Effect of Hypotonic 0.4% Hyaluronic Acid Drops in Dry Eye Patients: A Cross-Over Study

Treating Sjögren's Syndrome: Insights for the Clinician

Sjögren's syndrome (SS) is a systemic autoimmune disease that affects the exocrine glands, mainly the salivary and lachrymal glands, with consequent persistent dryness of the mouth and eyes. In addition to the clinical manifestations related to the exocrine gland involvement, a consistent prevalence of patients may present systemic manifestations. Some of these can be ascribed to the periepithelial extension of lymphocytic infiltration whilst others are determined by an immunomediated process affecting small- or medium-size vessels. While the use of tear and saliva substitutes and local or systemic stimulation of residual secretions represent the mainstays of the therapy of sicca component, different immunomodulating or immunosuppressive agents are usually required to treat extraglandular features, similarly to what happens in other connective tissue diseases. In the last few years, the advancement in the understanding the pathogenetic mechanisms of this disorder and the availability of new biologic target therapies seem to offer completely new therapeutic options. The use of B cell depleting or modulating therapies has achieved promising results.

Assessment and Management of Dry Eye Patients for Non-Ophthalmic Healthcare Practitioners

Dry eye is a very common condition in many parts of the world. Both ophthalmologists and other healthcare professionals, such as optometrists and general practitioners, are often involved in the care of these patients. The main thrust of dry eye management is over-the-counter tear lubricants. There is a wide range of tear lubricants available today. These lubricants vary in viscosity, duration of action, type of preservatives, osmolarity/osmolality and pH. This article aims to educate healthcare professionals on 1) how to assess and manage patients with mild to moderate dry eyes and 2) how to identify patients who may need a referral to an ophthalmologist. Strategies on the use of available treatments and their limitations, as well as factors that may affect patient compliance will be discussed.

Dry eye syndrome: an update in office management

Dry eye syndrome is a multifactorial disease of the ocular surface and tear film that results in ocular discomfort, visual disturbances, and tear instability, with potential damage to the cornea and conjunctiva. Risk factors for dry eye syndrome include age (>50 years old), female sex, environments with low humidity, systemic medications, and autoimmune disorders. There are several treatment options that range from artificial tears to anti-inflammatory and immunosuppressant agents. Treatment of this highly prevalent condition can drastically improve the quality of life of individuals and prevent damage to the ocular surface.

Cytotoxicity assays of new artificial tears containing 2-methacryloyloxyethyl phosphorylcholine polymer for ocular surface cells

PURPOSE

2-Methacryloyloxyethyl phosphorylcholine (MPC) polymer is a multifunctional agent with antiadhesive, antithrombogenetic, and strong hydrating properties. MPC polymer-containing eye drops are the first such ophthalmic product to be commercially available; they contain approximately 0.1% Lipidure-PMB (copolymer of MPC and butyl methacrylate; NOF Corporation, Tokyo, Japan). This study evaluated the cytotoxicity of this new product toward ocular surface cells.

METHODS

SIRC (rabbit cornea), BCE C/D-1b (bovine cornea), RC-1 (rabbit cornea), and Chang (human conjunctiva) cell lines were tested in this study. Cell viability was measured using both the MTT assay and the neutral red test in cells treated for 10, 30, or 60 min with MPC-containing eye drops and 4 commercial ophthalmic solutions containing sodium hyaluronate (SH) at various doses (undiluted, twofold diluted, and tenfold diluted). Cell viability scores were calculated. Cell viability was analyzed using ANOVA and the Dunnett test.

RESULTS

After treatment with the MPC eye drops, cell viability rates were maintained at over 80% irrespective of the cell lines, dilution rates, exposure times, and assays, and were similar to those of the clinically approved artificial tear products other than Hyalein 0.1%, although some significant differences were found.

CONCLUSIONS

The MPC eye drops were tolerable to ocular surface cells, and comparable to single doses of clinically approved drugs containing sodium hyaluronate.

Impact of dry eye disease and treatment on quality of life

PURPOSE OF REVIEW

Recent increased awareness of dry eye disease (DED) by both clinicians and patients has been accompanied by improved recognition that it is a chronic disorder often requiring long-term management. DED, frequently associated with symptoms of discomfort and visual disturbance, also impairs quality of life (QoL), including aspects of physical, social, and psychological functioning. This review summarizes the available research on the impact of DED and its treatment on measures of QoL.

RECENT FINDINGS

A relative dearth of data supporting the effectiveness of DED treatments as assessed by QoL measures exists. Both cyclosporine ophthalmic emulsion 0.05% and hydroxypropyl cellulose ophthalmic inserts have been associated with improvements in Ocular Surface Disease Index scores, a disease-specific measure of QoL, and with enhancement of patients' ratings regarding their ability to perform activities of daily living.

SUMMARY

Because there is a lack of concordance between symptoms and diagnostic measures of DED, QoL measures provide clinicians a valuable tool for assessing the burden of disease as well as response to treatment. Such measures should be employed in clinical practice and in future trials of treatment modalities.