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Giannaccare G, Vaccaro S, Borselli M, Rossi C, Carnovale Scalzo G, Scalia G, Di Cesare Mannelli L, Ghelardini C, Zerillo L, Polvere I, Vito P, Zotti T, Stilo R, Scorcia V. A Novel Ophthalmic Solution Containing Glicopro ® Complex for the Treatment of Patients with Dry Eye Disease: Results from a Pilot Study. J Clin Med 2024; 13:1447. [PMID: 38592312 PMCID: PMC10932378 DOI: 10.3390/jcm13051447] [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: 01/05/2024] [Revised: 02/17/2024] [Accepted: 02/28/2024] [Indexed: 04/10/2024] Open
Abstract
(1) Background: Dry eye disease (DED) is a multifactorial ocular surface disease characterized by an imbalance in ocular surface homeostasis, and tear substitutes constitute the first line of treatment. The present study aimed to evaluate the changes in the signs and symptoms of patients with DED treated with a novel tear substitute containing the GlicoPro® complex. (2) Methods: Patients with DED not successfully responding to other tear substitutes were enrolled and treated with a novel ophthalmic solution (two drops four times daily). Patients were examined before starting the study treatment (T0) and after 30 (T1) and 60 (T2) days of treatment by means of Keratograph for the evaluation of the following: (i) tear meniscus height (TMH); (ii) noninvasive Keratograph break-up time (NIKBUT); (iii) bulbar redness; and (iv) infrared meibography. The SANDE questionnaire was administered to assess ocular discomfort symptoms. Analysis of the tear content of proenkephalin and Met/Leu-enkephalin was also performed. (3) Results: At T2, a significant improvement in NIKBUT first, average, and class, TMH, and SANDE score was found. The tear content of proenkephalins was significantly higher at T1, whereas processed active Met/Leu-enkephalins increased at both T1 and T2. (4) Conclusions: Our novel tear substitute based on GlicoPro® resulted in a significant improvement in ocular discomfort symptoms, tear volume, and stability in the patients treated. The increase in active peptides processed in tears may represent the pathophysiological substrate underlying this finding.
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Affiliation(s)
- Giuseppe Giannaccare
- Department of Ophthalmology, University Magna Græcia of Catanzaro, 88100 Catanzaro, Italy; (S.V.); (M.B.); (C.R.); (G.C.S.); (G.S.); (V.S.)
- Eye Clinic, Department of Surgical Science, University of Cagliari, 09124 Cagliari, Italy
| | - Sabrina Vaccaro
- Department of Ophthalmology, University Magna Græcia of Catanzaro, 88100 Catanzaro, Italy; (S.V.); (M.B.); (C.R.); (G.C.S.); (G.S.); (V.S.)
| | - Massimiliano Borselli
- Department of Ophthalmology, University Magna Græcia of Catanzaro, 88100 Catanzaro, Italy; (S.V.); (M.B.); (C.R.); (G.C.S.); (G.S.); (V.S.)
| | - Costanza Rossi
- Department of Ophthalmology, University Magna Græcia of Catanzaro, 88100 Catanzaro, Italy; (S.V.); (M.B.); (C.R.); (G.C.S.); (G.S.); (V.S.)
| | - Giovanna Carnovale Scalzo
- Department of Ophthalmology, University Magna Græcia of Catanzaro, 88100 Catanzaro, Italy; (S.V.); (M.B.); (C.R.); (G.C.S.); (G.S.); (V.S.)
| | - Giovanni Scalia
- Department of Ophthalmology, University Magna Græcia of Catanzaro, 88100 Catanzaro, Italy; (S.V.); (M.B.); (C.R.); (G.C.S.); (G.S.); (V.S.)
| | - Lorenzo Di Cesare Mannelli
- Department of Neuroscience, Psychology, Drug Research and Child Health-NEUROFARBA-Pharmacology and Toxicology Section, University of Florence, 50139 Florence, Italy; (L.D.C.M.); (C.G.)
| | - Carla Ghelardini
- Department of Neuroscience, Psychology, Drug Research and Child Health-NEUROFARBA-Pharmacology and Toxicology Section, University of Florence, 50139 Florence, Italy; (L.D.C.M.); (C.G.)
| | - Lucrezia Zerillo
- Department of Science and Technologies, University of Sannio, 82100 Benevento, Italy; (L.Z.); (I.P.); (P.V.); (T.Z.); (R.S.)
- Genus Biotech Srls, University of Sannio, 82100 Benevento, Italy
| | - Immacolata Polvere
- Department of Science and Technologies, University of Sannio, 82100 Benevento, Italy; (L.Z.); (I.P.); (P.V.); (T.Z.); (R.S.)
- Genus Biotech Srls, University of Sannio, 82100 Benevento, Italy
| | - Pasquale Vito
- Department of Science and Technologies, University of Sannio, 82100 Benevento, Italy; (L.Z.); (I.P.); (P.V.); (T.Z.); (R.S.)
- Genus Biotech Srls, University of Sannio, 82100 Benevento, Italy
| | - Tiziana Zotti
- Department of Science and Technologies, University of Sannio, 82100 Benevento, Italy; (L.Z.); (I.P.); (P.V.); (T.Z.); (R.S.)
- Genus Biotech Srls, University of Sannio, 82100 Benevento, Italy
| | - Romania Stilo
- Department of Science and Technologies, University of Sannio, 82100 Benevento, Italy; (L.Z.); (I.P.); (P.V.); (T.Z.); (R.S.)
| | - Vincenzo Scorcia
- Department of Ophthalmology, University Magna Græcia of Catanzaro, 88100 Catanzaro, Italy; (S.V.); (M.B.); (C.R.); (G.C.S.); (G.S.); (V.S.)
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Giannaccare G, Rossi C, Borselli M, Carnovale Scalzo G, Scalia G, Pietropaolo R, Fratto B, Pellegrini M, Yu AC, Scorcia V. Outcomes of low-level light therapy before and after cataract surgery for the prophylaxis of postoperative dry eye: a prospective randomised double-masked controlled clinical trial. Br J Ophthalmol 2023:bjo-2023-323920. [PMID: 37890879 DOI: 10.1136/bjo-2023-323920] [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: 05/11/2023] [Accepted: 10/04/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Despite increasing evidence shows that optimising ocular surface before cataract surgery is fundamental in patients with pre-existing dry eye disease (DED) to achieve the desired postoperative outcomes, the prophylactic treatment of healthy patients undergoing surgery aiming at preventing iatrogenic DED is worth investigating. METHODS This was a prospective, interventional, randomised, controlled, double-masked clinical trial. Patients were randomly assigned 1:1 to receive either low-level light therapy (LLLT) or sham treatment (LLLT with a power output <30%). Patients underwent two treatment sessions: 7±2 days before cataract surgery (T0) and 7±2 days after (T1). Outcome measures evaluated 30±4 days after surgery (T2) included Ocular Surface Disease Index (OSDI) questionnaire, non-invasive break-up time (NIBUT), tear meniscus height, meibomian gland loss (MGL) and redness score. RESULTS Out of 153 patients randomised to receive LLLT (n=73) or sham treatment (n=80), 131 (70 men, 61 women, mean age 73.53±7.29 years) completed regularly the study. Patients treated with LLLT had significantly lower OSDI scores compared with controls at T1 and T2 (respectively, 7.2±8.8 vs 14.8±13.0 and 9.0±9.0 vs 18.2±17.9; both p<0.001), higher NIBUT values at T2 (12.5±6.6 vs 9.0±7.8; p=0.007) and lower MGL Meiboscore values at T1 (1.59±0.70 vs 1.26±0.69; p=0.008). Unlike controls, patients treated with LLLT had significantly lower OSDI scores and higher NIBUT values at T2 compared with T0 (respectively, 9.0±9.0 vs 21.2±16.1; p<0.001 and 12.5±6.6 vs 9.7±7.2; p=0.007). CONCLUSION Two sessions of LLLT performed before and after cataract surgery were effective in ameliorating tear film stability and ocular discomfort symptoms. TRIAL REGISTRATION NUMBER NCT05754437.
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Affiliation(s)
- Giuseppe Giannaccare
- Department of Ophthalmology, Magna Graecia University of Catanzaro, Catanzaro, Italy
- Eye Clinic, Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
| | - Costanza Rossi
- Department of Ophthalmology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Massimiliano Borselli
- Department of Ophthalmology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | | | - Giovanni Scalia
- Department of Ophthalmology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Rocco Pietropaolo
- Department of Ophthalmology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Benedetta Fratto
- Department of Ophthalmology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Marco Pellegrini
- Department of Ophthalmology, Villa Igea Hospital, Forlì, Italy
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | - Angeli Christy Yu
- Department of Ophthalmology, Villa Igea Hospital, Forlì, Italy
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | - Vincenzo Scorcia
- Department of Ophthalmology, Magna Graecia University of Catanzaro, Catanzaro, Italy
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Penbe A, Oklar M, Kanar HS, Bayrak MZ, Ersarı B, Talan M, Gün RD, Orçun A, Şimşek Ş. The effects of facial mask use on ocular surface parameters and tear film cytokine profile in prolonged use. Int Ophthalmol 2023; 43:2623-2632. [PMID: 36856985 PMCID: PMC9975438 DOI: 10.1007/s10792-023-02661-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 02/19/2023] [Indexed: 03/02/2023]
Abstract
OBJECTIVE To compare tear fluid levels of matrix metalloproteinase 9 (MMP-9) and IL-1ß cytokines between healthcare workers wearing facial masks and controls with correlations in clinical findings. METHODS In a prospective, controlled clinical trial tear fluid was analyzed for MMP-9 and IL-1ß levels using a commercially available test (Invitrogen; Thermo Fisher Scientific Inc. Waltham, Massachusetts, USA). Symptoms and signs of dry eye disease (DED) were evaluated using the ocular surface disease index (OSDI), noninvasive tear break-up time (NIBUT), tear meniscus height (TMH), Oxford corneal staining, meibomiography, and clinical findings of meibomian gland dysfunction (MGD). RESULTS In the 38 eyes of healthcare workers and 30 eyes of controls, there was no statistically significant difference between the groups in terms of age and sex (p > 0.05). The mean OSDI score, daily mask wear time, meibomiography degree, and rate of positive clinical findings of MGD were higher in group 1 than in group 2, and the mean NIBUT was higher in group 2. (p > 0.05). The mean values of IL-1ß and MMP-9 were higher in group 1 (p = 0.036 and p = 0.001, respectively). The TMH and Oxford score percentages were similar between the two groups (p > 0.05). CONCLUSIONS Elevated levels of IL-1ß and MMP-9 in the basal tear fluid reveal increased ocular inflammation in healthcare professionals. Lower NIBUT values with higher OSDI and meibomian gland loss scores support ocular surface disturbance depending on regular mask use.
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Affiliation(s)
- Aysegul Penbe
- Department of Ophthalmology, Health Science University, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Semsi Denizer Caddesi, E-5, 34890 Kartal Istanbul, Turkey
| | - Murat Oklar
- Department of Ophthalmology, Health Science University, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Semsi Denizer Caddesi, E-5, 34890 Kartal Istanbul, Turkey
| | - Hatice Selen Kanar
- Department of Ophthalmology, Health Science University, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Semsi Denizer Caddesi, E-5, 34890 Kartal Istanbul, Turkey
| | - Müberra Zülal Bayrak
- Department of Ophthalmology, Health Science University, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Semsi Denizer Caddesi, E-5, 34890 Kartal Istanbul, Turkey
| | - Başak Ersarı
- Department of Ophthalmology, Health Science University, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Semsi Denizer Caddesi, E-5, 34890 Kartal Istanbul, Turkey
| | - Mustafa Talan
- Department of Ophthalmology, Health Science University, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Semsi Denizer Caddesi, E-5, 34890 Kartal Istanbul, Turkey
| | - Raziye Dönmez Gün
- Department of Ophthalmology, Health Science University, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Semsi Denizer Caddesi, E-5, 34890 Kartal Istanbul, Turkey
| | - Asuman Orçun
- Department of Ophthalmology, Health Science University, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Semsi Denizer Caddesi, E-5, 34890 Kartal Istanbul, Turkey
| | - Şaban Şimşek
- Department of Ophthalmology, Health Science University, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Semsi Denizer Caddesi, E-5, 34890 Kartal Istanbul, Turkey
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Malmin A, Thomseth VM, Førland PT, Khan AZ, Hetland HB, Chen X, Haugen IBK, Utheim TP, Forsaa VA. Associations between Serial Intravitreal Injections and Dry Eye. Ophthalmology 2023; 130:509-515. [PMID: 36693594 DOI: 10.1016/j.ophtha.2023.01.009] [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: 08/18/2022] [Revised: 11/25/2022] [Accepted: 01/17/2023] [Indexed: 01/22/2023] Open
Abstract
PURPOSE To investigate the effects of serial intravitreal injections (IVIs) on the ocular surface and meibomian glands (MGs) in patients treated with anti-vascular endothelial growth factor (anti-VEGF) for neovascular age-related macular degeneration (nAMD). DESIGN Retrospective, controlled, observational study. PARTICIPANTS Patients with nAMD receiving unilateral IVIs with anti-VEGF agents. The fellow eye was used as control. METHODS Tear film and ocular surface examinations were performed on a single occasion at a minimum of 4 weeks after IVI. A pre-IVI asepsis protocol with povidone-iodine (PVP-I) was applied. MAIN OUTCOME MEASURES Upper and lower MG loss, tear meniscus height (TMH), bulbar redness (BR) score, noninvasive tear break-up time (NIBUT), tear film osmolarity (TOsm), Schirmer test, corneal staining, fluorescein tear film break-up time (TBUT), meibomian gland expressibility (ME), and meibum quality. RESULTS Ninety patients with a mean age of 77.5 years (standard deviation [SD], 8.4; range 54-95) were included. The median number of IVIs in treated eyes was 19.5 (range, 2-132). Mean MG loss in the upper eyelid was 19.1% (SD, 11.3) in treated eyes and 25.5% (SD, 14.6) in untreated fellow eyes (P = 0.001). For the lower eyelid, median MG loss was 17.4% (interquartile range [IQR], 9.4-29.9) in treated eyes and 24.5% (IQR, 14.2-35.2) in fellow eyes (P < 0.001). Mean BR was 1.32 (SD, 0.46) in treated eyes versus 1.44 (SD, 0.45) in fellow eyes (P = 0.017). Median TMH was 0.36 mm (IQR, 0.28-0.52) in treated eyes and 0.32 mm (IQR, 0.24-0.49) in fellow eyes (P = 0.02). There were no differences between treated and fellow eyes regarding NIBUT, TOsm, Schirmer test, corneal staining, fluorescein TBUT, ME, or meibum quality. CONCLUSIONS Repeated IVIs with anti-VEGF with preoperative PVP-I application was associated with reduced MG loss, increased tear volume, and reduced signs of inflammation compared with fellow nontreated eyes in patients with nAMD. This regimen may thus have a beneficial effect on the ocular surface. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found after the references.
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Affiliation(s)
- Agni Malmin
- Department of Ophthalmology, Stavanger University Hospital, Stavanger, Norway; Department of Clinical Medicine, University of Bergen, Bergen, Norway.
| | - Vilde M Thomseth
- Department of Ophthalmology, Stavanger University Hospital, Stavanger, Norway; Department of Quality and Health Technology, University of Stavanger, Stavanger, Norway
| | - Per T Førland
- Department of Ophthalmology, Stavanger University Hospital, Stavanger, Norway
| | - Ayyad Z Khan
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
| | - Hanne B Hetland
- Department of Research, Section of Biostatistics, Stavanger University Hospital, Stavanger, Norway
| | - Xiangjun Chen
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway; Department of Ophthalmology, Hospital of Southern Norway, Arendal, Norway; Department of Ophthalmology, Vestre Viken Hospital Trust, Drammen, Norway
| | | | - Tor P Utheim
- Department of Ophthalmology, Stavanger University Hospital, Stavanger, Norway; Department of Clinical Medicine, University of Bergen, Bergen, Norway; Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway; Department of Ophthalmology, Hospital of Southern Norway, Arendal, Norway; Department of Ophthalmology, Vestre Viken Hospital Trust, Drammen, Norway
| | - Vegard A Forsaa
- Department of Ophthalmology, Stavanger University Hospital, Stavanger, Norway; Department of Quality and Health Technology, University of Stavanger, Stavanger, Norway
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Pastor-Pascual F, Pastor-Pascual R, Gálvez-Perez P, Dolz-Marco R, Gallego-Pinazo R. Use of Artificial Tears in Patients Undergoing Treatment with Anti-VEGF Intravitreal Injections. Clin Ophthalmol 2022; 16:3959-3972. [PMCID: PMC9719699 DOI: 10.2147/opth.s391082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 11/02/2022] [Indexed: 12/05/2022] Open
Abstract
Purpose To analyze the use of artificial tears in patients undergoing treatment with anti-vascular endothelial growth (anti-VEGF) intravitreal injections. Methods Thirty-four eyes undergoing anti-VEGF treatment were analyzed. Each patient underwent a subjective and objective evaluation of the ocular surface, using the Ocular Surface Disease Index (OSDI), Dry Eye Questionnaire (DEQ)-5, tear meniscus height (TMH), first and average non-invasive Keratograph Break-Up Time (NIKBUT), bulbar conjunctival redness, meibography and the Vision Break-Up Time (VBUT). Patients attended 5 visits (days 0, 7, 30, 37, and 60). All patients continued with their intravitreal injection treatment during the study (days 0, 30, and 60). Patients did not receive any artificial tear treatment during the first month of the study, and at the baseline visit they were randomly assigned to one of two study groups to receive either the Systane Hydration or the Viscofresh 10mg/mL formulation. Patients were instructed to instill one drop of the assigned study treatment 3 times a day for 30 days during the second month of the study. Results According to the Mixed Models for Repeated Measures analysis, there is not enough statistical evidence for any of the parameters examined to determine significant differences between being treated with artificial tears and not being treated (p > 0.05). There is, however, a tendency toward improved outcomes in some parameters when artificial tears were used. OSDI, DEQ-5, TMH, and meibography were not affected by either the type of artificial tear used or by the time (from day 30 to day 60; p > 0.05), but the NIKBUT and VBUT values increased over time during this period regardless of which treatment the patient was receiving. Conclusion The use of artificial tears may help to keep the tear film stable Future studies with larger samples should be conducted to elucidate whether the tendency reported in our study becomes significant.
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Affiliation(s)
- Francisco Pastor-Pascual
- Anterior Segment Department, Valencia, Spain,Correspondence: Francisco Pastor-Pascual, Clínica Oftalvist, Valencia, Spain, Tel +34 963 51 33 04, Email
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Lievens CW, Norgett Y, Allen PM, Vianya-Estopa M. Development and validation of a new photographic scale to grade lid wiper epitheliopathy. Cont Lens Anterior Eye 2022; 46:101773. [DOI: 10.1016/j.clae.2022.101773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 10/03/2022] [Accepted: 10/18/2022] [Indexed: 11/03/2022]
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Wu Y, Wang C, Wang X, Mou Y, Yuan K, Huang X, Jin X. Advances in Dry Eye Disease Examination Techniques. Front Med (Lausanne) 2022; 8:826530. [PMID: 35145982 PMCID: PMC8823697 DOI: 10.3389/fmed.2021.826530] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 12/24/2021] [Indexed: 01/13/2023] Open
Abstract
Dry eye-related ocular surface examination is very important in the diagnosis and treatment of dry eye disease. With the recent advances in science and technology, dry eye examination techniques have progressed rapidly, which has greatly improved dry eye diagnoses and treatment. However, clinically, confusion remains about which examination to choose, how to ensure the repeatability of the examination, and how to accurately interpret the examination results. In this review, we systematically evaluate previous examinations of dry eye, analyze the latest views and research hotspots, and provide a reference for the diagnosis and management of dry eye.
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