors have enabled us to quantify optical aberrations induced by the tear film. This has provided an objective method for assessing reduced optical quality in dry eye; thus, visual disturbances were included in the definition of dry eye disease in the 2007 Dry Eye Workshop report. In addition, sequential measurements of wavefront aberrations have provided us with valuable insights into the dynamic optical changes associated with tear film dynamics. This review will focus on the current knowledge of the mechanisms of wavefront variations that are caused by different aspects of tear film dynamics: specifically, quality, quantity and properties of the tear film, demonstrating the respective effects of dry eye, epiphora and instillation of eye drops on the quality of vision.
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Affiliation(s)
- Shizuka Koh
- Department of Innovative Visual Science, Osaka University Graduate School of Medicine, Osaka, Japan .,Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Cynthia I Tung
- Division of Surgery, Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | | | - Vishal Jhanji
- Department of Ophthalmology and Visual Sciences, Chinese University of Hong Kong, Hong Kong, China.,Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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147
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Ozlu E, Teberik K. Evaluation of ocular findings in patients with lichen planus. Postepy Dermatol Alergol 2019; 36:267-71. [PMID: 31333342 DOI: 10.5114/ada.2018.74464] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 02/22/2018] [Indexed: 12/30/2022] Open
Abstract
Introduction Lichen planus (LP) is a chronic, inflammatory disease of unknown etiology. Aim To evaluate the tear functions and the retinal and choroidal thickness (CT) in patients with LP. Material and methods In total, 33 patients and 30 healthy controls were enrolled. All participants were evaluated using the Ocular Surface Disease Index (OSDI) questionnaire, Schirmer 1 test (with anesthesia), tear break-up time (TBUT) test, intraocular pressure (IOP), axial length (AL), and central corneal thickness (CCT). The measurements of retinal thickness (RT) and CT were obtained by spectral domain optical coherence tomography. Results No significant difference was observed between the groups in IOP, AL, CCT, or RT (p > 0.05 in each group). There was a significant difference in the Schirmer 1 test, TBUT, and OSDI questionnaire (p < 0.05 in each group). Choroidal thickness in LP patients was thinner than that in the controls (p = 0.001 in each location). There was a moderate negative correlation between the disease duration and Schirmer 1 test, TBUT, and subfoveal CT (r = –0.426, r = –0.555, r = –0.637; p = 0.001, p = 0.001, p = 0.001, respectively). There was a moderate negative correlation between the oral mucosal involvement and Schirmer 1 test, TBUT, and subfoveal CT (r = –0.345, r = –0.392, r = –0.467; p = 0.006, p = 0.001, p = 0.001, respectively). There was a positive correlation between disease duration, oral mucosal involvement and OSDI score (r = 0.717, r = 0.345; p = 0.001, p = 0.006, respectively). Conclusions Lichen planus may influence tear function tests and may cause dry eye. Patients with LP had lower CT values than healthy controls. Further studies are needed to clarify the effect of LP on the eyes.
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Creager HM, Kumar A, Zeng H, Maines TR, Tumpey TM, Belser JA. Infection and Replication of Influenza Virus at the Ocular Surface. J Virol 2018; 92:e02192-17. [PMID: 29321303 DOI: 10.1128/JVI.02192-17] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 12/28/2017] [Indexed: 01/02/2023] Open
Abstract
Although influenza viruses typically cause respiratory tract disease, some viruses, particularly those with an H7 hemagglutinin, have been isolated from the eyes of conjunctivitis cases. Previous work has shown that isolates of multiple subtypes from both ocular and respiratory infections are capable of replication in human ex vivo ocular tissues and corneal or conjunctival cell monolayers, leaving the determinants of ocular tropism unclear. Here, we evaluated the effect of several variables on tropism for ocular cells cultured in vitro and examined the potential effect of the tear film on viral infectivity. All viruses tested were able to replicate in primary human corneal epithelial cell monolayers subjected to aerosol inoculation. The temperature at which cells were cultured postinoculation minimally affected infectivity. Replication efficiency, in contrast, was reduced at 33°C relative to that at 37°C, and this effect was slightly greater for the conjunctivitis isolates than for the respiratory ones. With the exception of a seasonal H3N2 virus, the subset of viruses studied in multilayer corneal tissue constructs also replicated productively after either aerosol or liquid inoculation. Human tears significantly inhibited the hemagglutination of both ocular and nonocular isolates, but the effect on viral infectivity was more variable, with tears reducing the infectivity of nonocular isolates more than ocular isolates. These data suggest that most influenza viruses may be capable of establishing infection if they reach the surface of ocular cells but that this is more likely for ocular-tropic viruses, as they are better able to maintain their infectivity during passage through the tear film.IMPORTANCE The potential spread of zoonotic influenza viruses to humans represents an important threat to public health. Unfortunately, despite the importance of cellular and tissue tropism to pathogenesis, determinants of influenza virus tropism have yet to be fully elucidated. Here, we sought to identify factors that limit the ability of most influenza viruses to cause ocular infection. Although ocular symptoms in humans caused by avian influenza viruses tend to be relatively mild, these infections are concerning due to the potential of the ocular surface to serve as a portal of entry for viruses that go on to establish respiratory infections. Furthermore, a better understanding of the factors that influence infection and replication in this noncanonical site may point toward novel determinants of tropism in the respiratory tract.
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Abstract
BACKGROUND Endoscopic dacryocystorhinostomies (eDCRs) show patency rates between 81% and 94%. However, dacryocystorhinostomy (DCR) failure and the need for revision remain a significant challenge. One of the principal challenges in revision eDCR is the need to surgically identify the correct osteotomy site and maintain long-term patency in the setting of previously instrumented and potentially scarred tissue. At the same time, the surgeon must assume that the blood supply to the commonly described anterior and posteriorly pedicled flaps has been compromised. OBJECTIVE The objective of the study is to describe a novel flap technique for revision eDCR. METHODS The superior based mucosal flap is a novel technique that provides a vascularized mucosa preserving technique in revision eDCR despite previous instrumentation of the lacrimal system. This technique provides wide exposure of the revision osteotomy site while simultaneously allowing a viable mucosal flap to be replaced at the conclusion of the procedure, thereby minimizing bone exposure and cicatricial restenosis. RESULTS The authors have utilized this technique in 13 procedures with 100% positive identification of the lacrimal sac, a 0% complication rate, and a 100% success rate after a mean follow-up of 26.93 ± 10.33 months (range 6-35 months). CONCLUSION The eDCR using the superior pedicled mucosal flap provides excellent exposure of the maxillary bone and the lacrimal sac. This method preserves vascularity of the flap using a superiorly based pedicle which is typically inviolate during both open and endoscopic primary DCR. The mucosal flap can then be replaced, thereby minimizing bone exposure and optimizing patency.
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Affiliation(s)
- Sarina K Mueller
- a Department of Otolaryngology , Massachusetts Eye and Ear, Harvard Medical School , Boston , MA , USA.,b Department of Otolaryngology , University of Erlangen-Nuremberg , Erlangen , Germany
| | - Suzanne K Freitag
- c Department of Ophthalmology , Massachusetts Eye and Ear, Harvard Medical School , Boston , MA , USA
| | - Daniel R Lefebvre
- c Department of Ophthalmology , Massachusetts Eye and Ear, Harvard Medical School , Boston , MA , USA
| | - Nahyoung G Lee
- c Department of Ophthalmology , Massachusetts Eye and Ear, Harvard Medical School , Boston , MA , USA
| | - Benjamin S Bleier
- a Department of Otolaryngology , Massachusetts Eye and Ear, Harvard Medical School , Boston , MA , USA
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Downie LE, Craig JP. Tear film evaluation and management in soft contact lens wear: a systematic approach. Clin Exp Optom 2018; 100:438-458. [PMID: 28940531 DOI: 10.1111/cxo.12597] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2017] [Revised: 06/09/2017] [Accepted: 07/05/2017] [Indexed: 12/13/2022] Open
Abstract
The human tear film is a highly ordered structure consisting of a thin layer of lipid on the surface and a thicker aqueous-mucin phase, which increases in mucin concentration toward the corneal epithelial cell layer. The health of the tear film and ocular surface influences the likelihood of being able to achieve successful contact lens wear. Contact lens discomfort and dryness are the most frequent reasons why contact lens wearers experience reduced wearing times, which can eventually lead to contact lens discontinuation. Comprehensive clinical assessment of tear film integrity and ocular surface health is therefore essential prior to commencing contact lens wear, to enable the ocular surface environment to be optimised to support lens wear. These parameters should also be evaluated over the course of contact lens wear, in order to identify any aspects requiring clinical management and ensure maintenance of optimal lens-wearing conditions. This review summarises current knowledge relating to the effects of soft contact lens wear on the tear film and ocular surface. It also provides a systematic approach to evaluating tear film and ocular surface integrity, in order to guide the clinical management of tear film anomalies with respect to contact lens wear.
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Affiliation(s)
- Laura E Downie
- Department of Optometry and Vision Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jennifer P Craig
- Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand
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