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Mohamed-Noriega K, González-Arocha CS, Morales-Wong F, Velasco-Sepúlveda BH, Rodríguez-Cuevas JO, Cepeda-Ortegón GE, Corral-Benavides SA, Martínez-Delgado JF, Mohamed-Noriega J, Fernández-De-Luna ML, Mohamed-Hamsho J. Meibomian Gland Dysfunction and Dropout in Diabetic Patients with Non-Proliferative Diabetic Retinopathy. Bioengineering (Basel) 2024; 11:907. [PMID: 39329649 PMCID: PMC11428935 DOI: 10.3390/bioengineering11090907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2024] [Revised: 08/19/2024] [Accepted: 09/05/2024] [Indexed: 09/28/2024] Open
Abstract
This study aims to compare meibomian gland (MG) dropout and MG dysfunction (MGD) between patients with diabetes mellitus (DM) with moderate-severe non-proliferative diabetic retinopathy (NPDR) and patients with no diabetes (NDM). This prospective, transversal, age, and gender-matched case-control study included 98 DM and 106 NDM eyes. Dry eye disease (DED) and MGD evaluations were performed, including meibography (Keratograph 5M®). The objective MG dropout percentage was obtained by analyzing meibography images with ImageJ software (v. 1.52o, National Institutes of Health, Bethesda, MD, USA) and was subsequently graded with Arita's meiboscore. The DM duration was 18 ± 9 years. The mean meiboscore (3.8 ± 0.8 vs. 3.4 ± 1.0, p = 0.001), meiboscore severity (p = 0.016), and MG dropout (45.1 ± 0.1% vs. 39.0 ± 0.4%, p < 0.001) were greater in DM than in NDM. All patients showed MG dropout (meiboscore > 1). Lower eyelids showed greater MG dropout in both groups. A correlation with age (r = 0.178, p = 0.014) and no correlations with DM duration or gender (p > 0.005) were observed. Patients with diabetes showed greater corneal staining (1.7 ± 1.3 vs. 0.9 ± 1.1; p < 0.001), reduced corneal sensitivity (5.4 ± 1.1 vs. 5.9 ± 0.4; p < 0.001), lower MG expressibility (3. 9 ± 1.6 vs. 4.4 ± 2.1; p = 0.017), and worse meibum quality (1.9 ± 0.8 vs. 1.7 ± 0.5; p = 0.019). Tear breakup time, osmolarity, MMP-9, Schirmer, and the Ocular Surface Disease Index showed no significant differences. In conclusion, patients with DM with NPDR have greater MG dropout and meiboscore, as well as more severe MGD and DED parameters than persons with NDM.
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Affiliation(s)
- Karim Mohamed-Noriega
- Ophthalmology Department, University Hospital, Faculty of Medicine, Autonomous University of Nuevo Leon (UANL), Monterrey 64460, Mexico
| | - Carla Sofía González-Arocha
- Ophthalmology Department, University Hospital, Faculty of Medicine, Autonomous University of Nuevo Leon (UANL), Monterrey 64460, Mexico
| | - Fernando Morales-Wong
- Ophthalmology Department, University Hospital, Faculty of Medicine, Autonomous University of Nuevo Leon (UANL), Monterrey 64460, Mexico
| | - Braulio Hernán Velasco-Sepúlveda
- Ophthalmology Department, University Hospital, Faculty of Medicine, Autonomous University of Nuevo Leon (UANL), Monterrey 64460, Mexico
| | - Jonathan Octavio Rodríguez-Cuevas
- Ophthalmology Department, University Hospital, Faculty of Medicine, Autonomous University of Nuevo Leon (UANL), Monterrey 64460, Mexico
| | - Gerardo Esteban Cepeda-Ortegón
- Ophthalmology Department, University Hospital, Faculty of Medicine, Autonomous University of Nuevo Leon (UANL), Monterrey 64460, Mexico
| | - Sergio Antonio Corral-Benavides
- Ophthalmology Department, University Hospital, Faculty of Medicine, Autonomous University of Nuevo Leon (UANL), Monterrey 64460, Mexico
| | - José Francisco Martínez-Delgado
- Ophthalmology Department, University Hospital, Faculty of Medicine, Autonomous University of Nuevo Leon (UANL), Monterrey 64460, Mexico
| | - Jibran Mohamed-Noriega
- Ophthalmology Department, University Hospital, Faculty of Medicine, Autonomous University of Nuevo Leon (UANL), Monterrey 64460, Mexico
| | - Marissa L Fernández-De-Luna
- Ophthalmology Department, University Hospital, Faculty of Medicine, Autonomous University of Nuevo Leon (UANL), Monterrey 64460, Mexico
| | - Jesús Mohamed-Hamsho
- Ophthalmology Department, University Hospital, Faculty of Medicine, Autonomous University of Nuevo Leon (UANL), Monterrey 64460, Mexico
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Mohamed-Noriega K, Charles-Cantu DE, Mohamed-Noriega J, Velasco-Sepúlveda BH, Morales-Wong F, Villarreal-Méndez G, Mohamed-Hamsho J. Face Mask and Tear Film Stability: A Pilot Study of the Objective Measurement of Tear Break-Up Time. J Clin Med 2023; 12:7727. [PMID: 38137796 PMCID: PMC10743798 DOI: 10.3390/jcm12247727] [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: 10/16/2023] [Revised: 11/29/2023] [Accepted: 12/09/2023] [Indexed: 12/24/2023] Open
Abstract
(1) Background: Mask-associated dry eye (MADE) has been associated with increased dry eye symptoms, apparently due to reduced tear break-up time (TBUT). This study aimed to determine the short-term impact of surgical face mask (FM) on tear film stability by measuring non-invasive tear break-up time (NIBUT). (2) Methods: Twenty-six healthy participants had NIBUT evaluated without FM, with surgical FM and with a surgical FM secured to the skin with adhesive tape (TFM). NIBUT-first was measured with Keratograph 5M (K5M, Oculus, Wetzlar, Germany). Each participant had NIBUT measured in four sessions on four consecutive days. Session 1: without FM vs. with FM. Session 2: with FM vs. without FM. Session 3: without FM vs. with TFM. Session 4: with TFM vs. without FM (3). The time between each measured setting was 2 min. Results: The mean ± SD NIBUT without FM was 8.9 ± 3.7, with FM 10.2 ± 4.1, and with TFM 8.4 ± 3.8 s. No significant differences were observed in NIBUT in any of the evaluated settings: without FM vs. with FM (p = 0.247), without FM vs. with TFM (p = 0.915), and with FM vs. with TFM (p = 0.11). (4) Conclusions: This study did not find a significant short-term effect of FM on NIBUT. Other variables or longer periods of exposure might trigger the symptoms and ocular surface alterations in MADE.
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Affiliation(s)
- Karim Mohamed-Noriega
- Department of Ophthalmology, University Hospital and Faculty of Medicine, Autonomous University of Nuevo León (UANL), Avenida Francisco I Madero 3501 y Avenida José Eleuterio González (Gonzalitos) S/N, Colonia Mitras Centro, Monterrey 64460, Nuevo León, Mexico; (D.E.C.-C.); (J.M.-N.); (B.H.V.-S.); (F.M.-W.); (G.V.-M.); (J.M.-H.)
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Araújo JNDM, Fernandes APNDL, Dantas AC, Ferreira MA, Lopes MVDO, Vitor AF. Ocular dryness in intensive care: proposal for a new nursing diagnosis. Rev Bras Enferm 2023; 76Suppl 4:e20220698. [PMID: 37971054 PMCID: PMC10642012 DOI: 10.1590/0034-7167-2022-0698] [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: 06/28/2022] [Accepted: 03/27/2023] [Indexed: 11/19/2023] Open
Abstract
OBJECTIVE to analyze the concept associated with diagnostic proposition Ocular dryness in adult patients hospitalized in an Intensive Care Unit, identifying its attributes, antecedents and consequences. METHODS a methodological study carried out through concept analysis, operationalized by scoping review. RESULTS the analysis of 180 studies allowed the identification of two attributes, 32 antecedents and 12 consequences. The attributes were tear film deficiency and ocular signs and/or symptoms. The prevalent antecedents were incomplete eyelid closure (lagophthalmos) and blinking mechanism decrease. Major consequences included conjunctival hyperemia and decreased tear volume. CONCLUSIONS this study allowed constructing nursing diagnosis Ocular dryness, part of domain 11, class 2, with 12 defining characteristics, 12 related factors, seven populations at risk and 13 associated conditions. This problem-focused proposal may provide targeted care by promoting early detection and implementing interventions that reduce the risk of ocular damage.
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Affiliation(s)
| | | | - Ana Clara Dantas
- Universidade Federal do Rio Grande do Norte. Natal, Rio Grande do Norte, Brazil
| | | | | | - Allyne Fortes Vitor
- Universidade Federal do Rio Grande do Norte. Natal, Rio Grande do Norte, Brazil
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Greiner JV, Ying GS, Pistilli M, Maguire MG, Asbell PA. Association of Tear Osmolarity With Signs and Symptoms of Dry Eye Disease in the Dry Eye Assessment and Management (DREAM) Study. Invest Ophthalmol Vis Sci 2023; 64:5. [PMID: 36626176 PMCID: PMC9838582 DOI: 10.1167/iovs.64.1.5] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Purpose To determine the relationships of (1) tear osmolarity (TO) levels with the severity of signs and symptoms of dry eye disease (DED) and (2) changes in TO with changes in signs and symptoms. Methods Patients (N = 405) with moderate to severe DED in the Dry Eye Assessment and Management (DREAM) Study were evaluated at baseline and at six and 12 months. Associations of TO with signs and symptoms were evaluated using Pearson correlation coefficient (r) and regression models. Results The mean (standard deviation [SD]) TO was 303 (16) mOsm/L at baseline and 303 (18) mOsm/L at both six and 12 months. TO was higher in older patients (306 mOsm/L for ≥70 years vs. 300 mOsm/L for <50 years; P = 0.01) and those with Sjögren's disease (311 vs. 302 mOsm/L; P < 0.0001). TO did not differ between patients randomized to placebo and omega-3 fatty acid supplementation. TO was weakly correlated with conjunctival (r = 0.18; P < 0.001) and corneal staining scores (r = 0.17; P < 0.001), tear film break-up time (r = 0.06; P = 0.03), and Schirmer test score (r = -0.07; P = 0.02) but not with Ocular Surface Disease Index scores (r = 0.03; P = 0.40). Changes in signs and were not significantly correlated with change in TO at six or 12 months. Conclusions Within DREAM, TO was weakly correlated with DED signs, explaining <5% variability in signs. Changes in tear osmolarity were not associated with changes in signs and symptoms of DED, indicating that the association may not be causal.
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Affiliation(s)
- Jack V. Greiner
- Schepens Eye Research Institute of Massachusetts Eye & Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, United States
| | - Gui-shuang Ying
- Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Maxwell Pistilli
- Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Maureen G. Maguire
- Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Penny A. Asbell
- Department of Ophthalmology, Hamilton Eye Institute Health Science Center, The University of Tennessee, Memphis, Tennessee, United States
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Passos I, Almada SVE, Reis P. Astenopia digital em controladores de tráfego aéreo: diagnóstico e avaliação na Força Aérea Portuguesa. REVISTA BRASILEIRA DE OFTALMOLOGIA 2021. [DOI: 10.37039/1982.8551.20210024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Verjee MA, Brissette AR, Starr CE. Dry Eye Disease: Early Recognition with Guidance on Management and Treatment for Primary Care Family Physicians. Ophthalmol Ther 2020; 9:877-888. [PMID: 33090327 PMCID: PMC7708574 DOI: 10.1007/s40123-020-00308-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 09/24/2020] [Indexed: 02/01/2023] Open
Abstract
Primary care presentations of dry eye disease (DED) are common and pose a diagnostic challenge due to the variety of symptoms and the absence of certainty for family practitioners. While there are many published articles on the topic, the 2017 Tear Film and Ocular Surface Society Dry Eye Workshop was a landmark report in distinguishing multifactorial differences. Redefined terms clarified the DED disorder. The ocular surface—the tear/air interface—is the primary refractive component of the eye, which is why DED is so significant and impacts vision. There is a high prevalence of DED in the community, ranging from 5% to 30% of people across multiple studies. Elderly patients have up to 75% increased risk of DED and receive more intensive treatment than younger age groups. DED is also more common in women than men, occurring in 9.8% of postmenopausal women. The causes of DED span defective lacrimal apparatus and systemic disorders. Despite its prevalence, up to one-half of patients with confirmed DED do not receive proper alleviating treatment. Risk factors on functional and environmental bases follow. Tools to elicit a diagnosis more confidently are outlined using the Ocular Surface Disease Index (OSDI) and the Symptom Assessment in Dry Eye questionnaires (SANDE). Lacritin, lutein, vitamin A, and balanced nutrition are essential contributors to maintaining healthy eyes with appropriate management and treatment. The authors hope that this paper will prompt a more accurate and expedient diagnosis of DED in primary care practice and an earlier recognition of specialist referrals. Dry eye disease (DED) poses a diagnostic challenge to primary care physicians. The condition involves the tear/air interface, at the corneal (ocular) surface, where light enters the eye. Any change in light refraction affects regular sight. Symptoms of DED include itching, grittiness, foreign body sensation, redness, excessive tearing, and visual blurring, the lattermost being the most common presentation. Ultimately, the untreated disease leads to continued discomfort and visual deficit, but when severe, it can result in blindness. Up to 30% of the population suffers from DED, with the elderly, particularly women, more affected. Unfortunately, up to 50% of those affected have inadequate treatment. Questionnaires help in diagnosis. Simple office tests can indicate the severity of eye problems. Technology with smartphone photography can take high-resolution images, which are useful in education and teaching. A multitude of conditions cause DED, including blepharitis, an infection of the eyelids. Environmental risks also abound. Proper nutrition is essential in maintaining eye health. Intermittent eye symptoms are likely to be underrated by the public, by purchasing over-the-counter products such as artificial tears rather than seeking a proper medical check. Newer prescription medications are now available for DED relief before advancing to debility requiring specialist treatment. Dry Eye Disease: Early Recognition with Guidance on Management and Treatment for Primary CareFamily Physicians (MP4 95031 kb)
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Affiliation(s)
- Mohamud A Verjee
- Medical Student Affairs, & Medical Education, Weill Cornell Medicine - Qatar, Doha, Qatar.
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Araújo MGD, Vitor AF, Silva ABD, Carvalho LMD, Alves DLBDS, Araújo JNDM. Validation of nursing outcome indicators of the nursing outcomes classification: dry eye severity. Rev Bras Enferm 2020; 73:e20190854. [DOI: 10.1590/0034-7167-2019-0854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 05/26/2020] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Objective: To validate the content of the indicators of the nursing outcome Dry eye severity, of the Nursing Outcomes Classification, in adult patients admitted to the intensive care unit. Methods: Methodological study of content validity, developed in two stages: the first, consisting of 23 specialists; and the second, of a consensus group formed by ten nurses. For analyzing the data in the first stage, we used the content validity index and binomial test for each indicator; in the second stage, the discussions of each meeting were transcripted, and the indicators that achieved 100% consensus were validated. Results: Of the 14 indicators evaluated by the specialists, 7 presented a cut-off point below 0.80, but did not show statistical significance in the binomial test. In the consensus group’s validation, six indicators were reformulated. Conclusion: This study considered the 14 indicators valid for evaluating patients admitted to the intensive care unit.
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Naroo SA. BCLA conference delivers the key topics. Cont Lens Anterior Eye 2019; 42:339-340. [PMID: 31248820 DOI: 10.1016/j.clae.2019.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Shehzad A Naroo
- School of Life and Health Sciences, Ophthalmic Research Group, Aston University, Aston Street, Birmingham B4 7ET, United Kingdom.
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