1
|
Maulvi FA, Desai DT, Kalaiselvan P, Dumpati S, Kuppusamy R, Masoudi S, Shah DO, Willcox MDP. Lipid-based eye drop formulations for the management of evaporative dry eyes. Cont Lens Anterior Eye 2024; 47:102154. [PMID: 38523013 DOI: 10.1016/j.clae.2024.102154] [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: 10/20/2023] [Revised: 03/01/2024] [Accepted: 03/21/2024] [Indexed: 03/26/2024]
Abstract
Dry eye disease is a progressive prevalent ocular surface disorder that arises from various factors and is characterized by insufficient quality and/or quantity of tears. The underlying pathophysiology is intricate and can progress to chronic, difficult-to-treat conditions. Multiple strategies and therapeutic approaches are utilized in its management that target one or more etiopathological components of dry eyes, which may include aqueous tear deficiency or evaporative dry eyes. The primary focus of this paper is on treatment alternatives that utilize lipids for the treatment of evaporative dry eyes. This may arise from either abnormal lipid production or inadequate lipid spreading caused by meibomian gland dysfunction. The hypothesis behind the development of these lipid-containing eye drops is that if they can imitate the lipid layer, they may be able to help in the management of the signs and symptoms of evaporative dry eyes. The lipids used in commercial formulations for dry eyes are mineral oil, castor oil, phospholipids, omega-3 fatty acid, and medium-chain triglycerides. The literature suggests the potential of lipid-containing eye drops to alleviate some of the signs and symptoms and enhance the quality of life for individuals suffering from evaporative dry eyes.
Collapse
Affiliation(s)
- Furqan A Maulvi
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales 2052, Australia; Maliba Pharmacy College, Uka Tarsadia University, Surat 394350, India.
| | - Ditixa T Desai
- Maliba Pharmacy College, Uka Tarsadia University, Surat 394350, India
| | - Parthasarathi Kalaiselvan
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales 2052, Australia
| | - Srikanth Dumpati
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales 2052, Australia
| | - Rajesh Kuppusamy
- Faculty of Science, School of Chemistry, The University of Sydney, New South Wales 2006, Australia
| | - Simin Masoudi
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales 2052, Australia
| | - Dinesh O Shah
- Department of Chemical Engineering and Department of Anesthesiology, University of Florida, Gainesville, FL 32611, USA
| | - Mark D P Willcox
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales 2052, Australia
| |
Collapse
|
2
|
Vaughan M, García-Porta N, Tabernero J, Gantes-Nuñez J, Artal P, Pardhan S. Ocular effects of exposure to low-humidity environment with contact lens wear: A pilot study. Ophthalmic Physiol Opt 2024; 44:718-726. [PMID: 38551074 DOI: 10.1111/opo.13308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 03/13/2024] [Accepted: 03/16/2024] [Indexed: 05/01/2024]
Abstract
PURPOSE To compare the ocular effects of exposure to a low-humidity environment with and without contact lens (CL) wear using various non-invasive tests. METHODS Fourteen habitual soft CL wearers were exposed to controlled low humidity (5% relative humidity [RH]) in an environmental chamber for 90 min on two separate occasions. First, when wearing their habitual spectacles and then, on a separate visit, when wearing silicone hydrogel CLs that were fitted specifically for this purpose. All participants had adapted to the new CL prior to data collection. Three non-invasive objective measurements were taken at each visit: blinking rate, objective ocular scatter (measured using the objective scatter index) and ocular surface cooling rate (measured using a long-wave infrared thermal camera). At each visit, measurements were taken before the exposure in comfortable environmental conditions (RH: 45%), and after exposure to environmental stress (low humidity, RH: 5%). RESULTS CL wearers showed increased blinking rate (p < 0.005) and ocular scatter (p = 0.03) but similar cooling rate of the ocular surface (p = 0.08) when compared with spectacle wear in comfortable environmental conditions. The exposure to low humidity increased the blinking rate significantly with both types of corrections (p = 0.01). Interestingly, ocular scatter (p = 0.96) and cooling rate (p = 0.73) were not significantly different before and after exposure to low humidity. There were no significant two-way interactions between correction and exposure in any of the measurements. CONCLUSIONS CLs significantly increased the blinking rate, which prevented a quick degradation of the tear film integrity as it was refreshed more regularly. It is hypothesised that the increased blinking rate in CL wearers aids in maintaining ocular scatter quality and cooling rate when exposed to a low-humidity environment. These results highlight the importance of blinking in maintaining tear film stability.
Collapse
Affiliation(s)
- Megan Vaughan
- Vision and Eye Research Institute, School of Medicine, Anglia Ruskin University, Cambridge, UK
| | - Nery García-Porta
- Applied Physics Department, Optics and Optometry Faculty, University of Santiago de Compostela, Santiago, Spain
- Institute of Materials (iMATUS), University of Santiago de Compostela, Santiago, Spain
| | - Juan Tabernero
- Vision and Eye Research Institute, School of Medicine, Anglia Ruskin University, Cambridge, UK
- Department of Electromagnetism and Electronics, University of Murcia, Murcia, Spain
| | | | - Pablo Artal
- Laboratorio de Óptica, Centro de Investigación en Óptica y Nanofísica, Campus Espinardo, University of Murcia, Murcia, Spain
| | - Shahina Pardhan
- Vision and Eye Research Institute, School of Medicine, Anglia Ruskin University, Cambridge, UK
| |
Collapse
|
3
|
Phan CM, Wy Chan V, Drolle E, Hui A, Ngo W, Bose S, Shows A, Liang S, Sharma V, Subbaraman L, Zheng Y, Shi X, Wu J, Jones L. Evaluating the in vitro wettability and coefficient of friction of a novel and contemporary reusable silicone hydrogel contact lens materials using an in vitro blink model. Cont Lens Anterior Eye 2024; 47:102129. [PMID: 38423868 DOI: 10.1016/j.clae.2024.102129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 02/09/2024] [Accepted: 02/20/2024] [Indexed: 03/02/2024]
Abstract
PURPOSE To evaluate the in vitro wettability and coefficient of friction of a novel amphiphilic polymeric surfactant (APS), poly(oxyethylene)-co-poly(oxybutylene) (PEO-PBO) releasing silicone hydrogel (SiHy) contact lens material (serafilcon A), compared to other reusable SiHy lens materials. METHODS The release of fluorescently-labelled nitrobenzoxadiazole (NBD)-PEO-PBO was evaluated from serafilcon A over 7 days in a vial. The wettability and coefficient of friction of serafilcon A and three contemporary SiHy contact lens materials (senofilcon A; samfilcon A; comfilcon A) were evaluated using an in vitro blink model over their recommended wearing period; t = 0, 1, 7, 14 days for all lens types and t = 30 days for samfilcon A and comfilcon A (n = 4). Sessile drop contact angles were determined and in vitro non-invasive keratographic break-up time (NIKBUT) measurements were assessed on a blink model via the OCULUS Keratograph 5 M. The coefficient of friction was measured using a nano tribometer. RESULTS The relative fluorescence of NBD-PEO-PBO decreased in serafilcon A by approximately 18 % after 7 days. The amount of NBD-PEO-PBO released on day 7 was 50 % less than the amount released on day 1 (6.5±1.0 vs 3.4±0.5 µg/lens). The reduction in PEO-PBO in the lens also coincided with an increase in contact angles for serafilcon A after 7 days (p < 0.05), although there were no changes in NIKBUT or coefficient of friction (p > 0.05). The other contact lens materials had stable contact angles and NIKBUT over their recommended wearing period (p > 0.05), with the exception of samfilcon A, which had an increase in contact angle after 14 days as compared to t = 0 (p < 0.05). Senofilcon A and samfilcon A also showed an increase in coefficient of friction at 14 and 30 days, respectively, compared to their blister pack values (p < 0.05). CONCLUSION The results indicate that serafilcon A gradually depletes its reserve of PEO-PBO over 1 week, but this decrease did not significantly change the lens performance in vitro during this time frame.
Collapse
Affiliation(s)
- Chau-Minh Phan
- Centre for Ocular Research & Education (CORE), School of Optometry and Vision Science, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada; Centre for Eye and Vision Research (CEVR), 17W Hong Kong Science Park, Hong Kong, China.
| | - Vivian Wy Chan
- Centre for Ocular Research & Education (CORE), School of Optometry and Vision Science, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada
| | - Elizabeth Drolle
- Centre for Ocular Research & Education (CORE), School of Optometry and Vision Science, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada
| | - Alex Hui
- Centre for Ocular Research & Education (CORE), School of Optometry and Vision Science, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada; School of Optometry and Vision Science, Faculty of Medicine and Health, UNSW Sydney, Australia
| | - William Ngo
- Centre for Ocular Research & Education (CORE), School of Optometry and Vision Science, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada; Centre for Eye and Vision Research (CEVR), 17W Hong Kong Science Park, Hong Kong, China
| | - Susmita Bose
- Centre for Ocular Research & Education (CORE), School of Optometry and Vision Science, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada
| | - Amanda Shows
- Alcon Research LLC, Fort Worth TX & Johns Creek, GA, USA
| | - Shuang Liang
- Alcon Research LLC, Fort Worth TX & Johns Creek, GA, USA
| | - Vinay Sharma
- Alcon Research LLC, Fort Worth TX & Johns Creek, GA, USA
| | | | - Ying Zheng
- Alcon Research LLC, Fort Worth TX & Johns Creek, GA, USA
| | - Xinfeng Shi
- Alcon Research LLC, Fort Worth TX & Johns Creek, GA, USA
| | - James Wu
- Alcon Research LLC, Fort Worth TX & Johns Creek, GA, USA
| | - Lyndon Jones
- Centre for Ocular Research & Education (CORE), School of Optometry and Vision Science, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada; Centre for Eye and Vision Research (CEVR), 17W Hong Kong Science Park, Hong Kong, China
| |
Collapse
|
4
|
Di Zazzo A, Barabino S, Fasciani R, Aragona P, Giannaccare G, Villani E, Rolando M. One Soul and Several Faces of Evaporative Dry Eye Disease. J Clin Med 2024; 13:1220. [PMID: 38592038 PMCID: PMC10932174 DOI: 10.3390/jcm13051220] [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: 11/20/2023] [Revised: 02/02/2024] [Accepted: 02/04/2024] [Indexed: 04/10/2024] Open
Abstract
The ocular surface system interacts with, reacts with, and adapts to the daily continuous insults, trauma, and stimuli caused by direct exposure to the atmosphere and environment. Several tissue and para-inflammatory mechanisms interact to guarantee such an ultimate function, hence maintaining its healthy homeostatic equilibrium. Evaporation seriously affects the homeostasis of the system, thereby becoming a critical trigger in the pathogenesis of the vicious cycle of dry eye disease (DED). Tear film lipid composition, distribution, spreading, and efficiency are crucial factors in controlling water evaporation, and are involved in the onset of the hyperosmolar and inflammatory cascades of DED. The structure of tear film lipids, and subsequently the tear film, have a considerable impact on tears' properties and main functions, leading to a peculiar clinical picture and specific management.
Collapse
Affiliation(s)
- Antonio Di Zazzo
- Ophthalmology Complex Operative Unit, Foundation Campus Bio-Medico University Hospital, 00128 Rome, Italy
- Ophthalmology Unit, Campus Bio-Medico University, 00128 Rome, Italy
| | - Stefano Barabino
- Ocular Surface & Dry Eye Center, ASST Fatebenefratelli SACCO, Kilan Univeristy, 20123 Milan, Italy;
| | - Romina Fasciani
- Ophthalmology Unit, “Fondazione Policlinico Universitario A. Gemelli IRCCS”, 00128 Rome, Italy;
- Ophtalmology Unit, Catholic University of “Sacro Cuore”, 00128 Rome, Italy
| | - Pasquale Aragona
- Ophthalmology Clinic, Department of Biomedical Sciences, University Hospital of Messina, 98122 Messina, Italy;
| | - Giuseppe Giannaccare
- Eye Clinic, Department of Surgical Sciences, University of Cagliari, 09124 Cagliari, Italy;
| | - Edoardo Villani
- Eye Clinic, San Giuseppe Hospital, IRCCS Multimedica, University of Milan, 20123 Milan, Italy;
| | - Maurizio Rolando
- Ocular Surface and Dry Eye Center, ISPRE Ophthalmics, 16129 Genoa, Italy;
| |
Collapse
|
5
|
Wang TH, Tsai YJ, Wang YH, Wu CL, Lin IC. Relationship between Dry Eye Disease and Dyslipidemia: A Systematic Review. J Clin Med 2023; 12:6631. [PMID: 37892769 PMCID: PMC10607063 DOI: 10.3390/jcm12206631] [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: 08/17/2023] [Revised: 09/28/2023] [Accepted: 10/17/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Dyslipidemia has been suggested to be associated with the occurrence of dry eye disease (DED). However, whether dyslipidemia is responsible for the development of DED remains unclear. In this systematic review, we explored the relationship between DED and dyslipidemia by using quantitative data. METHODS Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we conducted a comprehensive literature search in several databases, including PubMed, Embase, Cochrane Library, Web of Science, and Google Scholar, and obtained six relevant studies. RESULTS Our findings indicated that the majority of the selected studies reported a statistically significant association between dyslipidemia and DED, particularly in women. However, our quantitative analysis revealed that only two studies reported statistically significant differences in total cholesterol and high-density lipoprotein cholesterol values. CONCLUSION No statistically significant differences exist in the majority of lipid profile parameters between individuals with and without DED, but there is a statistically significant association between dyslipidemia and DED.
Collapse
Affiliation(s)
- Tzu-Hao Wang
- Division of General Medicine, Department of Medical Education, Shuang Ho Hospital, New Taipei City 23561, Taiwan;
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei City 11031, Taiwan
| | - Yuan-Jen Tsai
- Department of Family Medicine, Taipei Medical University Hospital, Taipei City 11031, Taiwan;
| | - Yuan-Hung Wang
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei City 11031, Taiwan;
- Department of Medical Research, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan
| | - Chien-Liang Wu
- Department of Ophthalmology, School of Medicine, College of Medicine, Taipei Medical University, Taipei City 11031, Taiwan;
- Department of Ophthalmology, Wan Fang Hospital, Taipei Medical University, Taipei City 11696, Taiwan
| | - I-Chan Lin
- Department of Ophthalmology, School of Medicine, College of Medicine, Taipei Medical University, Taipei City 11031, Taiwan;
- Department of Ophthalmology, Wan Fang Hospital, Taipei Medical University, Taipei City 11696, Taiwan
| |
Collapse
|
6
|
Abusharha A, Pearce EI, Afsar T, Razak S. Protecting Tear-Film Stability under Adverse Environmental Conditions Using a Mucomimetic with a Non-Newtonian Viscosity Agent. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1862. [PMID: 37893580 PMCID: PMC10608101 DOI: 10.3390/medicina59101862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/11/2023] [Accepted: 10/18/2023] [Indexed: 10/29/2023]
Abstract
Background and Objectives: Tamarind-seed polysaccharide (TSP) and hyaluronic acid (HA) have mucoadhesive properties that improve drug absorption and delay in drug elimination from the ocular surface. We aimed to evaluate TSP/HA-containing formulation for its efficiency in dry-eye symptoms induced by adverse environments and the interaction between mucomimic polymer and tear-film parameters. Materials and Methods: The participants were exposed to 5% relative humidity (RH) in a Controlled Environment Chamber (CEC) under constant room temperature (21 °C). Tear-film parameters were assessed at 40% RH and 5% RH. Rohto Dry Eye Relief drops were used in the two treatment modalities, protection (drops instilled before exposure to the dry environment) and relief (drops instilled after exposure to the dry environment). The HIRCAL grid, Servomed EP3 Evaporimeter, and Keeler's TearScope-Plus were used to screen for non-invasive tear break-up time (NITBUT), tear evaporation rate, and lipid-layer thickness (LLT) using protection and relief treatment methodology. Results: LLT was found to be significantly thinner at 5% RH compared with at 40% RH (p = 0.007). The median LLT dropped from 50-70 nm (grade 3) at 40% RH to 10-50 nm (grade 2) at 5% RH. TSP/HA eye drops significantly augment LLT in both treatment modalities, protection (p = 0.01) and relief (p = 0.004) at 5% RH. The mean evaporation rate doubled from 40.93 at 40% RH to 82.42 g/m2/h after exposure to 5% RH. In protection mode, the TSP/HA allowed the average evaporation rate to be much lower than when no TSP/HA was used at 5% RH (p < 0.008). No alteration in evaporation rate was recorded when the TSP/HA drop was used after exposure (relief). The mean NITBUT was reduced from 13 s in normal conditions to 6 s in the dry environment. Instillation of TSP/HA eye drops resulted in significant improvement (p = 0.006) in tear stability, where the NITBUT increased to 8 s in both protection (before exposure) and relief (after exposure) (p = 0.001). Although improved, these values were still significantly lower than NITBUT observed at 40% RH. Conclusions: Significant protection of tear-film parameters was recorded post instillation of TSP/HA eye drop under a desiccating environment. Both treatment methods (protection and relief) were shown to be effective. The presence of TSP/HA enhances the effectiveness of teardrops in protecting the tear-film parameters when exposed to adverse environments.
Collapse
Affiliation(s)
- Ali Abusharha
- Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia;
| | - E. Ian Pearce
- Department of Vision Science, School of Health and Life Sciences, Glasgow Caledonian University, 70 Cowcaddence Road, Glasgow G4 0BA, UK;
| | - Tayyaba Afsar
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia;
| | - Suhail Razak
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia;
| |
Collapse
|
7
|
Xie G, Lin S, Wu F, Liu J. Nanomaterial-based ophthalmic drug delivery. Adv Drug Deliv Rev 2023; 200:115004. [PMID: 37433372 DOI: 10.1016/j.addr.2023.115004] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 06/27/2023] [Accepted: 07/04/2023] [Indexed: 07/13/2023]
Abstract
The low bioavailability and side effects of conventional drugs for eye disease necessitate the development of efficient drug delivery systems. Accompanying the developments of nanofabrication techniques, nanomaterials have been recognized as promising tools to overcome these challenges due to their flexible and programmable properties. Given the advances achieved in material science, a broad spectrum of functional nanomaterials capable of overcoming various ocular anterior and posterior segment barriers have been explored to satisfy the demands for ocular drug delivery. In this review, we first highlight the unique functions of nanomaterials suitable for carrying and transporting ocular drugs. Then, various functionalization strategies are emphasized to endow nanomaterials with superior performance in enhanced ophthalmic drug delivery. The rational design of several affecting factors is essential for ideal nanomaterial candidates and is depicted as well. Lastly, we introduce the current applications of nanomaterial-based delivery systems in the therapy of different ocular anterior and posterior segment diseases. The limitations of these delivery systems as well as potential solutions are also discussed. This work will inspire innovative design thinking for the development of nanotechnology-mediated strategies for advanced drug delivery and treatment toward ocular diseases.
Collapse
Affiliation(s)
- Guocheng Xie
- Shanghai Key Laboratory for Nucleic Acid Chemistry and Nanomedicine, Institute of Molecular Medicine, State Key Laboratory of Oncogenes and Related Genes, Shanghai Cancer Institute, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Sisi Lin
- Shanghai Key Laboratory for Nucleic Acid Chemistry and Nanomedicine, Institute of Molecular Medicine, State Key Laboratory of Oncogenes and Related Genes, Shanghai Cancer Institute, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Feng Wu
- Shanghai Key Laboratory for Nucleic Acid Chemistry and Nanomedicine, Institute of Molecular Medicine, State Key Laboratory of Oncogenes and Related Genes, Shanghai Cancer Institute, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China.
| | - Jinyao Liu
- Shanghai Key Laboratory for Nucleic Acid Chemistry and Nanomedicine, Institute of Molecular Medicine, State Key Laboratory of Oncogenes and Related Genes, Shanghai Cancer Institute, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China.
| |
Collapse
|
8
|
Patel S, Mittal R, Kumar N, Galor A. The environment and dry eye-manifestations, mechanisms, and more. FRONTIERS IN TOXICOLOGY 2023; 5:1173683. [PMID: 37681211 PMCID: PMC10482047 DOI: 10.3389/ftox.2023.1173683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 08/07/2023] [Indexed: 09/09/2023] Open
Abstract
Dry eye disease (DED) is a multifactorial condition that often presents with chronic symptoms of pain (that can be characterized as "dryness," "burning," and "irritation," to name a few) and/or fluctuating or poor-quality vision. Given its multifactorial nature, several pathophysiologic mechanisms have been identified that can underlie symptoms, including tear film, ocular surface, and/or corneal somatosensory nerve abnormalities. Research has focused on understanding how environmental exposures can increase the risk for DED flares and negatively impact the tear film, the ocular surface, and/or nerve health. Given that DED is a common condition that negatively impacts physical and mental functioning, managing DED requires multiple strategies. These can include both medical approaches and modulating adverse environmental conditions, the latter of which may be a cost-effective way to avoid DED flares. Thus, an understanding of how environmental exposures relate to disease is important. This Review summarizes research on the relationships between environmental exposures and DED, in the hope that this information will engage healthcare professionals and patients to consider environmental manipulations in their management of DED.
Collapse
Affiliation(s)
- Sneh Patel
- Division of Physical Medicine and Rehabilitation, Veterans Affairs (VA) Greater Los Angeles Healthcare System, Los Angeles, CA, United States
- University of California Los Angeles (UCLA), Los Angeles, CA, United States
| | - Rhiya Mittal
- University of Miami Leonard M. Miller School of Medicine, Miami, FL, United States
- Bascom Palmer Eye Institute, University of Miami, Miami, FL, United States
| | - Naresh Kumar
- Department of Public Health Sciences, University of Miami, Miami, FL, United States
| | - Anat Galor
- Bascom Palmer Eye Institute, University of Miami, Miami, FL, United States
- Ophthalmology and Research Services, Miami VA Medical Center, Miami, FL, United States
| |
Collapse
|
9
|
Zhang K, Di G, Bai Y, Liu A, Bian W, Chen P. Aquaporin 5 in the eye: Expression, function, and roles in ocular diseases. Exp Eye Res 2023; 233:109557. [PMID: 37380095 DOI: 10.1016/j.exer.2023.109557] [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: 01/05/2023] [Revised: 05/26/2023] [Accepted: 06/25/2023] [Indexed: 06/30/2023]
Abstract
As a water channel protein, aquaporin 5 (AQP5) is essential for the maintenance of the normal physiological functions of ocular tissues. This review provides an overview of the expression and function of AQP5 in the eye and discusses their role in related eye diseases. Although AQP5 plays a vital role in ocular functions, such as maintaining corneal and lens transparency, regulating water movement, and maintaining homeostasis, some of its functions in ocular tissues are still unclear. Based on the key role of AQP5 in eye function, this review suggests that in the future, eye diseases may be treated by regulating the expression of aquaporin.
Collapse
Affiliation(s)
- Kaier Zhang
- Department of Human Anatomy, Histology and Embryology, School of Basic Medicine, Qingdao University, Qingdao, 266071, Shandong Province, China
| | - Guohu Di
- Department of Human Anatomy, Histology and Embryology, School of Basic Medicine, Qingdao University, Qingdao, 266071, Shandong Province, China
| | - Ying Bai
- Department of Human Anatomy, Histology and Embryology, School of Basic Medicine, Qingdao University, Qingdao, 266071, Shandong Province, China
| | - Anxu Liu
- Department of Human Anatomy, Histology and Embryology, School of Basic Medicine, Qingdao University, Qingdao, 266071, Shandong Province, China
| | - Wenhan Bian
- Department of Human Anatomy, Histology and Embryology, School of Basic Medicine, Qingdao University, Qingdao, 266071, Shandong Province, China
| | - Peng Chen
- Department of Human Anatomy, Histology and Embryology, School of Basic Medicine, Qingdao University, Qingdao, 266071, Shandong Province, China; Clinical Laboratory, Qingdao Central Hospital, The Second Affiliated Hospital of Medical College of Qingdao University, Qingdao, 266042, Shandong Province, China.
| |
Collapse
|
10
|
Yang X, Reneker LW, Zhong X, Huang AJW, Jester JV. Meibomian gland stem/progenitor cells: The hunt for gland renewal. Ocul Surf 2023; 29:497-507. [PMID: 37422152 PMCID: PMC10528929 DOI: 10.1016/j.jtos.2023.07.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 06/29/2023] [Accepted: 07/05/2023] [Indexed: 07/10/2023]
Abstract
Meibomian glands (MGs) secrete lipid (meibum) onto the ocular surface to form the outermost layer of the tear film. Proper meibum secretion is essential for stabilizing the tear film, reducing aqueous tear evaporation, and maintaining the homeostasis of the ocular surface. Atrophy of MG as occurs with aging, leads to reduction of meibum secretion, loss of ocular surface homeostasis and evaporative dry eye disease (EDED). Since MGs are holocrine glands, secretion of meibum requires continuous self-renewal of lipid-secreting acinar meibocytes by stem/progenitor cells, whose proliferative potential is dramatically reduced with age leading to MG atrophy and an age-related meibomian gland dysfunction (ARMGD). Understanding the cellular and molecular mechanisms regulating meibocyte stem/progenitor cell maintenance and renewal may provide novel approaches to regenerating MG and treating EDED. Towards that end, recent label retaining cell and lineage-tracing experiments as well as knock-out transgenic mouse studies have begun to identify the location and identities of meibocyte progenitor cells and potential growth and transcription factors that may regulate meibocyte renewal. In addition, recent reports have shown that ARMGD may be reversed by novel therapeutics in mice. Herein, we discuss our current understanding of meibocyte stem/progenitor cells and the hunt for gland renewal.
Collapse
Affiliation(s)
- Xiaowei Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Lixing W Reneker
- Department of Ophthalmology, University of Missouri, Columbia, MO, USA
| | - Xingwu Zhong
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, Guangdong, China; Hainan Eye Hospital and Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Haikou, Hainan, China
| | - Andrew J W Huang
- Department of Ophthalmology and Visual Sciences, Washington University in St. Louis, St. Louis, Missouri, USA
| | - James V Jester
- Department of Ophthalmology and Biomedical Engineering, University of California Irvine, Irvine, CA, USA.
| |
Collapse
|
11
|
Watson SL, Jones LW, Stapleton F, Hinds M, Ng A, Tan J, Alster Y, Bosworth C, Rafaeli O, DePuy V. Efficacy and safety of AZR-MD-001 selenium sulfide ophthalmic ointment in adults with meibomian gland dysfunction: A vehicle-controlled, randomized clinical trial. Ocul Surf 2023; 29:537-546. [PMID: 37478969 DOI: 10.1016/j.jtos.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 06/22/2023] [Accepted: 07/02/2023] [Indexed: 07/23/2023]
Abstract
PURPOSE Meibomian gland dysfunction (MGD) is a chronic progressive disease with downstream effects on ocular signs and symptoms. AZR-MD-001 is a selenium sulfide ophthalmic ointment that was investigated as a potential treatment option for patients with MGD. METHODS A Phase 2, multi-center, double-masked, parallel group study was conducted across 29 sites, with 245 patients randomized 1:1:1 to AZR-MD-001 0.5%, AZR-MD-001 1.0% or vehicle applied to the lower eyelid, twice weekly. Patients were eligible for the trial if they presented with signs and symptoms of MGD. Co-primary efficacy endpoints were the changes from baseline in number of open glands (Meibomian Glands Yielding Liquid Secretion [MGYLS] score) and patient-reported ocular surface symptoms (Ocular Surface Disease Index [OSDI] total score) at Month 3. Efficacy outcomes were captured at Day 14, Month 1.5 and Month 3. Safety and tolerability were assessed for treatment-emergent adverse events (TEAEs). RESULTS AZR-MD-001 0.5% (n = 82 patients) treatment resulted in significant improvements in MGYLS score, with patients experiencing an average increase from baseline of 4.2 and 2.4 open glands secreting meibum for the drug and vehicle, respectively (p < 0.001) and from baseline a mean OSDI total score improvement of 7.3 and 3.8 for the drug and vehicle, respectively (p < 0.05). Most TEAEs were mild and transient, with 3 serious adverse events (SAEs) reported with AZR-MD-001 (none related to study drug). CONCLUSIONS Co-primary endpoints were met for AZR-MD-001 0.5% at Month 3, with a statistically significant improvement in the signs and symptoms of MGD. AZR-MD-001 was safe and well tolerated. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03652051, ANZCTR Registration Number: AZ201801.
Collapse
Affiliation(s)
- Stephanie L Watson
- The University of Sydney, Faculty of Medicine and Health, Save Sight Institute, Sydney, NSW, 2000, Australia.
| | - Lyndon W Jones
- Centre for Ocular Research & Education (CORE), School of Optometry & Vision Science, University of Waterloo, Waterloo, Ontario, N2L 3G1, Canada
| | - Fiona Stapleton
- School of Optometry and Vision Science, UNSW Sydney, Australia
| | - Mark Hinds
- Ophthalmic Trials Australia, Brisbane, Australia
| | - Alison Ng
- Centre for Ocular Research & Education (CORE), School of Optometry & Vision Science, University of Waterloo, Waterloo, Ontario, N2L 3G1, Canada
| | - Jacqueline Tan
- School of Optometry and Vision Science, UNSW Sydney, Australia
| | | | | | | | | |
Collapse
|
12
|
Chiang MC, Liu YC, Chen BY, Wu DL, Wu CL, Cheng CW, Chang WL, Lee HJ. Purple Sweet Potato Powder Containing Anthocyanin Mitigates High-Fat-Diet-Induced Dry Eye Disease. Int J Mol Sci 2023; 24:ijms24086983. [PMID: 37108146 PMCID: PMC10138706 DOI: 10.3390/ijms24086983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 04/04/2023] [Accepted: 04/06/2023] [Indexed: 04/29/2023] Open
Abstract
Purple sweet potato (PSP) powder with anthocyanins possesses the ability to reduce oxidative stress and inflammation. Studies have presumed a positive correlation between body fat and dry eye disease (DED) in adults. The regulation of oxidative stress and inflammation has been proposed as the mechanism underlying DED. This study developed an animal model of high fat diet (HFD)-induced DED. We added 5% PSP powder to the HFD to evaluate the effects and underlying mechanisms in mitigating HFD-induced DED. A statin drug, atorvastatin, was also added to the diet separately to assess its effect. The HFD altered the structure of lacrimal gland (LG) tissue, reduced LG secretory function, and eliminated the expression of proteins related to DED development, including α-smooth muscle actin and aquaporin-5. Although PSP treatment could not significantly reduce body weight or body fat, it ameliorated the effects of DED by preserving LG secretory function, preventing ocular surface erosion, and preserving LG structure. PSP treatment increased superoxide dismutase levels but reduced hypoxia-inducible factor 1-α levels, indicating that PSP treatment reduced oxidative stress. PSP treatment increased ATP-binding cassette transporter 1 and acetyl-CoA carboxylase 1 levels in LG tissue, signifying that PSP treatment regulated lipid homeostasis maintenance to reduce the effects of DED. In conclusion, PSP treatment ameliorated the effects of HFD-induced DED through the regulation of oxidative stress and lipid homeostasis in the LG.
Collapse
Affiliation(s)
- Ming-Cheng Chiang
- School of Medicine, Chung Shan Medical University, Taichung 40221, Taiwan
- Department of Ophthalmology, Cathay General Hospital, Taipei 10687, Taiwan
| | - Ying-Chung Liu
- Department of Ophthalmology, Cathay General Hospital, Taipei 10687, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung 40221, Taiwan
| | - Bo-Yi Chen
- Department of Optometry, Chung Shan Medical University, Taichung 40221, Taiwan
| | - Dai-Lin Wu
- School of Medicine, Chung Shan Medical University, Taichung 40221, Taiwan
| | - Chia-Lian Wu
- Department of Optometry, Chung Shan Medical University, Taichung 40221, Taiwan
| | - Chun-Wen Cheng
- Institute of Medicine, Chung Shan Medical University, Taichung 40221, Taiwan
| | - Wen-Lung Chang
- Institute of Medicine, Chung Shan Medical University, Taichung 40221, Taiwan
- Yi-Yeh Biotechnology Co., Taichung 40221, Taiwan
| | - Huei-Jane Lee
- Department of Biochemistry, School of Medicine, Chung Shan Medical University, Taichung 40221, Taiwan
- Department of Clinical Laboratory, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
| |
Collapse
|
13
|
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.
Collapse
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
| |
Collapse
|
14
|
Caycedo Lozano AR, Arias Ortiz WA, Martín V, Ramírez S, Medina Siervo CA. Analysis of diagnostic tests in patients with dry eye and hypothyroidism: an observational study. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2023; 98:163-169. [PMID: 36114138 DOI: 10.1016/j.oftale.2022.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 03/13/2022] [Indexed: 10/14/2022]
Abstract
PURPOSE Colombia is a country with a high prevalence of hypothyroidism, approximately 18.5% compared to the rest of Latin American countries, which is estimated at 10%. That is why in the ophthalmology consultation we find a large proportion of patients with this disease and who also present symptoms of dry eye. When conducting a search in the medical literature, most publications refer to the clinical presentation of dry eye in hyperthyroidism, which is why the main objective of this study is to evaluate tear function tests in the diagnosis of dry eye in patients with hypothyroidism. METHODS This is an observational, cross-sectional study carried out in the period between May and December 2019 in the ocular surface unit of the Ophthalmic Technology Center (CTO) in Bogotá. The tests of: OSDI test (Ocular Surface Disease Index), Schirmer type I, tear meniscus height, NiBUT, Osmolarity, Ferning test, Lisamine Green test of 59 patients with Dry Eye Disease (DED) and history of hypothyroidism. RESULTS Schirmer type I and NiBUT tests were the parameters that presented the highest percentage of severity, while lissamine green staining and meniscometry showed a tendency to normality. CONCLUSIONS The population of this study presents a mixed type dry eye without epithelial cell damage.
Collapse
Affiliation(s)
| | - W A Arias Ortiz
- Grupo de investigación Medicina Comunitaria y Salud Colectiva, Universidad del Bosque, Bogotá, Colombia
| | - V Martín
- Clínica de Optometría San Francisco, Bogotá, Colombia; Universidad de la Salle - Edificio Centro Médico de la Sabana, Bogotá, Colombia
| | - S Ramírez
- Universidad de la Salle - Edificio Centro Médico de la Sabana, Bogotá, Colombia
| | - C A Medina Siervo
- Fundación Universitaria Sanitas, Unidad de Superficie Ocular, Centro de Tecnología Oftálmica, Bogotá, Colombia
| |
Collapse
|
15
|
Twa MD. Optometry and Vision Science's Top Articles: The First 100 Years. Optom Vis Sci 2023; 100:183-186. [PMID: 36947572 DOI: 10.1097/opx.0000000000002000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023] Open
Affiliation(s)
- Michael D Twa
- Editor in Chief Optometry and Vision Science University of Houston College of Optometry Houston, TX
| |
Collapse
|
16
|
Xu X, Li G, Zuo YY. Effect of Model Tear Film Lipid Layer on Water Evaporation. Invest Ophthalmol Vis Sci 2023; 64:13. [PMID: 36656568 PMCID: PMC9872843 DOI: 10.1167/iovs.64.1.13] [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: 01/20/2023] Open
Abstract
Purpose A majority of in vitro models were incapable of reproducing the evaporation resistance of tear film lipid layer (TFLL) in vivo. The purpose of this research is to develop a novel in vitro model to study the effect of TFLL on water evaporation. Methods A ventilated, closed-chamber, droplet evaporimeter with a constant surface area has been invented to study the evaporation resistance of TFLL. This evaporimeter ensures a rigorous control of environmental conditions, including the temperature, relative humidity, airflow rate, surface area, and surface pressure, thus allowing for reproducible water evaporation measurements over a time period of only 5 minutes. The volumetric evaporation rate of this droplet evaporimeter is less than 2.7 µL/min, comparable to the basal tear production of healthy adults. Together with direct film imaging using atomic force microscopy (AFM), we have studied the effect of a model TFLL on water evaporation, as a function of the lipid composition and surface pressure. Results A model TFLL composed of 40% wax esters, 40% cholesteryl esters, and 20% polar lipids was capable of reducing the water evaporation rate by 11% at surface pressure 47 mN/m. AFM revealed that the model TFLL at high surface pressures consists of discrete droplets/aggregates of the nonpolar lipids residing atop a polar lipid monolayer with phase separation. Conclusions The TFLL may resist water evaporation with a combined mechanism by increasing film compactness of the polar lipid film at the air-water surface, and, to a lesser extent, by increasing film thickness of the nonpolar lipid film.
Collapse
Affiliation(s)
- Xiaojie Xu
- Department of Mechanical Engineering, University of Hawaii at Manoa, Honolulu, Hawaii, United States
| | - Guangle Li
- Department of Mechanical Engineering, University of Hawaii at Manoa, Honolulu, Hawaii, United States
| | - Yi Y. Zuo
- Department of Mechanical Engineering, University of Hawaii at Manoa, Honolulu, Hawaii, United States,Department of Pediatrics, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii, United States
| |
Collapse
|
17
|
Safonova TN, Zaitseva GV, Kintyukhina NP. [Evolution of dry eye disease diagnostics]. Vestn Oftalmol 2023; 139:81-89. [PMID: 37144373 DOI: 10.17116/oftalma202313903281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
This article reviews modern functional and instrumental examination methods included in the diagnostic algorithm for dry eye disease. The described methods can serve as an objective criterion for the effectiveness of the therapy.
Collapse
Affiliation(s)
- T N Safonova
- Krasnov Research Institute of Eye Diseases, Moscow, Russia
| | - G V Zaitseva
- Krasnov Research Institute of Eye Diseases, Moscow, Russia
| | | |
Collapse
|
18
|
Zahn I, Garreis F, Schicht M, Rötzer V, Waschke J, Liu Y, Altersberger VL, Paulsen F, Dietrich J. A New Organotypic 3D Slice Culture of Mouse Meibomian Glands Reveals Impact of Melanocortins. Int J Mol Sci 2022; 23:ijms232314947. [PMID: 36499274 PMCID: PMC9737810 DOI: 10.3390/ijms232314947] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/20/2022] [Accepted: 11/24/2022] [Indexed: 12/05/2022] Open
Abstract
The meibomian glands (MGs) within the eyelids produce a lipid-rich secretion that forms the superficial layer of the tear film. Meibomian gland dysfunction (MGD) results in excessive evaporation of the tear film, which is the leading cause of dry eye disease (DED). To develop a research model similar to the physiological situation of MGs, we established a new 3D organotypic slice culture (OSC) of mouse MGs (mMGs) and investigated the effects of melanocortins on exocrine secretion. Tissue viability, lipid production and morphological changes were analyzed during a 21-day cultivation period. Subsequently, the effects on lipid production and gene expression were examined after stimulation with a melanocortin receptor (MCR) agonist, α-melanocyte-stimulating hormone (α-MSH), and/or an MCR antagonist, JNJ-10229570. The cultivation of mMGs OSCs was possible without impairment for at least seven days. Stimulation with the MCR agonists induced lipid production in a dose-dependent manner, whereas this effect was tapered with the simultaneous incubation of the MCR antagonist. The new 3D OSC model is a promising approach to study the (patho-) physiological properties of MG/MGD while reducing animal studies. Therefore, it may accelerate the search for new treatments for MGD/DED and lead to new insights, such as that melanocortins likely stimulate meibum production.
Collapse
Affiliation(s)
- Ingrid Zahn
- Institute of Functional and Clinical Anatomy, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany
- Correspondence: (I.Z.); (F.P.); Tel.: +49-9131-85-26734 (I.Z.); +49-9131-85-22865 (F.P.)
| | - Fabian Garreis
- Institute of Functional and Clinical Anatomy, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany
| | - Martin Schicht
- Institute of Functional and Clinical Anatomy, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany
| | - Vera Rötzer
- Department of Anatomy, Ludwig-Maximilians-Universität, 80336 Munich, Germany
| | - Jens Waschke
- Department of Anatomy, Ludwig-Maximilians-Universität, 80336 Munich, Germany
| | - Yuqiuhe Liu
- Institute of Functional and Clinical Anatomy, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany
| | - Valerian L. Altersberger
- Institute of Functional and Clinical Anatomy, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany
- Department of Anatomy, Ludwig-Maximilians-Universität, 80336 Munich, Germany
| | - Friedrich Paulsen
- Institute of Functional and Clinical Anatomy, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany
- Correspondence: (I.Z.); (F.P.); Tel.: +49-9131-85-26734 (I.Z.); +49-9131-85-22865 (F.P.)
| | - Jana Dietrich
- Institute of Functional and Clinical Anatomy, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany
| |
Collapse
|
19
|
Sahin Atik S, Altın Ekin M. The role of Meibomian glands on the development of dry eye disease in patients with unilateral pseudoexfoliation. J Fr Ophtalmol 2022; 45:915-920. [DOI: 10.1016/j.jfo.2022.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 03/08/2022] [Accepted: 03/14/2022] [Indexed: 10/18/2022]
|
20
|
Correlation between tear film lipid layer thickness and transepidermal water loss from the ocular area in patients with dry eye disease and in healthy controls. PLoS One 2022; 17:e0270810. [PMID: 35857784 PMCID: PMC9299348 DOI: 10.1371/journal.pone.0270810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 06/17/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose This study aimed to evaluate the correlation between tear film lipid layer thickness and transepidermal water loss (TEWL) from the ocular area in patients with short tear break-up time (TBUT)-type dry eye and healthy controls. Methods This prospective study included 25 eyes of patients with short TBUT-type dry eye disease and 25 eyes of healthy controls. Results Tear film lipid layer thickness was measured using an interferometer, and TEWL from the ocular area was measured using a Tewameter TM300 with custom-made goggles. The correlation between tear film lipid layer thickness and TEWL was evaluated. Additionally, other parameters such as TBUT, Schirmer I score, ocular surface staining, the presence and type of meibomian gland dysfunction (MGD), ocular surface disease index (OSDI), and visual analog scale (VAS) scores were evaluated. Tear film lipid layer thickness did not show a significant correlation with TEWL from the ocular area measured using a Tewameter TM300. However, tear film lipid layer thickness was significantly correlated with tear break-up time (p = 0.004) and ocular surface staining by NEI (National Eye Institute) scheme (p = 0.03). TEWL showed positive correlation with the Schirmer I score (p = 0.004). Conclusions The tear film lipid layer affected the stability of the tear film more than the amount of TEWL in patients with short TBUT dry eye and healthy controls.
Collapse
|
21
|
Preparation and Characterisation of a Cyclodextrin-Complexed Mānuka Honey Microemulsion for Eyelid Application. Pharmaceutics 2022; 14:pharmaceutics14071493. [PMID: 35890390 PMCID: PMC9324298 DOI: 10.3390/pharmaceutics14071493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 07/11/2022] [Accepted: 07/13/2022] [Indexed: 11/26/2022] Open
Abstract
Honey has been widely purported as a natural remedy due to its antimicrobial and anti-inflammatory effects. In recent years, several studies have suggested that the considerably high methylglyoxal (MGO) concentration in Mānuka honey (MH) makes it particularly effective to manage bacterial overload, such as that observed in blepharitis. However, the poor solubility, high viscosity, and osmolarity of aqueous honey solutions, especially at the high MGO concentrations studied in the literature, render the formulation of an acceptable dosage form for topical application to the eyelids challenging. Here, the antibacterial properties of raw MH and alpha-cyclodextrin (α-CD)-complexed MH were evaluated at relatively low MGO concentrations, and a liquid crystalline-forming microemulsion containing α-CD-complexed MH was formulated. After determining pH and osmolarity, ocular tolerability was assessed using human primary corneal epithelial cells and chorioallantoic membranes, while the antibacterial efficacy was further evaluated in vitro. The α-CD–MH complex had significantly greater antibacterial activity against Staphylococcus aureus than either constituent alone, which was evident even when formulated as a microemulsion. Moreover, the final formulation had a physiologically acceptable pH and osmolarity for eyelid application and was well-tolerated when diluted 1:10 with artificial tear fluid, as expected to be the case after accidental exposure to the ocular surface in the clinical setting. Thus, a safe and efficient MH dosage form was developed for topical application to the eyelids, which can potentially be used to support optimal eyelid health in the management of blepharitis.
Collapse
|
22
|
Markoulli M, Wong K, Jia T, Siddireddy JS, Briggs N, Tan J. The effect of hydroxypropyl-guar nanoemulsion on signs and symptoms of dry eye. Cont Lens Anterior Eye 2022; 45:101736. [PMID: 35835650 DOI: 10.1016/j.clae.2022.101736] [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: 02/03/2022] [Revised: 05/24/2022] [Accepted: 06/28/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE To examine the effect of hydroxypropyl-guar nanoemulsion (HP-Guar nanoemulsion, Alcon Laboratories Ltd, Fort Worth, TX, USA) versus saline (0.9% sodium chloride; Pfizer Inc., Bentley WA Australia) on the comfort and tear film properties of people with dry eye disease both in the short-term (up to 2 h post-drop instillation) and longer-term (after 4 weeks of 4-times daily use), and to examine the effect on tear inflammatory markers after 4 weeks. METHODS This was a prospective, investigator-masked, randomised, cross-over dispensing study. Twenty participants with dry eye disease (5 males: 15 females) with average age 46.9 ± 14.4 (range 26 to 70) years were randomized to either HP-Guar nanoemulsion, or saline eye drops. Ocular symptoms, lipid layer thickness, tear evaporation, tear osmolarity and non-invasive break-up time were measured pre-drop instillation, 1 h and 2 h post-eye drop instillation, and after 4-weeks of 4-times daily drop use. Tear inflammatory mediators were measured pre-drop instillation and after 4-weeks. After 4-weeks, patients had a 4-week washout period and then crossed over to the alternate drop. RESULTS With HP-Guar nanoemulsion, participants reported less grittiness/burning/stinging 1 h post eye drop instillation compared to baseline (79.5 ± 23.3 vs. 66.8 ± 27.7, p = 0.02); less dryness 1 h and 2 h post eye drop instillation compared to baseline (77.8 ± 23.0 and 76.2 ± 23.7 vs. 61.0 ± 27.1 respectively, p < 0.01 for both); and greater overall satisfaction 1 h post drop instillation and after 4 weeks of daily use compared to baseline (80.4 ± 21.6 and 83.4 ± 16.6 vs. 68.6 ± 26.0 respectively, p ≤ 0.011 for both). With saline, participants reported less dryness after 4 weeks of daily use compared to baseline (74.2 ± 23.8 vs. 60.2 ± 24.0, p < 0.01). For HP-Guar nanoemulsion, average lipid layer thickness was significantly thicker 2 h post drop-instillation (79.5 ± 21.7 nm) compared to baseline (63.7 ± 18.9 nm) and the 4-week assessment (62.4 ± 23.1 nm, p < 0.01 for both). For saline, average lipid layer thickness was significantly thicker at 1 h and 2 h post eye drop instillation (76.0 ± 23.8 nm and 80.4 ± 24.8 nm) compared to baseline (61.0 ± 15.6 nm, p < 0.01 for both). There was no difference in inflammatory mediators or other tear variables between drops or visits. CONCLUSION HP-Guar nanoemulsion was more effective for improving a range of subjective dry eye symptoms both in the short and long-term compared to saline. Both HP-Guar nanoemulsion and saline transiently increased lipid layer thickness.
Collapse
Affiliation(s)
- Maria Markoulli
- School of Optometry and Vision Science, UNSW Sydney, Sydney, NSW, Australia
| | - Katherine Wong
- School of Optometry and Vision Science, UNSW Sydney, Sydney, NSW, Australia
| | - Tianni Jia
- School of Optometry and Vision Science, UNSW Sydney, Sydney, NSW, Australia
| | | | - Nancy Briggs
- Stats Central, UNSW Sydney, Sydney, NSW, Australia
| | - Jacqueline Tan
- School of Optometry and Vision Science, UNSW Sydney, Sydney, NSW, Australia.
| |
Collapse
|
23
|
Montani G, Landini L, Martino M. Short- and long-term effects of a multi-component, artificial tear on preocular tear film stability, tear evaporation and tear film optical dynamic: a prospective randomized double-phase study. Curr Eye Res 2022; 47:1252-1258. [PMID: 35749148 DOI: 10.1080/02713683.2022.2093381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIM To evaluate the short- (within 90 minutes) and long-term (after 21 days of treatment) effects of an artificial tear containing carbomer, hyaluronic acid, glycerol, and medium-chain triglycerides in patients with mild-to-moderate dry eye symptoms. PATIENTS AND METHODS Subjects received the tested artificial tears in the right eye and control artificial tears in the left eye and were assessed 10, 30, 60, and 90 minutes after instillation in the short-term study phase. They received the study product in both eyes in the long-term phase. Non-invasive break-up time (NIBUT), tear lipid layer pattern, tear evaporation, and tear film objective optical dynamics (TFOOD) were measured in controlled environmental conditions. RESULTS In total, 32 patients (10 males, mean age 42 ± 11 years) were enrolled. During the short-term phase, NIBUT increased significantly in the right eyes at all time points compared with baseline (all p < 0.05). Conversely, in the left eyes, NIBUT increased significantly at 10 and 30 min (p < 0.05). The tear evaporation values increased at 10 minutes and decreased at 30 and 60 minutes (p < 0.05) in the right eyes, while they increased only at 10 minutes (p < 0.05) in the left eyes. Compared with baseline, the TFOOD was significantly more stable at all time points in the right eyes (p < 0.05), while it was more stable at 10 and 30 min in the left eyes (p < 0.05). In the long-term phase, treated eyes showed a significant increase in NIBUT values, a significant reduction of tear evaporation, a significant improvement of tear lipid layer pattern, and a more stable TFOOD compared with baseline (all p < 0.05). Symptoms, measured with the Ocular Surface Disease Index questionnaire, were also significantly reduced compared with baseline (p < 0.05). CONCLUSION The tested product increased tear film stability and reduced tear evaporation, normalizing lipid layer pattern and reducing symptoms in the short- and long-term observation.
Collapse
Affiliation(s)
- Giancarlo Montani
- Mathematics and Physics Department "Ennio De Giorgi," Salento University, Lecce, Italy.,Ce.R.C.A. Salento University, Lecce, Italy
| | | | - Maurizio Martino
- Mathematics and Physics Department "Ennio De Giorgi," Salento University, Lecce, Italy.,Ce.R.C.A. Salento University, Lecce, Italy
| |
Collapse
|
24
|
Pednekar DD, Liguori MA, Marques CNH, Zhang T, Zhang N, Zhou Z, Amoako K, Gu H. From Static to Dynamic: A Review on the Role of Mucus Heterogeneity in Particle and Microbial Transport. ACS Biomater Sci Eng 2022; 8:2825-2848. [PMID: 35696291 DOI: 10.1021/acsbiomaterials.2c00182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Mucus layers (McLs) are on the front line of the human defense system that protect us from foreign abiotic/biotic particles (e.g., airborne virus SARS-CoV-2) and lubricates our organs. Recently, the impact of McLs on human health (e.g., nutrient absorption and drug delivery) and diseases (e.g., infections and cancers) has been studied extensively, yet their mechanisms are still not fully understood due to their high variety among organs and individuals. We characterize these variances as the heterogeneity of McLs, which lies in the thickness, composition, and physiology, making the systematic research on the roles of McLs in human health and diseases very challenging. To advance mucosal organoids and develop effective drug delivery systems, a comprehensive understanding of McLs' heterogeneity and how it impacts mucus physiology is urgently needed. When the role of airway mucus in the penetration and transmission of coronavirus (CoV) is considered, this understanding may also enable a better explanation and prediction of the CoV's behavior. Hence, in this Review, we summarize the variances of McLs among organs, health conditions, and experimental settings as well as recent advances in experimental measurements, data analysis, and model development for simulations.
Collapse
Affiliation(s)
- Dipesh Dinanath Pednekar
- Department of Chemistry, Chemical and Biomedical Engineering, University of New Haven, West Haven, Connecticut 06516, United States
| | - Madison A Liguori
- Department of Chemistry, Chemical and Biomedical Engineering, University of New Haven, West Haven, Connecticut 06516, United States
| | | | - Teng Zhang
- Department of Mechanical and Aerospace Engineering, Syracuse University, Syracuse, New York 13244, United States.,BioInspired Syracuse, Syracuse University, Syracuse, New York 13244, United States
| | - Nan Zhang
- Department of Pharmaceutics, School of Pharmaceutical Sciences, Zhengzhou University, Zhengzhou 450001, PR China
| | - Zejian Zhou
- Department of Electrical and Computer Engineering and Computer Science, University of New Haven, West Haven, Connecticut 06516, United States
| | - Kagya Amoako
- Department of Chemistry, Chemical and Biomedical Engineering, University of New Haven, West Haven, Connecticut 06516, United States
| | - Huan Gu
- Department of Chemistry, Chemical and Biomedical Engineering, University of New Haven, West Haven, Connecticut 06516, United States
| |
Collapse
|
25
|
The Effect of Face Masks during COVID-19 Pandemic on Ocular Surface Temperature-A Clinical Thermographic Analysis. Diagnostics (Basel) 2022; 12:diagnostics12061431. [PMID: 35741241 PMCID: PMC9221900 DOI: 10.3390/diagnostics12061431] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 06/02/2022] [Accepted: 06/03/2022] [Indexed: 11/18/2022] Open
Abstract
Due to the COVID-19 pandemic, the center for disease control and prevention (CDC) recommends face-mask wearing for all people above the age of two years. The wearing of face masks creates a unique airflow towards the ocular surface which may influence the normal physiological conditions of the ocular and periocular surface. Healthy subjects with no ocular history were enrolled in this cross-sectional study. The Therm-App thermal imaging camera was used for ocular surface temperature (OST) measurements during inspirium and expirium. Five regions of interest (ROIs) were used to measure OST: medial conjunctive, cornea, lateral conjunctive, upper eyelid and entire orbital area. Additional measurements in the same locations were made with the upper margin of the mask taped with micropore surgical tape. Thirty-one patients were included in this study. OST during expirium was significantly higher compared to the temperature during inspirium in all locations measured (p < 0.001, paired samples t-test). The temperature of the upper eyelid was higher by more than 0.5 °C during expirium. Taping the mask’s upper edges to the skin resulted in non-significant temperature changes in inspirium vs. expirium. In conclusion, wearing a face mask creates air flow towards the periocular and ocular surface, which changes the OST mostly on the eyelids.
Collapse
|
26
|
Blanco-Campoy DG, Graue-Hernández EO, Quiróz-Casian N, Vélez-Cordero JR, Yáñez-Soto B. In-vitro evaluation of the evaporation retardation by Meibomian lipids in homogeneous and non-homogeneous evaporation. J Colloid Interface Sci 2022; 625:210-219. [PMID: 35716616 DOI: 10.1016/j.jcis.2022.06.032] [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: 07/29/2021] [Revised: 05/25/2022] [Accepted: 06/06/2022] [Indexed: 10/31/2022]
Abstract
HYPOTHESIS An important function of the Tear Film Lipid Layer (TFLL) is the retardation of evaporation. We propose two micro-scaled systems to quantify the influence of the TFLL in evaporation for single patients, which may contribute as an improvement on the diagnosis of Meibomian Gland Dysfunctions (MGD). EXPERIMENTS Meibum was extracted from 10 patients with hypersecretory MGD and 9 healthy controls. The lipids were placed over water, and the evaporation was determined in the case of homogeneous evaporation over a surface (pendant drop), and the case where the evaporation depends on a pinned triple contact line (meniscus). FINDINGS For the homogeneous case, the presence of Meibum reduced evaporation in 30%, although there was no significant difference between controls and MGD patients. However, evaporation induced by menisci was 25 % higher in MGD patients. Our results contribute to the evidence of the inhibition of evaporation by Meibum. Our study also suggests that the evaporation induced by contact points may be a more relevant model to measure differences in evaporation due to the composition of Meibum. This model may also have connotations in the occurrence of internal stresses in the tear film, inducing its instability.
Collapse
Affiliation(s)
| | - Enrique O Graue-Hernández
- Cornea & Refractive Surgery, Instituto de Oftalmología Fundación Conde de Valenciana, IAP, 06700, México
| | - Natalia Quiróz-Casian
- Cornea & Refractive Surgery, Instituto de Oftalmología Fundación Conde de Valenciana, IAP, 06700, México
| | - Juan R Vélez-Cordero
- Conacyt - Instituto de Física, Universidad Autónoma de San Luis Potosí 78000, México.
| | - Bernardo Yáñez-Soto
- Conacyt - Instituto de Física, Universidad Autónoma de San Luis Potosí 78000, México.
| |
Collapse
|
27
|
Vigo L, Senni C, Pellegrini M, Vagge A, Ferro Desideri L, Carones F, Scorcia V, Giannaccare G. Effects of a New Formulation of Multiple-Action Tear Substitute on Objective Ocular Surface Parameters and Ocular Discomfort Symptoms in Patients with Dry Eye Disease. Ophthalmol Ther 2022; 11:1441-1447. [PMID: 35567735 PMCID: PMC9253225 DOI: 10.1007/s40123-022-00518-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 04/22/2022] [Indexed: 12/02/2022] Open
Abstract
Introduction Recently, there has been a progressive shift from simple water-adding medications towards complex multi-action combined formulas aimed at disrupting different mechanisms within the dry eye disease (DED) vicious cycle. This study evaluated the efficacy and tolerability of Trimix eye drops (Off Health Italia, Italy), a combination of viscosity-enhancing hyaluronic acid, trehalose, and cationic liposomes comprising stearylamine and phospholipids, in patients with DED. Methods In this prospective, pilot study patients diagnosed with mild to moderate DED were enrolled and treated with Trimix eye drops three times daily for 2 months. Ocular surface workup was performed before (V0) and after therapy (V1) by means of IDRA (SBM Sistemi, Turin, Italy), for the measurement of (i) noninvasive break-up time (NIBUT); (ii) tear meniscus height (TMH); (iii) lipid layer thickness (LLT); (iv) infrared meibography (percentage of meibomian gland loss); (v) bulbar redness (Efron scale). Treatment tolerability was scored on a visual analog scale ranging from 0 (none/not at all) to 100 (much/very) for eight questions. Ocular discomfort symptoms were scored using the Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire. Results Overall, 25 subjects (mean age 60.32 ± 14.55 years) were included in the study. At V1, TMH, NIBUT, and LLT significantly increased compared to V0 (from 0.29 ± 0.06 to 0.46 ± 0.06 mm, 6.34 ± 2.61 to 7.58 ± 2.52 s, and from 63.26 ± 17.15 to 68.42 ± 15.63 nm, respectively; all P < 0.04). Concerning ocular discomfort symptoms, SPEED score significantly improved at V1 (from 16.63 ± 6.32 to 8.30 ± 5.98; P < 0.001); moreover, treatment tolerability was high for all eight items investigated. Conclusions Two-month treatment with Trimix formulation improved objective signs and subjective symptoms in patients with DED, showing also a good tolerability profile.
Collapse
Affiliation(s)
- Luca Vigo
- Carones Ophthalmology Center, Via Domodossola 19, 20145, Milan, Italy
| | - Carlotta Senni
- Department of Ophthalmology, University Vita-Salute-IRCCS Ospedale San Raffaele, Via Olgettina 60, 20132, Milan, Italy
| | - Marco Pellegrini
- Department of Translational Medicine, University of Ferrara, Via Savonarola 9, 44121, Ferrara, Italy.,Department of Ophthalmology, Ospedali Privati Forlì "Villa Igea", Via Gramsci 42/44, 47122, Forlì, Italy.,Istituto Internazionale per la Ricerca e Formazione in Oftalmologia, Via Gramsci 42/44, 47122, Forlì, Italy
| | - Aldo Vagge
- Eye Clinic of Genoa, Policlinico San Martino, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genova, Via Balbi 5, 16126, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Via Largo Rosanna Benzi 10, 16132, Genoa, Italy
| | - Lorenzo Ferro Desideri
- Eye Clinic of Genoa, Policlinico San Martino, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genova, Via Balbi 5, 16126, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Via Largo Rosanna Benzi 10, 16132, Genoa, Italy
| | - Francesco Carones
- Carones Ophthalmology Center, Via Domodossola 19, 20145, Milan, Italy
| | - Vincenzo Scorcia
- Department of Ophthalmology, University "Magna Græcia" of Catanzaro, Viale Europa, 88100, Catanzaro, Italy
| | - Giuseppe Giannaccare
- Department of Ophthalmology, University "Magna Græcia" of Catanzaro, Viale Europa, 88100, Catanzaro, Italy.
| |
Collapse
|
28
|
Arroyo CAD, Byambajav M, Fernández I, Martin E, González-García MJ, López-Miguel A, Valencia-Nieto L, Hagan S, Enríquez-de-Salamanca A. Diurnal variation on tear stability and correlation with tear cytokine concentration. Cont Lens Anterior Eye 2022; 45:101705. [PMID: 35562228 DOI: 10.1016/j.clae.2022.101705] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 04/28/2022] [Accepted: 05/04/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE To investigate the effect of time of day on tear evaporation rate (TER) and tear break-up time, and its possible relationship with the concentration of inflammatory tear molecules (cytokines) in healthy subjects. METHODS Participants with healthy ocular surfaces attended 3 visits, including the screening visit (V0), the 2nd visit (V1) and the 3rd visit (V2). There were 7-day intervals between visits. Participants with Dry Eye Disease (DED) were excluded by using appropriate clinical tests during V0. Clinical evaluation (TER and Non-Invasive Tear Break-Up Time (NITBUT)) and tear collection were performed during V1 and V2, between 9 and 10AM and 3-4PM. The relative humidity and temperature of the examination room were also measured. The tear fluid concentrations of 15 cytokines were measured by multiplex bead analysis. RESULTS Seven men and 10 women (mean age ± S.D; 25.1 ± 6.63 years old) participated in the study. There were no differences in neither the TER and NITBUT outcomes, nor humidity and temperature among times or visits. Eleven out of the 15 cytokines measured were detectable in tear fluids in > 50% of the participants. In the tear levels, no significant (p > 0.05) inter- and/or intra-day differences were detected for EGF, fractalkine, IL-1RA, IL-1β and IP-10. However, significant inter-day differences were found in the tear levels of IL-10 (p = 0.027), IFN-γ (p = 0.035) and TNF-α(p = 0.04) and intra-day differences in the tear levels of IL-8/CXCL8 (p = 0.034) and MCP-1 (p = 0.002). A significant correlation between TER and IL1-β, IL-2, and Fractalkine (p = 0.03, p = 0.03 and p = 0.046, respectively) was found at V1. CONCLUSIONS NITBUT and TER values had no significant variability over the course of a day (AM versus PM), or on different days in healthy participants when humidity and temperature were constant. However, some tear molecule levels did show inter- and intra-day variability, having an inconsistent and moderate correlation with TER diurnal variation.
Collapse
Affiliation(s)
| | - Mungunshur Byambajav
- Department of Vision Sciences, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow G4 0BA, UK
| | - Itziar Fernández
- IOBA (Institute of Applied Ophthalmobiology), Universidad de Valladolid, Valladolid, Spain; CIBER-BBN (Biomedical Research Networking Center in Bioengineering Biomaterials and Nanomedicine), Valladolid, Spain
| | - Eilidh Martin
- Department of Vision Sciences, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow G4 0BA, UK
| | | | - Alberto López-Miguel
- IOBA (Institute of Applied Ophthalmobiology), Universidad de Valladolid, Valladolid, Spain
| | - Laura Valencia-Nieto
- IOBA (Institute of Applied Ophthalmobiology), Universidad de Valladolid, Valladolid, Spain
| | - Suzanne Hagan
- Department of Vision Sciences, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow G4 0BA, UK
| | - Amalia Enríquez-de-Salamanca
- IOBA (Institute of Applied Ophthalmobiology), Universidad de Valladolid, Valladolid, Spain; CIBER-BBN (Biomedical Research Networking Center in Bioengineering Biomaterials and Nanomedicine), Valladolid, Spain
| |
Collapse
|
29
|
Acera A, Abad B, Pereiro X, Rodríguez FD, Ruzafa N, Duran JA, Vecino E. Comparative study of the lipid profile of tears and plasma enriched in growth factors. Exp Eye Res 2022; 219:109061. [DOI: 10.1016/j.exer.2022.109061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 03/19/2022] [Accepted: 03/30/2022] [Indexed: 01/05/2023]
|
30
|
Jun I, Kim S, Kim H, Kim SW, Ji YW, Kim KP, Lee TG, Seo KY. Evaluation of Meibum Lipid Composition According to Tear Interferometric Patterns: RRH: Meibum Composition According to Interferometric Patterns. Am J Ophthalmol 2022; 240:37-50. [PMID: 35227696 DOI: 10.1016/j.ajo.2022.02.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 02/09/2022] [Indexed: 11/17/2022]
Abstract
PURPOSE To determine the relationship between tear film interferometric patterns and properties of lipid, including rheological properties. DESIGN Prospective, cross-sectional laboratory investigation. METHOD This study included 105 subjects (94 dry eye patients and 11 normal participants). The subjects were divided into 3 categories (group 1, normal; group 2, thin; and group 3, irregular) according to interferometric patterns. According to tear interferometric patterns, ultra-performance liquid chromatography (LC) quadrupole-linear ion trap/mass spectrometry (MS)-based analysis was used to investigate lipid profiling of meibum. Rheological properties were examined by using a Langmuir-Blodgett trough with saline solution. RESULTS Normal subjects showed Pearl-like patterns, and dry eye patients showed either irregular or thin patterns. Group 2 tended to be the evaporative type, and group 3 tended to be the aqueous-deficient type. Lipid profiling using LC-MS identified 280 lipid species of 25 lipid classes. In the meibum of the patient groups, the content of cholesteryl esters and nonpolar lipids was lower than that in the normal group. However, the content of polar lipids such as sphingolipids and phospholipids in the patient groups was higher than that in the normal group. Rheological properties showed that the lift-off areas were comparable among the 3 groups and the surface tension was the highest in group 1, followed by group 3 and group 2. CONCLUSIONS The findings of this study suggest that tear interferometric patterns are associated with lipid profiling of meibum and its rheological properties. These results may contribute toward the development of new treatment modalities.
Collapse
Affiliation(s)
- Ikhyun Jun
- From the Institute of Vision Research (I.J, Y.W.J, K.Y.S), Department of Ophthalmology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemungu, Seoul 03722, South Korea; Corneal Dystrophy Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemungu, Seoul 03722, South Korea
| | - Sehui Kim
- Department of Chemical and Biomolecular Engineering, Yonsei University (S.K, T.G.L), 50 Yonsei-ro, Seodaemungu, Seoul 03722, South Korea
| | - Hyoseon Kim
- Department of Applied Chemistry, Institute of Natural Science, Global Center for Pharmaceutical Ingredient Materials, Kyung Hee University (H.K, K.P.K), Yongin, South Korea; Department of Biomedical Science and Technology, Kyung Hee Medical Science Research Institute, Kyung Hee University, Seoul (H.K, K.P.K), South Korea
| | - Sun Woong Kim
- Department of Ophthalmology, Wonju Severance Christian Hospital, 20 Ilsan-ro, Wonju 26426, South Korea
| | - Yong Woo Ji
- From the Institute of Vision Research (I.J, Y.W.J, K.Y.S), Department of Ophthalmology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemungu, Seoul 03722, South Korea
| | - Kwang Pyo Kim
- Department of Applied Chemistry, Institute of Natural Science, Global Center for Pharmaceutical Ingredient Materials, Kyung Hee University (H.K, K.P.K), Yongin, South Korea; Department of Biomedical Science and Technology, Kyung Hee Medical Science Research Institute, Kyung Hee University, Seoul (H.K, K.P.K), South Korea
| | - Tai Gyu Lee
- Department of Chemical and Biomolecular Engineering, Yonsei University (S.K, T.G.L), 50 Yonsei-ro, Seodaemungu, Seoul 03722, South Korea
| | - Kyoung Yul Seo
- From the Institute of Vision Research (I.J, Y.W.J, K.Y.S), Department of Ophthalmology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemungu, Seoul 03722, South Korea
| |
Collapse
|
31
|
von Ahrentschildt A, Hanenberg L, Robich ML, Jones-Jordan LA, Marx S, Sickenberger W, Powell DR, Kwan JT, Wong S, Srinivasan S, Jones L, Pucker AD. Morphological characteristics of Meibomian Glands and their Influence on Dry Eye disease in contact lens wearers. Ocul Surf 2022; 24:93-99. [DOI: 10.1016/j.jtos.2022.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 01/21/2022] [Accepted: 01/29/2022] [Indexed: 11/16/2022]
|
32
|
Huang X, Xu L, Wang W, Hu W, Li X, Zhang H, Chen J, Li G. Correlations Between Single-Photon Emission Computed Tomography Parameters of Salivary Glands and Dry Eye Tests in Patients With Sjögren's Syndrome. Front Med (Lausanne) 2022; 8:781382. [PMID: 35096874 PMCID: PMC8795081 DOI: 10.3389/fmed.2021.781382] [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: 09/22/2021] [Accepted: 12/16/2021] [Indexed: 11/23/2022] Open
Abstract
Objective To evaluate the correlations between Single-Photon Emission Computed Tomography (SPECT) parameters of salivary glands and dry eye parameters in patients with Sjögren's syndrome (SS). Methods A total of 28 patients with SS participated in this prospective study. Dry eye assessments include tear film break-up time (TBUT), corneal fluorescein staining scoring (CFS), Schirmer's I test (SIT) examination and SPECT of salivary gland. The following quantitative parameters were derived from SPECT imaging for salivary glands: Uptake index (UI), the time needed to achieve the minimum counts after Vit C stimulation (Ts), and excretion fraction (EF). The relation between the aforementioned parameters and TBUT, CFS and SIT were analyzed with SPSS 22.0 software. Results All the 28 eyes of the 28 subjects were examined. The mean SIT was 6.04 ± 4.64 mm/5 min (0–18 mm/5 min); the mean CFS was 3.07 ± 2.65 (0–10) and the mean BUT was 2.11 ± 1.97 s (0–9 s). The mean EF value was 0.52 ± 0.12 (0.26–0.75) in parotid glands and 0.45 ± 0.10 (0.30–0.67) in submandibular glands, respectively. The mean UI value was 9.33 ± 1.68 (6.03–13.20) in parotid glands and 9.92 ± 1.48 (7.08–12.60) in submandibular glands, respectively. The mean Ts (min) was 5.32 ± 3.01 (2.00–12.00) in parotid glands and 11.09 ± 7.40 (2.00- 29.00 min) in submandibular glands, respectively. It was found that EF positively correlates with SIT in patients with SS (r = 0.499 and 0.426 in parotid glands and submandibular glands, with P < 0.05), while no significant correlation was found between the UI, Ts and CFS, TBUT (P > 0.05). Conclusions The EF was positively correlated with SIT in patients with SS, it could reflex the dysfunction of salivary glands in SS patients. So, EF may be a valuable parameter for the diagnosis of SS patients with lacrimal gland secretion dysfunction.
Collapse
Affiliation(s)
- Xiaoyu Huang
- Department of Ophthalmology, Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Lingjuan Xu
- Department of Ophthalmology, Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Wei Wang
- Department of Ophthalmology, Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Weikun Hu
- Department of Ophthalmology, Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Xinyu Li
- Department of Ophthalmology, Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Hong Zhang
- Department of Ophthalmology, Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Jing Chen
- Department of Nuclear Medicine, Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Guigang Li
- Department of Ophthalmology, Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| |
Collapse
|
33
|
Pena-Verdeal H, Ramos L, Garcia-Queiruga J, García-Resúa C, Giráldez MJ, Yebra-Pimentel E. Validation of a New Software Application for Tear Breakup Measurement. Optom Vis Sci 2022; 99:159-166. [PMID: 34897233 DOI: 10.1097/opx.0000000000001852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
SIGNIFICANCE Tear film instability has been recognized as one key mechanism on dry eye disease. There is a need for new instruments, methods, or protocols to improve the repeatability and reproducibility of the tear film stability to facilitate its clinical evaluation use as a rapid and reliable primary diagnostic test. PURPOSE The present pilot study aimed to validate a method to automatically measure the tear film breakup time (BUT). METHODS A total of 264 videos of BUT were randomly selected among the clinical history of subjects attending the optometry clinic. Videos were stored in a backup server through a secure file transfer protocol and analyzed by three different examiners: two masked observers (subjective evaluation) and a third investigator using the automatic software application (objective evaluation). Subjective evaluation was conducted only once on an online software designed for this protocol where videos were presented in random masked order. Automatic evaluation based on color and texture analysis was performed by (1) automatic localization of sequences of interest in the video, (2) extraction of the region of interest within each frame, and (3) automatic BUT measurement from evolution curves in the region of interest as time elapsed from the beginning of the sequence of interest until the curve exceeds a threshold. RESULTS Substantial correlation was observed among the examiners (intraclass correlation coefficient, 0.752). There was a statistical difference between observer 1 and 2 evaluations (t test, P < .001), whereas data provided by the software showed no significant differences from those of the observers (t test, P ≥ .26). Similar results to the whole data set analysis were obtained when the sample was reassessed only considering mean BUT values ≤15 seconds. CONCLUSIONS The present pilot study showed acceptable clinical results for the software application designed to objectively measure the BUT.
Collapse
Affiliation(s)
| | - Lucía Ramos
- Departamento de Computación (VARPA), Universidade da Coruña, A Coruña, Spain
| | - Jacobo Garcia-Queiruga
- Departamento de Física Aplicada (Area de Optometría), Facultad de Óptica y Optometría, Universidad de Santiago de Compostela, Santiago de Compostela, Galicia, Spain
| | - Carlos García-Resúa
- Departamento de Física Aplicada (Area de Optometría), Facultad de Óptica y Optometría, Universidad de Santiago de Compostela, Santiago de Compostela, Galicia, Spain
| | - María J Giráldez
- Departamento de Física Aplicada (Area de Optometría), Facultad de Óptica y Optometría, Universidad de Santiago de Compostela, Santiago de Compostela, Galicia, Spain
| | - Eva Yebra-Pimentel
- Departamento de Física Aplicada (Area de Optometría), Facultad de Óptica y Optometría, Universidad de Santiago de Compostela, Santiago de Compostela, Galicia, Spain
| |
Collapse
|
34
|
Human meibum and tear film derived cholesteryl and wax esters in meibomian gland dysfunction and tear film structure. Ocul Surf 2022; 23:12-23. [PMID: 34774809 PMCID: PMC9875797 DOI: 10.1016/j.jtos.2021.10.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 10/27/2021] [Accepted: 10/29/2021] [Indexed: 02/07/2023]
Abstract
PURPOSE This study evaluated the presence and roles of cholesteryl esters (CEs) and wax esters (WEs) from human tear film and meibum in meibomian gland dysfunction (MGD). METHODS Out of 195 enrolled subjects, 164 and 179 subjects provided tear and meibum samples, respectively. Subjects were classified into normal, asymptomatic MGD, MGD, and mixed (MGD & aqueous deficient). The precorneal tear film (PCTF) thinning rate (evaporation) was measured using optical coherence tomography. Lipids extracted from tear and meibum samples were infused into a SCIEX 5600 TripleTOF mass spectrometer. CE and WE intensities quantified with Analyst 1.7 TF and LipidView 1.3 were compared across disease groups in MetaboAnalyst 5.0 and correlated with PCTF thinning rates. RESULTS The numbers of unique CEs and WEs identified in the samples were 125 and 86, respectively. Unsupervised Principal Component (PC) analysis and supervised Partial Least Square Discriminant analysis exhibited little separation among groups for both CEs and WEs in tears and meibum. Spearman's correlation analyses showed no association between either the first or second PC scores with PCTF thinning rates. CONCLUSION The abundances of human PCTF and meibum-derived CEs and WEs were independent of MGD disease status and PCTF thinning (evaporation). CEs and WEs alterations do not contribute to alterations in tear film dynamics in MGD, such as has been demonstrated by the (O-acyl) ω-hydroxy fatty acids (OAHFAs).
Collapse
|
35
|
Bai Y, Ngo W, Khanal S, Nichols JJ. Characterization of the thickness of the Tear Film Lipid Layer in Meibomian Gland Dysfunction using high resolution optical microscopy. Ocul Surf 2021; 24:34-39. [PMID: 34968765 DOI: 10.1016/j.jtos.2021.12.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 12/21/2021] [Accepted: 12/23/2021] [Indexed: 12/19/2022]
Abstract
PURPOSE To evaluate the thickness of the tear film lipid layer (TFLL) in meibomian gland dysfunction (MGD) using a high-resolution optical microscope. METHODS The Ocular Surface Disease Index (OSDI) and meibum grade score (MGS) were used to classify 190 subjects into four groups: normal (OSDI<13 and MGS<10), mixed (OSDI≥13 and MGS<10), asymptomatic MGD (OSDI<13 and MGS≥10), and MGD (OSDI≥13 and MGS≥10). The high-resolution optical microscope was used to capture TFLL images in vivo. The histograms of TFLL thickness were analyzed and curve-fitted using probability density functions (PDFs). RESULTS There were three obvious peaks in the distributions of TFLL across the groups. From the curve-fitting process, the main outcomes are displayed according to each Gaussian function with the position of peak (μ) and the summed percentage within the range of standard deviation (σ). The normal group had distribution as follows: 33.3 ± 0.005 nm, 26%; 53.9 ± 0.019 nm, 40%; 79.4 ± 0.064 nm, 12%. The mixed group had a distribution as follows: 33.8 ± 0.004 nm, 32%; 53.1 ± 0.115 nm, 21%; 71.7 ± 0.232 nm, 27%. The asymptomatic MGD group had a distribution as follows: 33.5 ± 0.004 nm, 20%; 49.2 ± 0.041 nm, 25%; 62.9 ± 0.063 nm, 47%. The MGD group had a distribution as follows: 34.3 ± 0.004 nm, 34%; 53.7 ± 0.022 nm, 28%; 74.9 ± 0.060 nm, 16%. CONCLUSIONS The MGD and mixed groups had the largest percentages of TFLL thicknesses fall within the thinnest modes (peak 34.3 and 33.8 nm, respectively). These data show that measures of central tendency (e.g., averages, medians) do not fully appreciate the variable distributions of TFLL across disease spectra.
Collapse
Affiliation(s)
- Yuqiang Bai
- Department of Optometry and Vision Science, School of Optometry, University of Alabama at Birmingham, Birmingham, AL, USA
| | - William Ngo
- Centre for Ocular Research & Education, School of Optometry & Vision Science, University of Waterloo, Waterloo, Ontario, Canada; Centre for Eye and Vision Research (CEVR), 17W Hong Kong Science Park, Hong Kong
| | - Safal Khanal
- Department of Optometry and Vision Science, School of Optometry, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jason J Nichols
- Department of Optometry and Vision Science, School of Optometry, University of Alabama at Birmingham, Birmingham, AL, USA.
| |
Collapse
|
36
|
A review of meibomian gland structure, function, and contact lens wear. Cont Lens Anterior Eye 2021; 45:101560. [PMID: 34955427 DOI: 10.1016/j.clae.2021.101560] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 11/24/2021] [Accepted: 12/12/2021] [Indexed: 01/04/2023]
Abstract
PURPOSE To provide a balanced literature review of the studies that have evaluated the effect of contact lenses on meibomian gland (MG) health. METHODS A PubMed.gov literature search was conducted on or before May 15, 2021. No other time constraints were applied. Search terms included the following: "meibomian gland(s)" plus "contact lens(es)" or "meibography" plus "contact lens(es)". Only full text articles written in English were considered. The reference lists of recovered papers were used to identify articles missed during the primary search. Included articles were required to discuss the impact of contact lenses on MG morphology or function and were graded according to the level of evidence presented. RESULTS The literature indicates that contact lenses impact MG function; however, the data are equivocal regarding contact lenses inducing MG structural changes. The literature likewise indicates that the mechanism(s) by which contact lenses impact the MGs are likely multifactorial. Recent data suggests that MGs may have some plasticity. Detected differences between studies likely stem from varied populations evaluated, study designs, and the duration of the evaluation periods. CONCLUSIONS With this literature review finding conflicting relationships between MG health and contact lens use, future longitudinal studies with standardized clinical MG assessments are needed to determine the true impact of contact lenses on MG health. Until these data are obtained, contact lens wearers should undergo a full MG evaluation, especially because recent data suggest that MG treatments may restore MG structure and function.
Collapse
|
37
|
Gao H, Chen H, Xie HT, Xu KK, Shi BJ, Huang YK. Changes in Meibum Lipid Composition With Ocular Demodex Infestation. Transl Vis Sci Technol 2021; 10:6. [PMID: 34874449 PMCID: PMC8662575 DOI: 10.1167/tvst.10.14.6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Purpose The purpose of this study was to understand the impact of Demodex infection in the lipid component of meibum in patients. Methods The meibum samples were collected from four groups of subjects: (1) Demodex-negative with non-MGD (D−M−; n = 10); (2) Demodex-positive with non-MGD (D+M−; n = 10); (3) Demodex-negative with MGD (D−M+; n = 10); and (4) Demodex-positive with MGD (D+M+; n = 10). A liquid chromatography–mass spectrometry (LC-MS) system consisting of ultra-performance liquid chromatography and a Q Exactive high-resolution mass spectrometer was used for lipids separation and detection. Results Compared with the D−M− group, the D+M− group had lower levels of phosphatidylcholines (PCs) and lysophosphatidylcholines (LPCs) and higher levels of phosphatidylethanolamines (PEs). Compared with the D−M+ group, the levels of sphingomyelins (SMs) and PCs in the D+M+ group were decreased, whereas the levels of (O-acyl)-ω-hydroxy fatty acids (OAHFAs), ceramides (CERs), LPCs, and diacylglycerols (DGs) were significantly increased. Triacylglycerols (TGs), DGs, CERs, and OAHFAs were decreased in D−M+ group, whereas levels of PEs, phosphatidylinositols, and phosphatidylglycerols were increased in meibum obtained from the D−M+ group compared with those in the D−M− group. TGs, SMs, CERs, and PEs were decreased in the D+M+ group, whereas levels of LPCs, LPEs, PCs, and PEs were increased in meibum from the D−M+ group compared with those in the D+M− group. Conclusions To the best of our knowledge, this is the first study to assess the changes in meibum from patients with ocular Demodex infestation. The significant increase of OAHFAs in the Demodex-positive group suggest that OAHFAs may be associated with the progress of ocular Demodex infections. Translational Relevance OAHFAs could be a potential new therapeutic target for ocular Demodex infestation.
Collapse
Affiliation(s)
- Hui Gao
- Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Aier Eye Hospital of Wuhan University, Wuhan, China
| | - Hua Chen
- Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hua-Tao Xie
- Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kang-Kang Xu
- Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Bing-Jie Shi
- Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yu-Kan Huang
- Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| |
Collapse
|
38
|
Tchegnon E, Liao CP, Ghotbi E, Shipman T, Wang Y, McKay RM, Le LQ. Epithelial stem cell homeostasis in Meibomian gland development, dysfunction, and dry eye disease. JCI Insight 2021; 6:e151078. [PMID: 34499624 PMCID: PMC8564894 DOI: 10.1172/jci.insight.151078] [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: 05/04/2021] [Accepted: 09/08/2021] [Indexed: 11/17/2022] Open
Abstract
Dry eye disease affects over 16 million adults in the US, and the majority of cases are due to Meibomian gland dysfunction. Unfortunately, the identity of the stem cells involved in Meibomian gland development and homeostasis is not well elucidated. Here, we report that loss of Krox20, a zinc finger transcription factor involved in the development of ectoderm-derived tissues, or deletion of KROX20-expressing epithelial cells disrupted Meibomian gland formation and homeostasis, leading to dry eye disease secondary to Meibomian gland dysfunction. Ablation of Krox20-lineage cells in adult mice also resulted in dry eye disease, implicating Krox20 in homeostasis of the mature Meibomian gland. Lineage-tracing and expression analyses revealed a restricted KROX20 expression pattern in the ductal areas of the Meibomian gland, although Krox20-lineage cells generate the full, mature Meibomian gland. This suggests that KROX20 marks a stem/progenitor cell population that differentiates to generate the entire Meibomian gland. Our Krox20 mouse models provide a powerful system that delineated the identity of stem cells required for Meibomian gland development and homeostasis and can be used to investigate the factors underlying these processes. They are also robust models of Meibomian gland dysfunction-related dry eye disease, with a potential for use in preclinical therapeutic screening.
Collapse
Affiliation(s)
- Edem Tchegnon
- Department of Dermatology and.,Genetics, Development and Disease Graduate Program, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Chung-Ping Liao
- Department of Dermatology and.,Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | | | | | | | | | - Lu Q Le
- Department of Dermatology and.,Genetics, Development and Disease Graduate Program, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Hamon Center for Regenerative Science and Medicine.,Simmons Comprehensive Cancer Center, and.,O'Donnell Brain Institute, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| |
Collapse
|
39
|
Suzuki T, Kitazawa K, Cho Y, Yoshida M, Okumura T, Sato A, Kinoshita S. Alteration in meibum lipid composition and subjective symptoms due to aging and meibomian gland dysfunction. Ocul Surf 2021; 26:310-317. [PMID: 34666148 DOI: 10.1016/j.jtos.2021.10.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 10/06/2021] [Accepted: 10/15/2021] [Indexed: 12/14/2022]
Abstract
PURPOSE To investigate the alteration in lipid composition of meibum, objective clinical signs, and subjective symptoms associated with aging and meibomian gland (MG) dysfunction (MGD). METHODS In 10 MGD patients [4 males/6 females, mean age: 65.6 ± 7.9 years (range: 50-79 years)] and 24 healthy volunteer subjects [young subjects: 6 males/6 females, mean age: 25.7 ± 3.8 years (range: 20-35 years), elderly subjects: 6 males/6 females, mean age: 58.4 ± 7.5 years (range: 50-79 years)], three objective clinical signs were evaluated: MG orifice obstruction, meibum score, and tear film lipid layer interference pattern. Subjective symptoms were analyzed via a 15-item questionnaire. After careful collection of meibum samples, comprehensive lipid analysis was performed via liquid chromatography-mass spectrometry. Data was analyzed via JMP® ver. 13 (SAS Institute, Inc., Cary, NC) statistical analysis software. RESULTS In the MGD patients and elderly subjects, there was a significant decrease in non-polar lipids such as cholesterol esters (ChEs), while a significant increase in polar lipids [cholesterol (Ch), (O-acyl)-ω-hydroxy fatty acid (OAHFA), and free fatty acid (FA)] in total lipids (Tukey-Kramer test: p < 0.05). Triglyceride was significantly increased only in MGD patients (p < 0.05). Symptom scores representative of vision quality (i.e., blurred vision/haziness) were significantly negatively-correlated with the ratio of the non-polar lipid ChE, while significantly positively correlated with the polar lipids Ch, OAHFA, and FA (Spearman's rank correlation coefficient: p < 0.05). CONCLUSIONS Our findings revealed that both MGD and aging affect the composition ratio of major meibum lipids, resulting in the appearance of subjective symptoms.
Collapse
Affiliation(s)
- Tomo Suzuki
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan; Department of Ophthalmology, Kyoto City Hospital Organization, Kyoto, Japan.
| | - Koji Kitazawa
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yuko Cho
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan; Department of Ophthalmology, Kyoto City Hospital Organization, Kyoto, Japan
| | - Masataka Yoshida
- Research and Development Headquarters, Lion Corporation, Tokyo, Japan
| | - Takashi Okumura
- Research and Development Headquarters, Lion Corporation, Tokyo, Japan
| | - Atsushi Sato
- Research and Development Headquarters, Lion Corporation, Tokyo, Japan
| | - Shigeru Kinoshita
- Department of Frontier Medical Science and Technology for Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| |
Collapse
|
40
|
Protection against corneal hyperosmolarity with soft-contact-lens wear. Prog Retin Eye Res 2021; 87:101012. [PMID: 34597771 DOI: 10.1016/j.preteyeres.2021.101012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 09/18/2021] [Accepted: 09/21/2021] [Indexed: 01/03/2023]
Abstract
Hyperosmotic tear stimulates human corneal nerve endings, activates ocular immune response, and elicits dry-eye symptoms. A soft contact lens (SCL) covers the cornea preventing it from experiencing direct tear evaporation and the resulting blink-periodic salinity increases. For the cornea to experience hyperosmolarity due to tear evaporation, salt must transport across the SCL to the post-lens tear film (PoLTF) bathing the cornea. Consequently, limited salt transport across a SCL potentially protects the ocular surface from hyperosmotic tear. In addition, despite lens-wear discomfort sharing common sensations to dry eye, no correlation is available between measured tear hyperosmolarity and SCL-wear discomfort. Lack of documentation is likely because clinical measurements of tear osmolarity during lens wear do not interrogate the tear osmolarity of the PoLTF that actually overlays the cornea. Rather, tear osmolarity is clinically measured in the tear meniscus. For the first time, we mathematically quantify tear osmolarity in the PoLTF and show that it differs significantly from the clinically measured tear-meniscus osmolarity. We show further that aqueous-deficient dry eye and evaporative dry eye both exacerbate the hyperosmolarity of the PoLTF. Nevertheless, depending on lens salt-transport properties (i.e., diffusivity, partition coefficient, and thickness), a SCL can indeed protect against corneal hyperosmolarity by reducing PoLTF salinity to below that of the ocular surface during no-lens wear. Importantly, PoLTF osmolarity for dry-eye patients can be reduced to that of normal eyes with no-lens wear provided that the lens exhibits a low lens-salt diffusivity. Infrequent blinking increases PoLTF osmolarity consistent with lens-wear discomfort. Judicious design of SCL material salt-transport properties can ameliorate corneal hyperosmolarity. Our results confirm the importance of PoLTF osmolarity during SCL wear and indicate a possible relation between PoLTF osmolarity and contact-lens discomfort.
Collapse
|
41
|
Mussi N, Haque W, Robertson DM. The Association Between Risk Factors for Metabolic Syndrome and Meibomian Gland Disease in a Dry Eye Cohort. Clin Ophthalmol 2021; 15:3821-3832. [PMID: 34539177 PMCID: PMC8445099 DOI: 10.2147/opth.s322461] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 07/22/2021] [Indexed: 01/02/2023] Open
Abstract
Purpose Risk factors for metabolic syndrome include abdominal obesity, insulin resistance, hypertension, high triglycerides and/or low high-density lipoprotein cholesterol, and hyperglycemia. Risk factors for metabolic syndrome have been associated with dry eye disease; however, their association with meibomian gland disease (MGD), a subtype of dry eye, is unclear. In the present study, we investigated risk factors for metabolic syndrome in a dry eye cohort with and without MGD. Methods This retrospective case-control study evaluated electronic medical records at a major urban outpatient medical center to identify patients with a known diagnosis of dry eye disease with and without MGD. Males and females were matched for age, smoking status, race, ethnicity, and body mass index (BMI). Patient demographics, anthropometric measurements, medical history, clinical findings, and serologies were analyzed. A diagnosis of MGD was based on clinical signs noted in the medical record. Results MGD was not associated with BMI, smoking, type 2 diabetes mellitus, hypertension or hyperlipidemia in this dry eye cohort. MGD was associated with male sex and increasing age. While increasing age was weakly correlated with decreased low density lipoprotein cholesterol and non-high density lipoprotein cholesterol, serum lipid levels were not associated with MGD. Conclusion Importantly, we found that risk factors for metabolic syndrome are not specifically associated with an increase in MGD when compared to non-MGD dry eye subjects. While risk factors for metabolic syndrome are associated with dry eye disease, they likely reflect a chronic systemic state of low-grade inflammation that negatively impacts the function of both lacrimal and meibomian glands.
Collapse
Affiliation(s)
- Natalia Mussi
- Department of Ophthalmology, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Waqas Haque
- Department of Ophthalmology, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Danielle M Robertson
- Department of Ophthalmology, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| |
Collapse
|
42
|
Bertsch P, Bergfreund J, Windhab EJ, Fischer P. Physiological fluid interfaces: Functional microenvironments, drug delivery targets, and first line of defense. Acta Biomater 2021; 130:32-53. [PMID: 34077806 DOI: 10.1016/j.actbio.2021.05.051] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 05/24/2021] [Accepted: 05/25/2021] [Indexed: 12/13/2022]
Abstract
Fluid interfaces, i.e. the boundary layer of two liquids or a liquid and a gas, play a vital role in physiological processes as diverse as visual perception, oral health and taste, lipid metabolism, and pulmonary breathing. These fluid interfaces exhibit a complex composition, structure, and rheology tailored to their individual physiological functions. Advances in interfacial thin film techniques have facilitated the analysis of such complex interfaces under physiologically relevant conditions. This allowed new insights on the origin of their physiological functionality, how deviations may cause disease, and has revealed new therapy strategies. Furthermore, the interactions of physiological fluid interfaces with exogenous substances is crucial for understanding certain disorders and exploiting drug delivery routes to or across fluid interfaces. Here, we provide an overview on fluid interfaces with physiological relevance, namely tear films, interfacial aspects of saliva, lipid droplet digestion and storage in the cell, and the functioning of lung surfactant. We elucidate their structure-function relationship, discuss diseases associated with interfacial composition, and describe therapies and drug delivery approaches targeted at fluid interfaces. STATEMENT OF SIGNIFICANCE: Fluid interfaces are inherent to all living organisms and play a vital role in various physiological processes. Examples are the eye tear film, saliva, lipid digestion & storage in cells, and pulmonary breathing. These fluid interfaces exhibit complex interfacial compositions and structures to meet their specific physiological function. We provide an overview on physiological fluid interfaces with a focus on interfacial phenomena. We elucidate their structure-function relationship, discuss diseases associated with interfacial composition, and describe novel therapies and drug delivery approaches targeted at fluid interfaces. This sets the scene for ocular, oral, or pulmonary surface engineering and drug delivery approaches.
Collapse
|
43
|
Pult H, Khatum FS, Trave-Huarte S, Wolffsohn JS. Effect of Eye Spray Phospholipid Concentration on the Tear Film and Ocular Comfort. Eye Contact Lens 2021; 47:445-448. [PMID: 33813585 PMCID: PMC8294836 DOI: 10.1097/icl.0000000000000788] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To evaluate the effect of eye spray phospholipid concentration on symptoms and tear film stability. METHODS High-concentration (Tears Again, Optima Pharma GmbH, Hallbergmoos, Germany) and low-concentration (Ocuvers, Innomedis AG, Germany) phospholipid eye sprays were sprayed onto the closed eyelids of 30 subjects (33.2±1.8 years; 20 women) in a multicentered, prospective, crossover study. Ocular comfort (visual analog scale) and noninvasive tear film stability (NIBUT) of each eye were evaluated before application (along with the Ocular Surface Disease Index), 10 min after application, and 30 min after application. RESULTS Comfort (high concentration: 68.5±16.4 vs. low concentration: 70.7±14.5 phospholipid) and NIBUT (high concentration: 11.5±4.6 sec vs. low concentration: 11.2±6.0 sec phospholipid) were not different (P>0.3) between sprays before application, but comfort (by 12 points, P=0.001) and NIBUT (by 5 sec, P=0.016) were significantly better with a high-concentration phospholipid spray at both 10 min and 30 min time points than those with the low-concentration phospholipid spray. CONCLUSIONS The liposomal eye spray with higher concentration of phospholipids significantly improved ocular comfort and tear film stability in contrast to the eye spray with lower concentration of phospholipids, hence practitioners need to choose an appropriate eye spray to maximize the patient benefit.
Collapse
Affiliation(s)
- Heiko Pult
- Optometry and Vision Sciences Research Group (H.P., F.S.K., S.T.H., J.S.W.), College of Health and Life Sciences, Aston University, Birmingham, United Kingdom; Dr. Heiko Pult—Optometry and Vision Research (H.P.), Weinheim, Germany; and School of Biomedical & Life Sciences (H.P.), Cardiff University, Cardiff, United Kingdom.
| | - Farzana S. Khatum
- Optometry and Vision Sciences Research Group (H.P., F.S.K., S.T.H., J.S.W.), College of Health and Life Sciences, Aston University, Birmingham, United Kingdom; Dr. Heiko Pult—Optometry and Vision Research (H.P.), Weinheim, Germany; and School of Biomedical & Life Sciences (H.P.), Cardiff University, Cardiff, United Kingdom.
| | - Sonia Trave-Huarte
- Optometry and Vision Sciences Research Group (H.P., F.S.K., S.T.H., J.S.W.), College of Health and Life Sciences, Aston University, Birmingham, United Kingdom; Dr. Heiko Pult—Optometry and Vision Research (H.P.), Weinheim, Germany; and School of Biomedical & Life Sciences (H.P.), Cardiff University, Cardiff, United Kingdom.
| | - James S. Wolffsohn
- Optometry and Vision Sciences Research Group (H.P., F.S.K., S.T.H., J.S.W.), College of Health and Life Sciences, Aston University, Birmingham, United Kingdom; Dr. Heiko Pult—Optometry and Vision Research (H.P.), Weinheim, Germany; and School of Biomedical & Life Sciences (H.P.), Cardiff University, Cardiff, United Kingdom.
| |
Collapse
|
44
|
Ding JE, Kim YH, Yi SM, Graham AD, Li W, Lin MC. Ocular surface cooling rate associated with tear film characteristics and the maximum interblink period. Sci Rep 2021; 11:15030. [PMID: 34294850 PMCID: PMC8298610 DOI: 10.1038/s41598-021-94568-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 07/12/2021] [Indexed: 02/07/2023] Open
Abstract
The surface of the human eye is covered with a protective tear film that refreshes with each blink. Natural blinking occurs involuntarily, but one can also voluntarily blink or refrain from blinking. The maximum time one can refrain from blinking until the onset of discomfort is the maximum interblink period (MIBP). During the interblink period the tear film evaporates and thins from the ocular surface. Infrared thermography provides a non-invasive measure of the ocular surface temperature (OST). Due to evaporation, ocular surface cooling (OSC) generally occurs when the eyes are open and exposed to the environment. The purpose of our study was to investigate the effect of OSC rate on the MIBP, and to investigate the association of the MIBP with tear film characteristics in subjects who do and do not exhibit OSC. The MIBP was measured simultaneously with OST over time. Non-invasive tear breakup time, tear meniscus height, tear lipid layer thickness, and Schirmer I test strip wetted lengths were measured on a day prior to the thermography visit. Subjects were divided into cooling and non-cooling groups based on OSC rate, and demographic and tear film characteristics were tested for inter-group differences. A faster OSC rate was associated with an exponentially shorter duration of the MIBP overall and within the cooling group alone. Faster non-invasive tear breakup time was significantly associated with a shorter MIBP in both groups. These results suggest that tear film evaporation initiates a pathway that results in the onset of ocular discomfort and the stimulus to blinking. The presence of a subset of subjects with no or minimal OSC who nevertheless have a short MIBP indicates that evaporative cooling is not the only mechanism responsible for the onset of ocular discomfort.
Collapse
Affiliation(s)
- Jennifer E. Ding
- grid.47840.3f0000 0001 2181 7878Clinical Research Center, School of Optometry, University of California, Berkeley, 360 Minor Hall, Berkeley, CA 94720-2020 USA
| | - Young Hyun Kim
- grid.47840.3f0000 0001 2181 7878Clinical Research Center, School of Optometry, University of California, Berkeley, 360 Minor Hall, Berkeley, CA 94720-2020 USA ,grid.47840.3f0000 0001 2181 7878Vision Science Graduate Group, University of California, Berkeley, CA 94720 USA ,grid.47840.3f0000 0001 2181 7878Chemical and Biomolecular Engineering Department, University of California, Berkeley, CA 94720 USA
| | - Sarah M. Yi
- grid.47840.3f0000 0001 2181 7878Clinical Research Center, School of Optometry, University of California, Berkeley, 360 Minor Hall, Berkeley, CA 94720-2020 USA
| | - Andrew D. Graham
- grid.47840.3f0000 0001 2181 7878Clinical Research Center, School of Optometry, University of California, Berkeley, 360 Minor Hall, Berkeley, CA 94720-2020 USA
| | - Wing Li
- grid.47840.3f0000 0001 2181 7878Clinical Research Center, School of Optometry, University of California, Berkeley, 360 Minor Hall, Berkeley, CA 94720-2020 USA
| | - Meng C. Lin
- grid.47840.3f0000 0001 2181 7878Clinical Research Center, School of Optometry, University of California, Berkeley, 360 Minor Hall, Berkeley, CA 94720-2020 USA ,grid.47840.3f0000 0001 2181 7878Vision Science Graduate Group, University of California, Berkeley, CA 94720 USA
| |
Collapse
|
45
|
Khanal S, Bai Y, Ngo W, Nichols KK, Wilson L, Barnes S, Nichols JJ. Human Meibum and Tear Film Derived (O-Acyl)-Omega-Hydroxy Fatty Acids as Biomarkers of Tear Film Dynamics in Meibomian Gland Dysfunction and Dry Eye Disease. Invest Ophthalmol Vis Sci 2021; 62:13. [PMID: 34236383 PMCID: PMC8267210 DOI: 10.1167/iovs.62.9.13] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To investigate the association between precorneal tear film (PCTF)- and meibum-derived (O-Acyl)-omega-hydroxy fatty acids (OAHFAs) and PCTF thinning in meibomian gland health and dysfunction. Methods Of 195 eligible subjects (18-84 years, 62.6% female), 178 and 170 subjects provided both PCTF optical coherence tomography (OCT) imaging and mass spectrometry data for tears (n = 178) and meibum (n = 170). The PCTF thinning rate was measured in the right eye using an ultra-high-resolution, custom-built OCT. Tear and meibum samples from the right eye were infused into the SCIEX 5600 TripleTOF mass spectrometer in the negative ion mode. Intensities (m/z) of preidentified OAHFAs were measured with Analyst 1.7TF and LipidView 1.3 (SCIEX). Principal component (PC) analyses and Spearman's correlations (ρ) were performed to evaluate the association between OAHFAs and PCTF thinning rates. Results In meibum and tear samples, 76 and 78 unique OAHFAs were detected, respectively. The first PC scores of the meibum-derived OAHFAs had statistically significant correlations with PCTF thinning rates (ρ = 0.18, P = 0.016). Among 10 OAHFAs with the highest first PC loadings, six OAHFAs had negative correlations with PCTF thinning rate (18:2/16:2, ρ = -0.19, P = 0.01; 18:2/30:1, ρ = -0.21, P = 0.008; 18:1/28:1, ρ = -0.22, P = 0.004; 18:1/30:1, ρ = -0.22, P = 0.005; 18:1/25:0, ρ = 0.22, P = 0 .006; and 18:1/26:1, ρ = -0.22, P = 0.006), while one OAHFA had a positive correlation with PCTF thinning rate (18:2/18:1, ρ = 0.48, P = 0.006). Tear film-derived OAHFAs had no association with the PCTF thinning rate. Conclusions Several human meibum-derived OAHFAs showed significant associations with PCTF thinning, suggesting that these OAHFAs could be implicated in the mechanism underlying the stabilization and thinning of the PCTF. The tear-film derived OAHFAs were, however, independent of the rate of PCTF thinning.
Collapse
Affiliation(s)
- Safal Khanal
- Department of Optometry and Vision Science, School of Optometry, University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - Yuqiang Bai
- Department of Optometry and Vision Science, School of Optometry, University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - William Ngo
- Centre for Ocular Research & Education, School of Optometry & Vision Science, University of Waterloo, Waterloo, Ontario, Canada.,Centre for Eye and Vision Research, 17W Hong Kong Science Park, Hong Kong
| | - Kelly K Nichols
- Department of Optometry and Vision Science, School of Optometry, University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - Landon Wilson
- Department of Pharmacology and Toxicology, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States.,Targeted Metabolomics and Proteomics Laboratory, University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - Stephen Barnes
- Department of Pharmacology and Toxicology, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States.,Targeted Metabolomics and Proteomics Laboratory, University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - Jason J Nichols
- Department of Optometry and Vision Science, School of Optometry, University of Alabama at Birmingham, Birmingham, Alabama, United States
| |
Collapse
|
46
|
Tóth N, Szalai E, Rák T, Lillik V, Nagy A, Csutak A. Reliability and clinical applicability of a novel tear film imaging tool. Graefes Arch Clin Exp Ophthalmol 2021; 259:1935-1943. [PMID: 33779800 PMCID: PMC8277647 DOI: 10.1007/s00417-021-05162-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 03/06/2021] [Accepted: 03/12/2021] [Indexed: 11/25/2022] Open
Abstract
PURPOSE The aim of our research was to investigate the reliability and clinical applicability of a modern tear film imaging tool by comparing the inter- and intragrader difference. The further goal was to compare the non-invasive tear break-up time (NIBUT) measured with the LacryDiag® device with traditional tear film break-up time (TBUT). METHODS Comprehensive ophthalmological examination was performed, including LacryDiag® (Quantel Medical, France) (lower tear meniscus height measuring (LTMH), superior and inferior eyelid meibography (MeibS MeibI), interferometry (INT), NIBUT), slit lamp examination, and TBUT. Two independent, well-trained graders selected and analyzed the LTMH, MeibI, MeibS, and INT. The second grader reanalyzed the data 1 month later. Intra- and inter-examiner reliabilities were evaluated using intraclass correlation coefficients (ICC), while for categorical variable, Cohen's kappa statistics were provided. The Bland-Altman plot was used for visualization of the agreement between measurements. RESULTS Fifty healthy volunteers were examined. For LTMH both the inter- and intragrader variabilities were excellent. Between two graders, the ICC of MeibI was poor; however, between two graders, the ICC of MeibS was good, and the intragrader variability in MeibI and MeibS was excellent. For the INT, both intra- and intergrading were in fair and moderate agreement, although the intragrader agreement was higher. Comparing the NIBUT and TBUT, the agreement was slight. CONCLUSION Based on our results, examination of a patient during follow-up should be performed by the same examiner, because of the slight agreement. The LacryDiag® is a non-invasive, easy-to-use device, which can examine the tear film and save the recordings for easier follow-up.
Collapse
Affiliation(s)
- Noémi Tóth
- Department of Ophthalmology, University of Pécs, Medical School, Akác u. 1, Pécs, 7623, Hungary
- Doctoral School of Clinical Medicine, University of Debrecen, Debrecen, 4032, Hungary
| | - Eszter Szalai
- Department of Ophthalmology, University of Pécs, Medical School, Akác u. 1, Pécs, 7623, Hungary
| | - Tibor Rák
- Department of Ophthalmology, University of Pécs, Medical School, Akác u. 1, Pécs, 7623, Hungary
| | - Veronika Lillik
- Department of Ophthalmology, University of Pécs, Medical School, Akác u. 1, Pécs, 7623, Hungary
- Medical School, University of Pécs, Pécs, 7624, Hungary
| | - Attila Nagy
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, 4028, Hungary
| | - Adrienne Csutak
- Department of Ophthalmology, University of Pécs, Medical School, Akác u. 1, Pécs, 7623, Hungary.
- Doctoral School of Clinical Medicine, University of Debrecen, Debrecen, 4032, Hungary.
| |
Collapse
|
47
|
Lee JH, Kim CH, Choe CM, Choi TH. Correlation Analysis between Ocular Surface Parameters with Subjective Symptom Severity in Dry Eye Disease. KOREAN JOURNAL OF OPHTHALMOLOGY 2021; 34:203-209. [PMID: 32495528 PMCID: PMC7269733 DOI: 10.3341/kjo.2019.0133] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 12/16/2019] [Accepted: 01/03/2020] [Indexed: 12/17/2022] Open
Abstract
Purpose To evaluate the clinical symptoms of patients with dry eyes, based on the ocular surface disease index (OSDI) and analyze the relationship between OSDI and various ocular surface parameters. Methods This was a retrospective study that included 45 eyes of 45 dry eye patients who visited the Seoul Nune Eye Hospital from August 2017 to December 2017. The patients were assessed by non-invasive keratography for the first break-up time, lipid layer thickness (LLT), tear osmolarity, tear matrix metalloproteinase-9 immunoassay as well as with the conventional Schirmer I test and fluorescein break-up time. The patient's symptoms were evaluated by the OSDI questionnaires and correlations were analyzed based on the parameters described above. Results There were significant negative correlations between OSDI and non-invasive keratography for the first break-up time (p = 0.038, r = −0.330), and LLT (p = 0.005, r = −0.426). However, there were no significant correlations between OSDI and fluorescein break-up time, Schirmer I score, and tear osmolarity (p = 0.173, 0.575, and 0.844 respectively). OSDI was not significantly different between matrix metalloproteinase-9 positive and negative groups (p = 0.768). Conclusions Non-invasive examinations such as non-invasive keratograph break-up time and interferometry of LLT can be efficient tools for evaluating dry eye symptoms.
Collapse
|
48
|
Khanal S, Ngo W, Nichols KK, Wilson L, Barnes S, Nichols JJ. Human meibum and tear film derived (O-acyl)-omega-hydroxy fatty acids in meibomian gland dysfunction. Ocul Surf 2021; 21:118-128. [PMID: 34052415 DOI: 10.1016/j.jtos.2021.05.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 04/22/2021] [Accepted: 05/23/2021] [Indexed: 02/07/2023]
Abstract
PURPOSE The molecular basis of the tear film and lipid layer alterations in meibomian gland dysfunction (MGD) is unknown. This study aimed to identify and compare (O-acyl)-omega-hydroxy fatty acids (OAHFAs) derived from human meibum and tears in MGD. METHODS Of 195 eligible subjects (18-84 years, 62.6% female), 183 and 174 provided samples for tears and meibum, respectively. Subjects were classified into four groups: Normal, Asymptomatic MGD, MGD, and Mixed. Samples from the right eye of each subject were infused into the SCIEX 5600 TripleTOF mass spectrometer in negative ion mode. Lipid intensities identified with Analyst1.7 TF and SCIEX LipidView1.3 were normalized by an internal standard and total ion current, then statistically compared in MetaboAnalyst 4.0. RESULTS In meibum and tears, 76 and 78 unique OAHFAs were identified, respectively. The five most frequent and abundant OAHFAs were 18:2/16:2, 18:1/32:1, 18:1/30:1, 18:2/32:1, and 18:1/34:1. Two OAHFAs, 18:2/20:2 and 18:2/20:1, were identified only in tears. Initial univariate analysis revealed three differently regulated OAHFAs in meibum and eight in tears. Partial Least Square Discriminant Analysis showed 18:1/32:1, 18:2/16:2, 18:1/34:1 and 18:0/32:1 in tears, and 18:2/16:2, 18:1/32:1 and 18:2/32:2 in meibum, had variable importance in projection scores >1.5 and contributed the most to the separation of groups. In both meibum and tears, all OAHFAS except 18:2/16:2 were reduced in MGD compared to the normal group. CONCLUSION MGD is accompanied by differential expression of specific OAHFAs in meibum and tears. These results suggest OAHFAs play a role in the altered biochemical profile of the tear film lipid layer in humans with MGD.
Collapse
Affiliation(s)
- Safal Khanal
- Department of Optometry and Vision Science, School of Optometry, University of Alabama at Birmingham, Birmingham, AL, USA
| | - William Ngo
- Centre for Ocular Research & Education, School of Optometry & Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Kelly K Nichols
- Department of Optometry and Vision Science, School of Optometry, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Landon Wilson
- Department of Pharmacology and Toxicology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA; Targeted Metabolomics and Proteomics Laboratory, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Stephen Barnes
- Department of Pharmacology and Toxicology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA; Targeted Metabolomics and Proteomics Laboratory, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jason J Nichols
- Department of Optometry and Vision Science, School of Optometry, University of Alabama at Birmingham, Birmingham, AL, USA.
| |
Collapse
|
49
|
Monolayers of Cholesterol and Cholesteryl Stearate at the Water/Vapor Interface: A Physico-Chemical Study of Components of the Meibum Layer. COLLOIDS AND INTERFACES 2021. [DOI: 10.3390/colloids5020030] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Langmuir monolayers containing different amounts of cholesterol and cholesteryl stearate were studied at two different temperatures (24 °C and 35 °C). The main goal was to contribute towards the understanding of how the variations in the chemical composition may affect the physico-chemical properties of these specific lipid monolayers. The model mixture was chosen considering that cholesteryl esters are present in cell membranes and some other biological systems, including human tear lipids. Therefore, an investigation into the effect of the lipid monolayer composition on their interfacial properties may elucidate some of the fundamental reasons for the deficiencies in cell membranes and tear film functioning in vivo. The experimental results have shown that the molar ratio of the mixture plays a crucial role in the modulation of the Langmuir film properties. The condensing effects of the cholesterol and the interactions between the lipids in the monolayer were the main factors altering the monolayer response to dilatational deformation. The modification of the mixture compositions leads to significant changes in the Langmuir films and the mechanical performance, altering the ability of the monolayer to reduce the surface tension and the viscoelastic properties of the monolayers. This suggests that subtle modifications of the biomembrane composition may significantly alter its physiological function.
Collapse
|
50
|
Abstract
Purpose: The meibomian glands are located in the tarsal plate of the upper and lower eyelid and are responsible for the production of a lipid-rich secretion, the meibum, which forms the outer component of the tear film. Meibomian gland dysfunction results in excessive evaporation of the tear film and is the leading cause of dry eye disease (DED). Despite the high prevalence of DED, the etiology of meibomian gland dysfunction is only basically understood. In addition, the molecular mechanisms of meibomian gland maturation and physiological function are currently the focus of research.Methods: A systematic literature search was performed using the main scientific databases, including all relevant published articles up to September 2020.Results: This article provides an overview of the current state of knowledge about meibomian gland stem cells, cell surface marker expression and PPARγ signaling, as well as the pathological causes of meibomian gland dysfunction.Conclusion: Androgen deficiency, hyperkeratinization, PPARγ signaling and inflammatory reactions including neutrophil extracellular traps (NETs) seem to be key factors within the pathological processes of the meibomian gland.
Collapse
Affiliation(s)
- Jana Dietrich
- Institute of Anatomy, Department of Functional and Clinical Anatomy, Friedrich Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Fabian Garreis
- Institute of Anatomy, Department of Functional and Clinical Anatomy, Friedrich Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Friedrich Paulsen
- Institute of Anatomy, Department of Functional and Clinical Anatomy, Friedrich Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany.,Department of Topographic Anatomy and Operative Surgery, Sechenov University, Moscow, Russia
| |
Collapse
|