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Shahraki T, Baradaran-Rafii A, Ayyala R, Arabi A, Jarstad J, Memar F. New advances in medical management of dry eye: optimizing treatment strategies for enhanced relief. Int Ophthalmol 2024; 44:49. [PMID: 38337030 DOI: 10.1007/s10792-024-02978-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 10/29/2023] [Indexed: 02/12/2024]
Abstract
PURPOSE Dry eye disease (DED) is a prevalent ocular surface disease that is conventionally characterized by tear film hyperosmolarity and instability. This review presents a summarized classification of DED, followed by a comprehensive discussion of the most recent topical and systemic medications and clinical recommendations for selecting the most appropriate option for each patient. METHODS An extensive literature search was conducted on electronic databases, such as PubMed, Scopus, and Web of Science, using keywords including "dry eye syndrome," "ocular surface disease," "medical management," "artificial tears," "topical immunomodulators," and "meibomian gland dysfunction." RESULTS The underlying reasons for DED can range from insufficient aqueous tear production to increased tear evaporation. Recent literature has provided a more in-depth understanding of the pathophysiology of DED by examining the tear film's lipid, aqueous, and mucin layers. However, despite these advancements, medical management of patients with symptomatic DED has not fully reflected this modernized knowledge of its pathophysiology. CONCLUSION To develop a rationalized strategy for treating DED, it is crucial to have updated knowledge of therapeutic options, their mechanisms of actions, and indications based on the DED type and underlying causes.
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Affiliation(s)
- Toktam Shahraki
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, No. 23, Paidarfard St., Boostan 9 St., Pasdaran Ave, Tehran, Iran.
| | - Alireza Baradaran-Rafii
- Department of Ophthalmology, University of South Florida, Morsani College of Medicine, Tampa, FL, USA
| | - Ramesh Ayyala
- Department of Ophthalmology, University of South Florida, Morsani College of Medicine, Tampa, FL, USA
| | - Amir Arabi
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, No. 23, Paidarfard St., Boostan 9 St., Pasdaran Ave, Tehran, Iran
| | - John Jarstad
- Department of Ophthalmology, University of South Florida, Morsani College of Medicine, Tampa, FL, USA
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Calderón-García AÁ, Valencia-Nieto L, Valencia-Sandonis C, López-de la Rosa A, Blanco-Vazquez M, Fernández I, García-Vázquez C, Arroyo-Del Arroyo C, González-García MJ, Enríquez-de-Salamanca A. Gene expression changes in conjunctival cells associated with contact lens wear and discomfort. Ocul Surf 2024; 31:31-42. [PMID: 38128761 DOI: 10.1016/j.jtos.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 10/27/2023] [Accepted: 12/09/2023] [Indexed: 12/23/2023]
Abstract
PURPOSE This study aimed to analyze the differences in the expression of pain-related genes in conjunctival epithelial cells among symptomatic contact lens (CL) wearers (SCLWs), asymptomatic CL wearers (ACLWs), and non-CL wearers (non-CLWs). METHODS For this study, 60 participants (20 non-CLWs, 40 CLWs) were enrolled. The CLW group comprised 20 ACLWs and 20 SCLWs according to the Contact Lens Dry Eye Questionnaire short form©. Conjunctival cells were collected using impression cytology, and RNA was isolated and used to determine the expression levels of 85 human genes involved in neuropathic and inflammatory pain. The effects of CL wear and discomfort were evaluated using mixed-effects ANOVA with partially nested fixed-effects model. Gene set enrichment analysis was performed to assign biological meaning to sets of differentially expressed genes. RESULTS Six genes (CD200, EDN1, GRIN1, PTGS1, P2RX7, and TNF) were significantly upregulated in CLWs compared to non-CLWs. Eleven genes (ADORA1, BDKRB1, CACNA1B, DBH, GRIN1, GRM1, HTR1A, PDYN, PTGS1, P2RX3, and TNF) were downregulated in SCLWs compared to ACLWs. These genes were mainly related to pain, synaptic transmission and signaling, ion transport, calcium transport and concentration, and cell-cell signaling. CONCLUSIONS CL wear modified the expression of pain- and inflammation-related genes in conjunctival epithelial cells. These changes may be in part, along with other mechanisms, responsible for CL discomfort in SCLWs.
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Affiliation(s)
- Andrés Ángel Calderón-García
- Institute of Applied Ophthalmobiology (IOBA), Universidad de Valladolid, Valladolid, Spain; Department of Theoretical Physics, Atomic and Optics, Universidad de Valladolid, Valladolid, Spain
| | - Laura Valencia-Nieto
- Institute of Applied Ophthalmobiology (IOBA), Universidad de Valladolid, Valladolid, Spain; Department of Theoretical Physics, Atomic and Optics, Universidad de Valladolid, Valladolid, Spain
| | - Cristina Valencia-Sandonis
- Institute of Applied Ophthalmobiology (IOBA), Universidad de Valladolid, Valladolid, Spain; Department of Theoretical Physics, Atomic and Optics, Universidad de Valladolid, Valladolid, Spain
| | - Alberto López-de la Rosa
- Institute of Applied Ophthalmobiology (IOBA), Universidad de Valladolid, Valladolid, Spain; Department of Theoretical Physics, Atomic and Optics, Universidad de Valladolid, Valladolid, Spain
| | - Marta Blanco-Vazquez
- Institute of Applied Ophthalmobiology (IOBA), Universidad de Valladolid, Valladolid, Spain
| | - Itziar Fernández
- Institute of Applied Ophthalmobiology (IOBA), Universidad de Valladolid, Valladolid, Spain; Networking Research Center on Bioengineering Biomaterials and Nanomedicine (CIBER-BBN), Valladolid, Spain; Department of Statistics and Operations Research, Universidad de Valladolid, Valladolid, Spain
| | - Carmen García-Vázquez
- Institute of Applied Ophthalmobiology (IOBA), Universidad de Valladolid, Valladolid, Spain
| | - Cristina Arroyo-Del Arroyo
- Institute of Applied Ophthalmobiology (IOBA), Universidad de Valladolid, Valladolid, Spain; Department of Theoretical Physics, Atomic and Optics, Universidad de Valladolid, Valladolid, Spain
| | - María J González-García
- Institute of Applied Ophthalmobiology (IOBA), Universidad de Valladolid, Valladolid, Spain; Department of Theoretical Physics, Atomic and Optics, Universidad de Valladolid, Valladolid, Spain; Networking Research Center on Bioengineering Biomaterials and Nanomedicine (CIBER-BBN), Valladolid, Spain.
| | - Amalia Enríquez-de-Salamanca
- Institute of Applied Ophthalmobiology (IOBA), Universidad de Valladolid, Valladolid, Spain; Networking Research Center on Bioengineering Biomaterials and Nanomedicine (CIBER-BBN), Valladolid, Spain
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3
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Ax T, Ganse B, Fries FN, Szentmáry N, de Paiva CS, March de Ribot F, Jensen SO, Seitz B, Millar TJ. Dry eye disease in astronauts: a narrative review. Front Physiol 2023; 14:1281327. [PMID: 37929210 PMCID: PMC10620524 DOI: 10.3389/fphys.2023.1281327] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 10/03/2023] [Indexed: 11/07/2023] Open
Abstract
Long-duration spaceflight can have adverse effects on human health. One of the most common ocular conditions experienced by astronauts is dry eye disease (DED). Symptoms of DED include feelings of eye irritation, eye strain, foreign body sensation and blurred vision. Over 30% of International Space Station expedition crew members reported irritation and foreign body sensation. We reviewed the current literature on the prevalence and mechanisms of DED in astronauts and its potential implications for long-duration spaceflight, including the influence of environmental factors, such as microgravity and fluid shift on tear film physiology in space. DED has negative effects on astronaut performance, which is why there is a need for further research into the pathophysiology and countermeasures. As an in-flight countermeasure, neurostimulation seems to be among the most promising options.
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Affiliation(s)
- Timon Ax
- Department of Ophthalmology, Saarland University Medical Center, Homburg/Saar, Germany
- School of Medicine, Western Sydney University, Sydney, NSW, Australia
| | - Bergita Ganse
- Werner Siemens-Endowed Chair for Innovative Implant Development (Fracture Healing), Departments and Institutes of Surgery, Saarland University, Homburg/Saar, Germany
- Department of Trauma, Hand and Reconstructive Surgery, Departments and Institutes of Surgery, Saarland University, Homburg/Saar, Germany
| | - Fabian N. Fries
- Department of Ophthalmology, Saarland University Medical Center, Homburg/Saar, Germany
- Dr. Rolf M. Schwiete Center for Limbal Stem Cell and Aniridia Research, Saarland University, Homburg/Saar, Germany
| | - Nóra Szentmáry
- Dr. Rolf M. Schwiete Center for Limbal Stem Cell and Aniridia Research, Saarland University, Homburg/Saar, Germany
| | - Cintia S. de Paiva
- Ocular Surface Center, Department of Ophthalmology, Baylor College of Medicine, Cullen Eye Institute, Houston, TX, United States
| | | | - Slade O. Jensen
- School of Medicine, Western Sydney University, Sydney, NSW, Australia
- Antimicrobial Resistance and Mobile Elements Group, Ingham Institute of Applied Medical Research, Sydney, NSW, Australia
| | - Berthold Seitz
- Department of Ophthalmology, Saarland University Medical Center, Homburg/Saar, Germany
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Chester T, Garg S(S, Johnston J, Ayers B, Gupta P. How Can We Best Diagnose Severity Levels of Dry Eye Disease: Current Perspectives. Clin Ophthalmol 2023; 17:1587-1604. [PMID: 37304329 PMCID: PMC10254642 DOI: 10.2147/opth.s388289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 05/22/2023] [Indexed: 06/13/2023] Open
Abstract
Dry eye disease (DED) is a common ocular condition, but the diagnosis relative to other ocular conditions and the evaluation of severity of the condition has often been difficult. This challenge can be due to clinical signs and symptoms not always correlating with each other. An understanding of the various components which create the condition, as well as the diagnostic measures used to evaluate these components, is useful to the clinician working with DED patients. This review paper will discuss traditional diagnostic options, diagnostic imaging, and Advanced Point of Care testing capabilities to determine the severity level of dry eye disease more adequately.
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Affiliation(s)
| | - Sumit (Sam) Garg
- Department of Ophthalmology, Gavin Herbert Eye Institute, University of California-Irvine, Irvine, CA, USA
| | - Josh Johnston
- Georgia Eye Partners, Atlanta, GA, USA
- Southern College of Optometry, Memphis, TN, USA
| | - Brandon Ayers
- Ophthalmic Partners PC, Cornea Service, Wills Eye Hospital, Philadelphia, PA, USA
| | - Preeya Gupta
- Triangle Eye Consultants, Raleigh, NC, USA
- Department of Ophthalmology, Tulane University, New Orleans, LA, USA
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Brahmbhatt P, Khanna S, Griffin S, Bouchard CS. A Retrospective Analysis of Tear Film and Blink Parameters in Patients With Ocular Surface Disease. Eye Contact Lens 2023; 49:241-246. [PMID: 37167586 DOI: 10.1097/icl.0000000000000994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2023] [Indexed: 05/13/2023]
Abstract
OBJECTIVES We had two objectives: (1) to investigate differences in tear film and blink parameters in patients with six ocular surface diseases (OSD): ocular graft versus host disease (oGVHD), Stevens-Johnson syndrome (SJS), lax eyelid syndrome, meibomian gland dysfunction (MGD), obstructive sleep apnea, and dry eye disease; and (2) to characterize the relationships between lipid layer thickness (LLT), meiboscore, Schirmer I test, and three blink parameters: partial blink rate (PBR), interblink interval (IBI), and interpalpebral fissure height (IPFH) in this group of patients. METHODS This is a single-site retrospective analysis of 228 patients (456 eyes) with six different primary OSD at Loyola University Medical Center between January 2018 and July 2020. Objective parameters included: LLT, IBI, PBR, IPFH, Pult meiboscore, and Schirmer I score. Linear mixed effects models were used to analyze the relationships between these parameters. RESULTS The meiboscore was highest in patients with SJS compared with the other five groups. There was significant variability in IPFH across different groups, with patients with oGVHD having the smallest height. An increase in IPFH was associated with increases in IBI, PBR, and Schirmer score. Patients with no partial blinks demonstrated a statistically significant higher IBI than patients who showed 1%-50% partial blinks. Finally, no statistically significant relationship was found between the following: (1) meiboscore and LLT, (2) OSDI and IPFH, (3) Schirmer score and IBI, or (4) LLT and IBI. CONCLUSIONS There were fewer than anticipated differences in objective tear film and blink parameters between patients with six different OSD. A statistically significant association was found between IPFH and Schirmer score and IPFH and IBI, representing new findings in tear film research. Further investigation of the relationship between IPFH and IBI is needed.
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Affiliation(s)
- Puja Brahmbhatt
- Loyola University Chicago Stritch School of Medicine (P.B.); and Department of Ophthalmology (S.K., S.G., C.S.B.), Loyola University Medical Center, Maywood, IL
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6
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Monfared N, Murphy PJ. Features and influences on the normal tear evaporation rate. Cont Lens Anterior Eye 2023; 46:101809. [PMID: 36621341 DOI: 10.1016/j.clae.2022.101809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 12/23/2022] [Accepted: 12/28/2022] [Indexed: 01/09/2023]
Abstract
Tear evaporation is a normal physiological phenomenon that has an important role in regulating blink activity and tear production. An altered tear evaporation rate (TER) is a defining characteristic of evaporative dry eye disease (DED), and the measurement of tear evaporation is a useful clinical test for diagnosis. Reported values for a normal TER cover a broad range, which may be due to the influence of ocular, environmental, and systemic factors. For improved disease diagnosis, a fuller understanding of the normal TER range is essential. This paper reports on a literature review of the current knowledge of these normal influences on TER.
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Affiliation(s)
- Naeimeh Monfared
- School of Optometry and Vision Science, University of Waterloo, Waterloo, Canada.
| | - Paul J Murphy
- School of Optometry and Vision Science, University of Waterloo, Waterloo, Canada
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Wolffsohn JS, Lingham G, Downie LE, Huntjens B, Inomata T, Jivraj S, Kobia-Acquah E, Muntz A, Mohamed-Noriega K, Plainis S, Read M, Sayegh RR, Singh S, Utheim TP, Craig JP. TFOS Lifestyle: Impact of the digital environment on the ocular surface. Ocul Surf 2023; 28:213-252. [PMID: 37062428 DOI: 10.1016/j.jtos.2023.04.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 04/06/2023] [Indexed: 04/18/2023]
Abstract
Eye strain when performing tasks reliant on a digital environment can cause discomfort, affecting productivity and quality of life. Digital eye strain (the preferred terminology) was defined as "the development or exacerbation of recurrent ocular symptoms and/or signs related specifically to digital device screen viewing". Digital eye strain prevalence of up to 97% has been reported, due to no previously agreed definition/diagnostic criteria and limitations of current questionnaires which fail to differentiate such symptoms from those arising from non-digital tasks. Objective signs such as blink rate or critical flicker frequency changes are not 'diagnostic' of digital eye strain nor validated as sensitive. The mechanisms attributed to ocular surface disease exacerbation are mainly reduced blink rate and completeness, partial/uncorrected refractive error and/or underlying binocular vision anomalies, together with the cognitive demand of the task and differences in position, size, brightness and glare compared to an equivalent non-digital task. In general, interventions are not well established; patients experiencing digital eye strain should be provided with a full refractive correction for the appropriate working distances. Improving blinking, optimizing the work environment and encouraging regular breaks may help. Based on current, best evidence, blue-light blocking interventions do not appear to be an effective management strategy. More and larger clinical trials are needed to assess artificial tear effectiveness for relieving digital eye strain, particularly comparing different constituents; a systematic review within the report identified use of secretagogues and warm compress/humidity goggles/ambient humidifiers as promising strategies, along with nutritional supplementation (such as omega-3 fatty acid supplementation and berry extracts).
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Affiliation(s)
- James S Wolffsohn
- College of Health & Life Sciences, School of Optometry, Aston University, Birmingham, UK; Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand.
| | - Gareth Lingham
- Centre for Eye Research Ireland, Technological University Dublin, Dublin, Ireland
| | - Laura E Downie
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Byki Huntjens
- Division of Optometry and Visual Sciences, City, University of London, EC1V 0HB, UK
| | - Takenori Inomata
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Saleel Jivraj
- College of Health & Life Sciences, School of Optometry, Aston University, Birmingham, UK
| | | | - Alex Muntz
- Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand
| | - Karim Mohamed-Noriega
- Department of Ophthalmology, University Hospital and Faculty of Medicine, Autonomous University of Nuevo León (UANL). Monterrey, 64460, Mexico
| | - Sotiris Plainis
- College of Health & Life Sciences, School of Optometry, Aston University, Birmingham, UK; Laboratory of Optics and Vision, School of Medicine, University of Crete, Greece
| | - Michael Read
- Division of Pharmacy and Optometry, The University of Manchester, Manchester, UK
| | - Rony R Sayegh
- Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Sumeer Singh
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Tor P Utheim
- Department of Ophthalmology, Oslo University Hospital, Oslo, Norway
| | - Jennifer P Craig
- College of Health & Life Sciences, School of Optometry, Aston University, Birmingham, UK; Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand
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Chidi-Egboka NC, Jalbert I, Chen J, Briggs NE, Golebiowski B. Blink Rate Measured In Situ Decreases While Reading From Printed Text or Digital Devices, Regardless of Task Duration, Difficulty, or Viewing Distance. Invest Ophthalmol Vis Sci 2023; 64:14. [PMID: 36763349 PMCID: PMC9927758 DOI: 10.1167/iovs.64.2.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Abstract
Purpose To compare blinking measured in situ during various tasks and examine relationships with ocular surface symptoms. The day-to-day repeatability of the blink rate and interblink interval was assessed. Methods Twenty-four students (28.6 ± 6.3 years; 8 male and 16 female) completed six reading tasks (printed text, laptop, TV, smartphone, smartphone at 50% brightness, smartphone with complex text), and two nonreading tasks (conversation, walking) in a randomized cross-over study. Ocular surface symptoms and clinical signs were assessed. The blink rate and interblink interval were measured using a wearable eye tracking headset. Blink parameters were compared across tasks and time (linear mixed model and post hoc comparisons with Bonferroni correction). Associations between blinking, symptoms, ocular surface, and clinical signs were assessed (Spearman's correlation). The smartphone reading task was completed twice to determine the coefficient of repeatability. Results The blink rate was lower (mean 10.7 ± 9.7 blinks/min) and the interblink interval longer (mean 9.6 ± 8.7 seconds) during all reading tasks compared with conversation (mean 32.4 ± 12.4 blinks/min; 1.5 ± 0.6 seconds) and walking (mean 31.3 ± 15.5 blinks/min; 1.9 ± 1.3s) (P < 0.001). There were no significant differences in blink parameters between any of the reading tasks or between conversation and walking. Changes in blinking occurred within 1 minute of starting the task. No associations were evident between blink rate or interblink interval and ocular surface symptoms or signs. The coefficient of repeatability was ±12.4 blinks/min for blink rate and ±18.8 seconds for interblink interval. Conclusions Spontaneous blinking can be measured reliably in situ. The blink rate was decreased and the interblink interval increased during reading compared with conversation and walking. Changes in blinking were immediate, sustained, and not associated with ocular surface symptoms or signs.
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Affiliation(s)
- Ngozi Charity Chidi-Egboka
- School of Optometry and Vision Science, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
| | - Isabelle Jalbert
- School of Optometry and Vision Science, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
| | - Jiaying Chen
- School of Optometry and Vision Science, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
| | - Nancy E. Briggs
- School of Optometry and Vision Science, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia,Mark Wainwright Analytical Centre, UNSW Sydney, Sydney, NSW, Australia
| | - Blanka Golebiowski
- School of Optometry and Vision Science, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
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Altinbas E, Elibol A, Fıratlı G, Ayhan C, Celebi ARC. Assessment of risk factors on eye dryness in young adults using visual display device in both contact lens wearers and non-wearers. Int Ophthalmol 2023; 43:441-450. [PMID: 35920942 PMCID: PMC9362648 DOI: 10.1007/s10792-022-02441-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 07/05/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE Researchers are interested in examining the impact of visual display devices (VDDs) on the development of dry eye illness because their use is becoming more common among college students. The goal of this study was to see if there was a link between certain risk factors and the development of eye dryness in VDDs using young adults who wore contact lenses and those who did not. METHODS The self-administrated survey was hosted in Google Forms, sent via e-mail to the participants. It consisted of two parts of assessing different risk factors (i.e., environmental conditions, angle of gaze, and years of VDD use) with contact lens use and Ocular Surface Disease Index (OSDI) questionnaire. The OSDI scores of the entire sample who suffer from dry eye and the subgroup using contact lenses were calculated. The relationship between different risk factors with the OSDI scores was also assessed. RESULTS A total of 274 young adults from college students and academic staff (216 female, 58 male) were suffering from eye dryness. Eighty-eight of the 274 participants wore contact lenses. The mean OSDI scores of the 274 young adults were 32.92. Mean OSDI scores in contact lens wearers and non-wearers were 34.36 and 32.24, respectively (p < 0.01). There was a statistically significant relationship between OSDI score and indoor environmental conditions in computer using VDD group. Using a computer in a dark environment and above the line of sight resulted in a higher OSDI scores. Females who wore contact lenses while using a computer for more than three years had significantly higher OSDI scores than non-wearer females. Tablet type VDD use increased the mean ODSI scores of the contact lens wearers significantly. CONCLUSIONS Dry eye symptoms were shown to be increased in the contact lens wearer group with the increased duration of computer VDD use, decreased indoor environmental brightness conditions, and above the line of sight.
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Affiliation(s)
- Ekin Altinbas
- Department of Ophthalmology, School of Medicine, Acibadem University, Istanbul, Turkey
| | - Alperen Elibol
- Department of Ophthalmology, School of Medicine, Acibadem University, Istanbul, Turkey
| | - Göktuğ Fıratlı
- Department of Ophthalmology, School of Medicine, Acibadem University, Istanbul, Turkey
| | - Cemre Ayhan
- Department of Ophthalmology, School of Medicine, Acibadem University, Istanbul, Turkey
| | - Ali Riza Cenk Celebi
- Department of Ophthalmology, School of Medicine, Acibadem University, Istanbul, Turkey.
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10
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Vicente García-Marqués J, Talens-Estarelles C, García-Lázaro S, Cerviño A. Assessment of condition-induced changes on the ocular surface using novel methods to assess the tear film dynamics and the lipid layer. Cont Lens Anterior Eye 2022; 46:101799. [PMID: 36577612 DOI: 10.1016/j.clae.2022.101799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 12/13/2022] [Accepted: 12/21/2022] [Indexed: 12/27/2022]
Abstract
OBJECTIVES To assess the effects of different condition-induced changes on current and novel ocular surface metrics. METHODS Eighty-four healthy volunteers (22.4 ± 2.6 years) participated in this study. The ocular surface and tear film response to (1) computer use, (2) contact lens insertion and (3) tear film instillation during computer use with contact lenses were assessed. Current metrics included the ocular surface disease (OSDI) questionnaire, 5-item dry eye questionnaire (DEQ-5), bulbar redness, tear meniscus height (TMH) and non-invasive keratograph break-up time (NIKBUT). Novel metrics included the lipid layer thickness obtained from the intensity of the reflected Placido disk and the speed of tear film particles post-blink. RESULTS Higher dry eye symptoms, TMH and bulbar redness, and lower values in metrics related to the intensity of the Placido disk pattern and to particle speed were found after the computer reading task (p < 0.036). When a contact lens was fitted, lower TMH, NIKBUT and particle speed metrics were obtained (p < 0.044). Mixed ANOVA revealed that artificial tears significantly ameliorated the effect of computer reading on OSDI, DEQ-5, NIKBUT, metrics related to the intensity of the Placido disk pattern and metrics related to particle speed (p < 0.033). CONCLUSIONS Computer use and contact lens wear worsened dry eye signs and symptoms, but artificial tears ameliorated this effect. Newly developed methods can serve as a tool to detect changes in the tear film triggered by different ocular surface-disturbing conditions.
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Affiliation(s)
| | | | - Santiago García-Lázaro
- Department of Optics and Optometry and Vision Sciences. University of Valencia. Valencia, Spain
| | - Alejandro Cerviño
- Department of Optics and Optometry and Vision Sciences. University of Valencia. Valencia, Spain.
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11
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Kamøy B, Magno M, Nøland ST, Moe MC, Petrovski G, Vehof J, Utheim TP. Video display terminal use and dry eye: preventive measures and future perspectives. Acta Ophthalmol 2022; 100:723-739. [PMID: 35122403 PMCID: PMC9790652 DOI: 10.1111/aos.15105] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 01/07/2022] [Accepted: 01/20/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Dry eye disease (DED) is a common cause of ocular pain and discomfort. Dry eye disease (DED) stems from a loss-of-tear film homeostasis and is frequently seen in video display terminal (VDT) users. Video display terminal (VDT) use reduces blink rates and increases incomplete blinks, leading to tear film instability and ocular inflammation, promoting DED. PURPOSE To assess and evaluate the methods for preventing VDT-associated DED and ocular discomfort. METHODS Studies were found using PubMed and Embase with the search terms: (digital visual terminal* OR computer use OR screen use OR smartphone OR display OR visual display terminal* OR computer vision syndrome OR tablet OR phone OR screen time) AND (dry eye OR DED). RESULTS Thirty-one relevant articles were found. Ten described single-visit studies, whereas 21 had a prolonged follow-up. Most preventive measures of VDT-associated DED aimed to increase blink rate or directly prevent tear film instability, ocular inflammation, mucin loss or ocular surface damage. Using an adjustable chair and ergonomic training, blink animations and omega-3 supplementation improved signs and symptoms of VDT-associated DED. Taking frequent breaks was associated with fewer symptoms, but no study assessed the commonly suggested 20-20-20 rule. CONCLUSION Preventive measures, such as blink animation programmes, oral intake of omega-3 fatty acids and improved ergonomics act on different parts of the vicious cycle of dry eye and could supplement each other. A comparison of the efficacy of the different interventions as well as more evidence of the effect of increased humidity, VDT filters and ergonomic practices, are required.
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Affiliation(s)
- Bjørnar Kamøy
- Institute of Clinical MedicineFaculty of MedicineUniversity of OsloOsloNorway
| | - Morten Magno
- Institute of Clinical MedicineFaculty of MedicineUniversity of OsloOsloNorway,Department of Plastic and Reconstructive SurgeryOslo University HospitalOsloNorway,Department of Medical BiochemistryOslo University HospitalOsloNorway,Department of OphthalmologyUniversity of GroningenUniversity Medical Center GroningenGroningenThe Netherlands
| | - Sara T Nøland
- Institute of Clinical MedicineFaculty of MedicineUniversity of OsloOsloNorway
| | - Morten C Moe
- Institute of Clinical MedicineFaculty of MedicineUniversity of OsloOsloNorway,Department of OphthalmologyOslo University HospitalOsloNorway
| | - Goran Petrovski
- Institute of Clinical MedicineFaculty of MedicineUniversity of OsloOsloNorway,Department of OphthalmologyOslo University HospitalOsloNorway
| | - Jelle Vehof
- Department of OphthalmologyUniversity of GroningenUniversity Medical Center GroningenGroningenThe Netherlands,Department of OphthalmologyVestfold Hospital TrustTønsbergNorway,Department of EpidemiologyUniversity of GroningenUniversity Medical Center GroningenGroningenThe Netherlands
| | - Tor P. Utheim
- Department of Medical BiochemistryOslo University HospitalOsloNorway,Department of OphthalmologyOslo University HospitalOsloNorway,Department of OphthalmologySørlandet Hospital ArendalArendalNorway,Department of OphthalmologyStavanger University HospitalStavangerNorway,Department of Computer ScienceOslo Metropolitan UniversityOsloNorway,Department of Clinical MedicineFaculty of MedicineUniversity of BergenBergenNorway,Department of Quality and Health TechnologyThe Faculty of Health SciencesUniversity of StavangerStavangerNorway,Department of OphthalmologyVestre Viken Hospital TrustDrammenNorway,Department of Oral BiologyFaculty of DentistryUniversity of OsloOsloNorway,National Centre for Optics, Vision and Eye CareDepartment of Optometry, Radiography and Lighting DesignFaculty of Health SciencesUniversity of South‐Eastern NorwayKongsbergNorway,Department of Health and Nursing ScienceThe Faculty of Health and Sport SciencesUniversity of AgderGrimstadNorway,The Norwegian Dry Eye ClinicOsloNorway
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12
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Tovar A, Gomez A, Serrano A, Blanco MP, Galor A, Swaminathan SS, de Rivero Vaccari JP, Sabater AL. Role of Caspase-1 as a Biomarker of Ocular Surface Damage. Am J Ophthalmol 2022; 239:74-83. [PMID: 35151638 DOI: 10.1016/j.ajo.2022.01.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 01/20/2022] [Accepted: 01/20/2022] [Indexed: 11/16/2022]
Abstract
PURPOSE To examine the potential of caspase-1 as a biomarker for ocular surface damage. DESIGN Cross-sectional study. METHODS A total of 113 tear samples (64 subjects) were analyzed. Sixty-one samples were from individuals with dry eye disease (DED), defined as Ocular Surface Disease Index (OSDI) ≥13 and/or corneal staining (CS) ≥3; 32 were from individuals who used glaucoma medication, irrespective of DED metrics; and 20 were from controls (CS <3 and OSDI <13). All individuals completed a medical history form and underwent an ocular surface assessment. Protein levels of caspase-1 were determined by enzyme-linked immunosorbent assay off Schirmer's strips. The primary analysis compared caspase-1 levels in individuals with signs of ocular surface damage (CS ≥3) in both case groups and controls. Secondary correlational analyses were conducted to examine relationships between caspase-1 levels and ocular signs and symptoms. Finally, area under the curve (AUC) analyses were performed to examine relationships between inflammatory markers and CS. RESULTS The mean age of the population was 58±18 years; 70% were female. Tear samples from individuals with ocular surface damage presented higher caspase-1 levels than the control group. Caspase-1 levels showed a moderate positive correlation with CS (Spearman r = 0.31; P = .001) and eye redness (Spearman r = 0.39; P = .004), and a negative correlation with Schirmer's (Spearman r = -0.46; P < .001) and tear break-up time (Spearman r = -0.33; P = .0006). Caspase-1 showed higher sensitivity and AUC for detecting ocular surface damage than InflammaDry, and its expression was not affected by anti-inflammatory agents. CONCLUSION Caspase-1 levels were higher in the tears of individuals with ocular surface damage, suggesting its potential to be used as a biomarker and/or therapeutic target.
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Affiliation(s)
- Arianna Tovar
- From the Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA (A.T, A.G, A.S, M.P.B, S.S.S, A.L.S)
| | - Angela Gomez
- From the Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA (A.T, A.G, A.S, M.P.B, S.S.S, A.L.S)
| | - Andres Serrano
- From the Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA (A.T, A.G, A.S, M.P.B, S.S.S, A.L.S)
| | - Maricarmen Perez Blanco
- From the Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA (A.T, A.G, A.S, M.P.B, S.S.S, A.L.S)
| | - Anat Galor
- From the Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA (A.T, A.G, A.S, M.P.B, S.S.S, A.L.S)
| | - Swarup S Swaminathan
- From the Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA (A.T, A.G, A.S, M.P.B, S.S.S, A.L.S)
| | - Juan Pablo de Rivero Vaccari
- Department of Neurological Surgery and The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, FL, USA (J.P.R.V)
| | - Alfonso L Sabater
- From the Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA (A.T, A.G, A.S, M.P.B, S.S.S, A.L.S).
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13
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Lin CC, Hung JH, Huang YH. Immediate Ocular Changes After Light-Emitting Diode Displays Exposure-A Preliminary Study. Front Med (Lausanne) 2022; 9:848794. [PMID: 35445041 PMCID: PMC9015093 DOI: 10.3389/fmed.2022.848794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 03/15/2022] [Indexed: 11/17/2022] Open
Abstract
Purpose Computer vision syndrome (CVS) is one of the most frequently encountered problems among video display terminals (VDT) users, but little is known regarding the short-term effect after exposure to light-emitting diodes (LED). The purpose of this study was to determine if short-term exposure to LED leads to changes in corrected distance visual acuity (CDVA), lipid layer thickness (LLT), blink rates, partial blink ratio, and computer vision syndrome questionnaire (CVS-Q) score. Design Prospective, cross-sectional study. Methods In this study, participants were recruited at the National Cheng-Kung University Hospital, a tertiary referral center in southern Taiwan, for examination. Participants were asked to complete the CVS-Q and undergo a series of ocular examinations, including CDVA, LLT, blink rates and partial blink ratio before and after watching an LED display for 15 min. Main Outcome Measures were changes in CDVA, LLT, blink rates, partial blink ratio, and CVS-Q measurements. Results In total, 120 eyes from 60 participants (mean age: 35.7 ± 9.4 years) were included; 31 participants were men (51.7%), and 29 were women (48.3%). The CDVA, LLT, blink rates, and partial blink ratio did not change after watching the LED display. The CVS-Q score significantly improved after short-term LED exposure (P < 0.001). A subgroup analysis of subjects with a baseline LLT of <60 nm or ≥60 nm determined that LLT significantly decreased in individuals with a baseline LLT of ≥60 nm (P = 0.016). Conclusion Short-term use of LED displays reduced LLT in individuals with a baseline LLT of ≥60 nm, despite the visual symptoms of CVS improved subjectively. Therefore, digital device users should be aware of the potential negative effects of LED exposure on the eyes.
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Affiliation(s)
- Chia-Chen Lin
- Department of Ophthalmology, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan
| | - Jia-Horung Hung
- Department of Ophthalmology, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan.,Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yi-Hsun Huang
- Department of Ophthalmology, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan
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14
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Talens-Estarelles C, García-Marqués JV, Cerviño A, García-Lázaro S. Ocular surface predisposing factors for digital display-induced dry eye. Clin Exp Optom 2022; 106:373-379. [PMID: 35254958 DOI: 10.1080/08164622.2022.2048173] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
CLINICAL RELEVANCE The use of digital displays is recognised as a consistent risk factor for dry eye disease. BACKGROUND To identify ocular parameters contributing to the impact of computer use on dry eye. METHODS The ocular surface of 82 undergraduate students with a mean age of 22.8 ± 2.1 years was assessed at baseline and after reading on a computer for 30 minutes. Measurements included the ocular surface disease index (OSDI) questionnaire, 5-item dry eye questionnaire (DEQ-5), tear meniscus height, non-invasive keratograph break-up time (NIKBUT), conjunctival bulbar redness, meibomian gland dropout percentage, spontaneous blink rate and percentage of incomplete blinks. Multiple linear regressions and generalised linear mixed models were conducted to explore the associations between baseline parameters and pre-task - post-task differences and to predict the impact of computer use, respectively. RESULTS Greater dry eye symptoms (p < 0.0005), higher tear meniscus height and conjunctival bulbar redness (p < 0.0005 and p = 0.012, respectively) and shorter NIKBUT (p = 0.03) were obtained after reading on the computer for 30 minutes. The baseline score obtained with the OSDI and DEQ-5 was positively associated with the increase in symptoms with computer use (p < 0.0005), while the change in conjunctival redness and pre-task NIKBUT were associated with the change in NIKBUT (p ≤ 0.005). No ocular surface parameter revealed an association with tear meniscus height changes. Having a positive OSDI score at baseline increased the odds of painful and sore eyes (p = 0.012), while a higher pre-task NIKBUT increased the odds of a reduction in tear stability (p = 0.038). CONCLUSIONS Participants with greater dry eye symptoms were more likely to experience a greater increase in symptomatology with computer operation, while the participants with longer NIKBUT and greater conjunctival redness were more likely to suffer a greater reduction in tear stability.
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Affiliation(s)
- Cristian Talens-Estarelles
- Optometry Research Group, Department of Optics & Optometry & Vision Sciences, University of Valencia, Valencia, Spain
| | - José Vicente García-Marqués
- Optometry Research Group, Department of Optics & Optometry & Vision Sciences, University of Valencia, Valencia, Spain
| | - Alejandro Cerviño
- Optometry Research Group, Department of Optics & Optometry & Vision Sciences, University of Valencia, Valencia, Spain
| | - Santiago García-Lázaro
- Optometry Research Group, Department of Optics & Optometry & Vision Sciences, University of Valencia, Valencia, Spain
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15
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Bellantone RA, Shah KB, Patel PG, Kaplan M, Xu X, Li V, Newman B, Abul Kaisar M. Cyclosporine release and distribution in ophthalmic emulsions determined by pulsatile microdialysis. Int J Pharm 2022; 615:121521. [DOI: 10.1016/j.ijpharm.2022.121521] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 01/15/2022] [Accepted: 01/23/2022] [Indexed: 11/16/2022]
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16
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Talens-Estarelles C, García-Marqués JV, Cervino A, García-Lázaro S. Online Vs In-person Education: Evaluating the Potential Influence of Teaching Modality on Dry Eye Symptoms and Risk Factors During the COVID-19 Pandemic. Eye Contact Lens 2021; 47:565-572. [PMID: 34224445 DOI: 10.1097/icl.0000000000000816] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To assess the potential effects of switching to online lecture format on dry eye symptoms and dry eye disease (DED) risk factors. METHODS An anonymous cross-sectional online survey was conducted in 812 university students (mean age, 21.5±4.0 years). Participants were classified according to the number of hours the participants took online lectures into online students or in-person students. Respondents completed a total of three DED questionnaires (Ocular Surface Disease Index [OSDI]; 5-item Dry Eye Questionnaire; 8-item Contact Lens Dry Eye Questionnaire) and were surveyed on dry eye risk factors contemplated by the Tear Film and Ocular Surface Society Dry Eye Workshop II in addition to other factors potentially linked to dry eye. RESULTS Five hundred twenty-three subjects (64.4%) were classified into the online group and 289 (35.6%) into the in-person group. No statistically significant age (P=0.266) or sex (P=0.423) differences were found between groups. Students taking online lectures used the computer more, spent less time outdoors, practised more exercise, wore a face mask for less time, experienced fewer allergies and fewer psoriasis episodes, and obtained a higher OSDI score (P<0.029 for all). Multivariate logistic regression analysis revealed that the hours of online lectures taken per week was independently associated with having a positive OSDI score (P=0.022). CONCLUSIONS Taking online lectures is independently associated with having dry eye symptoms. Despite a lower prevalence of DED risk factors, a higher computer use is probably behind the greater ocular dryness reported by online students.
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Affiliation(s)
- Cristian Talens-Estarelles
- Optometry Research Group, Department of Optics & Optometry & Vision Sciences, University of Valencia, Valencia, Spain
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17
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Hwang M, Han S, Seo JW, Jeon KJ, Lee HS. Traffic-related particulate matter aggravates ocular allergic inflammation by mediating dendritic cell maturation. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2021; 84:661-673. [PMID: 33998398 DOI: 10.1080/15287394.2021.1922111] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The aim of this study was to determine the effects of traffic-related particulate matter (PM) on allergic inflammation of ocular surfaces. BALB/c mice were sensitized with ovalbumin (OVA) and aluminum hydroxide via intraperitoneal injection. Two weeks later, mice were challenged with eye drops containing OVA concomitant with either traffic-related PM2.5 or vehicle eye drops. Topical OVA challenges were administered following unilateral subconjunctival injection of magnetic-bead-sorted CD11c+ dendritic cells (DC). The following were assessed: (1) clinical signs, (2) infiltration of inflammatory cells into conjunctiva, (3) serum levels of OVA-specific IgE production, and (4) T-cell cytokine secretion with topical application of PM2.5, compared to saline vehicle. PM2.5 was found to increase production of OVA-specific IgE in serum and Th2 immune response-related cytokines including interleukin (IL)-4, IL-17A, and IL-13 compared to vehicle control. It is of interest that PM2.5 treatment also elevated the population of mature DCs in draining lymph nodes (LNs). Exposure with PM2.5 was associated with a significant rise in conjunctival expression of IL-1β, IL-6, IL-17, and TNF. After subconjunctival injection of CD11c+DCs from PM2.5-treated allergic conjunctivitis (AC) mice into naïve mice, T cell responses and OVA-specific IgE were also enhanced. Data suggest that traffic-related PM2.5 exacerbated allergic conjunctivitis as evidenced by increased infiltration of inflammatory cells into the conjunctiva and Th2 responses in the draining LNs associated with enhanced maturation of DCs. Our findings provide new insight into the hazardous potential of traffic-related PM2.5 on allergic diseases, such as asthma or atopic dermatitis.
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Affiliation(s)
- Moonwon Hwang
- Department of Ophthalmology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sehyun Han
- Department of Environmental Engineering, Inha University, Incheon, Republic of Korea
| | - Jeong-Won Seo
- Department of Ophthalmology, Hallym University Dongtan Sacred Heart Hospital, College of Medicine, Hallym University, Gyeonggi-do, Republic of Korea
| | - Ki-Joon Jeon
- Department of Environmental Engineering, Inha University, Incheon, Republic of Korea
| | - Hyun Soo Lee
- Department of Ophthalmology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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18
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Flix-Díez L, Delicado-Miralles M, Gurdiel-Álvarez F, Velasco E, Galán-Calle M, Lerma Lara S. Reversed Polarity bi-tDCS over M1 during a Five Days Motor Task Training Did Not Influence Motor Learning. A Triple-Blind Clinical Trial. Brain Sci 2021; 11:brainsci11060691. [PMID: 34070256 PMCID: PMC8225177 DOI: 10.3390/brainsci11060691] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 05/18/2021] [Accepted: 05/22/2021] [Indexed: 12/04/2022] Open
Abstract
Transcranial direct current stimulation (tDCS) has been investigated as a way of improving motor learning. Our purpose was to explore the reversal bilateral tDCS effects on manual dexterity training, during five days, with the retention component measured after 5 days to determine whether somatosensory effects were produced. In this randomized, triple-blind clinical trial, 28 healthy subjects (14 women) were recruited and randomized into tDCS and placebo groups, although only 23 participants (13 women) finished the complete protocol. Participants received the real or placebo treatment during five consecutive days, while performing a motor dexterity training program of 20 min. The motor dexterity and the sensitivity of the hand were assessed pre- and post-day 1, post 5 days of training, and 5 days after training concluded. Training improved motor dexterity, but tDCS only produced a tendency to improve retention. The intervention did not produce changes in the somatosensory variables assessed. Thus, reversal bi-tDCS had no effects during motor learning on healthy subjects, but it could favor the retention of the motor skills acquired. These results do not support the cooperative inter-hemispheric model.
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Affiliation(s)
- Laura Flix-Díez
- Department of Physical Therapy, University of Valencia (UV), 46003 Valencia, Spain;
| | - Miguel Delicado-Miralles
- Instituto de Neurociencias de Alicante (UMH-CSIC), 03550 Sant Joant d’Alacant, Spain; (M.D.-M.); (E.V.)
| | - Francisco Gurdiel-Álvarez
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine University of Rey Juan Carlos, 28922 Alcorcón, Spain;
| | - Enrique Velasco
- Instituto de Neurociencias de Alicante (UMH-CSIC), 03550 Sant Joant d’Alacant, Spain; (M.D.-M.); (E.V.)
| | - María Galán-Calle
- Health Sciences Faculty, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain;
| | - Sergio Lerma Lara
- Health Sciences Faculty, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain;
- Motion in Brains Research Group, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain
- Correspondence: ; Tel.: +34-91-5035900 (ext. 255)
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19
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Jaiswal S, Asper L, Long J, Lee A, Harrison K, Golebiowski B. Ocular and visual discomfort associated with smartphones, tablets and computers: what we do and do not know. Clin Exp Optom 2021; 102:463-477. [DOI: 10.1111/cxo.12851] [Citation(s) in RCA: 103] [Impact Index Per Article: 34.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 08/06/2018] [Accepted: 10/07/2018] [Indexed: 11/29/2022] Open
Affiliation(s)
- Sukanya Jaiswal
- School of Optometry and Vision Science, The University of New South Wales, Sydney, New South Wales, Australia,
| | - Lisa Asper
- School of Optometry and Vision Science, The University of New South Wales, Sydney, New South Wales, Australia,
| | - Jennifer Long
- School of Optometry and Vision Science, The University of New South Wales, Sydney, New South Wales, Australia,
| | - Abigail Lee
- School of Optometry and Vision Science, The University of New South Wales, Sydney, New South Wales, Australia,
| | - Kirsten Harrison
- School of Optometry and Vision Science, The University of New South Wales, Sydney, New South Wales, Australia,
| | - Blanka Golebiowski
- School of Optometry and Vision Science, The University of New South Wales, Sydney, New South Wales, Australia,
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20
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Bron AJ, Willshire C. Tear Osmolarity in the Diagnosis of Systemic Dehydration and Dry Eye Disease. Diagnostics (Basel) 2021; 11:387. [PMID: 33668748 PMCID: PMC7996182 DOI: 10.3390/diagnostics11030387] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 02/17/2021] [Accepted: 02/18/2021] [Indexed: 12/23/2022] Open
Abstract
Systemic dehydration due to inadequate water intake or excessive water loss, is common in the elderly and results in a high morbidity and significant mortality. Diagnosis is often overlooked and there is a need for a simple, bedside diagnostic test in at-risk populations. Body hydration is highly regulated with plasma osmolality (pOsm) being tightly controlled over a wide range of physiological conditions. By contrast, normal tear osmolarity (tOsm) is more variable since the tear film is exposed to evaporation from the open eye. While plasma hyperosmolality is a diagnostic feature of systemic dehydration, tear hyperosmolality, with other clinical features, is diagnostic of dry eye. Studies in young adults subjected to exercise and water-deprivation, have shown that tOsm may provide an index of pOsm, with the inference that it may provide a simple measure to diagnose systemic dehydration. However, since the prevalence of both dry eye and systemic dehydration increases with age, the finding of a raised tOsm in the elderly could imply the presence of either condition. This diagnostic difficulty can be overcome by measuring tear osmolality after a period of evaporative suppression (e.g., a 45 min period of lid closure) which drives tOsm osmolality down to a basal level, close to that of the pOsm. The arguments supporting the use of this basal tear osmolarity (BTO) in the diagnosis of systemic dehydration are reviewed here. Further studies are needed to confirm that the BTO can act as a surrogate for pOsm in both normally hydrated subjects and in patients with systemic dehydration and to determine the minimum period of lid closure required for a simple, "point-of-care" test.
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Affiliation(s)
- Anthony J. Bron
- Nuffield Department of Clinical Neurosciences and Nuffield Laboratory of Ophthalmology, University of Oxford, Oxford OX2 6HZ, UK
| | - Catherine Willshire
- Ophthalmology Research, Hinchingbrooke Hospital, North West Anglia Trust, Huntingdon PE29 6NT, UK;
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21
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Abstract
The precorneal tear film keeps the eye surface moist and helps to maintain normal eye function. The outermost lipid layer of the tear film, which attenuates tear film evaporation, contains meibum secreted from the meibomian gland. Most meibum lipids are neutral, including wax esters (WEs), cholesteryl esters (CEs), and diesters (DEs), along with some polar lipids including free fatty acids (FFAs), O-acyl-ω-hydroxy fatty acids (OAHFAs), and trace phospholipids. Detection of neutral lipids by mass spectrometry (MS) is challenging due to interference from impurities, particularly when working with minute-volume meibum samples. Here, we describe procedures for sample preparation and MS analysis of these elusive meibum lipids that can be used to examine dry eye disease mechanisms. Because the method described here minimizes impurity peaks for lipids generally, neutral and otherwise, it may be applied to high-sensitivity analysis of other biological samples.
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Affiliation(s)
- Jianzhong Chen
- Department of Optometry and Vision Science, The University of Alabama at Birmingham, Birmingham, AL, USA.
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22
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Abstract
Prolonged and continuous daily use of digital screens, or visual display terminals (VDTs), has become the norm in occupational, educational, and recreational settings. An increased global dependence on VDTs has led to a rise in associated visual complaints, including eye strain, ocular dryness, burning, blurred vision, and irritation, to name a few. The principal causes for VDT-associated visual discomfort are abnormalities with oculomotor/vergence systems and dry eye (DE). This review focuses on the latter, as advances in research have identified symptomology and ocular surface parameters that are shared between prolonged VDT users and DE, particularly the evaporative subtype. Several mechanisms have been implicated in VDT-associated DE, including blink anomalies, damaging light emission from modern devices, and inflammatory changes. The presence of preexisting DE has also been explored as an inciting and exacerbating factor. We review the associations between digital screens and DE, mechanisms of damage, and therapeutic options, hoping to raise awareness of this entity with the goal of reducing the global morbidity and economic impact of screen-associated visual disability.
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Affiliation(s)
- Divy Mehra
- Surgical Services, Miami Veterans Affairs Medical Center, Miami, FL
- Bascom Palmer Eye Institute, University of Miami, Miami, FL
| | - Anat Galor
- Surgical Services, Miami Veterans Affairs Medical Center, Miami, FL
- Bascom Palmer Eye Institute, University of Miami, Miami, FL
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23
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Ozek D, Karaca EE, Evren Kemer O. The effect of conjunctivochalasis detected by anterior segment optical coherence tomography on tear function in an elderly population. Ther Adv Ophthalmol 2020; 12:2515841420930876. [PMID: 33225211 PMCID: PMC7649867 DOI: 10.1177/2515841420930876] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 04/24/2020] [Indexed: 11/16/2022] Open
Abstract
Introduction: The aim of this study was to evaluate conjunctivochalasis (CCH) and its relationship with tear meniscus and tear function in an elderly population. Materials and methods: This prospective, observational study included 144 eyes of 144 patients aged >65 years who were referred to our clinic for various reasons. The patients were separated into group 1 including 64 eyes of 64 patients with CCH and group 2 including 80 eyes of 80 patients without CCH. All patients in both groups underwent a full ophthalmological examination, and the presence of CCH, fluorescein tear break-up time (FTBUT) test, Schirmer test, ocular surface staining (Oxford grading score) and OSDI (Ocular Surface Disease Index) test results were recorded. Measurements of the conjunctivochalasis area (CCHA), tear meniscus height (TMH) and tear meniscus area (TMA) were taken using anterior segment optic coherence tomography (AS-OCT). Results: Group 1 comprised 34 females and 30 males with a mean age of 71.15 ± 12.34 years. Group 2 comprised 43 females and 37 males with a mean age of 68.16 ± 6.05 years (p = 0.122). The CCH rate was 44.4% in all of the examined patients. The OSDI score and the ocular surface staining test were significantly higher (p < 0.05), and the FTBUT, TMH and TMA were significantly lower (p < 0.05) in group 1 than in group 2. The Schirmer I test results were not significantly different between the two groups. Conclusion: The prevalence of CCH is quite high in elderly individuals and may disrupt tear function in these patients.
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Affiliation(s)
- Dilay Ozek
- Associate Professor, Department of Ophthalmology, Ankara City Hospital, Dumlupinar Bulvari 364/B D.24 Etimesgut, Ankara, Turkey
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24
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Talens-Estarelles C, García-Marqués JV, Cervino A, García-Lázaro S. Use of digital displays and ocular surface alterations: A review. Ocul Surf 2020; 19:252-265. [PMID: 33053438 DOI: 10.1016/j.jtos.2020.10.001] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 09/15/2020] [Accepted: 10/07/2020] [Indexed: 11/29/2022]
Abstract
Digital display use has been accepted to be implicated as a contributing factor for dry eye disease (DED). Abnormal blinking during computer operation, including a reduced blink rate and an incomplete eyelid closure, increased palpebral fissure as consequence of high visualization angles, and meibomian gland dysfunction associated to long-term display use, are behind the increased prevalence of dry eye signs and symptoms found in digital display users. Previous research reveals significant reductions in tear volume and stability, alterations in tear film composition, including increased osmolarity, inflammatory cytokines, oxidative stress markers and reduced mucin secretion, eyelid abnormalities and ocular surface damage, encompassing corneal and conjunctival staining and bulbar redness, as a direct consequence of digital display use. In this regard, individual differences in the way that the various digital displays are typically set up and used may account for differences in their effects on induced dryness signs and symptoms. Furthermore, factors such as the use of contact lenses or inappropriate working environments, usually accompanying the use of displays, may significantly increase the prevalence and the severity of induced dry eye. Other factors, such as old age and female gender are also relevant in the appearance of associated alterations. Finally, clinicians should adopt a treatment strategy based on a multidirectional approach, with various treatments being applied in conjunction.
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Affiliation(s)
- Cristian Talens-Estarelles
- Department of Optics & Optometry & Vision Sciences. University of Valencia. Dr. Moliner, 50 46100, Burjassot (Valencia), Spain
| | - José Vicente García-Marqués
- Department of Optics & Optometry & Vision Sciences. University of Valencia. Dr. Moliner, 50 46100, Burjassot (Valencia), Spain
| | - Alejandro Cervino
- Department of Optics & Optometry & Vision Sciences. University of Valencia. Dr. Moliner, 50 46100, Burjassot (Valencia), Spain
| | - Santiago García-Lázaro
- Department of Optics & Optometry & Vision Sciences. University of Valencia. Dr. Moliner, 50 46100, Burjassot (Valencia), Spain.
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Karakus S, Dai X, Zhu X, Gottsch JD. The role of lid margin structures in the meibomian gland function and ocular surface health. EXPERT REVIEW OF OPHTHALMOLOGY 2020. [DOI: 10.1080/17469899.2021.1826309] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Sezen Karakus
- Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USA
| | - Xi Dai
- School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Xi Zhu
- Department of Biology and Public Health Studies, Johns Hopkins University, Baltimore, MD, USA
| | - John D Gottsch
- Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USA
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Loss of Concentration May Occur by Blink Inhibition in DED Simulation Models. Life (Basel) 2020; 10:life10050061. [PMID: 32414123 PMCID: PMC7281572 DOI: 10.3390/life10050061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 05/12/2020] [Accepted: 05/12/2020] [Indexed: 01/08/2023] Open
Abstract
Purpose: Patients with dry eye disease (DED) often suffer productivity loss and distress due to bothersome symptoms. The aim of this study was to objectively quantify and compare productivity-related emotional states obtained from brain waveforms in natural and simulated DED conditions. Method: 25 healthy adults (6 females and 19 males; mean age ± standard deviation, 22.6 ± 8.3 years) were recruited for the study, which included an electroencephalogram (EEG), measurements of interblinking time, and questionnaires. DED was simulated by suppressing blinking, while spontaneous blinking served as a control. Elements of concentration, stress, and alertness were extracted from the raw EEG waveforms and the values were compared during spontaneous and suppressed blinking. The relation with DED-related parameters was then explored. Written informed consent was obtained from all participants. Results: All participants successfully completed the experimental protocol. Concentration significantly decreased during suppressed blinking in 20 participants (80%), when compared with spontaneous blinking, whereas there were no or small differences in stress or alertness between spontaneous and suppressed blinking. The change in concentration was correlated with interblinking time (β = −0.515, p = 0.011). Conclusion: Loss of concentration was successfully captured in an objective manner using the EEG. The present study may enable us to understand how concentration is affected during blink suppression, which may happen in office work, particularly during computer tasks. Further study using detailed ocular evaluation is warranted to explore the effect of different interventions.
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Yang M, Hu Z, Yue R, Yang L, Zhang B, Chen Y. The Efficacy and Safety of Qiming Granule for Dry Eye Disease: A Systematic Review and Meta-Analysis. Front Pharmacol 2020; 11:580. [PMID: 32425798 PMCID: PMC7204435 DOI: 10.3389/fphar.2020.00580] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Accepted: 04/15/2020] [Indexed: 01/19/2023] Open
Abstract
Background Dry eye disease (DED) is a common complication in clinical practice. Qiming granule, a traditional Chinese patent medicine, is widely used in treating DED in China. However, its effect is still largely unknown. Objectives This research aims to evaluate the efficacy and safety of QG on DED. Methods Three English database and four Chinese databases without restriction on language and publication bias were searched. Qualified literature was selecting according to inclusion and exclusion criteria, extracted the data, and conducted a meta-analysis. Results A total of 11 articles were included in this meta-analysis. The methodological quality of included studies was low. The results showed that QG was effective for DED (RR:1.26, 95%CI:1.12 to 1.41, P=0.0001). The results combined with random effects model showed that QG could significantly prolong the tear film break up time (MD: 2.93, 95% CI: 2.22 to 3.65, P < 0.00001), increase the amount of tears in patients with DED (MD: 2.94, 95% CI: 1.83 to 4.04, P < 0.00001) and repair the corneal defects in patients (MD: -0.71, 95% CI: -1.25 to -0.17, P < 0.00001). Conclusions This study found that despite of the apparently positive results of some outcomes, it is premature to confirm the efficacy of QG in treating DED. More high-quality studies are still needed in the future to further confirm the efficacy and safety.
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Affiliation(s)
- Maoyi Yang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Zhipeng Hu
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Rensong Yue
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Liangjun Yang
- Department of Gastroenterology, Tongde Hospital of Zhejiang Province, Hangzhou, China
| | - Boxun Zhang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yuan Chen
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Sagara H, Sekiryu T, Imaizumi K, Shintake H, Sugiyama U, Maehara H. Impact of tear metrics on the reliability of perimetry in patients with dry eye. PLoS One 2019; 14:e0222467. [PMID: 31527920 PMCID: PMC6748565 DOI: 10.1371/journal.pone.0222467] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 08/30/2019] [Indexed: 11/20/2022] Open
Abstract
Background The application of artificial tears before performing perimetry can improve the reliability and results of perimetry in patients with glaucoma and dry eye (DE). However, the effects of ocular surface and tear film conditions on perimetry measurements and reliability have not been fully characterized. Methods This prospective, cross-sectional, multicenter study investigated tear metrics in perimetry and assessed the relationships that existed among ocular surface condition, tear condition, and perimetry reliability. Forty-three eyes (43 patients) with DE disease according to the 2016 Japanese diagnostic criteria of DE and 43 eyes (43 subjects) of age- and visual field mean deviation-matched normal control subjects were studied. Perimetry was performed using the Humphrey Field Analyzer (30–2 SITA-Standard). Schirmer’s test, strip meniscometry value, blink rate, tear film break-up time (TFBUT), fluorescein staining of ocular surface, and Dry Eye-related Quality of Life Score (DEQS) were measured. Blink rate was re-measured during perimetry. TFBUT and fluorescein staining were re-evaluated after perimetry. Perimetry reliability was evaluated with fixation loss, false-positive, and false-negative rates. Results Blink rate during perimetry was significantly lower for both patients with DE and normal controls (both P<0.001). TFBUT after perimetry was significantly higher than before perimetry in patients with DE (P<0.001). Fluorescein staining of ocular surface was significantly increased in patients with DE and normal control subjects (P = 0.002 and P<0.001, respectively). Spearman correlation analysis revealed that blink rate during perimetry was negatively correlated with fixation-loss rate (r = -0.393, P = 0.009) in patients with DE. Conclusions Performing perimetry was associated with a significant change in tear condition and ocular surface condition in both patients with DE and normal control subjects. The changes in tear condition and ocular surface condition may impact the reliability of perimetry in patients with DE.
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Affiliation(s)
- Hideto Sagara
- The Marui Eye Clinic, Minamisoma City, Fukushima, Japan
- Department of Ophthalmology, Fukushima Medical University School of Medicine, Fukushima City, Fukushima, Japan
- * E-mail:
| | - Tetsuju Sekiryu
- Department of Ophthalmology, Fukushima Medical University School of Medicine, Fukushima City, Fukushima, Japan
| | - Kimihiro Imaizumi
- Department of Ophthalmology, Fukushima Medical University School of Medicine, Fukushima City, Fukushima, Japan
| | - Hiroaki Shintake
- Department of Ophthalmology, Fukushima Medical University School of Medicine, Fukushima City, Fukushima, Japan
| | - Urara Sugiyama
- Department of Ophthalmology, Fukushima Medical University School of Medicine, Fukushima City, Fukushima, Japan
| | - Hiroki Maehara
- Department of Ophthalmology, Fukushima Medical University School of Medicine, Fukushima City, Fukushima, Japan
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Natural history of dry eye disease: Perspectives from inter-ethnic comparison studies. Ocul Surf 2019; 17:424-433. [DOI: 10.1016/j.jtos.2019.03.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Revised: 03/06/2019] [Accepted: 03/12/2019] [Indexed: 02/03/2023]
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Hirata H, Dallacasagrande V, Mizerska K, Ivakhnitskaia E, Rosenblatt MI. Ambient Air Currents Activate Corneal Nerves During Ocular Desiccation in Rats: Simultaneous Recordings of Neural Activity and Corneal Temperature. Invest Ophthalmol Vis Sci 2019; 59:4031-4043. [PMID: 30098191 PMCID: PMC6082328 DOI: 10.1167/iovs.18-24604] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Purpose Previously we found two types of corneal neurons that we hypothesized to play an important role in tearing. One type is called low threshold–cold sensitive plus dry sensitive (LT-CS + DS), and the other is termed high threshold–cold sensitive plus dry sensitive (HT-CS + DS). The present study examined critical stimuli influencing the activity of these neurons to elucidate environmental factors that may trigger this ocular reflex. Methods Single corneal neurons were extracellularly recorded from the trigeminal ganglia in response to ocular stimuli that mimic environmental conditions one encounters in daily life. They included an ocular desiccation and slight air currents and were presented while simultaneously monitoring the ocular surface temperatures (OST) in rats. Results The results showed that the changes in steady state (SS) activity of the neurons closely followed the changes in SS OST: during the sustained ocular desiccation, neural firing displayed numerous small sudden increases in activities (“spiking”); these “spiking” activities of LT-CS + DS neurons were replicated by a minute air current that induced slight ocular surface cooling of approximately 0.2–0.1°C; and the responses of HT-CS + DS neurons showed an inconsistent relationship to the changes in SS OST or exhibited little evidence for “spiking” activities. Conclusions These results suggest that LT-CS + DS neurons play a role in the afferent trigger of tearing as we face the environment, exposing the cornea to prevailing air currents that produce a slight cooling of the ocular surface. By contrast, HT-CS + DS neurons may serve to protect the eyes from extreme dryness by eliciting nociception-evoked tearing when the OST or osmolarity of tears becomes injurious.
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Affiliation(s)
- Harumitsu Hirata
- Department of Ophthalmology, Weill Cornell Medical College, New York, New York, United States
| | | | - Kamila Mizerska
- Department of Ophthalmology, Weill Cornell Medical College, New York, New York, United States
| | - Evguenia Ivakhnitskaia
- Department of Ophthalmology and Visual Sciences, University of Illinois College of Medicine, Chicago, Illinois, United States
| | - Mark I Rosenblatt
- Department of Ophthalmology and Visual Sciences, University of Illinois College of Medicine, Chicago, Illinois, United States
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Fujita H, Sano K, Baba T, Tanaka T, Ohno-Matsui K. Blind working time in visual display terminal users. J Occup Health 2019; 61:175-181. [PMID: 30866126 PMCID: PMC6499340 DOI: 10.1002/1348-9585.12027] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 08/07/2018] [Accepted: 08/08/2018] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVES Blind working (BW) time (time during which vision is not required), the interblink interval (IBI), and subjective symptoms were investigated in workers using visual display terminals (VDTs). SUBJECTS AND METHODS To investigate BW time, 10 VDT users were instructed to close their eyes when this did not interfere with their work. They were video recorded for 60 minutes using a webcam attached to the display on which they were engaged in regular data input tasks, and BW time was measured. The values of the IBI during the final 20 minutes of the BW experiment and during the final 20 minutes of normal working without BW were compared. A questionnaire was administered to investigate subjective symptoms using a visual analogue scale. RESULTS The total BW time during the final 20-minute period was 20.6-121.0 seconds (1.7%-10.1%). The mean IBI of 5.5 ± 4.5 seconds during the BW experiment was not significantly different from that of 6.2 ± 5.6 seconds during normal working, and the mean of three IBIs immediately after BW during the BW experiment was 2.7 ± 1.0 seconds, significantly shorter than the 6.2 ± 5.6 seconds during normal working. Dry eye, ocular fatigue, and blurred vision during normal working improved when subjects were engaged in BW. CONCLUSIONS VDT users could engage in BW during VDT work, the IBI was shorter immediately after BW, and subjective symptoms improved. These results suggest that BW may provide a more effective measure for the management of VDT working time.
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Affiliation(s)
- Hiroki Fujita
- Fujita Eye Clinic, Chiba, Japan.,Kuwano Kyoritsu Hospital, Fukushima, Japan
| | - Kenji Sano
- Asumigaoka Sano Eye Clinic, Chiba, Japan.,Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Graduate School, Tokyo, Japan
| | - Tomio Baba
- Kuwano Kyoritsu Hospital, Fukushima, Japan
| | | | - Kyoko Ohno-Matsui
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Graduate School, Tokyo, Japan
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Sano K, Kawashima M, Imada T, Suzuki T, Nakamura S, Mimura M, Tanaka KF, Tsubota K. Enriched environment alleviates stress-induced dry-eye through the BDNF axis. Sci Rep 2019; 9:3422. [PMID: 30833600 PMCID: PMC6399317 DOI: 10.1038/s41598-019-39467-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 01/24/2019] [Indexed: 01/20/2023] Open
Abstract
The number of patients with dry eye disease (DED) is increasing, and DED has become an urgent public health problem. A comorbidity of mental disorders has been reported in DED patients. We hypothesized that physical and psychological stressors impair tear secretion. To examine the relationship between stress loading and decreased tear secretion, we established a stress-induced DED mouse model, which permitted us to address the underlying mechanism of pathogenesis and resilience. Enriched environment (EE) was an effective intervention to prevent and alleviate stress-induced decreased tear secretion. Because stress loading resulted in decreased brain-derived neurotrophic factor (BDNF) expression while EE resulted in increased expression, we focused on the role of BDNF in tear secretion. Using two distinct Bdnf gene knockdown mice, we evaluated whether BDNF was a deterministic factor in regulating tear secretion in healthy and stressed conditions. Bdnf knockdown mice showed decreased basal tear secretion and loss of stress tolerance by EE for tear secretion. These results suggest that BDNF expression is related to tear secretion and to the pathology of DED.
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Affiliation(s)
- Kokoro Sano
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, 160-8582, Japan
| | - Motoko Kawashima
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, 160-8582, Japan
| | - Toshihiro Imada
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, 160-8582, Japan
| | - Toru Suzuki
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, 160-8582, Japan
| | - Shigeru Nakamura
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, 160-8582, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, 160-8582, Japan
| | - Kenji F Tanaka
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, 160-8582, Japan.
| | - Kazuo Tsubota
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, 160-8582, Japan.
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Relationship Between Ocular Surface Epithelial Damage, Tear Abnormalities, and Blink in Patients With Dry Eye. Cornea 2019; 38:318-324. [PMID: 30601288 DOI: 10.1097/ico.0000000000001841] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Considering that tears play the role of a lubricant, it is speculated that in the pathophysiology of dry eye, increased friction during blinking results in corneal and conjunctival damage, which may subsequently affect the blink. The purpose of this study was to investigate the relationship between ocular surface epithelial damage, tear abnormalities, and blinks in patients with dry eye. METHODS This study involved 45 eyes of 45 female patients with dry eye (mean age: 57.6 years). In all eyes, tear meniscus radius (mm), spread grade of the tear film lipid layer (SG: 1-5: 1 being the best), fluorescein breakup time (FBUT, seconds), corneal and bulbar conjunctival epithelial damage (CED: 15 points maximum and CONJUNCTIVAL EPITHELIAL DAMAGE (CjED): 6 points maximum, respectively), and Schirmer I test (ST1, mm) were evaluated. Blink rate (BR, blinks per minute), palpebral aperture height (mm), upper-eyelid opening-phase amplitude/upper-eyelid closing-phase amplitude (mm), upper-eyelid opening-phase duration/upper-eyelid closing-phase duration (ms), and upper-eyelid opening-phase maximum velocity/upper-eyelid closing-phase maximum velocity (mm/s) were measured using a custom-made high-speed blink analyzer. Finally, the factors that determine CED and CjED were investigated by multiple regression analysis, in which the parameters were chosen using the stepwise procedure. RESULTS CED and CjED were found to be described as 2.687 + (1.816 × SG) - (0.937 × FBUT) (R = 0.656, P < 0.0001) and 0.684 + (0.801 × SG) - (0.526 × FBUT) - (0.041 × ST1) + (0.010 × upper-eyelid closing-phase maximum velocity) (R = 0.714, P < 0.0001), respectively. CONCLUSIONS Although CED was significantly related to only tear abnormalities, CjED was significantly related to tear abnormalities and blinking.
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34
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Tear film change and ocular symptoms after reading printed book and electronic book: a crossover study. Jpn J Ophthalmol 2019; 63:137-144. [DOI: 10.1007/s10384-018-00648-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 11/05/2018] [Indexed: 10/27/2022]
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35
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Dry Eye Syndrome Preferred Practice Pattern®. Ophthalmology 2019; 126:P286-P334. [DOI: 10.1016/j.ophtha.2018.10.023] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 10/09/2018] [Indexed: 01/04/2023] Open
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The influences of smartphone use on the status of the tear film and ocular surface. PLoS One 2018; 13:e0206541. [PMID: 30379901 PMCID: PMC6209417 DOI: 10.1371/journal.pone.0206541] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 10/15/2018] [Indexed: 11/19/2022] Open
Abstract
PURPOSE To investigate the influences of smartphone use on ocular symptoms, status of the tear film, and oxidative stress indices in the tears and at the ocular surface. METHODS Eighty healthy volunteers were enrolled in the study. Subjective symptoms and asthenopia were evaluated using the ocular surface disease index (OSDI), visual analogue scale (VAS), and computer vision syndrome (CVS) score before and after smartphone or computer display (control) use. The status of the tear film was evaluated using fluorescein film break-up time (FBUT), non-invasive keratograph break up time (NIKBUT), Schirmer score, keratoepitheliopathy (KEP), and tear meniscus height (TMH). Oxidative stress markers in the tear film including hexanoyl lysine (HEL), 4-hydroxy-2-nonenal (4-HNE), malondialdehyde (MDA), and 8-oxo-2'-deoxyguanosine (8-OHdG) in the tear film were measured using ELISA. Reactive oxygen species (ROS) at the ocular surface were measured through 2',7'-dichloro-dihydrofluorescein diacetate. All measurements were conducted at baseline, and after use for 1 and 4 h. RESULTS All parameters showed no significant group-wise differences at baseline. Scores of OSDI, VAS, fatigue, burning sensation, and dryness showed significant increases after 1 and 4 h of smartphone use compared with those at baseline (all P < 0.05). The smartphone group showed higher OSDI, fatigue, burning, and dryness scores than the control group at 4 h. Smartphone use showed significantly decreased FBUT and NIBUT at 4 h than those at baseline (P < 0.01). In the smartphone group, the concentration of HEL significantly increased at 4 h compared with that at baseline and 1 h (P < 0.01). Both groups showed increased ROS with higher value in the smartphone group versus the control group at 4 h (P < 0.01). CONCLUSIONS Smartphone use could not only aggravate subjective symptom indices such as the OSDI, VAS, and CVS but also induce tear film instability and oxidative stress indices in the tears and at the ocular surface.
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Affiliation(s)
- Janine A Clayton
- From the Office of Research on Women's Health, National Institutes of Health, Bethesda, MD
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38
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Tear evaporation rates: What does the literature tell us? Cont Lens Anterior Eye 2018; 41:297-306. [DOI: 10.1016/j.clae.2017.12.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Revised: 10/18/2017] [Accepted: 12/01/2017] [Indexed: 12/15/2022]
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39
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Effects of collected road dusts on cell viability, inflammatory response, and oxidative stress in cultured human corneal epithelial cells. Toxicol Lett 2018; 284:152-160. [DOI: 10.1016/j.toxlet.2017.12.012] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 12/16/2017] [Accepted: 12/19/2017] [Indexed: 11/21/2022]
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40
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Willshire C, Bron AJ, Gaffney EA, Pearce EI. Basal Tear Osmolarity as a metric to estimate body hydration and dry eye severity. Prog Retin Eye Res 2018; 64:56-64. [PMID: 29476817 DOI: 10.1016/j.preteyeres.2018.02.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 02/02/2018] [Accepted: 02/20/2018] [Indexed: 01/28/2023]
Abstract
The osmolarities of various bodily fluids, including tears, saliva and urine, have been used as indices of plasma osmolality, a measure of body hydration, while tear osmolarity is used routinely in dry eye diagnosis, the degree of tear hyperosmolarity providing an index of disease severity. Systemic dehydration, due to inadequate water intake or excessive water loss is common in the elderly population, has a high morbidity and may cause loss of life. Its diagnosis is often overlooked and there is a need to develop a simple, bedside test to detect dehydration in this population. We hypothesize that, in the absence of tear evaporation and with continued secretion, mixing and drainage of tears, tear osmolarity falls to a basal level that is closer to that of the plasma than that of a tear sample taken in open eye conditions. We term this value the Basal Tear Osmolarity (BTO) and propose that it may be measured in tear samples immediately after a period of evaporative suppression. This value will be particular to an individual and since plasma osmolarity is controlled within narrow limits, it is predicted that it will be stable and have a small variance. It is proposed that the BTO, measured immediately after a defined period of eye closure, can provide a new metric in the diagnosis of systemic dehydration and a yardstick against which to gauge the severity of dry eye disease.
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Affiliation(s)
- C Willshire
- Vision and Eye Research Unit, Anglia Ruskin University, Cambridge, UK
| | - A J Bron
- Vision and Eye Research Unit, Anglia Ruskin University, Cambridge, UK; Nuffield Department of Clinical Neurosciences and Nuffield Laboratory of Ophthalmology, University of Oxford, UK.
| | - E A Gaffney
- Wolfson Centre of Mathematical Biology, Mathematical Institute, University of Oxford, UK
| | - E Ian Pearce
- School of Health and Life Sciences, Glasgow Caledonian University, UK
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Vu CHV, Kawashima M, Yamada M, Suwaki K, Uchino M, Shigeyasu C, Hiratsuka Y, Yokoi N, Tsubota K. Influence of Meibomian Gland Dysfunction and Friction-Related Disease on the Severity of Dry Eye. Ophthalmology 2018; 125:1181-1188. [PMID: 29459039 DOI: 10.1016/j.ophtha.2018.01.025] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 01/18/2018] [Accepted: 01/19/2018] [Indexed: 10/18/2022] Open
Abstract
PURPOSE To evaluate the effect of meibomian gland dysfunction (MGD) and friction-related disease (FRD) on the severity of dry eye disease (DED). DESIGN Cross-sectional observational study. PARTICIPANTS This study enrolled 449 patients with DED (63 men and 386 women; mean age, 62.6±15.7 years [range, 21-90 years]) for analysis. METHODS Subjective symptoms, the ocular surface, tear function, and the presence of MGD and FRD (superior limbic keratoconjunctivitis, conjunctivochalasis, and lid wiper epitheliopathy) were investigated. MAIN OUTCOME MEASURES Schirmer value, tear film breakup time (TBUT), and keratoconjunctival score. RESULTS We classified the participants into aqueous-deficient dry eye (ADDE; n = 231 [51.4%]) and short TBUT dry eye subtype (TBUT-DE; n = 109 [24.3%]) subgroups. The TBUT was shorter in patients with MGD than in those without MGD, whereas other ocular signs showed no difference (TBUT: MGD present, 1.97±1.02 seconds; MGD absent, 2.94±1.63 seconds [P < 0.001]; ADDE/MGD present, 1.94±1.08 seconds; ADDE/MGD absent, 2.77±1.61 seconds [P < 0.001]; short TBUT-DE/MGD present, 2.07±0.97 seconds; short TBUT-DE/MGD absent, 2.94±1.23 seconds [P = 0.01]). The ADDE patients with FRD showed a worse TBUT than ADDE patients without FRD (TBUT: ADDE/FRD present, 2.08±1.39 seconds; ADDE/FRD absent, 2.92±1.54 seconds; P < 0.001). CONCLUSIONS This study showed associations between MGD, FRD, or both and ocular signs in DED. In the presence of MGD, FRD, or both, TBUT was significantly shortened regardless of the dry eye status or subtype.
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Affiliation(s)
- Chi Hoang Viet Vu
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Motoko Kawashima
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.
| | - Masakazu Yamada
- Department of Ophthalmology, Kyorin University, Tokyo, Japan
| | - Kazuhisa Suwaki
- Department of Japan Medical Affairs, Santen Pharmaceutical Co., Ltd., Osaka, Japan
| | - Miki Uchino
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Chika Shigeyasu
- Department of Ophthalmology, Kyorin University, Tokyo, Japan
| | - Yoshimune Hiratsuka
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Norihiko Yokoi
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kazuo Tsubota
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
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Giannaccare G, Versura P, Sebastiani S, Fariselli C, Pellegrini M, Campos E. Dry eye disease in strabismus patients: Does eye deviation harm ocular surface? Med Hypotheses 2017; 111:15-18. [PMID: 29406988 DOI: 10.1016/j.mehy.2017.12.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 12/13/2017] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Dry eye disease is a multifactorial disease which affects the ocular surface system, and determines ocular discomfort symptoms and visual disturbance. Various types of ocular surgery, including strabismus one, represents a recognized cause for iatrogenic dry eye. However, it is not uncommon that strabismus patients, even not undergone to surgery, report symptoms of ocular discomfort and dryness. Hypothesis We hypothesize that two possible mechanisms may determine dry eye in strabismus patients by setting up a specific vicious circle: firstly, the increased exposure of the area of the bulbar conjunctiva located on the opposite side compared to the deviation may cause the thinning of the tear film lipid layer, with increased tear film instability; secondly, the dysfunctional lubricity secondary to the altered relationship between the eyelids and the deviated globe may cause blinking-related microtrauma, and thus inflammation and tear hyperosmolarity. These two entry points into the vicious circle of dry eye may determine a cascade of detrimental mechanisms, leading to further damage of the tear film, thus closing the disease circle. DISCUSSION Strabismus patients may be affected by signs and symptoms of dry eye syndrome. The increased exposure of the bulbar conjunctival area along with the dysfunctional lubricity between the eyelids and the deviated eye could be the main underlying pathophysiological mechanisms acting as entry points into the vicious circle of dry eye disease. If our hypothesis was to be confirmed, ocular surface parameters should be routinely investigated in strabismus patients, whilethe use of tear substitutes with the aim of moistening and nourishing the ocular surface could help in reducing dry eye signs and symptoms.
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Affiliation(s)
- Giuseppe Giannaccare
- Ophthalmology Unit, S.Orsola-Malpighi Teaching Hospital, University of Bologna, Bologna, Italy.
| | - Piera Versura
- Ophthalmology Unit, S.Orsola-Malpighi Teaching Hospital, University of Bologna, Bologna, Italy
| | - Stefano Sebastiani
- Ophthalmology Unit, S.Orsola-Malpighi Teaching Hospital, University of Bologna, Bologna, Italy
| | - Chiara Fariselli
- Ophthalmology Unit, S.Orsola-Malpighi Teaching Hospital, University of Bologna, Bologna, Italy
| | - Marco Pellegrini
- Ophthalmology Unit, S.Orsola-Malpighi Teaching Hospital, University of Bologna, Bologna, Italy
| | - Emilio Campos
- Ophthalmology Unit, S.Orsola-Malpighi Teaching Hospital, University of Bologna, Bologna, Italy
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McMonnies CW. Conjunctival Tear Layer Temperature, Evaporation, Hyperosmolarity, Inflammation, Hyperemia, Tissue Damage, and Symptoms: A Review of an Amplifying Cascade. Curr Eye Res 2017; 42:1574-1584. [DOI: 10.1080/02713683.2017.1377261] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Charles W. McMonnies
- School of Optometry and Vision Science, University of New South Wales, Kensington, Australia
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Randomized Trial of Desktop Humidifier for Dry Eye Relief in Computer Users. Optom Vis Sci 2017; 94:1052-1057. [DOI: 10.1097/opx.0000000000001136] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Poh S, Lee R, Gao J, Tan C, Gupta P, Sabanayagam C, Cheng CY, Wong TY, Tong L. Factors that influence tear meniscus area and conjunctivochalasis: The Singapore Indian eye study. Ophthalmic Epidemiol 2017; 25:70-78. [DOI: 10.1080/09286586.2017.1351999] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
| | - Ryan Lee
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Singapore National Eye Centre, Singapore
| | - Jennifer Gao
- The Ottawa Eye Institute, University of Ottawa, Ottawa, Canada
| | - Carin Tan
- Singapore National Eye Centre, Singapore
| | | | | | - Ching-Yu Cheng
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Singapore National Eye Centre, Singapore
- Singapore Eye Research Institute, Singapore
- Duke-NUS Medical School, Singapore
| | - Tien-Yin Wong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Singapore National Eye Centre, Singapore
- Singapore Eye Research Institute, Singapore
- Duke-NUS Medical School, Singapore
| | - Louis Tong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Singapore National Eye Centre, Singapore
- Singapore Eye Research Institute, Singapore
- Duke-NUS Medical School, Singapore
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Bron AJ, de Paiva CS, Chauhan SK, Bonini S, Gabison EE, Jain S, Knop E, Markoulli M, Ogawa Y, Perez V, Uchino Y, Yokoi N, Zoukhri D, Sullivan DA. TFOS DEWS II pathophysiology report. Ocul Surf 2017; 15:438-510. [PMID: 28736340 DOI: 10.1016/j.jtos.2017.05.011] [Citation(s) in RCA: 1001] [Impact Index Per Article: 143.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 05/26/2017] [Indexed: 12/18/2022]
Abstract
The TFOS DEWS II Pathophysiology Subcommittee reviewed the mechanisms involved in the initiation and perpetuation of dry eye disease. Its central mechanism is evaporative water loss leading to hyperosmolar tissue damage. Research in human disease and in animal models has shown that this, either directly or by inducing inflammation, causes a loss of both epithelial and goblet cells. The consequent decrease in surface wettability leads to early tear film breakup and amplifies hyperosmolarity via a Vicious Circle. Pain in dry eye is caused by tear hyperosmolarity, loss of lubrication, inflammatory mediators and neurosensory factors, while visual symptoms arise from tear and ocular surface irregularity. Increased friction targets damage to the lids and ocular surface, resulting in characteristic punctate epithelial keratitis, superior limbic keratoconjunctivitis, filamentary keratitis, lid parallel conjunctival folds, and lid wiper epitheliopathy. Hybrid dry eye disease, with features of both aqueous deficiency and increased evaporation, is common and efforts should be made to determine the relative contribution of each form to the total picture. To this end, practical methods are needed to measure tear evaporation in the clinic, and similarly, methods are needed to measure osmolarity at the tissue level across the ocular surface, to better determine the severity of dry eye. Areas for future research include the role of genetic mechanisms in non-Sjögren syndrome dry eye, the targeting of the terminal duct in meibomian gland disease and the influence of gaze dynamics and the closed eye state on tear stability and ocular surface inflammation.
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Affiliation(s)
- Anthony J Bron
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK; Vision and Eye Research Unit, Anglia Ruskin University, Cambridge, UK.
| | - Cintia S de Paiva
- Department of Ophthalmology, Baylor College of Medicine, Houston, TX, USA
| | - Sunil K Chauhan
- Schepens Eye Research Institute & Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Stefano Bonini
- Department of Ophthalmology, University Campus Biomedico, Rome, Italy
| | - Eric E Gabison
- Department of Ophthalmology, Fondation Ophtalmologique Rothschild & Hôpital Bichat Claude Bernard, Paris, France
| | - Sandeep Jain
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Erich Knop
- Departments of Cell and Neurobiology and Ocular Surface Center Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Maria Markoulli
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Yoko Ogawa
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Victor Perez
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA
| | - Yuichi Uchino
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Norihiko Yokoi
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Driss Zoukhri
- Tufts University School of Dental Medicine, Boston, MA, USA
| | - David A Sullivan
- Schepens Eye Research Institute & Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
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Abstract
The members of the Tear Film Subcommittee reviewed the role of the tear film in dry eye disease (DED). The Subcommittee reviewed biophysical and biochemical aspects of tears and how these change in DED. Clinically, DED is characterized by loss of tear volume, more rapid breakup of the tear film and increased evaporation of tears from the ocular surface. The tear film is composed of many substances including lipids, proteins, mucins and electrolytes. All of these contribute to the integrity of the tear film but exactly how they interact is still an area of active research. Tear film osmolarity increases in DED. Changes to other components such as proteins and mucins can be used as biomarkers for DED. The Subcommittee recommended areas for future research to advance our understanding of the tear film and how this changes with DED. The final report was written after review by all Subcommittee members and the entire TFOS DEWS II membership.
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Jones L, Downie LE, Korb D, Benitez-del-Castillo JM, Dana R, Deng SX, Dong PN, Geerling G, Hida RY, Liu Y, Seo KY, Tauber J, Wakamatsu TH, Xu J, Wolffsohn JS, Craig JP. TFOS DEWS II Management and Therapy Report. Ocul Surf 2017; 15:575-628. [DOI: 10.1016/j.jtos.2017.05.006] [Citation(s) in RCA: 578] [Impact Index Per Article: 82.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 05/03/2017] [Indexed: 02/06/2023]
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Visual acuity and quality of life in dry eye disease: Proceedings of the OCEAN group meeting. Ocul Surf 2017; 15:169-178. [DOI: 10.1016/j.jtos.2016.11.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 10/14/2016] [Accepted: 11/28/2016] [Indexed: 11/19/2022]
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Comparing the Effects of Particulate Matter on the Ocular Surfaces of Normal Eyes and a Dry Eye Rat Model. Cornea 2017; 36:605-610. [DOI: 10.1097/ico.0000000000001171] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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