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Münch K, Nöhre M, Westenberger A, Akkus D, Morfeld M, Brähler E, Framme C, de Zwaan M. Prevalence and Correlates of Dry Eye in a German Population Sample. Cornea 2024; 43:685-692. [PMID: 37713656 PMCID: PMC11073563 DOI: 10.1097/ico.0000000000003374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 06/24/2023] [Accepted: 07/24/2023] [Indexed: 09/17/2023]
Abstract
PURPOSE In this cross-sectional survey, we assessed the prevalence of dry eye disease (DED) in a representative German population sample. In addition, we examined the associations between DED, health-related quality of life (HRQoL), and level of fatigue. Finally, we further validated the German version of the Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire and present norm data of the German population. METHODS A random sample of German residents aged 16 years and older was recruited between October and December 2021. All participants completed the SPEED, Short Form 36, and Multidimensional Fatigue Inventory 20 questionnaires. RESULTS Of the 2495 participants who completed the survey, 450 (21.6%; 95% confidence intervals 20.0-23.1) reported a SPEED total score of ≥4, indicating a positive screening for DED. DED was significantly more common in women and older age. Participants who screened positive for DED reported significantly higher levels of fatigue and lower values in all domains of HRQoL. A receiver operating characteristic curve of the SPEED was generated using an ophthalmologist's diagnosis. The area under the curve was estimated to be 0.886 (95% confidence intervals 0.858-0.913). A cutoff score ≥4 seemed to be appropriate as an indicator of DED. Cronbach's α was excellent (0.95). CONCLUSIONS DED is common in the German population. We confirmed associations with sex, age, HRQoL, and fatigue level, indicating a high burden of DED. The German version of the SPEED is a valid instrument for the assessment of DED symptoms.
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Affiliation(s)
- Kathrin Münch
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Mariel Nöhre
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Adrian Westenberger
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Dilek Akkus
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Matthias Morfeld
- Department of Applied Human Sciences, Magdeburg-Stendal University of Applied Sciences, Stendal, Sachsen-Anhalt, Germany
| | - Elmar Brähler
- Integrated Research and Treatment Center Adiposity Diseases, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
- Department of Psychosomatic Medicine, University Medical Center of Johannes Gutenberg University Mainz, Mainz, Germany; and
| | - Carsten Framme
- Department of Ophthalmology, Hannover Medical School, Hannover, Germany.
| | - Martina de Zwaan
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
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Talens-Estarelles C, Talens-Estarelles C, García-Lázaro S. Ocular surface changes following computer use in post-LASIK patients. Ophthalmic Physiol Opt 2024; 44:554-563. [PMID: 38386250 DOI: 10.1111/opo.13297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 02/08/2024] [Accepted: 02/13/2024] [Indexed: 02/23/2024]
Abstract
PURPOSE To assess the impact of computer use on the ocular surface of individuals after laser in situ keratomileusis (LASIK). METHODS The dry eye symptoms and ocular surface of 18 post-LASIK young individuals and 18 controls were evaluated before and after performing a 30-min task on a computer without (Visit 1) and with (Visit 2) initial instillation of artificial tears. Symptoms were assessed using the Ocular Surface Disease Index (OSDI), Symptom Assessment in Dry Eye questionnaire version two (SANDE II) and Computer Vision Syndrome Questionnaire (CVS-Q). The ocular surface was assessed by measuring corneal higher order aberrations, tear meniscus height (TMH), conjunctival redness, blink rate and incomplete blinking, lipid layer thickness (LLT) and non-invasive keratograph break-up time (NIKBUT). RESULTS SANDE II scores were >0 after the computer task in both groups (p ≤ 0.01). SANDE II and CVS-Q scores did not differ between LASIK and controls (p ≥ 0.43). Greater bulbar-temporal conjunctival redness, TMH and LLT and shorter NIKBUT were found after computer use in the LASIK group (p ≤ 0.04), whereas no changes were observed in the controls (p ≥ 0.20). Lower SANDE II and CVS-Q scores were reported at Visit 2 compared with Visit 1 in both groups (p ≤ 0.01). Likewise, no worsening of dry eye signs was observed at Visit 2 (p ≥ 0.11). CONCLUSIONS Ocular symptoms reported during computer use were comparable between the groups. However, a worsening of dry eye signs was mostly observed in post-LASIK individuals. The instillation of artificial tears was effective in preventing the effects of computer use on the ocular surface in post-LASIK patients.
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Affiliation(s)
| | | | - Santiago García-Lázaro
- Department of Optics & Optometry & Vision Science, University of Valencia, Valencia, Spain
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Greiner JV, Glonek T. Phospholipid analyses of rabbit ocular surface tissues. Exp Eye Res 2024; 243:109911. [PMID: 38663719 DOI: 10.1016/j.exer.2024.109911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 04/20/2024] [Accepted: 04/22/2024] [Indexed: 05/01/2024]
Abstract
The tissues of the integument covering the ocular surface comprise a mucus membrane functioning as a protective physical barrier and has the ability to mount a defensive inflammatory response. Since lipid metabolism has a role in both of these functions, we studied normal membrane phospholipids (PL) of the cornea and bulbar conjunctiva to (1) determine baseline PL profiles of these tissues, (2) compare and contrast these individual PL metabolite profiles as well as groups of metabolites, and (3) describe pathway-specific metabolic interrelations among these tissues. Corneal and conjunctival tissue samples were isolated from rabbit eyes (n = 30) and extracted with chloroform-methanol using a modified Folch procedure. 31P nuclear magnetic resonance spectroscopy was used to qualitatively and quantitatively measure tissue PL profiles. The cornea and conjunctiva, respectively, have the following PL composition (mole % of total detected phospholipid): phosphatidylglycerol (PG) -, 0.4; lysophosphatidylethanolamine 1.2, -; phosphatidic acid -, 0.4; diPG (cardiolipin) 2.1, 3.5; unknown PL at the chemical shift of 0.13 δ 1.5, 0.9; ethanolamine plasmalogen 11.2, 13.0; phosphatidylethanolamine 11.5, 12.8; phosphatidylserine 8.9, 10.1; sphingomyelin 10.2, 10.7; lysophosphatidylcholine 0.9, 1.4; phosphatidylinositol 5.3, 5.3; phosphatidylcholine (PC) plasmalogen or alkylacylPC 2.2, 1.9; PC 45.1, 40.0. In addition, 28 PL metabolic indices were calculated from these data, which permitted pathway-specific lipid analyses. This study (1) establishes PL profiles of the two ocular tissues of the integument that cover the surface of the eye, (2) compares and contrasts indices comprised of ratios and combinations of PL, and (3) describes pathway-specific metabolic interrelations among these tissues to serve as baselines for studies involving the distribution of tissue phospholipids.
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Affiliation(s)
- Jack V Greiner
- Department of Ophthalmology, Harvard Medical School, 243 Charles St., Boston, MA, USA; Schepens Eye Research Institute of Massachusetts Eye and Ear Infirmary, 20 Staniford St., Boston, MA, USA; Clinical Eye Research of Boston, 5 Whittier Pl, Ste. 102, Boston, MA, USA; Magnetic Resonance Laboratory, Chicago College of Osteopathic Medicine, Chicago, 5200 S. Ellis Ave., IL, USA.
| | - Thomas Glonek
- Clinical Eye Research of Boston, 5 Whittier Pl, Ste. 102, Boston, MA, USA; Magnetic Resonance Laboratory, Chicago College of Osteopathic Medicine, Chicago, 5200 S. Ellis Ave., IL, USA.
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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 2024:102154. [PMID: 38523013 DOI: 10.1016/j.clae.2024.102154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [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.
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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
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Francisco ZM, Sara MM, José-María SG, Facundo U, Carlos RDL, María GL, Jessica M, Carmen AL, Santiago OP, Juan Carlos SE. Standardized clinical evaluation of dry anophthalmic socket syndrome in a real-world approach. Cont Lens Anterior Eye 2024:102149. [PMID: 38521700 DOI: 10.1016/j.clae.2024.102149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 03/08/2024] [Accepted: 03/18/2024] [Indexed: 03/25/2024]
Abstract
PURPOSE To assess which signs and eye prosthesis care habits are related to subjective discomfort in patients with dry anophthalmic socket syndrome (DASS), using standardized tools from daily practice. METHODS 62 anophthalmic sockets were compared with their healthy fellow eye using the Standard Patient Evaluation of Eye Dryness (SPEED) score. The correlations between SPEED questionnaire and the prosthesis care, discharge characteristics score, conjunctival inflammation score, meibomian gland dysfunction (MGD) scores and Schirmer I test were studied. RESULT The anophthalmic sockets group achieved a higher SPEED test score (p < 0.01), discharge score (p < 0.01), conjunctival inflammation score (p < 0.01), MGD scores (p < 0.01) and lower Schirmer I test (p < 0.01) compared with their fellow, healthy eye. Patients with a prosthesis replacement of one year or less, those with a current fit time of one year or less and those with a cleaning frequency above one month reported better SPEED, (p < 0.01), conjunctiva inflammation (p < 0.01) and MGD scores (p < 0.01). CONCLUSION Most anophthalmic patients suffer mild to severe DASS, which seems related to discharge, conjunctival inflammation and MGD. Moreover, certain practices related to the care of the prosthesis such as replacing with a frequency lower than yearly, current fitting time inferior to one year and a removing and cleaning regime above one month, were related to a lower discomfort sensation, conjunctival inflammation and MGD. Clinicians should consider the DASS when facing patients with anophthalmic socket and discomfort symptoms.
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Affiliation(s)
- Zamorano-Martín Francisco
- Department of Ophthalmology, Hospital Regional Universitario de Málaga, Malaga, Spain; Deparment of Radiology and Physical Medicine, Ophthalmology and Otorhinolaryngology, Ophthalmology Area, Facultad de Medicina, Universidad de Málaga, Malaga, Spain
| | | | - Sánchez-González José-María
- Department of Physics of Condensed Matter, Optics Area, Universidad de Sevilla, Seville, Spain; Department of Ophthalmology (Tecnolaser Clinic Vision), Refractive Surgery Centre, Seville, Spain.
| | - Urbinati Facundo
- Department of Ophthalmology, Hospital Regional Universitario de Málaga, Malaga, Spain
| | - Rocha-de-Lossada Carlos
- Department of Ophthalmology, Hospital Regional Universitario de Málaga, Malaga, Spain; Department of Ophthalmology (Qvision), Vithas Virgen del Mar Hospital, Almeria, Spain
| | - García-Lorente María
- Department of Ophthalmology, Hospital Regional Universitario de Málaga, Malaga, Spain; Deparment of Radiology and Physical Medicine, Ophthalmology and Otorhinolaryngology, Ophthalmology Area, Facultad de Medicina, Universidad de Málaga, Malaga, Spain
| | - Mata Jessica
- Department of Ophthalmology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Alba-Linero Carmen
- Deparment of Radiology and Physical Medicine, Ophthalmology and Otorhinolaryngology, Ophthalmology Area, Facultad de Medicina, Universidad de Málaga, Malaga, Spain; Department of Ophthalmology, Hospital Universitario Virgen de la Victoria, Malaga, Spain
| | - Ortiz-Pérez Santiago
- Unidad de Gestión Clínica de Oftalmología, Hospital Universitario Virgen de las Nieves, Granada, Spain; Departamento de Cirugía y sus especialidades, Universidad de Granada, Spain; Granada Vision and Eye Research Team (VER), Instituto de Investigación Biosanitaria ibs. GRANADA, Granada, Spain
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Oucif Khaled MT, Zaater A, Ben Amor I, Zeghoud S, Ben Amor A, Hemmami H, Alnazza Alhamad A. Drug delivery methods based on nanotechnology for the treatment of eye diseases. Ann Med Surg (Lond) 2023; 85:6029-6040. [PMID: 38098602 PMCID: PMC10718325 DOI: 10.1097/ms9.0000000000001399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 10/04/2023] [Indexed: 12/17/2023] Open
Abstract
One of the most difficult tasks among the numerous medication delivery methods is ocular drug delivery. Despite having effective medications for treating ocular illness, we have not yet managed to develop an appropriate drug delivery strategy with the fewest side effects. Nanotechnology has the potential to significantly address the drawbacks of current ocular delivery systems, such as their insufficient therapeutic effectiveness and unfavourable side effects from invasive surgery or systemic exposure. The objective of the current research is to highlight and update the most recent developments in nano-based technologies for the detection and treatment of ocular diseases. Even if more work has to be done, the advancements shown here might lead to brand-new, very practical ocular nanomedicines.
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Affiliation(s)
- Mohammed Tayeb Oucif Khaled
- Department of Process Engineering and Petrochemical, Faculty of Technology, University of El Oued, El Oued, Algeria
- Renewable Energy Development unit in Arid Zones (UDERZA), University of El Oued, El Oued, Algeria
| | - Abdelmalekd Zaater
- Department of Agronomy, Faculty of Nature and Life Sciences, University of El Oued, El Oued, Algeria
- Biodiversity laboratory and application of biotechnology in agriculture, University of El Oued, El Oued, Algeria
| | - Ilham Ben Amor
- Department of Process Engineering and Petrochemical, Faculty of Technology, University of El Oued, El Oued, Algeria
- Renewable Energy Development unit in Arid Zones (UDERZA), University of El Oued, El Oued, Algeria
| | - Soumeia Zeghoud
- Department of Process Engineering and Petrochemical, Faculty of Technology, University of El Oued, El Oued, Algeria
- Renewable Energy Development unit in Arid Zones (UDERZA), University of El Oued, El Oued, Algeria
| | - Asma Ben Amor
- Department of Process Engineering and Petrochemical, Faculty of Technology, University of El Oued, El Oued, Algeria
- Renewable Energy Development unit in Arid Zones (UDERZA), University of El Oued, El Oued, Algeria
| | - Hadia Hemmami
- Department of Process Engineering and Petrochemical, Faculty of Technology, University of El Oued, El Oued, Algeria
- Renewable Energy Development unit in Arid Zones (UDERZA), University of El Oued, El Oued, Algeria
| | - Ali Alnazza Alhamad
- Department of Chemistry, Faculty of Science, University of Aleppo, Aleppo, Syrian Arab Republic
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Abusharha A, Pearce IE, Afsar T, Razak S. Evaluation of Therapeutic Capability of Emustil Drops against Tear Film Complications under Dry Environmental Conditions in Healthy Individuals. Medicina (Kaunas) 2023; 59:1298. [PMID: 37512109 PMCID: PMC10386218 DOI: 10.3390/medicina59071298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 06/23/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023]
Abstract
Background and Objectives: Dry eye disease (DED) is a multifactorial ailment of the tears and ocular surface. The purpose of this study was to assess the tear film physiology under controlled dry environmental conditions and compare the efficacy of oil-in-water emulsion drops on tear film parameters in protection and relief treatment modalities under low-humidity conditions. Emustil eye drops were used after exposure to a low-humidity environment in the relief method, whereas, in the protection method, the drops were applied before exposure to low humidity. Materials and Methods: 12 normal male subjects (mean age 34.0 ± 7.0 years) were exposed to ultra-dry environmental conditions. A number of tear film measurements were carried out under desiccating environmental conditions in a controlled environment chamber (CEC), where the chamber temperature sat at 21 °C with a relative humidity (RH) of 5%. Keeler's TearScope Plus and an HIRCAL grid were used to assess the tear break-up time and lipid layer thickness (LLT), and the evaporation rate was evaluated using a Servomed EP3 Evaporimeter. Results: LLT measurements showed that the dry environment affected LLT significantly (p = 0.031). The median grade of LLT dropped from grade 3 (50-70 nm) at 40% RH to grade 2 (13-50 nm) at 5% RH. A significant increase in LLT was seen after both modes of treatment, with a median LLT grade of 3 when the Emustil was used for both protection (p = 0.004) and relief (p = 0.016). The mean tear evaporation rate in normal environmental conditions (40%) was 40.46 ± 11.80 g/m2/h (0.11 µL/min) and increased sharply to 83.77 ± 20.37 g/m2/h (0.25 µL/min) after exposure to the dry environment. A minimal decrease in tear film evaporation rate was seen in relief; however, statistical tests showed that the decrease in tear film evaporation rate was not significant. Mean NITBUT dropped from 13.6 s at 40% RH to 6.6 s at 5% RH (p = 0.002). All NITBUT measurements at 5% RH (with or without the instillation of Emustil) were significantly lower than those at 40%. The instillation of Emustil at 5% RH resulted in a significant improvement in NITBUT for protection (p = 0.016) but this was not the case for relief (p = 0.0.56). Conclusions: A control environmental chamber (CEC) enables the analysis of tear film parameters comparable to those found in dry eye patients. This enables us to examine the capability of oil in emulsion drops to manage tear film disruption in healthy individuals. This study suggests that using Emustil oil-in-water emulsion before exposure to a dry environment should be advocated for people who work in dry environments.
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Affiliation(s)
- Ali Abusharha
- Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia
| | - Ian E Pearce
- Vision Sciences, Glasgow Caledonian University, 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
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Abusharha A, Pearce IE, Afsar T, Alsaqr A, Fagehi R, Razak S. Evaluation of different treatment modalities on the efficacy of hydroxypropyl Guar (HP-Guar) formulation on tear film stability (TFS) in subjects exposed to adverse environmental conditions. BMC Ophthalmol 2023; 23:226. [PMID: 37211592 DOI: 10.1186/s12886-023-02977-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 05/13/2023] [Indexed: 05/23/2023] Open
Abstract
The study aimed to assess the efficacy of hydroxypropyl guar (HP) formulation (Systane) to protect tear film parameters under desiccating environment using protection and relief treatment modalities. The subjects were exposed to adverse environmental conditions using a Controlled Environment Chamber (CEC) where the relative humidity (RH) was 5% and the ambient temperature was 21 °C and screened for Tear break-up time (TBUT), Tear film evaporation rate (TFER) and lipid layer thickness (LLT) using the HIRCAL grid, Servomed EP3 Evaporimeter and Keeler's TearScope-Plus respectively. Significant improvement in LLT was noticed in the protection modality. The mean tear film evaporation rate doubled after exposure to the humidity of 5% to a value of 105.37 g/m2/h (0.29 µl/min). All subjects displayed a significant reduction in non-invasive tear break-up time (NITBUT) with a mean NITBUT of 7.7 s after exposure to a desiccating environment for 15 min. A significant increase in NITBUT after the instillation of the drops was recorded in both methods. The results obtained from this study showed that a solution containing HP-Guar significantly improves tear film parameters under a desiccating environment. Apart from the tear evaporation rate, all tear parameters showed improvement after the use of HP-Guar eye drops. It is evident that tear film parameters respond differently to the management modalities and using CEC has the potential to provide researchers with a readily available method to evaluate the efficiency of tear supplementation.
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Affiliation(s)
- Ali Abusharha
- Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Ian E Pearce
- Vision Sciences, Glasgow Caledonian University, Glasgow, Scotland, UK
| | - Tayyaba Afsar
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.
| | - Ali Alsaqr
- Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Raied Fagehi
- Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Suhail Razak
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.
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Baiza-Durán LM, Muñoz-Villegas P, Sánchez-Ríos A, Olvera-Montaño O. Efficacy and Safety of an Ophthalmic DMPC-Based Nanoemulsion in Patients with Dry Eye Disease: A Phase I/II Randomized Clinical Trial. J Ophthalmol 2023; 2023:1431473. [PMID: 37077305 PMCID: PMC10110385 DOI: 10.1155/2023/1431473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 03/07/2023] [Accepted: 03/08/2023] [Indexed: 04/21/2023] Open
Abstract
Purpose The goals of this study were to evaluate the safety and efficacy of an ophthalmic 1,2-dimyristoyl-sn-glycero-3-phosphocholine (DMPC)-based nanoemulsion (Nanodrop®) in patients with dry eye disease (DED). Methods This was a randomized phase I/II multicentric, prospective, double-blind clinical trial. Patients (phase I: n = 25 and phase II: n = 101) were assigned to receive either PRO-176 (Nanodrop®) or Systane Balance® (control) for 29 days. Once the visits of the first 25 subjects were completed, if there were less than 20% of unexpected adverse events (AEs), related to PRO-176, recruitment was continued until the sample was completed for noninferiority (efficacy) analysis (phase II, n = 126). Efficacy endpoints were the ocular surface disease index (OSDI), tear break-up time (TBUT), epithelial defects, best corrected visual acuity (BCVA), and the incidence of expected AE. Results For the phase I portion of the study, there were no differences between groups regarding the incidence of AE. All related-AE symptoms in both groups were mild and expected. For the phase II subset, there was a significant reduction in OSDI scores at day 29 and noninferiority between treatments was confirmed (p=0.650, CI 95% [-8.7, 5.5]). Similar improvement was observed for TBUT although no significant intergroup differences were found (p=0.518, CI 95% [-0.08, 1.6]). There were no significant differences between treatments for epithelial staining or safety parameters. Conclusions Topical application of PRO-176 is as safe and effective as the controls. Both groups were clinically similar in terms of efficacy and safety. The results support the hypothesis that ophthalmic DMPC-based nanoemulsion may improve clinical parameters and symptoms in patients with DED. This trial is registered with NCT04111965.
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Affiliation(s)
| | | | | | - Oscar Olvera-Montaño
- Regional Medical Affairs Department, Laboratorios Sophia SA de CV, Guadalajara, Mexico
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Al Sabti K, Zechevikj S, Raizada S. Evaluation of lipid layer tear film changes after femtosecond small incision lenticule extraction. Ther Adv Ophthalmol 2022; 14:25158414221129534. [PMID: 36246953 PMCID: PMC9554113 DOI: 10.1177/25158414221129534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 09/12/2022] [Indexed: 11/06/2022] Open
Abstract
Background: Dry eye disease is common after refractive procedures due to tear film instability. There are several causative factors for tear film instability, but the state of individual components of the tear film is not assessed much in published literature. This article quantifies the lipid layer thickness (LLT) of the tear film using surface interferometry before and after the small incision lenticule extraction (SMILE) refractive procedure. Objectives: This study aimed to evaluate the effects of femtosecond SMILE on the postoperative stability of the LLT of the tear film. Design: This was a prospective, interventional, non-case–control study. Methods: A total of 160 eyes of 80 patients were enrolled in the study. The follow-up period was 6 months after surgery. A noninvasive surface interferometer was used to measure the thickness of the lipid layer before surgery and was repeated at 3 and 6 months after surgery. The main outcome measure was the change in average LLT at 3 and 6 months after SMILE and its statistical significance. Results: There were 48 women and 32 men. Age ranged from 21 to 42 years (mean = 27 ± 6.4). Mean LLT at baseline was [oculus dextrus (OD) = 53.38 (±7.24) nm; oculus sinister (OS) = 52.21 (±6.95) nm], at 3 months [OD = 54.38 (±5.75) nm; OS = 53.26 (±5.70)], and at 6 months [OD = 53.31 (±5.66) nm; OS = 52.39 (±5.94)]. Mean LLT showed mild improvement at 3 months after surgery (OD = 53.38–54.38 mm, p = 0.0417; OS = 52.21–53.26 mm, p = 0.0398). There was no significant change in LLT from the baseline before surgery to levels 6 months after surgery (p = 0.8914 OD; p = 0.7368 OS). Conclusion: The SMILE refractive procedure did not alter the LLT that remained stable and adequate at 6 months postoperative follow-up.
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Affiliation(s)
- Khalid Al Sabti
- Cornea and Refractive Surgery Unit, Kuwait Specialized Eye Center, Kuwait
| | | | - Seemant Raizada
- Cornea and Refractive Surgery Unit, Kuwait Specialized Eye Center, Kuwait
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Xie L, Chen S, Hong J, Jin X, Chen W, Rong B, Feng Y, Huang X, Li J, Song W, Lin L, Cheng Y, Yan X. The lack of correlation between symptoms and signs in patients with meibomian gland dysfunction: a secondary analysis of the multicenter, randomized controlled trial. BMC Ophthalmol 2022; 22:351. [PMID: 36031597 PMCID: PMC9420300 DOI: 10.1186/s12886-022-02576-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 08/17/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
This study was performed to investigate the association between symptoms and signs in patients with meibomian gland dysfunction (MGD).
Methods
Data were obtained from 122 MGD patients who were recruited for intense pulsed light therapy from November 2017 to April 2018 and the severity of their symptoms and signs at baseline were observed and recorded. Spearman correlation analyses were performed to analyze the relationships between SPEED score and signs. Subjects were divided into different subgroups based on possible influencing factors, and the differences in symptoms and signs were compared between different subgroups. Then influencing factors were controlled by regression analysis to explore the relationship between symptoms and signs and the strong factors affecting symptoms and signs.
Results
Analysis of baseline data showed that SPEED scores were not correlated with TBUT, CFSS, MGYSS or any index of eyelid margin abnormality (p > 0.05). In addition, abnormalities of lid margins, including hyperemia, thickening, rounding, hyperkeratinization, and telangiectasia around orifices, were more likely to occur in older patients, menopausal patients, and patients living in northern China. Multiple linear regression analysis indicated that there was still no correlation between symptoms and signs (p > 0.05) after adjusting for influencing factors. Further analysis suggested that each influencing factor has different effects on symptoms and signs, among which menopause affects the SPEED score (R = -4.112, p = 0.025), and age and region have significant effects on eyelid margin abnormalities.
Conclusions
In conclusion, the results demonstrated a poor correlation between symptoms and signs in MGD patients. Age, hormone, and a dry environment may influence the disease, which suggests that the severity of the disease needs to be comprehensively assessed.
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Sánchez-González JM, De-Hita-Cantalejo C, Sánchez-González MC. Hyaluronic Acid and Galacto-Xyloglucan Eyedrop Efficacy in Young-Adult Oral Contraceptive Users of Childbearing Age. J Clin Med 2022; 11:jcm11154458. [PMID: 35956073 PMCID: PMC9369423 DOI: 10.3390/jcm11154458] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/20/2022] [Accepted: 07/27/2022] [Indexed: 01/25/2023] Open
Abstract
To assess the efficacy of 0.4% hyaluronic acid and 0.2% galacto-xyloglucan for the subjective symptoms of dry eye disease and tear film invasive and noninvasive signs in 34 young-adult oral contraceptive users of childbearing age, a prospective, longitudinal, single-blind, clinical study was performed in a population of childbearing-age oral-contraceptive consumers. Subjective dry eye disease questionnaires, and invasive and noninvasive tear film assessments were reported before and after six weeks of hyaluronic acid with galacto-xyloglucan (HA-GX) treatment versus hyaluronic acid alone (HA). HA-GX treatment resulted in a greater decrease in the ocular surface disease index (17.01 ± 11.36 score points, p < 0.01) than the HA variation (11.61 ± 11.18 score points, p < 0.01). The standard patient evaluation of eye dryness also decreased more in the HA-GX group (4.06 ± 5.50 score points, p < 0.01) than in the HA alone group (0.70 ± 3.16, p = 0.21). Regarding noninvasive break-up time (NIBUT), the HA-GX group’s first NIBUT achieved an increase of 1.75 ± 1.16 s, p < 0.01, while the HA-alone group increased by only 0.54 ± 1.01 s, p < 0.01. The HA-GX group’s mean NIBUT reported an increase of 3.72 ± 5.69 s, p < 0.01; however, the HA-alone group achieved 2.19 ± 5.26 s, p = 0.05. Hyaluronic acid in combination with galacto-xyloglucan significantly decreased subjective dry eye disease symptoms and increased first and mean NIBUT compared to hyaluronic acid alone. Galacto-xyloglucan added efficacy in young-adult childbearing-age oral contraceptive users.
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Sánchez-González MC, De-Hita-Cantalejo C, Martínez-Lara C, Sánchez-González JM. Oral isotretinoin for acne vulgaris side effects on the ocular surface: Hyaluronic acid and galacto-xyloglucan as treatment for dry eye disease signs and symptoms. Front Med (Lausanne) 2022; 9:959165. [PMID: 35935781 PMCID: PMC9353322 DOI: 10.3389/fmed.2022.959165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 07/06/2022] [Indexed: 11/23/2022] Open
Abstract
The purpose was to assess the efficacy of 0.4% hyaluronic acid and 0.2% galacto-xyloglucan on the subjective symptoms of dry eye disease and invasive and non-invasive tear film signs in oral isotretinoin for acne vulgaris treatment. A prospective, longitudinal, single-blind, clinical study was performed in oral isotretinoin for the acne vulgaris consumer population. Subjective dry eye disease questionnaires and invasive and non-invasive tear film assessments were reported prior to and after 6 weeks of hyaluronic acid with galacto-xyloglucan (HA-GX) treatment vs. hyaluronic acid alone (HA). Participants in the HA-GX group reported a higher decrease in the ocular surface disease index (17.01 ± 11.36 score points) compared to the variation in participants in the HA group (11.61 ± 11.18 score points). Standard patient evaluation of eye dryness also decreased more in participants in the HA-GX group (4.06 ± 5.50 score points) than in participants who received HA alone (0.70 ± 3.16). Regarding non-invasive break-up time (NIBUT), participants in the HA-GX group first NIBUT achieved an increase of 1.75 ± 1.16 s while participants in the HA-alone group demonstrated an increase of only 0.54 ± 1.01 s. The HA-GX group mean NIBUT increased by of 3.72 ± 5.69 s; however, the value for the HA-alone group was 2.19 ± 5.26 s. Hyaluronic acid in combination with galacto-xyloglucan significantly decreased limbal and bulbar conjunctival redness classification and SPEED test outcomes. The inclusion of galacto-xyloglucan also increased BUT and mean NIBUT values compared to those obtained with hyaluronic acid alone.
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Affiliation(s)
- María Carmen Sánchez-González
- Vision Sciences Research Group (CIVIUS), Department of Physics of Condensed Matter, Optics Area, Pharmacy School, University of Seville, Seville, Spain
- *Correspondence: María Carmen Sánchez-González,
| | - Concepción De-Hita-Cantalejo
- Vision Sciences Research Group (CIVIUS), Department of Physics of Condensed Matter, Optics Area, Pharmacy School, University of Seville, Seville, Spain
| | - Concepción Martínez-Lara
- Department of Nursing, University Hospital Virgen Macarena, Universidad de Sevilla, Seville, Spain
- Department of Nursing, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, Spain
| | - José-María Sánchez-González
- Vision Sciences Research Group (CIVIUS), Department of Physics of Condensed Matter, Optics Area, Pharmacy School, University of Seville, Seville, Spain
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Sánchez-González JM, De-Hita-Cantalejo C, Martínez-Lara C, Sánchez-González MC. Lipid, Aqueous and Mucin Tear Film Layer Stability and Permanence within 0.15% Liposome Crosslinked Hyaluronic Acid versus 0.15% Non-Crosslinked Hyaluronic Acid Measured with a Novel Non-Invasive Ocular Surface Analyzer. J Clin Med 2022; 11:jcm11133719. [PMID: 35807004 PMCID: PMC9267243 DOI: 10.3390/jcm11133719] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/19/2022] [Accepted: 06/23/2022] [Indexed: 12/04/2022] Open
Abstract
To evaluate the stability and permanence of the liquid film created after the instillation of 0.15% crosslinked hyaluronic acid with liposomes and crocin versus the effect of 0.15% standard hyaluronic acid, a prospective, longitudinal, single-blind, single-center study was conducted in symptomatic populations with a novel noninvasive ocular surface analyzer. Limbal and bulbar redness classification, lipid layer thickness, tear meniscus height, and first and mean noninvasive break-up time (FNIBUT and MNIBUT) were performed before and 30 and 45 min after liposome-crosslinked hyaluronic acid (LCHA) and standard hyaluronic acid (HA) eye drop instillations. LCHA had a higher lipid layer thickness than HA (grades 2.00 ± 0.83 and 1.17 ± 0.63 on the Guillon pattern, respectively). LCHA achieved a better tear meniscus height than HA (0.23 ± 0.02 and 0.21 ± 0.02 mm, respectively). LCHA improved FNIBUT and MNIBUT more than HA (for FNIBUT, 6.30 ± 0.94 and 4.77 ± 0.89 s, respectively. For MNIBUT, 17.23 ± 5.11 and 12.41 ± 4.18 s, respectively). Crosslinking hyaluronic acid with liposomes and crocin significantly increases the permanence and stability of the lipid, aqueous, and mucin tear film layers. In a short-term period, liposome and crosslinked hyaluronic acid achieved better first and mean noninvasive break-up times than standard hyaluronic acid.
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Affiliation(s)
- José-María Sánchez-González
- Department of Physics of Condensed Matter, Optics Area, Vision Sciences Research Group (CIVIUS), Pharmacy School, University of Seville, 41012 Seville, Spain; (C.D.-H.-C.); (M.C.S.-G.)
- Correspondence: ; Tel.: +34-9554-20861
| | - Concepción De-Hita-Cantalejo
- Department of Physics of Condensed Matter, Optics Area, Vision Sciences Research Group (CIVIUS), Pharmacy School, University of Seville, 41012 Seville, Spain; (C.D.-H.-C.); (M.C.S.-G.)
| | - Concepción Martínez-Lara
- Department of Nursing, University Hospital Virgen Macarena, University of Seville, 41009 Seville, Spain;
- Nursing Department, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain
| | - María Carmen Sánchez-González
- Department of Physics of Condensed Matter, Optics Area, Vision Sciences Research Group (CIVIUS), Pharmacy School, University of Seville, 41012 Seville, Spain; (C.D.-H.-C.); (M.C.S.-G.)
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Labetoulle M, Benitez-del-Castillo JM, Barabino S, Herrero Vanrell R, Daull P, Garrigue JS, Rolando M. Artificial Tears: Biological Role of Their Ingredients in the Management of Dry Eye Disease. Int J Mol Sci 2022; 23:ijms23052434. [PMID: 35269576 PMCID: PMC8910031 DOI: 10.3390/ijms23052434] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 12/17/2021] [Accepted: 12/18/2021] [Indexed: 12/21/2022] Open
Abstract
Dry eye disease (DED) is the most common ocular surface disease, characterized by insufficient production and/or instability of the tear film. Tear substitutes are usually the first line of treatment for patients with DED. Despite the large variety of tear substitutes available on the market, few studies have been performed to compare their performance. There is a need to better understand the specific mechanical and pharmacological roles of each ingredient composing the different formulations. In this review, we describe the main categories of ingredients composing tear substitutes (e.g., viscosity-enhancing agents, electrolytes, osmo-protectants, antioxidants, lipids, surfactants and preservatives) as well as their effects on the ocular surface, and we provide insight into how certain components of tear substitutes may promote corneal wound healing, and/or counteract inflammation. Based on these considerations, we propose an approach to select the most appropriate tear substitute formulations according to the predominant etiological causes of DED.
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Affiliation(s)
- Marc Labetoulle
- Service d’Ophtalmologie, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, 94270 Le Kremlin Bicêtre, France;
| | | | - Stefano Barabino
- Centro Superficie Oculare e Occhio Secco, ASST Fatebenefratelli-Sacco, Ospedale L. Sacco, Università di Milano, 20157 Milan, Italy;
| | - Rocio Herrero Vanrell
- Research Group (UCM 920415), Innovation, Therapy and Pharmaceutical Development in Ophthalmology (InnOftal), Faculty of Pharmacy, Complutense University, 28040 Madrid, Spain;
| | - Philippe Daull
- Ophthalmic Innovation Center, Santen SAS, 91058 Evry, France;
| | | | - Maurizio Rolando
- Ocular Surface Centre, ISPRE (Instituto di Medicina Oftalmica) Ophthalmic, 16129 Genoa, Italy;
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Abusharha A, Shbear AA, Fagehi R, Alanazi MA, Alsaqr A, El-Hiti GA, Masmali AM. Assessment of the Efficiency of HP-Guar and hyaluronic Acid Tear Supplements to Control Tear Film Evaporation Rate in Dry Eye Subjects. Open Ophthalmol J 2021. [DOI: 10.2174/1874364102115010299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
The most common factor that could lead to dryness is the accelerated tear evaporation rate. Controlling the tear evaporation rate is increasingly used as a method to control dry eye complications. The present study explores the effects of different tear supplements formulations on tear film evaporation rate.
Objective:
This study aimed to evaluate the short-term effects of Systane ULTRA and Artelac Advanced eye drops on the tear film evaporation rate.
Methods:
Fifteen male dry eye subjects were enrolled in the current study. Tear film parameters were observed at several time points post installation (10, 20, 30, and 60 min). The tear film parameters observed in the current study were tear evaporation rate, noninvasive breakup time (NITBUT) and tear meniscus height (TMH). Two visits were required to conduct this study. One visit was conducted to assess the physiological tear film parameters with the use of Systane® ULTRA eye drop. The other visit was conducted to assess tear film parameters with the use of Artelac Advanced eye drop.
Results:
The mean tear evaporation rate at baseline was 52.58 ± 23.24 g/m2 h. A box plot of tear evaporation showed a reduction in tear film evaporation rate after instillation of Systane eye drop. A drop in tear film evaporation rate of 14% was observed at 20 and 60 min time point after instillation of Systane ULTRA eye drop. A significant increase in NITBUT was found after instillation of Systane ULTRA (P = 0.01) and Artelac Advanced (P = 0.02).
Conclusion:
The current study indicates a significant improvement in the tear film parameters using both HP-Guar and hyaluronic acid formulations. However, it was apparent that the use of HP-Guar was superior to hyaluronic acid in controlling the tear evaporation rate in dry eye subjects.
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17
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Sahu DK, Pradhan D, Biswasroy P, Kar B, Ghosh G, Rath G. Recent trends in nanocarrier based approach in the management of dry eye disease. J Drug Deliv Sci Technol 2021. [DOI: 10.1016/j.jddst.2021.102868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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18
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Garofalo R, Kunnen C, Rangarajan R, Manoj V, Ketelson H. Relieving the symptoms of dry eye disease: update on lubricating eye drops containing hydroxypropyl-guar. Clin Exp Optom 2021; 104:826-834. [PMID: 34137675 DOI: 10.1080/08164622.2021.1925208] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Hydroxypropyl-guar (HPG) is a thickening agent first added to lubricating eye drops in 2003. This agent, which enhances viscosity, has been used in the SYSTANE® family of lubricant eye drops (Alcon Laboratories, Inc., Fort Worth, TX, USA). HPG forms a partially linked gel with borate to prolong the retention of demulcents, such as polyethylene glycol and propylene glycol, on the eye. This helps to protect the ocular surface, thereby reducing the symptoms of dry eye disease (DED). The definition of DED has evolved with advances in research, leading to changes in HPG-containing eye care solutions. This article reviews current knowledge on the use of HPG-containing lubricating eye drops in the management of DED.
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Affiliation(s)
- Renee Garofalo
- Research & Development, Alcon Research, LLC, Fort Worth, TX, USA
| | - Carolina Kunnen
- Research & Development, Alcon Research, LLC, Fort Worth, TX, USA
| | | | | | - Howard Ketelson
- Research & Development, Alcon Vision, LLC, Fort Worth, TX, USA
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Torrent-Burgués J, Hoyo J, Tzanov T. Lipid artificial tears at a mimetic ocular interface. Chem Phys Lipids 2021; 238:105087. [PMID: 33964291 DOI: 10.1016/j.chemphyslip.2021.105087] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/26/2021] [Accepted: 04/28/2021] [Indexed: 10/21/2022]
Abstract
We studied the behaviour of three lipid tear products, commercialised by the same brand, as Langmuir films at the air/liquid interface to simulate the ocular environment. No significant differences were observed in the surface behaviour of two of them disclosing the same composition, but commercialised for different applications. The interaction of several subphases, namely sodium chloride, glucose, albumin and lysozyme present in the natural tear, with the lipid films was assessed at room temperature and the temperature of human tear using surface pressure-area isotherms and elastic modulus plots. There is a notable influence of sodium chloride and the proteins albumin and lysozyme on the surface pressure-area isotherm of the lipid Langmuir films. Albumin shifted this isotherm to lower areas while an opposite shift was caused by lysozyme. These studies could be useful for the formulation of new lipid-containing artificial tears, and for increasing the confidence of the customers in commercial eye care formulations.
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Affiliation(s)
- Juan Torrent-Burgués
- Grup de Biotecnologia Molecular i Industrial, Department of Chemical Engineering, Universitat Politècnica de Catalunya, Rambla Sant Nebridi 22, 08222, Terrassa, Spain.
| | - Javier Hoyo
- Grup de Biotecnologia Molecular i Industrial, Department of Chemical Engineering, Universitat Politècnica de Catalunya, Rambla Sant Nebridi 22, 08222, Terrassa, Spain
| | - Tzanko Tzanov
- Grup de Biotecnologia Molecular i Industrial, Department of Chemical Engineering, Universitat Politècnica de Catalunya, Rambla Sant Nebridi 22, 08222, Terrassa, Spain
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Affiliation(s)
- Jeffrey S Berger
- Northeastern State University, Oklahoma College of Optometry, Oklahoma, USA
E‐mail:
| | - Kyle R Head
- Northeastern State University, Oklahoma College of Optometry, Oklahoma, USA
E‐mail:
| | - Thomas O Salmon
- Northeastern State University, Oklahoma College of Optometry, Oklahoma, USA
E‐mail:
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21
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Craig JP, Muntz A, Wang MT, Luensmann D, Tan J, Trave Huarte S, Xue AL, Jones L, Willcox MD, Wolffsohn JS. Developing evidence-based guidance for the treatment of dry eye disease with artificial tear supplements: A six-month multicentre, double-masked randomised controlled trial. Ocul Surf 2021; 20:62-69. [DOI: 10.1016/j.jtos.2020.12.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 12/22/2020] [Accepted: 12/27/2020] [Indexed: 11/30/2022]
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22
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Watanabe K, Yoshida M, Okumura T, Sassa T, Kihara A, Uchiyama A. Improvement of Evaporative Dry Eye With Meibomian Gland Dysfunction in Model Mice by Treatment With Ophthalmic Solution Containing Mineral Oil. Transl Vis Sci Technol 2021; 10:21. [PMID: 34003999 PMCID: PMC8083063 DOI: 10.1167/tvst.10.4.21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose Meibomian gland dysfunction (MGD) is a major cause of evaporative dry eye. The purpose of this study is to assess the efficacy of a mineral oil-containing ophthalmic solution (MO) in mitigating the evaporative dry eye phenotypes in a mouse model in which fatty acid elongase Elovl1 is disrupted. Methods Elovl1-deficient mice were assessed in terms of number of plugged meibomian gland orifices, tear film breakup time (BUT), corneal fluorescein staining (CFS) score, tear quantity, and histology. The effects of the MO on the dry eye phenotypes were compared with those in groups not treated or treated with blank ophthalmic solution (BL). Results Untreated Elovl1-deficient mice exhibited dry eye phenotypes with MGD symptoms such as plugging of meibomian gland orifices (P = 0.002 compared with control mice), high CFS scores (P = 0.002), and shortened BUT (P < 0.001). Among three groups of Elovl1-deficient mice (MO treated, BL treated, and untreated), the MO-treated group exhibited fewer plugged orifices (MO treated, 7.6; BL treated, 10.5 [P = 0.033]; untreated, 13.0 [P < 0.001]), lower CFS scores (MO treated, 1.1; BL treated, 2.7 [P = 0.013]; untreated, 2.5 [P = 0.050]), and improved BUT (MO treated, 19.4 seconds; BL treated, 8.3 seconds [P = 0.098]; untreated, 1.5 seconds [P = 0.008]). Conclusions Elovl1-deficient mice exhibited multiple MGD symptoms, which were improved by MO. Translational Relevance Our findings reveal the usefulness of Elovl1-deficient mice as a model for dry eye with MGD and suggest the potential of mineral oil eye drops as a treatment for this condition.
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Affiliation(s)
- Keisuke Watanabe
- Pharmaceutical Research Laboratories, Research and Development Headquarters, Lion Corporation, Kanagawa, Japan
| | - Masataka Yoshida
- Pharmaceutical Research Laboratories, Research and Development Headquarters, Lion Corporation, Kanagawa, Japan
| | - Takashi Okumura
- Pharmaceutical Research Laboratories, Research and Development Headquarters, Lion Corporation, Kanagawa, Japan
| | - Takayuki Sassa
- Laboratory of Biochemistry, Faculty of Pharmaceutical Sciences, Hokkaido University, Sapporo, Japan
| | - Akio Kihara
- Laboratory of Biochemistry, Faculty of Pharmaceutical Sciences, Hokkaido University, Sapporo, Japan
| | - Akira Uchiyama
- Pharmaceutical Research Laboratories, Research and Development Headquarters, Lion Corporation, Kanagawa, Japan
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23
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Lee SM, Han KE. Investigation of Tear Lipid Layer Patterns According to Blinking Among Dry Eye Patients. J Korean Ophthalmol Soc 2021. [DOI: 10.3341/jkos.2021.62.2.155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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24
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Shin J, Rho CR, Hyon JY, Chung TY, Yoon KC, Joo CK. A Randomized, Placebo-Controlled Phase II Clinical Trial of 0.01% or 0.02% Cyclosporin A with 3% Trehalose in Patients with Dry Eye Disease. J Ocul Pharmacol Ther 2021; 37:4-11. [PMID: 33449860 DOI: 10.1089/jop.2020.0104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Purpose: To compare the efficacy and safety of HU00701 (0.01% cyclosporin A + 3% trehalose), HU007 (0.02% cyclosporin A + 3% trehalose) (all w/v), and placebo in patients with moderate to severe dry eye disease (DED). Methods: This was a multicenter, randomized, double-masked, parallel, placebo-controlled phase II study. In total, 114 patients were randomly assigned to the HU00701, HU007, placebo, or reference group. There was a 2-week run-in period before the 12-week intervention. Efficacy and safety were evaluated every 4 weeks. Results: The primary endpoint, change in corneal staining score from baseline to week 12, did not differ significantly among the control, HU00701, and HU007 groups in the full analysis. Of the secondary endpoints, only the tear film breakup time differed significantly at week 12 between the placebo and HU00701 groups. Twenty adverse events were reported by 15 patients, but the rate did not differ significantly among the 4 groups. The laboratory test, vital signs, and physical examination data showed no significant changes during the study. Conclusions: HU00701 and HU007 are safe, and HU007 effectively reduces the corneal staining score in patients with moderate-to-severe DED (NCT02917512).
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Affiliation(s)
- Jeongah Shin
- Department of Ophthalmology and Visual Science, College of Medicine, The Catholic University of Korea, Daejeon St. Mary's Hospital, Seoul, Republic of Korea
| | - Chang Rae Rho
- Department of Ophthalmology and Visual Science, College of Medicine, The Catholic University of Korea, Daejeon St. Mary's Hospital, Seoul, Republic of Korea
| | - Joon Young Hyon
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Tae-Young Chung
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyung Chul Yoon
- Department of Ophthalmology, Chonnam National University, Chonnam National University Hospital, Gwangju, Korea
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Tang Y, Liu R, Tu P, Song W, Qiao J, Yan X, Rong B. A Retrospective Study of Treatment Outcomes and Prognostic Factors of Intense Pulsed Light Therapy Combined With Meibomian Gland Expression in Patients With Meibomian Gland Dysfunction. Eye Contact Lens 2021; 47:38-44. [PMID: 32282398 PMCID: PMC7752209 DOI: 10.1097/icl.0000000000000704] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2020] [Indexed: 01/04/2023]
Abstract
OBJECTIVES To evaluate clinical changes after intense pulsed light and meibomian gland expression (IPL/MGX) treatment in meibomian gland dysfunction (MGD) patients, and to identify ideal candidates, and the therapeutic window, for IPL/MGX. METHODS This retrospective study reviewed the medical records of 44 MGD patients (44 eyes). The IPL/MGX treatment was applied on the eyelids three times at intervals of 4 weeks. Age, sex, relevant ocular history, Standard Patient Evaluation of Eye Dryness (SPEED), Ocular Surface Disease Index (OSDI), tear break-up time (TBUT), corneal fluorescein staining score (CFSS), meiboscore, meibomian gland loss score (MGLS), meibomian glands yielding secretion score (MGYSS), meibomian glands yielding clear secretion (MGYCS), and meibomian glands yielding liquid secretion (MGYLS) were analyzed. RESULTS Standard Patient Evaluation of Eye Dryness, OSDI, TBUT, CFSS, MGYSS, MGYLS, and MGYCS were significantly improved after three IPL/MGX treatments, but the meiboscore and MGLS remained unchanged. In patients who had better treatment outcomes (improvement in MGYSS >7), younger age (36.0, 22.5 vs. 53.0, 25.0 years; P=0.012), a longer TBUT (8.0, 4.5 vs. 6.0, 3.0 sec; P=0.010), better meiboscore (1.0, 0.5 vs. 2.0, 1.0; P=0.012), and less gland loss (19.8%, 20.3% vs. 41.1%, 30.2%; P=0.008) before IPL/MGX were noted. Sex, relevant ocular history, SPEED, OSDI, MGYSS, MGYLS, and MGYCS before IPL/MGX showed no significant differences between patients with an improvement in MGYSS >7 versus those with an improvement of ≤7. Meibomian glands yielding secretion score changes in patients who had a meiboscore of 0 to 1 and MGYSS of 0 before IPL/MGX (12.0, 10.0) were significantly higher than those who had a meiboscore of 2 to 3 and MGYSS of 0 (6.5, 9.3; P=0.031), or a meiboscore of 0 to 1 and MGYSS >0 (5.0, 11.5; P=0.041). CONCLUSIONS Improved dry eye symptoms, TBUT, corneal staining, and meibomian gland secretion were observed in MGD patients after IPL/MGX. Patients in the early stages of MGD maybe benefited most from IPL/MGX treatment.
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Affiliation(s)
- Yun Tang
- Departments of Ophthalmology (Y.T., R.L., W.S., J.Q., X.Y., B.R.) and Dermatology (P.T.), Peking University First Hospital, Beijing, China
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Weisenberger K, Fogt N, Swingle Fogt J. Comparison of nanoemulsion and non-emollient artificial tears on tear lipid layer thickness and symptoms. J Optom 2021; 14:20-27. [PMID: 32359936 PMCID: PMC7752989 DOI: 10.1016/j.optom.2020.03.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 03/08/2020] [Accepted: 03/09/2020] [Indexed: 05/02/2023]
Abstract
PURPOSE Dry eye disease (DED) is often managed with over-the-counter eye drops. This study evaluated the diurnal effects of a single drop of two ocular lubricants (nanoemulsion vs. non-emollient) on tear film lipid layer thickness (LLT) and symptoms of ocular dryness. Subjects were also assessed after 1 month of nanoemulsion eye drop use. METHODS Part 1 was a cross-over comparison of a nanoemulsion and a non-emollient eye drop. LLT and dry eye symptoms were measured at baseline and at 15min, 1h, 2h, 4h and 6h after instillation of each drop. Part 2 was a 1-month observational study assessing LLT and symptoms after 30-day use of the nanoemulsion drop four times daily (qid). RESULTS Total of 20 subjects completed the study (mean age=45.6±7.9, 15 female). Part 1 found a significant increase in average LLT 15min after nanoemulsion drop instillation in the overall and inferior third of the tear film for subjects with baseline LLT values <50nm. Average LLT values did not increase after use of the non-emollient. Symptoms of dryness improved up to 6h following instillation of both drops. Part 2 results found that using the nanoemulsion eye drop for 1 month improved symptoms reported on symptom surveys. CONCLUSION Nanoemulsion eye drop use increased average LLT in subjects with low baseline levels. Statistically and clinically significant improvement in symptoms were found on symptom surveys after qid-use (four times a day) of the nanoemulsion drop. Results suggest that a nanoemulsion eye drop can benefit subjects with dry eye symptoms.
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Affiliation(s)
| | - Nick Fogt
- Ohio State University College of Optometry, Columbus, OH, USA
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Yildirim Y, Ozsaygili C, Kucuk B. The short term effect of trehalose and different doses of sodium hyaluronate on anterior corneal aberrations in dry eye patients. Cutan Ocul Toxicol 2020; 40:14-20. [PMID: 33342322 DOI: 10.1080/15569527.2020.1861001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
AIM To evaluate the short-term effect of 0.15% sodium hyaluronate (SH), 0.20% SH, and Trehalose + 0.15% SH on anterior corneal aberrations in dry eye patients. METHODS 76 eyes of 76 dry eye patients were divided into three groups. Non-preserved 1.5 mg/mL SH was administered in group 1, non-preserved 2.0 mg/mL SH was administered in group 2, and non-preserved trehalose 30 mg/mL and 1.5 mg/mL SH was administered in group 3. Aberrometry measurements were performed before and 10 min after application of the artificial tear drop. Using the Pentacam Scheimpflug imaging system, total root mean square (RMS), lower-order aberration (LOA), higher-order aberrations (HOAs), spherical aberration (SA), trefoil, and coma aberrations were investigated. RESULTS In each group; the RMS of total, LOA, HOAs, and spherical aberration were significantly decreased after the artificial drop instillation, compared with those of them at baseline; and in groups 1 and 2, vertical trefoil term was also significantly increased, compared with those of them at baseline. According to intergroup analyzes, there was no significant outcome. CONCLUSIONS It was observed that three artificial tears reduced the anterior corneal aberrations, in a 10-min period. The short-term effect of three artificial tears on the anterior corneal aberration was similar.
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Affiliation(s)
- Yener Yildirim
- Ophthalmology Department, Kayseri City Training and Research Hospital, Kocasinan, Turkey
| | - Cemal Ozsaygili
- Ophthalmology Department, Kayseri City Training and Research Hospital, Kocasinan, Turkey
| | - Bekir Kucuk
- Ophthalmology Department, Kayseri City Training and Research Hospital, Kocasinan, Turkey
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Lim P, Han TA, Tong L. Short-Term Changes in Tear Lipid Layer Thickness After Instillation of Lipid Containing Eye Drops. Transl Vis Sci Technol 2020; 9:29. [PMID: 32855875 PMCID: PMC7422789 DOI: 10.1167/tvst.9.8.29] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 05/21/2020] [Indexed: 01/25/2023] Open
Abstract
Purpose Lipid-containing eye drops is increasingly popular in eye clinics to treat dry eye. Tear lipid layer thickness (LLT) changes after instillation of lipid eye drops have not been characterized. We aim to evaluate these changes of LLT using a noninvasive interferometry-based method. Methods This prospective clinical study was conducted on staff and patients from Singapore National Eye Centre with ad hoc recruitment. Noninvasive tear break up time was measured using the Keratographer 5M. LLTs were measured using a tear interferometer machine before and at 1, 5, and 15 minutes after instillation of lipid-containing drops, either Cationorm unidose or Artelac Lipids. Fluorescein clearance (tear clearance rate) and Schirmer tests were conducted. The tear clearance rate of fluorescein dye was based on the visual examination of the color of a Schirmer strip after 5 minutes, compared against color standards. Results This study included a total of 84 participants aged ≥21 years. Many were female (92.8%) and Chinese (89.2%). A tear clearance rate of 1/16 was most common (35.7%), whereas 1/128 and 1/32 were uncommon (3.57% each). Schirmer results were 6.5 ± 8.1 mm, and noninvasive tear break up times were 8.12 ± 6.25 mm. Participants with baseline LLT <60 nm had greater changes in LLT after Cationorm instillation, compared with those with an LLT of >60 nm. LLT changes over 15 minutes were not associated with tear clearance rate. Similar results were obtained when using Artelac Lipids. Conclusions Our results showed that participants' initial LLT affected their responsiveness to lipid-containing eye drops more than other factors. Translational Relevance Doctors may choose to measure the baseline LLT of patients before deciding whether to prescribe lipid eye drops to patients.
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Affiliation(s)
- Phoebe Lim
- Singapore Eye Research Institute, Singapore
| | | | - Louis Tong
- Singapore Eye Research Institute, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Singapore National Eye Centre, Singapore.,Duke-NUS Medical School, Singapore
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Muntz A, Marasini S, Wang MTM, Craig JP. Prophylactic action of lipid and non-lipid tear supplements in adverse environmental conditions: A randomised crossover trial. Ocul Surf 2020; 18:920-5. [PMID: 32805428 DOI: 10.1016/j.jtos.2020.08.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 07/26/2020] [Accepted: 08/06/2020] [Indexed: 11/22/2022]
Abstract
PURPOSE To evaluate the prophylactic benefits of lipid-based and non-lipid-based artificial tear lubricants, in dry eye disease, after adverse environmental exposure. METHODS Twenty-eight participants with dry eye disease were recruited in a prospective, double-masked, randomised crossover trial. On separate days, participants were randomised to receive a single application of a lipid-containing tear supplement (Systane Complete) to one eye, and a non-lipid containing eye drop (Systane Ultra) to the contralateral eye. Participants were then exposed to a previously validated simulated adverse environment. Symptoms, non-invasive tear film breakup time, lipid layer grade, and tear meniscus height were assessed at three time points; baseline, following eye drop instillation, and after exposure to the adverse environment. RESULTS Both treatments effected improvements in symptoms and non-invasive tear film stability following instillation (all p < 0.05), although an improvement in lipid layer quality was limited to the lipid-containing nano-emulsion tear supplement (p = 0.003). Although protective effects were conferred by both treatments following exposure to the simulated adverse environment, more favourable symptomology scores, non-invasive tear film stability, and lipid layer quality were observed in the lipid-containing tear supplement group (all p < 0.05). No significant changes were observed in tear meniscus height in both treatment groups (all p > 0.05). CONCLUSIONS Both the lipid and non-lipid-based artificial tear supplement demonstrated prophylactic benefits in a simulated adverse environment. However, the ability to preserve tear film quality and reduce dry eye symptomology was greater with the lipid-containing eye drop. TRIAL REGISTRATION NUMBER ACTRN12619000361101.
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Schmidl D, Schlatter A, Chua J, Tan B, Garhöfer G, Schmetterer L. Novel Approaches for Imaging-Based Diagnosis of Ocular Surface Disease. Diagnostics (Basel) 2020; 10:diagnostics10080589. [PMID: 32823769 PMCID: PMC7460546 DOI: 10.3390/diagnostics10080589] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 07/28/2020] [Accepted: 08/10/2020] [Indexed: 02/07/2023] Open
Abstract
Imaging has become indispensable in the diagnosis and management of diseases in the posterior part of the eye. In recent years, imaging techniques for the anterior segment are also gaining importance and are nowadays routinely used in clinical practice. Ocular surface disease is often synonymous with dry eye disease, but also refers to other conditions of the ocular surface, such as Meibomian gland dysfunction or keratitis and conjunctivitis with different underlying causes, i.e., allergies or infections. Therefore, correct differential diagnosis and treatment of ocular surface diseases is crucial, for which imaging can be a helpful tool. A variety of imaging techniques have been introduced to study the ocular surface, such as anterior segment optical coherence tomography, in vivo confocal microscopy, or non-contact meibography. The present review provides an overview on how these techniques can be used in the diagnosis and management of ocular surface disease and compares them to clinical standard methods such as slit lamp examination or staining of the cornea or conjunctiva. Although being more cost-intensive in the short term, in the long term, the use of ocular imaging can lead to more individualized diagnoses and treatment decisions, which in turn are beneficial for affected patients as well as for the healthcare system. In addition, imaging is more objective and provides good documentation, leading to an improvement in patient follow-up and education.
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Affiliation(s)
- Doreen Schmidl
- Department of Clinical Pharmacology, Medical University of Vienna, 1090 Vienna, Austria; (D.S.); (A.S.); (G.G.)
| | - Andreas Schlatter
- Department of Clinical Pharmacology, Medical University of Vienna, 1090 Vienna, Austria; (D.S.); (A.S.); (G.G.)
- Department of Ophthalmology, Vienna Institute for Research in Ocular Surgery-Karl Landsteiner Institute, Hanusch Hospital, 1140 Vienna, Austria
| | - Jacqueline Chua
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore 169856, Singapore; (J.C.); (B.T.)
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore 169857, Singapore
- SERI-NTU Advanced Ocular Engineering (STANCE), Nanyang Technological University, Singapore 639798, Singapore
| | - Bingyao Tan
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore 169856, Singapore; (J.C.); (B.T.)
- SERI-NTU Advanced Ocular Engineering (STANCE), Nanyang Technological University, Singapore 639798, Singapore
| | - Gerhard Garhöfer
- Department of Clinical Pharmacology, Medical University of Vienna, 1090 Vienna, Austria; (D.S.); (A.S.); (G.G.)
| | - Leopold Schmetterer
- Department of Clinical Pharmacology, Medical University of Vienna, 1090 Vienna, Austria; (D.S.); (A.S.); (G.G.)
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore 169856, Singapore; (J.C.); (B.T.)
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore 169857, Singapore
- SERI-NTU Advanced Ocular Engineering (STANCE), Nanyang Technological University, Singapore 639798, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore
- Institute of Molecular and Clinical Ophthalmology, CH-4031 Basel, Switzerland
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, 1090 Vienna, Austria
- Correspondence: ; Tel.: +43-1-40400-29810; Fax: +43-1-40400-29990
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Okumura Y, Inomata T, Iwata N, Sung J, Fujimoto K, Fujio K, Midorikawa-Inomata A, Miura M, Akasaki Y, Murakami A. A Review of Dry Eye Questionnaires: Measuring Patient-Reported Outcomes and Health-Related Quality of Life. Diagnostics (Basel) 2020; 10:E559. [PMID: 32764273 DOI: 10.3390/diagnostics10080559] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 07/21/2020] [Accepted: 08/03/2020] [Indexed: 02/07/2023] Open
Abstract
Dry eye disease (DED) is among the most common eye diseases and is becoming increasingly prevalent. Its symptoms cause a long-term decline in patients’ health-related quality of life (HRQL). Inconsistencies often occur between the clinical findings and the subjective symptoms of DED. Therefore, a holistic, balanced, and quantitative evaluation of the subjective symptoms and HRQL using patient-reported outcome questionnaires, in addition to clinical findings, is crucial for accurate DED assessment in patients. This paper reviewed the characteristics of current dry eye questionnaires, including their objectives, number of questions, inclusion of HRQL-related items, and whether they were properly evaluated for psychometric properties. Twenty-four questionnaires were identified; among them, the following six questionnaires that included items assessing HRQL and were properly evaluated for psychometric properties are recommended: the Ocular Surface Disease Index, Impact of Dry Eye in Everyday Life, Dry Eye-Related Quality-of-life Score, University of North Carolina Dry Eye Management Scale, Chinese version of Dry Eye-Related Quality of Life, and 25-Item National Eye Institute Visual Function Questionnaire. Dry eye questionnaires have different objectives and are available in different languages. Therefore, medical practitioners should confirm the characteristics of applicable questionnaires before selecting the most appropriate ones.
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Tauber J, Owen J, Bloomenstein M, Hovanesian J, Bullimore MA. Comparison of the iLUX and the LipiFlow for the Treatment of Meibomian Gland Dysfunction and Symptoms: A Randomized Clinical Trial. Clin Ophthalmol 2020; 14:405-418. [PMID: 32103887 PMCID: PMC7024784 DOI: 10.2147/opth.s234008] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 01/10/2020] [Indexed: 12/15/2022] Open
Abstract
Purpose To compare the effects of eyelid treatment with the iLUX MGD Treatment System and the LipiFlow Thermal Pulsation System on objective and subjective parameters of meibomian gland function and symptoms. Patients and Methods In this randomized, open-label, controlled, multicenter clinical trial, both eyes of 142 patients aged ≥18 years with Ocular Surface Disease Index (OSDI) scores ≥23, total meibomian gland scores (MGS) ≤12 in the lower eyelid of each eye, and tear break-up time (TBUT) <10 s were randomized 1:1 to iLUX or LipiFlow treatment, with stratification by test center. The primary effectiveness endpoints were changes in total MGS (masked) and TBUT from baseline to 4 weeks. The secondary effectiveness endpoint was changed in OSDI score from baseline to 4 weeks. Results Both devices significantly improved effectiveness outcomes, with no differences between the two devices. At the 4-week visit, mean MGS, TBUT, and OSDI scores improved at least 16.9 ± 11.5, 2.6 ± 3.2 s, and 28.0 ± 22.8, respectively, across treatment groups and treated eyes. Four device/procedure-related events occurred in the iLUX group, compared with none in the LipiFlow group, but there were no device-related adverse events that involved changes in lid margins, eyelids, or lash integrity. Corneal staining, intraocular pressure, and visual acuity did not differ in the two groups. Conclusion Both treatments produced significant improvements in meibomian gland function and symptoms. For all effectiveness measures, there were no statistically significant differences between the two treatments.
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Affiliation(s)
| | - James Owen
- TLC Laser Eye Centers-La Jolla, La Jolla, CA 92122, USA
| | | | | | - Mark A Bullimore
- University of Houston, College of Optometry, Houston, TX 77204, USA
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Fogt JS, Fogt N, King-Smith PE, Liu H, Barr JT. Changes in Tear Lipid Layer Thickness and Symptoms Following the Use of Artificial Tears with and Without Omega-3 Fatty Acids: A Randomized, Double-Masked, Crossover Study. Clin Ophthalmol 2019; 13:2553-2561. [PMID: 31908411 PMCID: PMC6930022 DOI: 10.2147/opth.s228261] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 11/27/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose To determine if an eye drop containing omega-3 fatty acids (Refresh Optive MEGA-3®, Allergan plc, Dublin, Ireland) increases the lipid layer thickness (LLT) of the tear film versus a non-emollient eye drop (Refresh Optive, Allergan plc). Methods Patients (≥30 years) with baseline LLT ≤75 nm completed the Current Symptoms Survey (CSS – a visual analog survey of dry eye symptoms), and LLT was measured pre- and post-instillation (15 and 60 mins) of their randomly assigned treatment. After washout, patients were tested with the other treatment. Primary endpoint: change in LLT from baseline. Secondary endpoint: CSS results. Results Of 21 patients enrolled, 19 completed the study. With the omega-3–containing eye drop, the mean (standard deviation) LLT increase from baseline at 15 mins was statistically significant in the overall field (8.8 [11.5] nm; P<0.001), and in each individual zone (superior, central, and inferior). At 1 hr, the LLT change from baseline was statistically significant overall (4.4 [9.7] nm; P<0.02) and in the inferior and central zones. With the aqueous eye drop, LLT change from baseline was only significant at 15 mins in the inferior field. The CSS analysis revealed a ≥8.68-unit decrease in mean average dryness score from baseline at 15 and 60 mins post-instillation of the lipid-based treatment (P≤0.03). Conclusion The eye drop containing omega-3 fatty acids increased LLT at 15 mins, maintaining it at 1 hr post-instillation. Dryness symptoms also improved and maintained improved levels 1 hr after instillation, indicating that the product may benefit symptomatic patients with evaporative dry eye.
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Affiliation(s)
- Jennifer S Fogt
- Ohio State University College of Optometry, Columbus, OH, USA
| | - Nick Fogt
- Ohio State University College of Optometry, Columbus, OH, USA
| | | | | | - Joseph T Barr
- Ohio State University College of Optometry, Columbus, OH, USA
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Fukuoka S, Arita R. Tear film lipid layer increase after diquafosol instillation in dry eye patients with meibomian gland dysfunction: a randomized clinical study. Sci Rep 2019; 9:9091. [PMID: 31235821 PMCID: PMC6591396 DOI: 10.1038/s41598-019-45475-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 05/14/2019] [Indexed: 12/13/2022] Open
Abstract
Diquafosol promotes secretion of tear fluid and mucin at the ocular surface and is administered for treatment of dry eye (DE). Tear film lipid layer is secreted from meibomian glands and stabilizes the tear film. We recently showed that diquafosol administration increased lipid layer thickness (LLT) for up to 60 min in normal human eyes. We here evaluated tear film lipid layer in DE patients (n = 47) with meibomian gland dysfunction (MGD) before as well as 30, 60, and 90 min after diquafosol administration. One drop of artificial tears or one drop of diquafosol was applied randomly to the eyes of each patient. Diquafosol significantly increased LLT at 30 (P < 0.001) and 60 (P = 0.042) min and noninvasive tear film breakup time for at least 90 min (P < 0.001 at each assessment point). Artificial tears had no such effect. Diquafosol significantly improved the tear interferometric pattern compared with artificial tears (P < 0.001 at each assessment point). A single topical administration of diquafosol thus improved LLT and tear film stability in DE patients with MGD, suggesting that diquafosol is a potential treatment not only for aqueous-deficient DE but also for evaporative DE associated with MGD.
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Affiliation(s)
- Shima Fukuoka
- Omiya Hamada Eye Clinic, 1-169-1 Sakuragicho, Omiya-ku, Saitama, Saitama, 330-0854, Japan.,Department of Ophthalmology, University of Tokyo School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.,Lid and Meibomian Gland Working Group (LIME), 626-11 Minami-Nakano, Minuma-ku, Saitama, Saitama, 337-0042, Japan
| | - Reiko Arita
- Itoh Clinic, 626-11 Minami-Nakano, Minuma-ku, Saitama, Saitama, 337-0042, Japan. .,Department of Ophthalmology, University of Tokyo School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan. .,Lid and Meibomian Gland Working Group (LIME), 626-11 Minami-Nakano, Minuma-ku, Saitama, Saitama, 337-0042, Japan.
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Masmali AM. Improvement of ferning patterns of lubricant eye drops mixed with various electrolytes and carboxymethylcellulose. Cont Lens Anterior Eye 2019; 42:633-639. [PMID: 31010720 DOI: 10.1016/j.clae.2019.04.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 04/07/2019] [Accepted: 04/08/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE To investigate the effect of the addition of electrolytes, basic tear solution (BTS), and sodium carboxymethylcellulose (SCMS) on the tear ferning (TF) patterns of Blink Contact Soothing Eye Drops® and Refresh Plus Tears®. METHOD Samples of Blink Contact Soothing Eye Drops® and Refresh Plus Tears® (10 μL) were mixed with different volumes (3-30 μL) of several electrolytes, namely sodium chloride, potassium chloride, calcium chloride, magnesium chloride hexahydrate, sodium hydrogen carbonate, and sodium dihydrogen phosphate, BTS, and SCMS. Samples (1 μL) of the mixtures were dried on a glass slide at room temperature and the TF patterns were inspected using a light microscope, graded using the Masmali five-point grading scale and compared to the corresponding TF grades of the artificial tears. RESULTS The TF grades of Blink Contact Soothing Eye Drops® and Refresh Plus Tears® improved from 1.2 and 1.5, respectively to 0.2 when calcium chloride was used as the electrolyte. Improvements in TF grades were also observed when other electrolytes (e.g., sodium dihydrogen phosphate), BTS, and SCMS were used. CONCLUSION The tear ferning test can be used to evaluate the effect of the addition of electrolytes to an artificial tear in-vitro. The TF patterns of artificial tear solutions such as Blink Contact Soothing Eye Drops® and Refresh Plus Tears® can be improved with the addition of various concentrations of electrolytes, BTS, and SCMS, however further research is still needed to understand the clinical relevance of TF patterns with respect to the management of dry eye symptoms and their potential role in the development of new artificial tears.
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Affiliation(s)
- Ali M Masmali
- Cornea Research Chair, Optometry Department, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh, 11433, Saudi Arabia.
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Guillon M, Shah S. Rationale for 24-hour management of dry eye disease: A review. Cont Lens Anterior Eye 2019; 42:147-154. [DOI: 10.1016/j.clae.2018.11.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 11/05/2018] [Accepted: 11/08/2018] [Indexed: 12/30/2022]
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Agarwal P, Khun D, Krösser S, Eickhoff K, Wells FS, Willmott GR, Craig JP, Rupenthal ID. Preclinical studies evaluating the effect of semifluorinated alkanes on ocular surface and tear fluid dynamics. Ocul Surf 2019; 17:241-9. [DOI: 10.1016/j.jtos.2019.02.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 01/23/2019] [Accepted: 02/25/2019] [Indexed: 12/22/2022]
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Kato H, Yokoi N, Watanabe A, Komuro A, Sonomura Y, Sotozono C, Kinoshita S. Relationship Between Ocular Surface Epithelial Damage, Tear Abnormalities, and Blink in Patients With Dry Eye. Cornea 2019; 38:318-24. [PMID: 30601288 DOI: 10.1097/ICO.0000000000001841] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Considering that tears play the role of a lubricant, it is speculated that in the pathophysiology of dry eye, increased friction during blinking results in corneal and conjunctival damage, which may subsequently affect the blink. The purpose of this study was to investigate the relationship between ocular surface epithelial damage, tear abnormalities, and blinks in patients with dry eye. METHODS This study involved 45 eyes of 45 female patients with dry eye (mean age: 57.6 years). In all eyes, tear meniscus radius (mm), spread grade of the tear film lipid layer (SG: 1-5: 1 being the best), fluorescein breakup time (FBUT, seconds), corneal and bulbar conjunctival epithelial damage (CED: 15 points maximum and CONJUNCTIVAL EPITHELIAL DAMAGE (CjED): 6 points maximum, respectively), and Schirmer I test (ST1, mm) were evaluated. Blink rate (BR, blinks per minute), palpebral aperture height (mm), upper-eyelid opening-phase amplitude/upper-eyelid closing-phase amplitude (mm), upper-eyelid opening-phase duration/upper-eyelid closing-phase duration (ms), and upper-eyelid opening-phase maximum velocity/upper-eyelid closing-phase maximum velocity (mm/s) were measured using a custom-made high-speed blink analyzer. Finally, the factors that determine CED and CjED were investigated by multiple regression analysis, in which the parameters were chosen using the stepwise procedure. RESULTS CED and CjED were found to be described as 2.687 + (1.816 × SG) - (0.937 × FBUT) (R = 0.656, P < 0.0001) and 0.684 + (0.801 × SG) - (0.526 × FBUT) - (0.041 × ST1) + (0.010 × upper-eyelid closing-phase maximum velocity) (R = 0.714, P < 0.0001), respectively. CONCLUSIONS Although CED was significantly related to only tear abnormalities, CjED was significantly related to tear abnormalities and blinking.
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Kitamura Y, Maehara S, Nakade T, Miwa Y, Arita R, Iwashita H, Saito A. Assessment of meibomian gland morphology by noncontact infrared meibography in Shih Tzu dogs with or without keratoconjunctivitis sicca. Vet Ophthalmol 2019; 22:744-750. [PMID: 30715776 PMCID: PMC6899988 DOI: 10.1111/vop.12645] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 12/07/2018] [Accepted: 12/28/2018] [Indexed: 12/17/2022]
Abstract
Objective To investigate meibomian gland (MG) morphology by noncontact infrared meibography in Shih Tzu dogs with or without keratoconjunctivitis sicca (KCS). Procedures Fourteen eyes of 12 Shih Tzu dogs (mean age of 10.7 years, range of 7‐13 years) presented to Yakumo Animal Hospital or Triangle Animal Eye Clinic from 2011 to 2017 with clinical signs and a Schirmer tear test (STT) result consistent with KCS (<10 mm/min) were examined. Twenty‐eight eyes of 16 Shih Tzu dogs (mean age of 12.4 years, range of 8 to 15 years) with a STT > 15 mm/min served as healthy controls. Both groups of dogs underwent routine slitlamp biomicroscopy followed by noncontact infrared meibography of the upper eyelid with both desktop‐type and mobile‐type systems.
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Affiliation(s)
- Yasunari Kitamura
- Yakumo Animal Hospital, Yakumo-cho, Japan.,Department of Small Animal Clinical Sciences, School of Veterinary Medicine, Rakuno Gakuen University, Ebetsu, Japan
| | - Seiya Maehara
- Department of Small Animal Clinical Sciences, School of Veterinary Medicine, Rakuno Gakuen University, Ebetsu, Japan
| | - Tetsuya Nakade
- Department of Small Animal Clinical Sciences, School of Veterinary Medicine, Rakuno Gakuen University, Ebetsu, Japan
| | - Yukihiro Miwa
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Reiko Arita
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.,Itoh Clinic, Saitama, Japan
| | | | - Akihiko Saito
- Department of Small Animal Clinical Sciences, School of Veterinary Medicine, Rakuno Gakuen University, Ebetsu, Japan.,Triangle Animal Eye Clinic, Tokyo, Japan
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Gomes JAP, Santo RM. The impact of dry eye disease treatment on patient satisfaction and quality of life: A review. Ocul Surf 2018; 17:9-19. [PMID: 30419303 DOI: 10.1016/j.jtos.2018.11.003] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 11/02/2018] [Accepted: 11/07/2018] [Indexed: 12/23/2022]
Abstract
Several aspects of the quality of life (QoL) and treatment satisfaction of patients with dry eye disease (DED) may be underestimated. Ocular symptoms, which are assessed by validated patient-reported questionnaires and may include stinging, burning, itchiness, grittiness, dryness and discomfort, reduce QoL by affecting daily activities and work productivity. Self-reported symptoms do not always correlate with post-treatment improvements in clinical measures such as tear film break-up time, inflammation and osmolarity. Thus, treatments may improve clinical ocular features without improving symptoms that affect daily life. This review explores 1500 abstracts from congress presentations and peer-reviewed journals for QoL and treatment satisfaction data on the use of active lubricants, osmoprotectants, secretagogues, and immunomodulators present in topical formulations for DED treatment, and validated symptom questionnaires. Patient-reported symptoms of DED are generally improved after treatment with topical formulations for tear replacement, tear stimulation or anti-inflammatory therapy compared with baseline or a control treatment. However, more data are required to compare the performance of active ingredients. It is fundamental to diagnose patients with DED accurately, recognising the major cause behind their dry eyes. Studies are also necessary to identify how patient satisfaction and QoL may be improved through long-term use of topical preparations. We conclude that careful and thorough consideration of patient-reported symptoms should be integrated into DED management to help tailor treatment to patient needs.
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Affiliation(s)
- José A P Gomes
- Department of Ophthalmology and Visual Sciences, Federal University of Sao Paulo (UNIFESP/EPM), Brazil.
| | - Ruth M Santo
- Department of Ophthalmology, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil.
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Bai Y, Ngo W, Gu B, Zhang Y, Nichols JJ. An imaging system integrating optical coherence tomography and interferometry for in vivo measurement of the thickness and dynamics of the tear film. Biomed Eng Online 2018; 17:164. [PMID: 30382929 PMCID: PMC6211479 DOI: 10.1186/s12938-018-0597-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 10/26/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The outermost layer of the tear film consists of a thin lipid layer (LL). The lipid layer serves as a barrier against evaporation of the aqueous component of the tear film. The ability to simultaneously image both the lipid layer thickness and overall tear film thickness is novel, and will help further understandings of mechanisms of how the lipid layer assembles and interacts with the full tear film thickness. METHODS We developed a system that combines simultaneous optical coherence tomography (OCT) and thickness dependent fringes (TDF) interferometry for in vivo imaging of the tear film. The OCT possesses an axial resolution of 1.38 µm in tear film, providing an accurate measurement of the thickness of the overall tear film. The TDF can detect a minimal change of approximately 15 nm in LL thickness. In addition, the spatial resolution of TDF images in x-y plane is 5 µm. RESULTS The effect of instilling artificial tears on the PCTF and PLTF was examined. In both contact lens and non-contact lens wear, it could be observed from the OCT results that instillation of artificial tears increased the thickness of the overall tear film immediately, followed by a gradual reduction thereafter. These findings were consistent with other studies. However, unlike those previous reports, the thickness of the LL in this study was quantified simultaneously with the TDF subsystem. The results showed that bulking agents such as these artificial tears were not necessarily intended to increase the LL thickness. Immediately after instillation of artificial tears, the PCTF increased from 4.4 ± 0.97 to 20.3 ± 3.6 µm. The PCTF then decreased to 8.8 ± 2.1 µm at 4 min post-instillation. The thicknesses of the LL were 62.4 ± 14.5 nm, 48.7 ± 5.3 nm, and 55.2 ± 9.8 nm at pre-drop instillation, post-drop instillation, and 4-min post-drop instillation, respectively. CONCLUSIONS In this work, we have described a novel imaging system that integrated OCT and TDF imaging techniques, which may facilitate the study of many physiological and clinical aspects of the tear film.
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Affiliation(s)
- Yuqiang Bai
- School of Optometry, University of Alabama at Birmingham, Birmingham, AL 35233 USA
| | - William Ngo
- School of Optometry, University of Alabama at Birmingham, Birmingham, AL 35233 USA
| | - Boyu Gu
- Department of Ophthalmology, University of Alabama at Birmingham, Birmingham, AL 35233 USA
| | - Yuhua Zhang
- Department of Ophthalmology, University of Alabama at Birmingham, Birmingham, AL 35233 USA
| | - Jason J. Nichols
- School of Optometry, University of Alabama at Birmingham, Birmingham, AL 35233 USA
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Rong B, Tang Y, Liu R, Tu P, Qiao J, Song W, Yan X. Long-Term Effects of Intense Pulsed Light Combined with Meibomian Gland Expression in the Treatment of Meibomian Gland Dysfunction. Photomed Laser Surg 2018; 36:562-567. [PMID: 30251914 DOI: 10.1089/pho.2018.4499] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Bei Rong
- Department of Ophthalmology and Peking University First Hospital, Beijing, China
| | - Yun Tang
- Department of Ophthalmology and Peking University First Hospital, Beijing, China
| | - Ruixing Liu
- Department of Ophthalmology and Peking University First Hospital, Beijing, China
| | - Ping Tu
- Department of Dermatology, Peking University First Hospital, Beijing, China
| | - Jing Qiao
- Department of Ophthalmology and Peking University First Hospital, Beijing, China
| | - Wenjing Song
- Department of Ophthalmology and Peking University First Hospital, Beijing, China
| | - Xiaoming Yan
- Department of Ophthalmology and Peking University First Hospital, Beijing, China
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Rong B, Tang Y, Tu P, Liu R, Qiao J, Song W, Toyos R, Yan X. Intense Pulsed Light Applied Directly on Eyelids Combined with Meibomian Gland Expression to Treat Meibomian Gland Dysfunction. Photomed Laser Surg 2018; 36:326-332. [PMID: 29688838 DOI: 10.1089/pho.2017.4402] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Bei Rong
- Department of Ophthalmology, Peking University First Hospital, Beijing, China
| | - Yun Tang
- Department of Ophthalmology, Peking University First Hospital, Beijing, China
| | - Ping Tu
- Department of Dermatology, Peking University First Hospital, Beijing, China
| | - Ruixing Liu
- Department of Ophthalmology, Peking University First Hospital, Beijing, China
| | - Jing Qiao
- Department of Ophthalmology, Peking University First Hospital, Beijing, China
| | - Wenjing Song
- Department of Ophthalmology, Peking University First Hospital, Beijing, China
| | | | - Xiaoming Yan
- Department of Ophthalmology, Peking University First Hospital, Beijing, China
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Glasgow BJ, Abduragimov AR. Interaction of ceramides and tear lipocalin. Biochim Biophys Acta Mol Cell Biol Lipids 2018; 1863:399-408. [PMID: 29331331 PMCID: PMC5835416 DOI: 10.1016/j.bbalip.2018.01.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 12/19/2017] [Accepted: 01/06/2018] [Indexed: 10/18/2022]
Abstract
The distribution of lipids in tears is critical to their function. Lipids in human tears may retard evaporation by forming a surface barrier at the air interface. Lipids complexed with the major lipid binding protein in tears, tear lipocalin, reside in the bulk (aqueous) and may have functions unrelated to the surface. Many new lipids species have been revealed through recent mass spectrometric studies. Their association with lipid binding proteins has not been studied. Squalene, (O-acyl) omega-hydroxy fatty acids (OAHFA) and ceramides are examples. Even well-known lipids such as wax and cholesteryl esters are only presumed to be unbound because extracts of protein fractions of tears were devoid of these lipids. Our purpose was to determine by direct binding assays if the aforementioned lipids can bind tear lipocalin. Lipids were screened for ability to displace DAUDA from tear lipocalin in a fluorescence displacement assay. Di- and tri-glycerides, squalene, OAHFA, wax and cholesterol esters did not displace DAUDA from tear lipocalin. However, ceramides displaced DAUDA. Apparent dissociation constants for ceramide-tear lipocalin complexes using fluorescent analogs were measured consistently in the submicromolar range with 3 methods, linear spectral summation, high speed centrifugal precipitation and standard fluorescence assays. At the relatively small concentrations in tears, all ceramides were complexed to tear lipocalin. The lack of binding of di- and tri-glycerides, squalene, OAHFA, as well as wax and cholesterol esters to tear lipocalin is consonant with residence of these lipids near the air interface.
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Affiliation(s)
- Ben J Glasgow
- Departments of Ophthalmology, Pathology and Laboratory Medicine, Jules Stein Eye Institute, University of California, Los Angeles, 100 Stein Plaza Rm. BH 623, Los Angeles, CA 90095, United States.
| | - Adil R Abduragimov
- Departments of Ophthalmology, Pathology and Laboratory Medicine, Jules Stein Eye Institute, University of California, Los Angeles, 100 Stein Plaza Rm. BH 623, Los Angeles, CA 90095, United States
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Abstract
PURPOSE To evaluate the impact of Optive (Allergan, Irvine, CA) and Optive Advanced (Allergan, Irvine, CA) on tear film stability and quality during a one-hour observation period when compared to saline (Pfizer, Perth, WA). METHODS This was a double-masked, cross-over study. Twenty participants attended three visits, randomly receiving either Optive, Optive Advanced or saline. Oculus Keratograph 5M (Oculus, Arlington, WA, USA), non-invasive keratograph break-up time (NIKBUT), Lipiview (TearScience Inc, Morrisville, NC, USA), lipid layer thickness (LLT) and comfort were measured prior to and 5, 15 and 60 min after drop instillation. RESULTS Optive Advanced demonstrated a significant increase in LLT between baseline (57.5 ± 12.3 nm) and both 5 min (67.5 ± 18.8 nm, p = 0.04) and 15 min (68.9 ± 17.3 nm, p = 0.04) but not 60 min (61.6 ± 14.3 nm, p = 0.47). Optive and saline were not different between timepoints for LLT (p > 0.05). There was no difference between timepoints for any of the drops for NIKBUT (p = 0.75). Comfort was significantly better at 5 min compared to baseline for Optive (8.3 ± 1.2 and 7.3 ± 1.4, respectively, p = 0.03) but not different for Optive Advance or saline (p > 0.05). CONCLUSIONS Optive Advanced increased LLT for 15 min following instillation, returning to baseline within one hour. This did not however, translate into an improvement in tear film stability over this time period. Only Optive demonstrated an improvement in comfort.
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Affiliation(s)
- Maria Markoulli
- a Faculty of Science , School of Optometry and Vision Science, UNSW Sydney , Sydney , Australia
| | - Amanda Sobbizadeh
- a Faculty of Science , School of Optometry and Vision Science, UNSW Sydney , Sydney , Australia
| | - Jacqueline Tan
- a Faculty of Science , School of Optometry and Vision Science, UNSW Sydney , Sydney , Australia
| | - Nancy Briggs
- b Stats Central, Mark Wainwright Analytical Centre , UNSW Sydney , Sydney , Australia
| | - Minas Coroneo
- c Department of Ophthalmology, Prince of Wales Clinical School, Faculty of Medicine , UNSW Sydney , Sydney , Australia
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Jones L, Downie LE, Korb D, Benitez-del-Castillo JM, Dana R, Deng SX, Dong PN, Geerling G, Hida RY, Liu Y, Seo KY, Tauber J, Wakamatsu TH, Xu J, Wolffsohn JS, Craig JP. TFOS DEWS II Management and Therapy Report. Ocul Surf 2017; 15:575-628. [DOI: 10.1016/j.jtos.2017.05.006] [Citation(s) in RCA: 578] [Impact Index Per Article: 82.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 05/03/2017] [Indexed: 02/06/2023]
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Guzman-Aranguez A, Fonseca B, Carracedo G, Martin-Gil A, Martinez-Aguila A, Pintor J. Dry Eye Treatment Based on Contact Lens Drug Delivery: A Review. Eye Contact Lens 2016; 42:280-8. [PMID: 26372476 DOI: 10.1097/ICL.0000000000000184] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Dry eye disease affects a substantial segment of the word population with increasing frequency. It is a multifactorial disease of the ocular surface and tear film, which causes ocular discomfort, visual disturbances, and tear instability with potential damage to the cornea and conjunctiva. Because of its multifactorial etiology, the use of different pharmacological treatment for dry eye treatment has been proposed, which include anti-inflammatory molecules, lubricants or comfort agents, and secretagogues. However, in some cases these pharmacological approaches only relieve symptoms temporarily, and consequently, eye care professionals continue to have difficulties managing dry eye. To improve pharmacological therapy that allows a more efficient and long-term action, effective ocular drug delivery of the currently available drugs for dry eye treatment is required. Contact lenses are emerging as alternative ophthalmic drugs delivery systems that provide an increased residence time of the drug at the eye, thus leading to enhanced bioavailability and more convenient and efficacious therapy. In this article, we reviewed the different techniques used to prepare contact lens-based drug delivery systems and focused on articles that describe the delivery of compounds for dry eye treatment through contact lenses.
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Bai Y, Nichols JJ. Advances in thickness measurements and dynamic visualization of the tear film using non-invasive optical approaches. Prog Retin Eye Res 2017; 58:28-44. [DOI: 10.1016/j.preteyeres.2017.02.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 02/09/2017] [Accepted: 02/20/2017] [Indexed: 12/13/2022]
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Fukuoka S, Arita R. Increase in tear film lipid layer thickness after instillation of 3% diquafosol ophthalmic solution in healthy human eyes. Ocul Surf 2017; 15:730-735. [PMID: 28363586 DOI: 10.1016/j.jtos.2017.03.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Revised: 03/20/2017] [Accepted: 03/20/2017] [Indexed: 12/17/2022]
Abstract
PURPOSE To evaluate the effect of 3% diquafosol ophthalmic solution on tear film lipid layer thickness (LLT) in normal human eyes by tear interferometry. METHODS Forty-seven healthy men (mean age of 42.4 years) randomly received one drop of artificial tears in one eye and one drop of 3% diquafosol ophthalmic solution in the other. LLT of each eye was quantified by tear interferometry before and 15, 30, and 60 min after instillation. Ocular symptoms were assessed before and 30 min after instillation. Baseline LLT, tear film breakup time (TBUT), meibomian gland area (meiboscore) of the upper and lower eyelids, and Schirmer test value were evaluated on a different day before treatment. RESULTS LLT before and 15, 30, and 60 min after diquafosol instillation was 62.3 ± 31.1, 77.0 ± 39.5, 79.3 ± 40.5, and 77.7 ± 43.6 nm, respectively, with the diquafosol-induced increase in LLT being significant at each time point. Artificial tears did not result in a significant increase in LLT. TBUT (ρ = 0.32, P = 0.026), meiboscore of the lower eyelid (ρ = -0.33, P = 0.022), and the maximum difference in LLT between before and after diquafosol instillation (ΔLLTmax) (ρ = 0.35, P = 0.016) were significantly correlated with baseline LLT in the diquafosol group. Age was not significantly related to baseline LLT or ΔLLTmax. Symptoms did not differ significantly between the two groups. CONCLUSIONS Topical instillation of 3% diquafosol ophthalmic solution increased LLT for up to 60 min in normal human eyes regardless of age.
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Affiliation(s)
- Shima Fukuoka
- Omiya Hamada Eye Clinic, Saitama, Japan; Lid and Meibomian Gland Working Group (LIME), Japan; Department of Ophthalmology, University of Tokyo School of Medicine, Tokyo, Japan
| | - Reiko Arita
- Lid and Meibomian Gland Working Group (LIME), Japan; Department of Ophthalmology, University of Tokyo School of Medicine, Tokyo, Japan; Department of Ophthalmology, Itoh Clinic, Saitama, Japan.
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Nejabat M, Reza SA, Zadmehr M, Yasemi M, Sobhani Z. Efficacy of Green Tea Extract for Treatment of Dry Eye and Meibomian Gland Dysfunction; A Double-blind Randomized Controlled Clinical Trial Study. J Clin Diagn Res 2017; 11:NC05-NC08. [PMID: 28384900 DOI: 10.7860/jcdr/2017/23336.9426] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 10/25/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION With an incidence rate of 9%, dry eye is a common problem of the ocular surface, especially in patients more than 40-year-old. Green tea extract has anti-oxidative, anti-bacterial, anti-androgen, and immunomodulatory properties. AIM To evaluate the efficacy of green tea extract for treatment of patients with dry eye and Meibomian Gland Dysfunction (MGD). MATERIALS AND METHODS In a double-blind randomized controlled clinical trial, 60 patients were selected within the age range of 30 to 70 years, and divided into two groups by blocked randomization method. Standard treatment included artificial tear eye drops, three times a day for a month for all patients. Topical green tea extract was prescribed three times a day for one month in one of the groups. All patients were evaluated at the beginning and end of the study for clinical symptoms based on the Ocular Surface Disease Index (OSDI) score, Schirmer's test, Tear Breakup Time (TBUT), corneal and conjunctival staining and meibum score. RESULTS The mean age of participants in the green tea and control group was 61 and 64 years respectively. In the green tea group, the mean score of clinical symptoms was 9±0.86 that improved to 4.86±0.55 after one month (p=0.002). Scores suggesting improvement of TBUTs and the health of meibomian glands were significantly higher in the green tea group (p=0.002). Furthermore, no side effects of the treatment were observed. CONCLUSION Green tea extract is an effective, safe, and well-tolerated topical treatment for mild and moderate evaporative dry eyes and MGD.
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Affiliation(s)
- Mahmood Nejabat
- Department of Ophthalmology, Poostchi Ophthalmology Research Center , Shiraz, Iran
| | - Salehi Ali Reza
- Assistant Professor of Epidemiology, Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences , Shiraz, Iran
| | - Mehdi Zadmehr
- Department of Ophthalmology, Poostchi Ophthalmology Research Center , Shiraz, Iran
| | - Masoud Yasemi
- Department of Ophthalmology, Poostchi Ophthalmology Research Center , Shiraz, Iran
| | - Zahra Sobhani
- Department of Pharmacology, School of Pharmacy, Shiraz University of Medical Sciences , Shiraz, Iran
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