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Calderón-García AÁ, Valencia-Nieto L, Valencia-Sandonis C, López-de la Rosa A, Blanco-Vazquez M, Fernández I, García-Vázquez C, Arroyo-Del Arroyo C, González-García MJ, Enríquez-de-Salamanca A. Gene expression changes in conjunctival cells associated with contact lens wear and discomfort. Ocul Surf 2024; 31:31-42. [PMID: 38128761 DOI: 10.1016/j.jtos.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 10/27/2023] [Accepted: 12/09/2023] [Indexed: 12/23/2023]
Abstract
PURPOSE This study aimed to analyze the differences in the expression of pain-related genes in conjunctival epithelial cells among symptomatic contact lens (CL) wearers (SCLWs), asymptomatic CL wearers (ACLWs), and non-CL wearers (non-CLWs). METHODS For this study, 60 participants (20 non-CLWs, 40 CLWs) were enrolled. The CLW group comprised 20 ACLWs and 20 SCLWs according to the Contact Lens Dry Eye Questionnaire short form©. Conjunctival cells were collected using impression cytology, and RNA was isolated and used to determine the expression levels of 85 human genes involved in neuropathic and inflammatory pain. The effects of CL wear and discomfort were evaluated using mixed-effects ANOVA with partially nested fixed-effects model. Gene set enrichment analysis was performed to assign biological meaning to sets of differentially expressed genes. RESULTS Six genes (CD200, EDN1, GRIN1, PTGS1, P2RX7, and TNF) were significantly upregulated in CLWs compared to non-CLWs. Eleven genes (ADORA1, BDKRB1, CACNA1B, DBH, GRIN1, GRM1, HTR1A, PDYN, PTGS1, P2RX3, and TNF) were downregulated in SCLWs compared to ACLWs. These genes were mainly related to pain, synaptic transmission and signaling, ion transport, calcium transport and concentration, and cell-cell signaling. CONCLUSIONS CL wear modified the expression of pain- and inflammation-related genes in conjunctival epithelial cells. These changes may be in part, along with other mechanisms, responsible for CL discomfort in SCLWs.
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Affiliation(s)
- Andrés Ángel Calderón-García
- Institute of Applied Ophthalmobiology (IOBA), Universidad de Valladolid, Valladolid, Spain; Department of Theoretical Physics, Atomic and Optics, Universidad de Valladolid, Valladolid, Spain
| | - Laura Valencia-Nieto
- Institute of Applied Ophthalmobiology (IOBA), Universidad de Valladolid, Valladolid, Spain; Department of Theoretical Physics, Atomic and Optics, Universidad de Valladolid, Valladolid, Spain
| | - Cristina Valencia-Sandonis
- Institute of Applied Ophthalmobiology (IOBA), Universidad de Valladolid, Valladolid, Spain; Department of Theoretical Physics, Atomic and Optics, Universidad de Valladolid, Valladolid, Spain
| | - Alberto López-de la Rosa
- Institute of Applied Ophthalmobiology (IOBA), Universidad de Valladolid, Valladolid, Spain; Department of Theoretical Physics, Atomic and Optics, Universidad de Valladolid, Valladolid, Spain
| | - Marta Blanco-Vazquez
- Institute of Applied Ophthalmobiology (IOBA), Universidad de Valladolid, Valladolid, Spain
| | - Itziar Fernández
- Institute of Applied Ophthalmobiology (IOBA), Universidad de Valladolid, Valladolid, Spain; Networking Research Center on Bioengineering Biomaterials and Nanomedicine (CIBER-BBN), Valladolid, Spain; Department of Statistics and Operations Research, Universidad de Valladolid, Valladolid, Spain
| | - Carmen García-Vázquez
- Institute of Applied Ophthalmobiology (IOBA), Universidad de Valladolid, Valladolid, Spain
| | - Cristina Arroyo-Del Arroyo
- Institute of Applied Ophthalmobiology (IOBA), Universidad de Valladolid, Valladolid, Spain; Department of Theoretical Physics, Atomic and Optics, Universidad de Valladolid, Valladolid, Spain
| | - María J González-García
- Institute of Applied Ophthalmobiology (IOBA), Universidad de Valladolid, Valladolid, Spain; Department of Theoretical Physics, Atomic and Optics, Universidad de Valladolid, Valladolid, Spain; Networking Research Center on Bioengineering Biomaterials and Nanomedicine (CIBER-BBN), Valladolid, Spain.
| | - Amalia Enríquez-de-Salamanca
- Institute of Applied Ophthalmobiology (IOBA), Universidad de Valladolid, Valladolid, Spain; Networking Research Center on Bioengineering Biomaterials and Nanomedicine (CIBER-BBN), Valladolid, Spain
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2
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Pastor-Zaplana JÁ, Gallar J, Acosta MC. Functional Changes of the Ocular Surface Sensory Nerves Due to Contact Lens Use in Young Symptomatic and Asymptomatic Users. Invest Ophthalmol Vis Sci 2023; 64:12. [PMID: 37938935 PMCID: PMC10637199 DOI: 10.1167/iovs.64.14.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 10/18/2023] [Indexed: 11/10/2023] Open
Abstract
Purpose The purpose of this study was to analyze the differences in corneal sensory nerve functionality in young asymptomatic (CL-A) and symptomatic (CL-S) contact lens (CL) users. Methods CL wearers (23.8 ± 1.0 years, n = 31) were classified as CL-S with an Ocular Surface Disease Index (OSDI) ≥ 13 (n = 14) or CL-A. Users of eye glasses (EG; 24.5 ± 0.8 years, n = 29) with OSDI < 13 participated as controls. The sensations evoked by mechanical, chemical (gas esthesiometer), and cold (4°C saline drops) stimuli were measured using the Visual Analogue Scales (VASs). Moreover, tear volume, tear break up time (TBUT), blinking frequency (BF), and ocular surface temperature (OST; IR thermography) were also measured. Results Mechanical and chemical stimuli produced similar scores in the CL-A and EG participants, although the CL-A subjects referred to stronger irritation (p < 0.05). Likewise, the VAS intensity in response to cold stimuli did not differ between CL-A and EG subjects, while the ability to detect cold was significantly worse in CL-S users (p < 0.05). CL-A users had a similar tear volume, a higher BF (p < 0.01) and shorter TBUT (p < 0.001) to EG wearers, and blinking and TBUT were also altered significantly in CL-S users (p < 0.01). Interestingly, the OST was significantly lower in CL-A users (p < 0.05) than in EG wearers, but not in CL-S users. Conclusions Using CLs modifies corneal sensitivity, blinking and tearing in young volunteers. Even if they have yet to develop clinical signs of inflammation, they display changes in corneal sensitivity consistent with the sensitization of corneal nociceptors and the inhibition cold thermoreceptors, phenomena that occur under inflammatory conditions. The differences in corneal sensitivity and OST between CL-A and CL-S users could reflect the extent of nerve damage and inflammation at the ocular surface.
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Affiliation(s)
- José Ángel Pastor-Zaplana
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Sant Joan d'Alacant, Spain
- Departamento de Patología y Cirugía, Universidad Miguel Hernández de Elche, Sant Joan d'Alacant, Spain
| | - Juana Gallar
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Sant Joan d'Alacant, Spain
- Instituto de Investigación Biomédica y Sanitaria de Alicante, Alicante, Spain
| | - M. Carmen Acosta
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Sant Joan d'Alacant, Spain
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Ouyang T, Su S, Deng H, Liu Y, Cui L, Rong J, Zhao J. Superhydrophilic Poly(2-hydroxyethyl methacrylate) Hydrogel with Nanosilica Covalent Coating: A Promising Contact Lens Material for Resisting Tear Protein Deposition and Bacterial Adhesion. ACS Biomater Sci Eng 2023; 9:5653-5665. [PMID: 37736672 DOI: 10.1021/acsbiomaterials.3c00856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/23/2023]
Abstract
Tear protein deposition and bacterial adhesion are the main drawbacks of the hydrogel contact lens. In this study, we developed a novel superhydrophilic poly(2-hydroxyethyl methacrylate) (NSCC-pHEMA) hydrogel with nanosilica covalent coating by the combination of colloidal silica immersion and dehydration treatment. The infrared spectroscopy and energy dispersive X-ray spectroscopy analyses confirmed the successful formation of Si-O covalent bonding between nanosilica and pHEMA hydrogel. This coating was highly stable against powerful sonication or long-term shaking immersion treatment. Among various NSCC-pHEMA hydrogels with different colloidal silica concentrations, the 7%NSCC-pHEMA hydrogel generated a superhydrophilic micro wrinkle surface with a root-mean-square roughness of 43.10 nm, which dramatically reduced the deposition of lysozyme and bovine serum albumin by 65% and 57%, respectively, and decreased the adhesion of S. aureus and E. coli by 59% and 66%, respectively, in comparison to the pHEMA hydrogel. However, the nanosilica coating had little effect on the mechanical properties, light transmittance, oxygen permeability, and equilibrium water content of the pHEMA hydrogel. NSCC-pHEMA hydrogels were nontoxic to both mouse fibroblasts (L929) and human immortalized keratinocytes (HaCaT). Thus, the superhydrophilic NSCC-pHEMA hydrogel is a potential contact lens material for resisting tear protein deposition and bacterial adhesion.
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Affiliation(s)
- Tao Ouyang
- Department of Materials Science and Engineering, College of Chemistry and Materials Science, Jinan University, Guangzhou 511436, China
| | - Shuxian Su
- Department of Materials Science and Engineering, College of Chemistry and Materials Science, Jinan University, Guangzhou 511436, China
| | - Haotian Deng
- Department of Materials Science and Engineering, College of Chemistry and Materials Science, Jinan University, Guangzhou 511436, China
| | - Yuying Liu
- Department of Materials Science and Engineering, College of Chemistry and Materials Science, Jinan University, Guangzhou 511436, China
| | - Lishu Cui
- Department of Materials Science and Engineering, College of Chemistry and Materials Science, Jinan University, Guangzhou 511436, China
| | - Jianhua Rong
- Department of Materials Science and Engineering, College of Chemistry and Materials Science, Jinan University, Guangzhou 511436, China
- Engineering Research Center of Artificial Organs and Materials, Ministry of Education, Guangzhou 511436, China
| | - Jianhao Zhao
- Department of Materials Science and Engineering, College of Chemistry and Materials Science, Jinan University, Guangzhou 511436, China
- Engineering Research Center of Artificial Organs and Materials, Ministry of Education, Guangzhou 511436, China
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Zhang S, Echegoyen J. Point of care diagnosis of dry eye disease with a sensitive immunoassay for dual biomarker detection. Biochem Biophys Rep 2022; 32:101396. [PMCID: PMC9694066 DOI: 10.1016/j.bbrep.2022.101396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 11/09/2022] [Accepted: 11/19/2022] [Indexed: 11/27/2022] Open
Abstract
Dry eye disease (DED) is a multifactorial eye disease with few effective methods for clinical diagnosis and treatment. It is the most common eye disease with significant health challenges of the unprecedented aging population. Recent proteomic studies and clinical research have led to the discovery of several biologically relevant biomarkers, with increased levels of Interleukin-6 (IL-6) and decreased levels of lactoferrin being clinically validated in the progression of DED. In this study, a sensitive point of care (POC) DED diagnostic method was developed for targeting dual biomarkers of IL-6 and lactoferrin in the tear samples. A paper-based lateral flow immunoassay (LFIA) was established in a double-antibody sandwich fashion with colloid gold nanoparticles acting as probes. The minimal detection concentrations were 0.1 ng/ml and 10 ng/ml for IL-6 and lactoferrin, respectively. Separated conventional ELISA tests were also performed with data confirming results from the LFIA tests. A trial study was conducted with 20 tear samples from DED patients and healthy controls. All DED tear samples exhibited significantly higher levels of IL-6 and decreased levels of lactoferrin, as compared to the normal controls. A quantitative analysis of LFIA images was carried out using ImageJ software for an accurate data interpretation. This dual biomarker detection method is sensitive and affordable with quick turnaround time. Design of a larger clinical study in the future can further validate this POC assay for early diagnosis as well as patients’ self-management of chronic states of DED. A point of care assay was established for in-home diagnosis of dry eye disease (DED). Two validated biomarkers were targeted to address the multifactorial nature of DED. The paper based lateral flow assays were validated by the conventional ELISA assays. Initial clinical trial tests were performed with 20 tear samples.
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Affiliation(s)
- Sydney Zhang
- Corresponding author. 13350 Camino Del Sur, Suite 8, San Diego, CA, 92129, USA.
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Corneal Confocal Analysis after Scleral Lens Wear in Keratoconus Patients: A Pilot Study. Optom Vis Sci 2022; 99:800-806. [PMID: 36301598 DOI: 10.1097/opx.0000000000001954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
SIGNIFICANCE Scleral lenses rely on the scleroconjunctival region without bearing the cornea, which could improve the symptoms and modify the corneal nerve plexus morphology. PURPOSE This study aimed to evaluate symptoms and changes in corneal nerve plexus morphology and density of Langerhans cells in keratoconus patients with and without intrastromal corneal ring before and after scleral lens wear. METHODS Sixteen scleral lens wearers with keratoconus were recruited for this short-term experimental pilot study. Subjects were divided into two groups: keratoconus group and intrastromal corneal ring segment group. All subjects were examined in two visits: baseline (before scleral lens wear) and after 6 months of scleral lens wear, after lens removal. The Schirmer I test, the Ocular Surface Disease Index, tear breakup time, and in vivo confocal microscopy were evaluated. RESULTS The mean age was 42.33 ± 11.27 years. A significant decrease in tear breakup time was found in the total group ( P = .01, Wilcoxon) compared with baseline. Ocular Surface Disease Index score had decreased after 6 months of scleral lens wear in the keratoconus with intrastromal corneal ring segment subgroup ( P = .03, Wilcoxon) and in the total group ( P = .001, Wilcoxon). No statistical changes in nerve density, tortuosity, and ramification were found for either the total group or the subgroup. However, the mean nerve length was higher in all groups, especially in the keratoconus subgroup ( P = .03, Wilcoxon) after 6 months of scleral lens wear. Regarding optical density, the total group showed a significant increase after 6 months of wearing ( P = .02, Wilcoxon). Finally, Langerhans cell density was not statistically different in any group. CONCLUSIONS These results suggest that scleral lens wearing improves the symptoms and increased the mean length nerves after 6 months of wear use in keratoconus patients.
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Abstract
Ophthalmology is the branch of medicine that deals with diseases of the eye, the organ responsible for vision, and its attachments. Biomaterials can be made with different types of materials and can replace or improve a function or an organ, specifically the eye in the case of ophthalmic biomaterials. Biomaterials are substances that interact with biological systems for a medical purpose, either as a therapeutic (treat, augment, repair, or replace a tissue function of the body) or a diagnostic agent, and have continued to improve over the years, leading to the creation of new biomaterials. With the arrival of new generations, biomaterials have succeeded in reducing complications and toxicity and improving biocompatibilities associated with older generations. With the aging population, eye problems are becoming more prevalent, and biomaterials have helped in recent years to improve or restore vision, improving the quality of life of many patients. This review focuses on the most clinically used ophthalmic biomaterials, including contact lenses, intraocular lenses, artificial tears, inlays and vitreous replacements. Tissue engineering is presented as a new tool that is able to be treat several ophthalmologic disorders.
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7
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Biochemistry of human tear film: A review. Exp Eye Res 2022; 220:109101. [DOI: 10.1016/j.exer.2022.109101] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 04/18/2022] [Accepted: 04/26/2022] [Indexed: 12/13/2022]
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8
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Insua Pereira E, Sampaio AP, Lira M. Effects of contact lens wear on tear inflammatory biomarkers. Cont Lens Anterior Eye 2022; 45:101600. [DOI: 10.1016/j.clae.2022.101600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 04/13/2022] [Accepted: 04/15/2022] [Indexed: 11/25/2022]
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Sánchez-Tena MÁ, Martinez-Perez C, Villa-Collar C, Alvarez-Peregrina C. Long-term effect of contact lens wear: A citation network study. Cont Lens Anterior Eye 2021; 45:101527. [PMID: 34732300 DOI: 10.1016/j.clae.2021.101527] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 09/10/2021] [Accepted: 10/15/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND Contact lenses can cause complications in 2/3 of the total population, but in most cases, they are mild and easy to manage. However, most of the studies are short-term. The aim of the study was to analyze the publications on the long-term effects of contact lens wear to understand the current research landscape through the analysis of dating networks as well as determining the different research areas and the most cited publications. METHODS The Web of Science database was used to perform the publication search, looking for the terms "Long-term" AND "contact lens wear" within the period between 1977 and January 2021. The CitNetExplorer and CiteSpace software were then used to conduct the publication analysis. To obtain the graphics, the VOSviewer software was used. RESULTS A total of 721 publications were found with 2999 citations generated within the network. The year 2010 was singled out as a "key year", considering the number of publications that emerged in that year and increase in adaptations of contact lens worldwide. The most widely cited publication was "Effects of long-term extended contact lens wear on the human cornea", an article by Holden et al., which was published in 1985. By using the clustering function, we were able to establish three clusters that encompassed the different research areas within this field: morphological changes, the loss of corneal sensitivity, tear film characteristics and longitudinal changes in ocular physiology. CONCLUSIONS The main research topic in this field focuses on the morphological changes that take place in the corneal endothelial cell layer.
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Affiliation(s)
- Miguel Ángel Sánchez-Tena
- Department of Optometry and Vision, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain; ISEC LISBOA - Instituto Superior de Educação e Ciências, 1750-179 Lisboa, Portugal.
| | - Clara Martinez-Perez
- ISEC LISBOA - Instituto Superior de Educação e Ciências, 1750-179 Lisboa, Portugal; Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Villaviciosa de Odón Madrid, Spain.
| | - Cesar Villa-Collar
- Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Villaviciosa de Odón Madrid, Spain
| | - Cristina Alvarez-Peregrina
- Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Villaviciosa de Odón Madrid, Spain.
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Fujimoto H, Ochi S, Yamashita T, Inoue Y, Kiryu J. Role of the Water Gradient Structure in Inhibiting Thin Aqueous Layer Break in Silicone Hydrogel-Soft Contact Lens. Transl Vis Sci Technol 2021; 10:5. [PMID: 34473222 PMCID: PMC8419878 DOI: 10.1167/tvst.10.11.5] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Purpose Soft contact lenses (SCLs) are effective for refractive error correction, but prolonged wear triggers discomfort and discontinuation. This study investigates whether water gradient technology of delefilcon A-based SCLs improve tear film dynamics. Methods This retrospective observational study included 50 asymptomatic delefilcon A or narafilcon A users. Data on thin aqueous layer break (TALB; %), noninvasive tear break-up time (NIBUT), tear meniscus height (TMH; mm), subjective dryness, and higher-order aberrations (HOAs) were collected. Measurements of the bare eye, the SCL-worn eye after 15 minutes (visit 1 [v1]) and 30 ± 5 days after v1 after SCL was worn for ≥5 hours (visit 2 [v2]) were recorded. Results TALB was significantly reduced in the delefilcon A group compared to the narafilcon A group (33.3% vs. 85.5% at v1; P < 0.0001 and 31.7% vs. 80.4% at v2; P < 0.0001). The NIBUT was also significantly higher in the former (4.2 ± 2.1 seconds vs. 2.9 ± 1.5 at v1; P < 0.01 and 4.1 ± 2.3 seconds vs. 2.7 ± 1.6 seconds at v2; P < 0.01) across both visits. The TMH was significantly reduced in the former in both v1 and v2. The total ocular HOAs were significantly lower in the former at v1 (P < 0.001) and v2 (P < 0.05) compared to the bare eye. Conclusions The water gradient technology of delefilcon A reduces TALB and increases NIBUT. Translational Relevance The use of water gradient technology improves tear film dynamics and alleviate pathological break-up pattern, improving lens performance.
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Affiliation(s)
- Hisataka Fujimoto
- Department of Ophthalmology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | | | | | | | - Junichi Kiryu
- Department of Ophthalmology, Kawasaki Medical School, Kurashiki, Okayama, Japan
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Graham AD, Lin MC. The relationship of pre-corneal to pre-contact lens non-invasive tear breakup time. PLoS One 2021; 16:e0247877. [PMID: 34181641 PMCID: PMC8238214 DOI: 10.1371/journal.pone.0247877] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 02/15/2021] [Indexed: 11/18/2022] Open
Abstract
Purpose To examine the relationship between pre-corneal and pre-contact lens tear film stability (TFS), and to determine whether pre-corneal TFS is a reliable predictor of subsequent pre-lens TFS after a contact lens is placed on the eye. Methods 667 records met inclusion criteria and were extracted from a soft contact lens multi-study database. Multivariable linear mixed effects models were fit to examine the association between pre-corneal and pre-lens TFS, adjusting for potential confounders and accounting for repeated measures. Receiver Operating Characteristic (ROC) analysis was employed to assess the predictive performance of pre-corneal TFS for subsequent pre-lens TFS. TFS was quantified for this analysis as the non-invasive tear breakup time (NITBUT). Results Pre-corneal NITBUT was significantly related to the pre-lens NITBUT at both 10 min (p<0.001) and 2–6 hrs (p<0.001) post-lens insertion. However, the sensitivities of pre-corneal NITBUT for predicting symptom-associated thresholds of pre-lens NITBUT ranged from 50–65%, and specificities ranged from 57–72%, suggesting poor-to-moderate diagnostic performance. Conclusions Despite the association of pre-corneal and pre-lens TFS, the inherent lability and sensitivity to environmental exposures of the tear film introduce significant variability into NITBUT measurements. Using pre-corneal NITBUT to identify likely successful contact lens candidates prior to fitting is thus not sufficiently accurate to be relied upon in the clinical setting.
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Affiliation(s)
- Andrew D. Graham
- Clinical Research Center, School of Optometry, University of California, Berkeley, California, United States of America
| | - Meng C. Lin
- Clinical Research Center, School of Optometry, University of California, Berkeley, California, United States of America
- Vision Science Group, University of California, Berkeley, California, United States of America
- * E-mail:
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Maldonado-Codina C, Navascues Cornago M, Read ML, Plowright AJ, Vega J, Orsborn GN, Morgan PB. The association of comfort and vision in soft toric contact lens wear. Cont Lens Anterior Eye 2020; 44:101387. [PMID: 33308907 DOI: 10.1016/j.clae.2020.11.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 11/11/2020] [Accepted: 11/13/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE This work set out to investigate if there was an association between subjective comfort and both subjective and measured vision during the use of contemporary daily disposable soft toric contact lenses. METHODS Thirty-eight habitual soft contact lens wearers wore each of three daily disposable toric lenses for one week in a prospective, crossover, randomised, single-masked study. The following clinical measures were recorded at dispensing and follow-up visits: biomicroscopy scores, lens fitting (including rotation and rotational stability), high and low contrast visual acuity, subjective vision quality and subjective ocular surface comfort. Subjective scores were collected using 0-10 numerical grading scales. Comfort scores were analysed using a linear regression model with age, sex, visit, phase of crossover ('phase'), lens type, lens rotation, lens rotational stability, visual acuity, cylinder power and subjective vision quality as factors of interest and then refined using backward stepwise regression. RESULTS Thirty six participants (31.1 ± 13.5 years) completed the study. Comfort scores were found to be associated with subjective vision quality (F = 127.0 ; p < 0.0001), phase (F = 7.2; p = 0.001) and lens type (F = 4.9; p = 0.009). Greater comfort scores were observed with greater subjective vision quality scores. Visual acuity was not statistically significant in the model. CONCLUSION This work suggests that symptoms of ocular discomfort may be more intense if there is also perceived visual compromise in daily disposable soft toric lenses. There was a stronger positive correlation between comfort and subjective vision quality compared with comfort and measured visual acuity.
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Affiliation(s)
- Carole Maldonado-Codina
- Eurolens Research, Division of Pharmacy and Optometry, Faculty of Biology, Medicine and Health, The University of Manchester, Oxford Rd, Manchester, M13 9PL, UK.
| | - Maria Navascues Cornago
- Eurolens Research, Division of Pharmacy and Optometry, Faculty of Biology, Medicine and Health, The University of Manchester, Oxford Rd, Manchester, M13 9PL, UK
| | - Michael L Read
- Eurolens Research, Division of Pharmacy and Optometry, Faculty of Biology, Medicine and Health, The University of Manchester, Oxford Rd, Manchester, M13 9PL, UK
| | - Andrew J Plowright
- Eurolens Research, Division of Pharmacy and Optometry, Faculty of Biology, Medicine and Health, The University of Manchester, Oxford Rd, Manchester, M13 9PL, UK
| | - Jose Vega
- CooperVision Incorporated, 6101 Bollinger Canyon Rd, Suite 500, San Ramon, CA, 94583, USA
| | - Gary N Orsborn
- CooperVision Incorporated, 6101 Bollinger Canyon Rd, Suite 500, San Ramon, CA, 94583, USA
| | - Philip B Morgan
- Eurolens Research, Division of Pharmacy and Optometry, Faculty of Biology, Medicine and Health, The University of Manchester, Oxford Rd, Manchester, M13 9PL, UK
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Abstract
The 2017 consensus report of the Asia Dry Eye Society (ADES) on the definition and diagnosis of dry eyes described dry eye disease as "Dry eye is a multifactorial disease characterized by unstable tear film causing a variety of symptoms and/or visual impairment, potentially accompanied by ocular surface damage." The report emphasized the instability of tear film and the importance of visual dysfunction in association with dry eyes, highlighting the importance of the evaluation of tear film stability. This report also discussed the concept of tear film-oriented therapy, which stemmed from the definition, and which is centered on provision of insufficient components in each tear film layer and ocular surface epithelium. The current ADES report proposes a simple classification of dry eyes based on the concept of tear film-oriented diagnosis and suggests that there are three types of dry eye: aqueous-deficient, decreased wettability, and increased evaporation. It is suggested that these three types respectively coincide with the problems of each layer: aqueous, membrane-associated mucins, and lipid/secretory mucin. Although each component cannot be quantitatively evaluated with the current technology, a practical diagnosis based on the patterns of fluorescein breakup is recommended. The Asia Dry Eye Society classification report suggests that for a practical use of the definition, diagnostic criteria and classification system should be integrated and be simple to use. The classification system proposed by ADES is a straightforward tool and simple to use, only through use of fluorescein, which is available even to non-dry eye specialists, and which is believed to contribute to an effective diagnosis and treatment of dry eyes.
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López-de la Rosa A, González-García MJ, Calonge M, Enríquez-de-Salamanca A. Tear Inflammatory Molecules in Contact Lens Wearers: A Literature Review. Curr Med Chem 2020; 27:523-548. [DOI: 10.2174/0929867326666190409152921] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 03/14/2019] [Accepted: 03/22/2019] [Indexed: 01/20/2023]
Abstract
Background:
Numerous studies have analysed the effect of using different Contact
Lenses (CLs) or care solutions, and suffering discomfort or diseases associated with CL wear
on the inflammatory mediator release into the tears.
Objective:
To summarize the published data on tear inflammatory molecules related to CL use.
Methods:
A PubMed-NCBI search has been conducted and those publications which carried
out original investigations including the analysis of tear inflammatory mediators in CL wearers
were selected.
Results:
Forty-three articles, from 1990 to 2019, have been included. Wearing hydrogel CLs,
rigid gas permeable CLs, and special designs for irregular corneas in keratoconus patients (CLs
with keratoconic design, hybrid CLs, piggyback fit, and scleral CLs) have been reported to alter
the concentration of several molecules in tears. Moreover, there seems to be an effect of the
wearing time and schedule, CL materials and designs, and care solutions used. Regarding CL
discomfort, its relation with inflammatory mediators is not clear. However, some diseases associated
to CL wear, such as giant papillary conjunctivitis, CL induced acute red eye, CL induced
peripheral ulcer, and acanthamoeba keratitis have been related to the release of certain inflammatory
mediators, which may serve as potential biomarkers.
Conclusion:
There is evidence suggesting that different aspects of CL wear alter the inflammatory
mediator profile in tears, which may indicate an inflammatory state of the lacrimal functional
unit. However, more studies need to be carried out to better understand how this inflammatory
process works and its repercussion on the different aspects of CL wear.
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Affiliation(s)
| | | | - Margarita Calonge
- Institute of Applied Ophthalmobiology (IOBA), University of Valladolid, Valladolid, Spain
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15
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16
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López-de la Rosa A, García-Vázquez C, Fernández I, Arroyo-Del Arroyo C, Enríquez-de-Salamanca A, González-García MJ. Substance P Level in Tears as a Potential Biomarker for Contact Lens Discomfort. Ocul Immunol Inflamm 2019; 29:43-56. [PMID: 31600092 DOI: 10.1080/09273948.2019.1668024] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Purpose: To analyze the effects of contact lens (CL) wear, time of the day, and CL discomfort (CLD) on clinical signs, tear inflammatory mediators and substance P.Methods: Thirty symptomatic and 30 asymptomatic CL wearers attended two visits (morning and afternoon) on two days (non-CL and CL wearing days). Comfort, meniscus area, noninvasive breakup time (NIBUT), tear collection, hyperemia, lid parallel conjunctival folds, fluorescein staining, and sensitivity were performed. The tear levels of 23 inflammatory mediators and substance P were measured.Results: Comfort, meniscus area, NIBUT, and MMP-9 were lower while conjunctival staining and EGF higher (p ≤ 0.015) on the CL wearing day. Comfort, IL-8/CXCL8, and VEGF were lower while EGF, IP-10/CXCL10, and MCP-1/CCL2 higher (p ≤ 0.047) in the afternoon. Comfort was lower and substance P higher (p ≤ 0.006) in symptomatic wearers.Conclusion: Substance P may be implicated in CLD etiology; its role and potential application as a biomarker should be further studied.
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Affiliation(s)
- Alberto López-de la Rosa
- Institute of Applied Ophthalmobiology (IOBA), University of Valladolid, Valladolid, Spain.,Department of Theoretical Physics, Atomic and Optics, University of Valladolid, Valladolid, Spain
| | - Carmen García-Vázquez
- Institute of Applied Ophthalmobiology (IOBA), University of Valladolid, Valladolid, Spain
| | - Itziar Fernández
- Institute of Applied Ophthalmobiology (IOBA), University of Valladolid, Valladolid, Spain.,Networking Research Center on Bioengineering Biomaterials and Nanomedicine (CIBER-BBN), Valladolid, Spain
| | - Cristina Arroyo-Del Arroyo
- Institute of Applied Ophthalmobiology (IOBA), University of Valladolid, Valladolid, Spain.,Department of Theoretical Physics, Atomic and Optics, University of Valladolid, Valladolid, Spain
| | - Amalia Enríquez-de-Salamanca
- Institute of Applied Ophthalmobiology (IOBA), University of Valladolid, Valladolid, Spain.,Networking Research Center on Bioengineering Biomaterials and Nanomedicine (CIBER-BBN), Valladolid, Spain
| | - María J González-García
- Institute of Applied Ophthalmobiology (IOBA), University of Valladolid, Valladolid, Spain.,Department of Theoretical Physics, Atomic and Optics, University of Valladolid, Valladolid, Spain.,Networking Research Center on Bioengineering Biomaterials and Nanomedicine (CIBER-BBN), Valladolid, Spain
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17
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Miyasaka K, Kazama Y, Iwashita H, Wakaiki S, Saito A. A novel strip meniscometry method for measuring aqueous tear volume in dogs: Clinical correlations with the Schirmer tear and phenol red thread tests. Vet Ophthalmol 2019; 22:864-871. [PMID: 30900351 DOI: 10.1111/vop.12664] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2017] [Revised: 01/29/2019] [Accepted: 02/22/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The strip meniscometry test (SMT) is a novel method for quantitative measurement of tear volume with only five seconds. We aimed to evaluate clinical correlations of SMT with the gold standard Schirmer tear test (STT) and phenol red thread test (PRT) in dogs, including normal and tear-deficient eyes. ANIMALS STUDIED Left eyes from 621 outpatient dogs with and without ocular disorders were evaluated. PROCEDURES Each subject underwent SMT, PRT, and STT without topical anesthesia in the described order with five-minute intervals. The total population was divided into four groups by classifying tear deficiency severity based on STT results: "severe" (0-5 mm/min), "moderate" (6-10 mm/min), "subclinical" (11-14 mm/min), and "normal" (15 or more mm/min). RESULTS The strongest correlation coefficient was found between SMT-STT (0.676), followed by PRT-STT (0.637) and SMT-PRT (0.600) pairs. Mean(SD) scores of SMT, PRT, and STT in total population were 9.47 (4.08) mm/5 s, 33.30 (8.52) mm/15 s, and 16.47 (7.01) mm/min. Significant differences were found among STT-classified groups, both using SMT and PRT results. Receiver operating characteristic (ROC) curves revealed that SMT better agreed with STT than PRT; agreement increased with increasing STT severity. A cutoff for SMT was identified at 10 mm/5 s to discriminate normal eyes from tear-deficient eyes, yielding high sensitivities and acceptable specificities. CONCLUSIONS SMT could be superior to PRT for discriminating tear-deficient eyes. The high sensitivity of SMT could be useful as an initial diagnostic tool to rule out normal eyes with the short testing time.
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18
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López-de la Rosa A, Arroyo-Del Arroyo C, Enríquez-de-Salamanca A, Pinto-Fraga J, López-Miguel A, González-García MJ. The ability of the Contact Lens Dry Eye Questionnaire (CLDEQ)-8 to detect ocular surface alterations in contact lens wearers. Cont Lens Anterior Eye 2018; 42:273-277. [PMID: 30497902 DOI: 10.1016/j.clae.2018.11.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 07/17/2018] [Accepted: 11/20/2018] [Indexed: 01/19/2023]
Abstract
PURPOSE To study whether some ocular surface alterations could be associated with contact lens (CL) wearers suffering from CL discomfort (CLD) detected using the Contact Lens Dry Eye Questionnaire (CLDEQ)-8. METHODS Forty-one soft CL wearers further classified into symptomatic CL wearers (SCLW) and asymptomatic CL wearers (ACLW) by the CLDEQ-8, and 20 non CL wearers (NCLW) were included. Tear osmolarity, slit-lamp biomicroscopy findings, tear film break-up time, corneal and conjunctival staining, and Schirmer test were performed 24 h after CL removal. Data were compared among groups using the analysis of variance and the Student t-test or the Kruskal-Wallis H and the Mann-Whitney U tests, applying the Bonferroni correction. Correlations between the CLDEQ-8 and the clinical signs were performed using the Spearman correlation coefficient. RESULTS Twenty-four SCLW, 17 ACLW and 20 NCLW were recruited. There were significant differences among groups for tear osmolarity (p < 0.001), limbal hyperaemia (p = 0.014), and tarsal hyperaemia (p = 0.031). Pairwise comparisons revealed that SCLW and ACLW had higher tear osmolarity (p < 0.003, both comparisons) and limbal hyperaemia (p = 0.027 and p = 0.048, respectively) than NCLW. Moreover, SCLW had higher tarsal hyperaemia (p = 0.030) than NCLW. No significant correlations were found (p > 0.05). CONCLUSION The CLDEQ-8 was ineffective to detect clinical alterations between SCLW and ACLW; therefore, the use of questionnaires alone remains being the best approach to detect CLD. The role of the tarsal conjunctiva in the development of CLD should be analyzed in future studies.
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Affiliation(s)
- Alberto López-de la Rosa
- Institute of Applied Ophthalmobiology (IOBA)-University of Valladolid, Valladolid, Spain; Department of Theoretical Physics, Atomic and Optics, University of Valladolid, Valladolid, Spain
| | - Cristina Arroyo-Del Arroyo
- Institute of Applied Ophthalmobiology (IOBA)-University of Valladolid, Valladolid, Spain; Department of Theoretical Physics, Atomic and Optics, University of Valladolid, Valladolid, Spain
| | - Amalia Enríquez-de-Salamanca
- Institute of Applied Ophthalmobiology (IOBA)-University of Valladolid, Valladolid, Spain; Networking Research Center on Bioengineering Biomaterials and Nanomedicine (CIBER-BBN), Valladolid, Spain
| | - José Pinto-Fraga
- Institute of Applied Ophthalmobiology (IOBA)-University of Valladolid, Valladolid, Spain; Networking Research Center on Bioengineering Biomaterials and Nanomedicine (CIBER-BBN), Valladolid, Spain
| | - Alberto López-Miguel
- Institute of Applied Ophthalmobiology (IOBA)-University of Valladolid, Valladolid, Spain; Redes temáticas de investigación cooperativa en salud (Oftared), Instituto de Salud Carlos III, Madrid, Spain
| | - María J González-García
- Institute of Applied Ophthalmobiology (IOBA)-University of Valladolid, Valladolid, Spain; Department of Theoretical Physics, Atomic and Optics, University of Valladolid, Valladolid, Spain; Networking Research Center on Bioengineering Biomaterials and Nanomedicine (CIBER-BBN), Valladolid, Spain.
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19
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Gad A, Vingrys AJ, Wong CY, Jackson DC, Downie LE. Tear film inflammatory cytokine upregulation in contact lens discomfort. Ocul Surf 2018; 17:89-97. [PMID: 30321605 DOI: 10.1016/j.jtos.2018.10.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Revised: 10/05/2018] [Accepted: 10/11/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE To investigate the ocular inflammatory response, using clinical and immunological techniques, in people experiencing contact lens (CL) discomfort. METHODS This study involved 38 adults who were full-time, silicone-hydrogel CL wearers. Participants were categorized into groups based upon a validated CL dry-eye questionnaire (CLDEQ-8) (n = 17 'asymptomatic', CLDEQ-8 score <9; n = 21 'symptomatic', CLDEQ-8 score ≥13). Examinations were performed at two visits (one with, and one without, CL wear), separated by one-week. Testing included: tear osmolarity, ocular redness, tear stability, ocular surface staining, meibography, tear production and tear collection. Tear osmolarity was taken from the inferior-lateral and superior-lateral menisci. The 'Inferior-Superior Osmotic Difference', I-SOD, was the absolute osmolarity difference between these menisci. Concentrations of seven cytokines (IL-2, IL-4, IL-6, IL-10, IL-17A, IFN-gamma, TNF-alpha) were assayed from basal tears using multiplex cytometric bead array. RESULTS At baseline, there was no significant difference in key clinical signs between asymptomatic and symptomatic CL wearers (p > 0.05). The I-SOD was greater in symptomatic than asymptomatic CL wearers (23.1 ± 2.6 versus 11.3 ± 1.4 mOsmol/L, p = 0.001). People experiencing CL discomfort had higher tear IL-17A (122.6 ± 23.7 versus 44.0 ± 10.0 pg/mL, p = 0.02) and reduced tear stability (6.3 ± 1.1 versus 10.4 ± 1.6 s, p = 0.03) after several hours of CL wear. Tear IL-17A levels correlated with both the I-SOD (r = 0.43, p = 0.01) and CLDEQ-8 score (r = 0.40, p = 0.01). CONCLUSIONS CL discomfort occurs in individuals having no clinical dry eye signs, and is associated with higher tear levels of the pro-inflammatory cytokine IL-17A. These findings support an association between the discomfort response and low-grade, ocular surface inflammation.
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Affiliation(s)
- Anne Gad
- Department of Optometry and Vision Sciences, Australia
| | | | - Chinn Yi Wong
- Department of Microbiology and Immunology at the Peter Doherty Institute of Infection and Immunity, The University of Melbourne, Parkville, Victoria, 3010, Australia
| | - David Charles Jackson
- Department of Microbiology and Immunology at the Peter Doherty Institute of Infection and Immunity, The University of Melbourne, Parkville, Victoria, 3010, Australia
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20
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Downie LE, Craig JP. Tear film evaluation and management in soft contact lens wear: a systematic approach. Clin Exp Optom 2018; 100:438-458. [PMID: 28940531 DOI: 10.1111/cxo.12597] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2017] [Revised: 06/09/2017] [Accepted: 07/05/2017] [Indexed: 12/13/2022] Open
Abstract
The human tear film is a highly ordered structure consisting of a thin layer of lipid on the surface and a thicker aqueous-mucin phase, which increases in mucin concentration toward the corneal epithelial cell layer. The health of the tear film and ocular surface influences the likelihood of being able to achieve successful contact lens wear. Contact lens discomfort and dryness are the most frequent reasons why contact lens wearers experience reduced wearing times, which can eventually lead to contact lens discontinuation. Comprehensive clinical assessment of tear film integrity and ocular surface health is therefore essential prior to commencing contact lens wear, to enable the ocular surface environment to be optimised to support lens wear. These parameters should also be evaluated over the course of contact lens wear, in order to identify any aspects requiring clinical management and ensure maintenance of optimal lens-wearing conditions. This review summarises current knowledge relating to the effects of soft contact lens wear on the tear film and ocular surface. It also provides a systematic approach to evaluating tear film and ocular surface integrity, in order to guide the clinical management of tear film anomalies with respect to contact lens wear.
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Affiliation(s)
- Laura E Downie
- Department of Optometry and Vision Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jennifer P Craig
- Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand
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21
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López-De La Rosa A, Arroyo-Del Arroyo C, Cañadas P, López-Miguel A, Calonge M, Enríquez-De-Salamanca A, González-García MJ. Are Contact Lens Discomfort or Soft Contact Lens Material Properties Associated with Alterations in the Corneal Sub-Basal Nerve Plexus? Curr Eye Res 2017; 43:487-492. [DOI: 10.1080/02713683.2017.1420804] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Alberto López-De La Rosa
- Instituto Universitario de Oftalmobiología Aplicada (IOBA), University of Valladolid, Valladolid, Spain
- Departamento de Física Teórica, Atómica y Óptica, University of Valladolid, Valladolid, Spain
| | - Cristina Arroyo-Del Arroyo
- Instituto Universitario de Oftalmobiología Aplicada (IOBA), University of Valladolid, Valladolid, Spain
- Departamento de Física Teórica, Atómica y Óptica, University of Valladolid, Valladolid, Spain
| | - Pilar Cañadas
- Instituto Universitario de Oftalmobiología Aplicada (IOBA), University of Valladolid, Valladolid, Spain
- Departamento de Física Teórica, Atómica y Óptica, University of Valladolid, Valladolid, Spain
| | - Alberto López-Miguel
- Instituto Universitario de Oftalmobiología Aplicada (IOBA), University of Valladolid, Valladolid, Spain
| | - Margarita Calonge
- Instituto Universitario de Oftalmobiología Aplicada (IOBA), University of Valladolid, Valladolid, Spain
- Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Valladolid, Spain
| | - Amalia Enríquez-De-Salamanca
- Instituto Universitario de Oftalmobiología Aplicada (IOBA), University of Valladolid, Valladolid, Spain
- Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Valladolid, Spain
| | - María J González-García
- Instituto Universitario de Oftalmobiología Aplicada (IOBA), University of Valladolid, Valladolid, Spain
- Departamento de Física Teórica, Atómica y Óptica, University of Valladolid, Valladolid, Spain
- Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Valladolid, Spain
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Abstract
PURPOSE The aim of this study was to analyze whether symptoms of discomfort in hydrogel contact lens (HCL) wearers were associated with changes in corneal sensitivity or levels of tear inflammatory mediators. METHODS Sixty-six subjects were included: 47 HCL wearers, further divided into 24 symptomatic and 23 asymptomatic wearers by the Contact Lens Dry Eye Questionnaire short form and 19 non-contact lens wearers. At least 24 h after HCL removal, we obtained scores from the Ocular Surface Disease Index and mechanical, hot, and cold corneal thresholds using a Belmonte esthesiometer. We collected 4 μl of tears with a capillary micropipette and measured levels of 12 inflammatory markers using a bead-based array: epidermal growth factor, fractalkine, interleukin-10 (IL-10), IL-1β, IL-1 receptor antagonist, IL-2, IL-4, IL-6, IL-8, monocyte chemoattractant protein 1, tumor necrosis factor-α, and matrix metalloproteinase 9. RESULTS There were no significant differences between groups in corneal sensitivity thresholds and levels of tear molecules. The following significant correlations were found in the total sample pooled: Ocular Surface Disease Index correlated with mechanical threshold (p < 0.01; rho = -0.324) and epidermal growth factor (p < 0.01, rho = -0.330), and mechanical threshold correlated with heat threshold (p < 0.01, rho = -0.321). CONCLUSIONS Twenty-four hours after HCL removal, symptoms of discomfort in HCL wearers are not related to changes in corneal sensitivity or tear inflammatory mediator levels. This might indicate either that HCL wear has no effect on these parameters or that ocular surfaces recover from HCL-caused effects during the first hours after HCL removal. However, there were correlations for associations between symptoms, corneal sensitivity, and some molecules in tears.
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23
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Boost M, Cho P, Wang Z. Disturbing the balance: effect of contact lens use on the ocular proteome and microbiome. Clin Exp Optom 2017; 100:459-472. [PMID: 28771841 DOI: 10.1111/cxo.12582] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Revised: 05/29/2017] [Accepted: 06/05/2017] [Indexed: 12/17/2022] Open
Abstract
Contact lens wear is a popular, convenient and effective method for vision correction. In recent years, contact lens practice has expanded to include new paradigms, including orthokeratology; however, their use is not entirely without risk, as the incidence of infection has consistently been reported to be higher in contact lens wearers. The explanations for this increased susceptibility have largely focused on physical damage, especially to the cornea, due to a combination of hypoxia, mechanical trauma, deposits and solution cytotoxicity, as well as poor compliance with care routines leading to introduction of pathogens into the ocular environment. However, in recent years, with the increasing availability and reduced cost of molecular techniques, the ocular environment has received greater attention with in-depth studies of proteins and other components. Numerous proteins were found to be present in the tears and their functions and interactions indicate that the tears are far more complex than formerly presumed. In addition, the concept of a sterile or limited microbial population on the ocular surface has been challenged by analysis of the microbiome. Ocular microbiome was not considered as one of the key sites for the Human Microbiome Project, as it was thought to be limited compared to other body sites. This was proven to be fallacious, as a wide variety of micro-organisms were identified in the analyses of human tears. Thus, the ocular environment is now recognised to be more complicated and interference with this ecological balance may lead to adverse effects. The use of contact lenses clearly changes the situation at the ocular surface, which may result in consequences which disturb the balance in the healthy eye.
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Affiliation(s)
- Maureen Boost
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong.,Squina International Centre for Infection Control, Hong Kong
| | - Pauline Cho
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong.,Squina International Centre for Infection Control, Hong Kong
| | - Zhaoran Wang
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong
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24
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Doughty MJ. A Grid-Based Nucleus Counting Method for Estimates of the Density of Superficial Conjunctival Cells from Impression Cytology Samples Taken from Normal Healthy Human Eyes. Curr Eye Res 2017; 42:1228-1234. [DOI: 10.1080/02713683.2017.1307414] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Michael J. Doughty
- Glasgow-Caledonian University, Department of Vision Sciences, Glasgow, Scotland
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25
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Cruzat A, Qazi Y, Hamrah P. In Vivo Confocal Microscopy of Corneal Nerves in Health and Disease. Ocul Surf 2017; 15:15-47. [PMID: 27771327 PMCID: PMC5512932 DOI: 10.1016/j.jtos.2016.09.004] [Citation(s) in RCA: 218] [Impact Index Per Article: 31.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2016] [Revised: 09/19/2016] [Accepted: 09/25/2016] [Indexed: 12/20/2022]
Abstract
In vivo confocal microscopy (IVCM) is becoming an indispensable tool for studying corneal physiology and disease. Enabling the dissection of corneal architecture at a cellular level, this technique offers fast and noninvasive in vivo imaging of the cornea with images comparable to those of ex vivo histochemical techniques. Corneal nerves bear substantial relevance to clinicians and scientists alike, given their pivotal roles in regulation of corneal sensation, maintenance of epithelial integrity, as well as proliferation and promotion of wound healing. Thus, IVCM offers a unique method to study corneal nerve alterations in a myriad of conditions, such as ocular and systemic diseases and following corneal surgery, without altering the tissue microenvironment. Of particular interest has been the correlation of corneal subbasal nerves to their function, which has been studied in normal eyes, contact lens wearers, and patients with keratoconus, infectious keratitis, corneal dystrophies, and neurotrophic keratopathy. Longitudinal studies have applied IVCM to investigate the effects of corneal surgery on nerves, demonstrating their regenerative capacity. IVCM is increasingly important in the diagnosis and management of systemic conditions such as peripheral diabetic neuropathy and, more recently, in ocular diseases. In this review, we outline the principles and applications of IVCM in the study of corneal nerves in various ocular and systemic diseases.
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Affiliation(s)
- Andrea Cruzat
- Cornea & Refractive Surgery Service, Department of Ophthalmology, Massachusetts Eye & Ear Infirmary, Harvard Medical School, Boston, MA, USA; Department of Ophthalmology, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Yureeda Qazi
- Cornea & Refractive Surgery Service, Department of Ophthalmology, Massachusetts Eye & Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - Pedram Hamrah
- Cornea & Refractive Surgery Service, Department of Ophthalmology, Massachusetts Eye & Ear Infirmary, Harvard Medical School, Boston, MA, USA; Boston Image Reading Center, Tufts Medical Center, Tufts University School of Medicine, Boston, MA; Cornea Service, New England Eye Center, Department of Ophthalmology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA.
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26
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27
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Pérez-Prados R, Piñero DP, Pérez-Cambrodí RJ, Madrid-Costa D. Soft multifocal simultaneous image contact lenses: a review. Clin Exp Optom 2016; 100:107-127. [PMID: 27800638 DOI: 10.1111/cxo.12488] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 04/27/2016] [Accepted: 06/12/2016] [Indexed: 11/30/2022] Open
Abstract
Soft multifocal simultaneous image contact lenses have boomed in recent years due to the growing number of presbyopic patients demanding visual solutions, allowing them to maintain their current standard of living. The concept of 'simultaneous image' is based on blur interpretation and/or blur tolerance of superimposed multiple images on the retina formed by various powers of a contact lens. This is the basis for a specific type of multifocal contact lens developed for the compensation of presbyopia. Manufacturers have released a great variety of soft simultaneous image lens designs to meet different patient needs but their fitting is still unsatisfactory in some cases. Some presbyopes discontinue wearing contact lenses due to some limitations in visual quality and comfort that can be overcome with an appropriate contact lens selection based on a comprehensive pre-fitting evaluation. This paper aims to review the different types of soft multifocal contact lenses that are currently available for presbyopic correction and to define the steps and factors crucial for their fitting, such as pupil, aberrations, accommodation and centring. A discussion about useful tools to achieve a customised fitting leading to a successful outcome, such as the defocus curve, power profile and questionnaires, is performed.
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Affiliation(s)
- Roque Pérez-Prados
- Centro Óptico Benalúa, Alicante, Spain.,Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
| | - David P Piñero
- Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain.,Department of Ophthalmology (Oftalmar), Medimar International Hospital, Alicante, Spain.,Foundation for the Visual Quality (FUNCAVIS, Fundación para la Calidad Visual), Alicante, Spain
| | - Rafael J Pérez-Cambrodí
- Department of Ophthalmology (Oftalmar), Medimar International Hospital, Alicante, Spain.,Foundation for the Visual Quality (FUNCAVIS, Fundación para la Calidad Visual), Alicante, Spain
| | - David Madrid-Costa
- Faculty of Optics and Optometry, Complutense University of Madrid, Madrid, Spain
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28
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Abstract
This review focuses on conjunctival goblet cells and their essential function in the maintenance of eye health. The main function of goblet cells is to produce and secrete mucins that lubricate the ocular surface. An excess or a defect in those mucins leads to several alterations that makes goblet cells central players in maintaining the proper mucin balance and ensuring the correct function of ocular surface tissues. A typical pathology that occurs with mucous deficiency is dry eye disease, whereas the classical example of mucous hyperproduction is allergic conjunctivitis. In this review, we analyze how goblet cell number and function can be altered in these diseases and in contact lens (CL) wearers. We found that most published studies focused exclusively on the goblet cell number. However, recent advances have demonstrated that, along with mucin secretion, goblet cells are also able to secrete cytokines and respond to them. We describe the effect of different cytokines on goblet cell proliferation and secretion. We conclude that it is important to further explore the effect of CL wear and cytokines on conjunctival goblet cell function.
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29
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Martín-Montañez V, Enríquez-de-Salamanca A, López-de la Rosa A, López-Miguel A, Fernández I, Calonge M, González-Méijome JM, González-García MJ. Effect of Environmental Conditions on the Concentration of Tear Inflammatory Mediators During Contact Lens Wear. Cornea 2016; 35:1192-8. [DOI: 10.1097/ico.0000000000000960] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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30
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Asharlous A, Mirzajani A, Jafarzadehpur E, KhabazKhoob M, Ostadimoghaddam H. Objective and subjective assessing efficacy of a lubricating drop in eyes wearing silicone hydrogel contact lenses. J Curr Ophthalmol 2016; 28:69-74. [PMID: 27331150 PMCID: PMC4909696 DOI: 10.1016/j.joco.2016.03.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Revised: 03/30/2016] [Accepted: 03/31/2016] [Indexed: 11/17/2022] Open
Abstract
Purpose To investigate the effect of a lubricating drop on optical quality, tear film stability, and subjective symptoms in individuals wearing silicone hydrogel contact lens. Methods In this one-day, prospective single-center clinical study, Pre-lens Tear Deformation Time (PL-TDT), Root-Mean-Square (RMS) of Low Order Aberrations (LOA) and High Order Aberrations (HOA), individual twelve Zernike coefficients, and subjective symptoms were assessed in 43 volunteers (mean age 19.58 ± 1.63, 86 eyes) at 6 h after inserting the contact lens and then at 60 min after instilling a lubricating drop (Comfort drops, Avizor, Madrid-Spain). Results PL-TDT, LOA-RMS, and HOA-RMS values measured before drop instillation were not significantly different with those measured after drop. None of the Zernike coefficients were significantly different after instilling lubricating drop. Statistically significant decrement in both frequency and severity values in blurry vision, dryness, discomfort, burning, itching, foreign body sensation, excessive blinking, and lacrimation were seen after drop instillation (all P < 0.05). Conclusion Our results showed that although the lubricating drop did not improve the tear film stability and optical quality in the silicone hydrogel contact lens wearers, subjects experienced a subjective improvement.
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Affiliation(s)
- Amir Asharlous
- Optometry Department, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Mirzajani
- Optometry Department, Iran University of Medical Sciences, Tehran, Iran
| | | | - Mehdi KhabazKhoob
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hadi Ostadimoghaddam
- Refractive Errors Research Center, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
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This issue at a glance. J Curr Ophthalmol 2016; 28:55-6. [PMID: 27331146 PMCID: PMC4909637 DOI: 10.1016/j.joco.2016.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Tong L, Beuerman R, Simonyi S, Hollander DA, Stern ME. Effects of Punctal Occlusion on Clinical Signs and Symptoms and on Tear Cytokine Levels in Patients with Dry Eye. Ocul Surf 2016; 14:233-41. [PMID: 26774908 DOI: 10.1016/j.jtos.2015.12.004] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 12/30/2015] [Accepted: 12/31/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE To investigate changes in signs, symptoms, and tear cytokines following punctal plug occlusion in patients with dry eye. METHODS A single-center study was conducted at Singapore Eye Research Institute. Nonabsorbable punctal plugs were inserted in the lower punctum of both eyes in patients with moderate dry eye. Over 3 weeks, in the more severe eye, dry eye symptoms, fluorescein corneal staining, Schirmer I (without topical anesthesia) test, tear film breakup time (TFBUT), and safety were assessed. Cytokine and matrix metalloproteinase-9 (MMP-9) levels in tear samples were measured. RESULTS Twenty-nine patients (mean age 49.8 years) with moderate dry eye were evaluated. At baseline, mean (standard deviation) global symptoms score was 53.8 (26.5), Schirmer I test score was 5.1 (2.8) mm, and TFBUT was 2.2 (0.6) seconds. After 3 weeks, punctal occlusion significantly reduced global irritation symptoms score (P<.001) and decreased fluorescein staining in all zones (P<.01) except the inferior zone (P=.42). No significant association between levels of cytokines or MMP-9 and either TFBUT or global irritation symptoms were observed at baseline. Levels of several cytokines and MMP-9 were higher in patients with Schirmer I test scores ≤8 mm at baseline. After 3 weeks of punctal occlusion, no significant changes in overall cytokine or MMP-9 levels were observed. CONCLUSIONS Punctal plug occlusion provided symptomatic relief and reduced fluorescein staining in all except the inferior zone. However, insertion of punctal plugs had minimal effect on tear cytokines and MMP-9 levels, suggesting a need for earlier treatment with anti-inflammatory agents for management of dry eye disease.
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Affiliation(s)
- Louis Tong
- Singapore Eye Research Institute, National Eye Centre, Singapore, Singapore; Yong Loo Lin School of Medicine, Singapore, Singapore; Singapore National Eye Center, Singapore, Singapore; Duke-NUS Medical School, Singapore, Singapore.
| | - Roger Beuerman
- Singapore Eye Research Institute, National Eye Centre, Singapore, Singapore
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Comparison of Morphological and Functional Meibomian Gland Characteristics Between Daily Contact Lens Wearers and Nonwearers. Cornea 2015; 34:1098-104. [DOI: 10.1097/ico.0000000000000511] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Navascues-Cornago M, Morgan PB, Maldonado-Codina C. Effect of Three Interventions on Contact Lens Comfort in Symptomatic Wearers: A Randomized Clinical Trial. PLoS One 2015; 10:e0135323. [PMID: 26267853 PMCID: PMC4533967 DOI: 10.1371/journal.pone.0135323] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Accepted: 07/16/2015] [Indexed: 11/23/2022] Open
Abstract
Purpose To investigate whether carrying out various interventions part way through the day influences comfort in symptomatic daily disposable (DD) contact lens wearers. Methods A subject-masked, randomized, controlled clinical trial was conducted in thirty symptomatic soft lens wearers who wore their habitual DD contact lenses bilaterally for 12 h on two separate days. Five hours after lens application, one of the following three interventions or a control was performed on each eye: replacing the existing lens with a new lens; removing and reapplying the same lens; performing a ‘scleral swish’; and no action (control). Comfort scores were recorded using SMS text messages every hour following lens application using a 0 (causes pain) to 100 (excellent comfort) scale. Comfort scores before lens application, at 6 mins post-application, and at 6 mins post-intervention were also recorded. Results There was a significant reduction in comfort from pre-lens application to 6 mins post-application for all groups (all p<0.05). Comfort gradually decreased from 6 mins to 5 h after lens application for each group (p<0.0001) with no significant difference between groups over the 5-h period (p = 0.09). There was no significant difference in comfort 6 mins post-intervention for any group (all p>0.05). After the intervention, comfort continued to decline (p<0.0001) with slightly lower mean scores for the control group compared to the new lens group (p = 0.003). Change in comfort relative to pre-intervention (5 h) was similar for all groups (p = 0.81). There was no difference in comfort at 12 h between groups (p = 0.83). Conclusion This work has confirmed that comfort shows a continual and significant decline over a 12-h wearing period in symptomatic DD contact lens wearers. None of the interventions investigated had any significant impact on end-of-day comfort. These data suggest discomfort in lens wearers is more heavily influenced by changes to the ocular environment rather than to the lens itself. Trial Registration Controlled-Trials.com ISRCTN10419752 http://www.controlled-trials.com/ISRCTN10419752
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Affiliation(s)
- Maria Navascues-Cornago
- Eurolens Research, Faculty of Life Sciences, The University of Manchester, Manchester, United Kingdom
- * E-mail:
| | - Philip B. Morgan
- Eurolens Research, Faculty of Life Sciences, The University of Manchester, Manchester, United Kingdom
| | - Carole Maldonado-Codina
- Eurolens Research, Faculty of Life Sciences, The University of Manchester, Manchester, United Kingdom
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Yüksel Elgin C, İskeleli G, Talaz S, Akyol S. Comparative Analysis of Tear Film Levels of Inflammatory Mediators in Contact Lens Users. Curr Eye Res 2015; 41:441-7. [DOI: 10.3109/02713683.2015.1037001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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D’Souza S, Tong L. Practical issues concerning tear protein assays in dry eye. EYE AND VISION (LONDON, ENGLAND) 2014; 1:6. [PMID: 26605353 PMCID: PMC4604107 DOI: 10.1186/s40662-014-0006-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/28/2014] [Accepted: 10/09/2014] [Indexed: 12/20/2022]
Abstract
Dry eye is a common clinical condition diagnosed by cumulative evidence of symptoms and signs. Many new treatments in dry eye are either expensive, invasive, have potential for side effects, or are not easily accessible. In severe dry eye, the ideal modality of treatment to begin with is often not clear as specific molecular disturbances are not evident from just examination of clinical manifestations. Assessing the effects of ongoing treatment is not straight forward since there is lack of agreement between clinical signs and symptoms. There is a need to have more objective methods of selecting treatment for dry eye and monitoring the effect of treatment. Recently, there are many new technologies applied to the discovery of tear biomarkers, for e.g., mass spectrometry based proteomics techniques and multiplex assays such as the bead-based sandwich indirect immunofluorescent assays. Tear proteins assays have even been made available as point-of-care devices. This review focuses on the evidence for the involvements of tear proteins in dry eye, possible changes in tear concentrations with therapy and the strength of evidence regarding dry eye pathology. Much remains to be done in terms of developing office-based assays and ascertaining their reliability, but current evidence suggests that tear proteins have a role in the clinical practice of dry eye.
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Affiliation(s)
- Sharon D’Souza
- />Narayana Nethralaya Superspeciality Eye Hospital and Post Graduate Institute, Bangalore, Karnataka India
| | - Louis Tong
- />Singapore Eye Research Institute, 11, Third Hospital Avenue, Singapore, 168751 Singapore
- />Singapore National Eye Center, Singapore, Singapore
- />Duke-NUS Graduate Medical School, Singapore, Singapore
- />Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Mann A, Tighe B. Contact lens interactions with the tear film. Exp Eye Res 2013; 117:88-98. [DOI: 10.1016/j.exer.2013.07.013] [Citation(s) in RCA: 91] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Revised: 07/02/2013] [Accepted: 07/12/2013] [Indexed: 12/28/2022]
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Contact Lens In Vitro Wettability by Interferometry Measures of Drying Dynamics. Eye Contact Lens 2013; 39:365-75. [DOI: 10.1097/icl.0b013e318297394c] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Stapleton F, Marfurt C, Golebiowski B, Rosenblatt M, Bereiter D, Begley C, Dartt D, Gallar J, Belmonte C, Hamrah P, Willcox M. The TFOS International Workshop on Contact Lens Discomfort: report of the subcommittee on neurobiology. Invest Ophthalmol Vis Sci 2013; 54:TFOS71-97. [PMID: 24058137 PMCID: PMC5963174 DOI: 10.1167/iovs.13-13226] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2013] [Accepted: 09/10/2013] [Indexed: 12/26/2022] Open
Abstract
This report characterizes the neurobiology of the ocular surface and highlights relevant mechanisms that may underpin contact lens-related discomfort. While there is limited evidence for the mechanisms involved in contact lens-related discomfort, neurobiological mechanisms in dry eye disease, the inflammatory pathway, the effect of hyperosmolarity on ocular surface nociceptors, and subsequent sensory processing of ocular pain and discomfort have been at least partly elucidated and are presented herein to provide insight in this new arena. The stimulus to the ocular surface from a contact lens is likely to be complex and multifactorial, including components of osmolarity, solution effects, desiccation, thermal effects, inflammation, friction, and mechanical stimulation. Sensory input will arise from stimulation of the lid margin, palpebral and bulbar conjunctiva, and the cornea.
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Affiliation(s)
- Fiona Stapleton
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Carl Marfurt
- Indiana University School of Medicine–Northwest, Gary, Indiana
| | - Blanka Golebiowski
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Mark Rosenblatt
- Weill Cornell Medical College, Cornell University, Ithaca, New York
| | - David Bereiter
- University of Minnesota School of Dentistry, Minneapolis, Minnesota
| | - Carolyn Begley
- Indiana University School of Optometry, Bloomington, Indiana
| | - Darlene Dartt
- Schepens Eye Research Institute, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
| | - Juana Gallar
- Instituto de Neurociencias de Alicante, Universidad Miguel Hernandez–Consejo Superior de Investigaciones Cientificas, Alicante, Spain
| | - Carlos Belmonte
- Instituto de Neurociencias de Alicante, Universidad Miguel Hernandez–Consejo Superior de Investigaciones Cientificas, Alicante, Spain
| | - Pedram Hamrah
- Massachusetts Eye and Ear Infirmary, Stoneham, Massachusetts
| | - Mark Willcox
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
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Kalsow CM, Reindel WT, Merchea MM, Bateman KM, Barr JT. Tear cytokine response to multipurpose solutions for contact lenses. Clin Ophthalmol 2013; 7:1291-302. [PMID: 23847409 PMCID: PMC3700914 DOI: 10.2147/opth.s44642] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE An increased risk of corneal infiltrative events has been noted with the use of certain contact lenses and multipurpose solutions (MPS). This study was designed to evaluate tear cytokine assay as a sensitive, objective, and quantitative measure of the ocular surface response to contact lens/MPS and to consider the assay's clinical relevance in the context of other measures of ocular surface response. METHODS Two MPS, ReNu® Fresh™ (RNF) and Opti-Free® RepleniSH (OFR), were used with daily wear silicone hydrogel contact lenses in a randomized, prospective crossover study involving 26 subjects. Clinical data collection (conjunctival hyperemia, ocular surface sensitivity, solution induced corneal staining (SICS) test score, and subjective responses) and tear cytokine assays were conducted masked. Responses were tracked as change from baseline throughout the experimental schedule. RESULTS SIMILAR RESPONSE PATTERNS FOR SEVERAL INFLAMMATORY CYTOKINES WERE SEEN THROUGHOUT BOTH PHASES: subjects who received OFR in Phase I had mean tear concentrations that were generally higher than those of the RNF Phase I group. OFR Phase I subjects had significant (P < 0.01) increases over baseline at day 1 and/or following washout for 13 cytokines (cc chemokine ligands [CCL] 3, CCL5, CCL11, granulocyte-macrophage colony-stimulating factor [GM-CSF], interferon [INF]-γ, interleukin [IL]-2, IL-4, IL-5, IL-6, IL-13, IL-15, IL-17, tumor necrosis factor [TNF]-α). These changes were not observed in RNF Phase I subjects, even though SICS test scores increased. Phase I OFR subjects also had increased dryness, while RNF Phase I subjects had decreased bulbar hyperemia. No changes were detected with respect to limbal hyperemia or surface sensitivity thresholds. CONCLUSION The tear cytokine assay can detect and differentiate contact lens/MPS induced increases in inflammatory cytokines. Changes in cytokine levels were consistent with measurement of hyperemia and dryness but not with SICS scores, thereby suggesting a proinflammatory response to OFR compared to RNF that is not related to SICS test score. Tear cytokine profiles may be useful for reconciling clinical relevance of test results and in revealing signaling involved in the development of corneal infiltrative events.
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Affiliation(s)
| | | | | | - Kirk M Bateman
- Bausch and Lomb, Inc, Rochester, NY, USA
- Statistics and Data Corporation, Tempe, AZ, USA
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Narayanan S, Redfern RL, Miller WL, Nichols KK, McDermott AM. Dry eye disease and microbial keratitis: is there a connection? Ocul Surf 2013; 11:75-92. [PMID: 23583043 DOI: 10.1016/j.jtos.2012.12.002] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Revised: 12/14/2012] [Accepted: 12/16/2012] [Indexed: 02/07/2023]
Abstract
Dry eye is a common ocular surface disease of multifactorial etiology characterized by elevated tear osmolality and inflammation leading to a disrupted ocular surface. The latter is a risk factor for ocular surface infection, yet overt infection is not commonly seen clinically in the typical dry eye patient. This suggests that important innate mechanisms operate to protect the dry eye from invading pathogens. This article reviews the current literature on epidemiology of ocular surface infection in dry eye patients and laboratory-based studies on innate immune mechanisms operating at the ocular surface and their alterations in human dry eye and animal models. The review highlights current understanding of innate immunity in dry eye and identifies gaps in our knowledge to help direct future studies to further unravel the complexities of dry eye disease and its sequelae.
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Affiliation(s)
- Srihari Narayanan
- University of the Incarnate Word, Rosenberg School of Optometry, San Antonio, TX, USA
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Contact Lens Dry Eye Questionnaire-8 (CLDEQ-8) and Opinion of Contact Lens Performance. Optom Vis Sci 2012; 89:1435-42. [DOI: 10.1097/opx.0b013e318269c90d] [Citation(s) in RCA: 105] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Elevated Tear Interleukin-6 and Interleukin-8 Levels Associated With Silicone Hydrogel and Conventional Hydrogel Contact Lens Wear. Eye Contact Lens 2012; 38:146-9. [DOI: 10.1097/icl.0b013e3182482910] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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