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Chiang JCB, Tajbakhsh Z, Wolffsohn JS. The clinical impact of contact lens wear on neural structure and function of the cornea. Clin Exp Optom 2024:1-11. [PMID: 39250904 DOI: 10.1080/08164622.2024.2401511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 08/13/2024] [Accepted: 09/01/2024] [Indexed: 09/11/2024] Open
Abstract
Contact lens (CL) use is growing rapidly, with a current estimate of over 100 million wearers worldwide. Vast improvements in materials and designs have occurred over the past decades with advancements in the understanding of ocular surface health with CL wear. However, the potential impact of CL on neural structures and function of the ocular surface, particularly in relation to the richly innervated cornea, remain poorly understood. Problems with sensation such as CL discomfort and conditions that may be associated with lens wear including dry eye disease also remain pervasive. This narrative review discusses the findings from studies involving soft or rigid CL wearers, assessed with c linical techniques designed for examining the neural integrity of the cornea, namely in vivo confocal microscopy and esthesiometry. While the collective findings remain equivocal in terms of the changes in corneal nerve morphology and function with conventional CL wear, more specialised CLs, namely orthokeratology lenses, which mechanically manipulates the structure of the cornea seem to produce more prominent changes in nerve distribution and sensitivity reduction. Given the intricate relationship between neural and immune mechanisms in maintaining balanced ocular surface health, the potential links between these structural and functional findings with parainflammation and neuroinflammation, as well as clinical issues including CL discomfort and dry eye disease, are also explored.
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Affiliation(s)
| | - Zahra Tajbakhsh
- Department of Optometry, University of Western Australia, Crawley, Australia
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2
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Blautain B, Rabut G, Dupas B, Riancho L, Liang H, Luzu J, Labbé A, Garrigue JS, Brignole-Baudouin F, Baudouin C, Kessal K. Multimodal Approach in Dry Eye Disease Combining In Vivo Confocal Microscopy and HLA-DR Expression. Transl Vis Sci Technol 2024; 13:39. [PMID: 39177993 PMCID: PMC11346170 DOI: 10.1167/tvst.13.8.39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 06/06/2024] [Indexed: 08/24/2024] Open
Abstract
Purpose The purpose of this study was to determine the association between corneal images provided by in vivo confocal microscopy (IVCM) with clinical parameters and conjunctival expression of HLA-DR antigen in patients with dry eye disease (DED). Methods Two hundred fourteen eyes of 214 patients with DED were analyzed, consisting of 2 groups of patients - 63 with autoimmune dry eye disease (AIDED) and 151 with non-autoimmune dry eye disease (NAIDED). Patients underwent a full clinical examination, including symptom screening, using the Ocular Surface Disease Index (OSDI) questionnaire, and objective analysis of DED signs by Schirmer's testing, tear break-up time (TBUT), Oxford's test, and IVCM corneal imaging. The IVCM scoring criteria were based on corneal sub-basal nerve density (ND), nerve morphology (NM), and inflammatory cell (IC) density. Quantification of conjunctival HLA-DR antigen was performed by flow cytometry. Results The total IVCM score (T-IVCM) as well as the IVCM-IC subscore (sc) were positively correlated with HLA-DR levels with r = 0.3, P < 0.001 and r = 0.3, P < 0.01, respectively in the total population of patients with DED. The IVCM-NDsc was negatively correlated with TBUT in patients with AIDED (r = -0.2, P < 0.05) and with the Schirmer's test in patients with NAIDED (r = -0.24, P < 0.05). However, the IVCM-NMsc was positively correlated with the Oxford score only in patients with AIDED (r = 0.3, P < 0.05). Conclusions The proposed IVCM scoring system showed significant correlations with clinical parameters along with conjunctival HLA-DR quantification in patients with DED. Translational Relevance The IVCM grading score represents an interesting point of commonality among clinical parameters, imaging, and molecular investigation of the ocular surface.
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Affiliation(s)
- Benjamin Blautain
- Hôpital National de la Vision des 15-20, INSERM-DGOS CIC1423, IHU FOReSight, Paris, France
- Hôpital National de la Vision des 15-20, Service 3, Paris, France
| | - Ghislaine Rabut
- Hôpital National de la Vision des 15-20, INSERM-DGOS CIC1423, IHU FOReSight, Paris, France
- Hôpital National de la Vision des 15-20, Service 3, Paris, France
| | - Bénédicte Dupas
- Hôpital National de la Vision des 15-20, INSERM-DGOS CIC1423, IHU FOReSight, Paris, France
- Hôpital National de la Vision des 15-20, Service 3, Paris, France
| | - Luisa Riancho
- Sorbonne Université UM80, INSERM UMR 968, CNRS UMR 7210, Institut de la Vision, IHU ForeSight, Paris, France
| | - Hong Liang
- Hôpital National de la Vision des 15-20, INSERM-DGOS CIC1423, IHU FOReSight, Paris, France
- Hôpital National de la Vision des 15-20, Service 3, Paris, France
- Sorbonne Université UM80, INSERM UMR 968, CNRS UMR 7210, Institut de la Vision, IHU ForeSight, Paris, France
| | - Jade Luzu
- Hôpital National de la Vision des 15-20, INSERM-DGOS CIC1423, IHU FOReSight, Paris, France
- Hôpital National de la Vision des 15-20, Service 3, Paris, France
| | - Antoine Labbé
- Hôpital National de la Vision des 15-20, INSERM-DGOS CIC1423, IHU FOReSight, Paris, France
- Hôpital National de la Vision des 15-20, Service 3, Paris, France
- Sorbonne Université UM80, INSERM UMR 968, CNRS UMR 7210, Institut de la Vision, IHU ForeSight, Paris, France
- Ambroise Paré, APHP, Service d'Ophtalmologie, Université Paris Saclay, Boulogne, France
| | | | - Françoise Brignole-Baudouin
- Hôpital National de la Vision des 15-20, INSERM-DGOS CIC1423, IHU FOReSight, Paris, France
- Sorbonne Université UM80, INSERM UMR 968, CNRS UMR 7210, Institut de la Vision, IHU ForeSight, Paris, France
- Hôpital National de la Vision des 15-20, Laboratoire d'Ophtalmobiologie, Paris, France
- Université Paris Cité, Faculté de Pharmacie, Paris, France
| | - Christophe Baudouin
- Hôpital National de la Vision des 15-20, INSERM-DGOS CIC1423, IHU FOReSight, Paris, France
- Hôpital National de la Vision des 15-20, Service 3, Paris, France
- Sorbonne Université UM80, INSERM UMR 968, CNRS UMR 7210, Institut de la Vision, IHU ForeSight, Paris, France
- Ambroise Paré, APHP, Service d'Ophtalmologie, Université Paris Saclay, Boulogne, France
| | - Karima Kessal
- Hôpital National de la Vision des 15-20, INSERM-DGOS CIC1423, IHU FOReSight, Paris, France
- Hôpital National de la Vision des 15-20, Service 3, Paris, France
- Sorbonne Université UM80, INSERM UMR 968, CNRS UMR 7210, Institut de la Vision, IHU ForeSight, Paris, France
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3
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Costa D, De Matteis V, Treso F, Montani G, Martino M, Rinaldi R, Corrado M, Cascione M. Impact of the physical properties of contact lens materials on the discomfort: role of the coefficient of friction. Colloids Surf B Biointerfaces 2024; 233:113630. [PMID: 37956592 DOI: 10.1016/j.colsurfb.2023.113630] [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: 09/06/2023] [Revised: 10/31/2023] [Accepted: 11/01/2023] [Indexed: 11/15/2023]
Abstract
Contact Lens Discomfort (CLD) is the main cause in contact lens (CLs) discontinuation, referred in literature as drop-out phenomenon. Despite such evidence was reported in several clinical studies, a relationship between physico-chemical properties of CLs and CLD is not still totally understood. In this regard, the friction of CLs surfaces seems to be related to discomfort feeling events, probably due to an alteration of the lubricate function of the tear film after the CL placement inside the ocular environment. In the last years, many studies have been finalized to the friction measurements of CLs surface, finding conflicting data due to a lack in standardized protocol. The aim of this review is primarily to show evident relationships between CLs surface properties (i.e. wettability, tear evaporation, tear film quality, etc.) and the coefficient of friction (CoF), resulting therefore the most relevant physical quantity in the CLs characterization. In addition, we reported the most recent studies in CLs tribology, which highlight that the introduction of a standard protocol in CoF measurements is necessary to obtain reproducible results, considering the aim to evaluate in a more precise way the relationship between this material surface property and comfort in CLs users.
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Affiliation(s)
- D Costa
- Department of Mathematics and Physics "Ennio De Giorgi", University of Salento, Via Arnesano, Lecce 73100, Italy
| | - V De Matteis
- Department of Mathematics and Physics "Ennio De Giorgi", University of Salento, Via Arnesano, Lecce 73100, Italy; Institute for Microelectronics and Microsystems (IMM), CNR, Via Monteroni, Lecce 73100, Italy.
| | - F Treso
- Department of Mathematics and Physics "Ennio De Giorgi", University of Salento, Via Arnesano, Lecce 73100, Italy; Centro di Ricerca in Contattologia Avanzata, Via Arnesano, Lecce 73100, Italy
| | - G Montani
- Department of Mathematics and Physics "Ennio De Giorgi", University of Salento, Via Arnesano, Lecce 73100, Italy; Centro di Ricerca in Contattologia Avanzata, Via Arnesano, Lecce 73100, Italy
| | - M Martino
- Department of Mathematics and Physics "Ennio De Giorgi", University of Salento, Via Arnesano, Lecce 73100, Italy; Centro di Ricerca in Contattologia Avanzata, Via Arnesano, Lecce 73100, Italy
| | - R Rinaldi
- Department of Mathematics and Physics "Ennio De Giorgi", University of Salento, Via Arnesano, Lecce 73100, Italy; Institute for Microelectronics and Microsystems (IMM), CNR, Via Monteroni, Lecce 73100, Italy
| | - M Corrado
- Department of Mathematics and Physics "Ennio De Giorgi", University of Salento, Via Arnesano, Lecce 73100, Italy
| | - M Cascione
- Department of Mathematics and Physics "Ennio De Giorgi", University of Salento, Via Arnesano, Lecce 73100, Italy; Institute for Microelectronics and Microsystems (IMM), CNR, Via Monteroni, Lecce 73100, Italy; Centro di Ricerca in Contattologia Avanzata, Via Arnesano, Lecce 73100, Italy.
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4
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Chen E, Rueff E, Nguyen AL. Impact of Mask-Associated Dry Eye on Symptom Score. Eye Contact Lens 2023; 49:433-437. [PMID: 37363998 DOI: 10.1097/icl.0000000000001009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2023] [Indexed: 06/28/2023]
Abstract
OBJECTIVES Owing to widespread mask use during the COVID-19 pandemic and clinical reports tying mask use with dryness, this study endeavors to determine if mask use is linked to symptoms of dry eye. METHODS A prospective, cross-sectional survey study was performed. The survey used a modified Standard Patient Evaluation of Eye Dryness Questionnaire (SPEED, TearScience, Morrisville, NC) within 15 min of the beginning and discontinuation of mask wear. The survey also asked about mask wear time, mask style, visual correction, age, and gender. RESULTS The change in SPEED scores was statistically significant ( P =0.03) between participants with mild SPEED score at baseline (0-9) versus severe SPEED score at baseline (10-28) (n=77: 59 female, 16 male, 1 nonbinary, and 1 declined to answer; range 22-55 years old). Participants in the severe group used masks with nose wire more than the mild group ( P =0.03). CONCLUSIONS In this sample, dry eye symptoms were most exacerbated with mask wear in those that had mild initial symptom scores compared with those with severe symptom scores at baseline. The use of nose wire masks may be protective, as the severe group used this type more and had significantly less exacerbation of symptoms postmask wear.
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Affiliation(s)
- Elaine Chen
- SCCO at MBKU (E.C., E.R., A.L.N.), Fullerton, CA; and California State University (A.L.N.), Fullerton, CA
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5
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Adigal SS, Bhandary SV, Hegde N, Nidheesh VR, John RV, Rizvi A, George SD, Kartha VB, Chidangil S. Protein profile analysis of tear fluid with hyphenated HPLC-UV LED-induced fluorescence detection for the diagnosis of dry eye syndrome. RSC Adv 2023; 13:22559-22568. [PMID: 37501778 PMCID: PMC10369224 DOI: 10.1039/d3ra04389d] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 07/12/2023] [Indexed: 07/29/2023] Open
Abstract
Tear fluid contains organic and inorganic constituents, variations in their relative concentrations could provide valuable information and can be useful for the detection of several ophthalmological diseases. This report describes the application of the lab-assembled light-emitting diode (LED)-based high-performance liquid chromatography system for protein profiling of tear fluids to diagnose dry eye disease. Principal Component Analysis (PCA), match/no-match, and Artificial Neural Network (ANN) based binary classification of protein profile data were performed for disease diagnosis. Results from the match/no-match test of the protein profile data showed 94.4% sensitivity and 87.8% specificity. ANN with the leaving one out procedure has given 91.6% sensitivity and 93.9% specificity.
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Affiliation(s)
- Sphurti S Adigal
- Centre of Excellence for Biophotonics, Department of Atomic and Molecular Physics, Manipal Academy of Higher Education Manipal Karnataka India 576104
| | - Sulatha V Bhandary
- Department of Ophthalmology, Kasturba Medical College Manipal Karnataka India 576104
| | - Nagaraj Hegde
- Ato-gear BV Schimmelt 28 5611 ZX Eindhoven Netherlands
| | - V R Nidheesh
- Centre of Excellence for Biophotonics, Department of Atomic and Molecular Physics, Manipal Academy of Higher Education Manipal Karnataka India 576104
| | - Reena V John
- Centre of Excellence for Biophotonics, Department of Atomic and Molecular Physics, Manipal Academy of Higher Education Manipal Karnataka India 576104
| | - Alisha Rizvi
- Department of Ophthalmology, Kasturba Medical College Manipal Karnataka India 576104
| | - Sajan D George
- Centre for Applied Nanotechnology, Department of Atomic and Molecular Physics, Manipal Academy of Higher Education Manipal Karnataka India 567104
| | - V B Kartha
- Centre of Excellence for Biophotonics, Department of Atomic and Molecular Physics, Manipal Academy of Higher Education Manipal Karnataka India 576104
| | - Santhosh Chidangil
- Centre of Excellence for Biophotonics, Department of Atomic and Molecular Physics, Manipal Academy of Higher Education Manipal Karnataka India 576104
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Byambajav M, Collier A, Shu X, Hagan S. Tear Fluid Biomarkers and Quality of Life in People with Type 2 Diabetes and Dry Eye Disease. Metabolites 2023; 13:733. [PMID: 37367891 DOI: 10.3390/metabo13060733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/04/2023] [Accepted: 06/05/2023] [Indexed: 06/28/2023] Open
Abstract
Dry eye disease (DED) can be extremely distressing and is common in type 2 diabetes (T2D). To investigate potential biomarkers of DED in T2D, panels of proteins in tears, alongside clinical signs and symptoms of DED, were assessed. Patients were classified into four groups: T2D + DED (n = 47), T2D-only (n = 41), DED-only (n = 17) and healthy controls (n = 17). All patients underwent the Ocular Surface Disease Index (OSDI) and Dry Eye-Related Quality of Life (DEQS) questionnaires, tear evaporation rate (TER), fluorescein tear break-up time (fTBUT), corneal fluorescein staining (CFS) and Schirmer 1 test assessments. Six metabolic proteins and 14 inflammatory cytokines were analyzed with multiplex bead analysis. Interleukin (IL)-6 and IL-8 concentrations in tears were significantly higher in the T2D + DED group, and these biomarkers were positively correlated with CFS. In addition, tear IL-6 was negatively correlated with fTBUT in the T2D + DED group. Clinical signs of DED in the T2D + DED group were similar to the DED-only group. The T2D + DED group had more patients with moderate and severe DED (versus the DED-only group), suggesting a different pathogenesis for DED in T2D versus DED-only. Therefore, IL-6 and IL-8 could potentially be diagnostic biomarkers of DED in T2D.
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Affiliation(s)
- Mungunshur Byambajav
- Department of Vision Sciences, School of Health & Life Sciences, Glasgow Caledonian University (GCU), Glasgow G4 0BA, UK
| | - Andrew Collier
- School of Health & Life Sciences, Glasgow Caledonian University (GCU), Glasgow G4 0BA, UK
| | - Xinhua Shu
- Department of Biological & Biomedical Sciences, School of Health & Life Sciences, Glasgow Caledonian University (GCU), Glasgow G4 0BA, UK
| | - Suzanne Hagan
- Department of Vision Sciences, School of Health & Life Sciences, Glasgow Caledonian University (GCU), Glasgow G4 0BA, UK
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7
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Osae EA, Jones L, Nichols JJ. The impact of contact lenses on meibomian gland morphology. Ocul Surf 2022; 24:148-155. [PMID: 35395385 DOI: 10.1016/j.jtos.2022.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 02/22/2022] [Accepted: 04/02/2022] [Indexed: 11/28/2022]
Abstract
Despite years of experience with contact lenses, controversy remains as to whether contact lenses adversely impact the meibomian glands (MG). This review summarizes the present body of evidence, showing that contact lens wear is associated with alterations in MG morphology (up to 80% higher gland atrophy compared to non-wearers) and qualitative changes in MG secretion. Key factors such as duration of contact lens wear, contact lens type (e.g., soft vs. rigid), edge design, and material modulus of elasticity are discussed in relation to the extent of MG morphological changes, the quality of MG secretion and other ocular surface parameters. Longitudinal studies of sufficient statistical power are needed to better understand how contact lens wear affects the MG, risk factors, and the clinical sequelae of these changes.
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Affiliation(s)
| | - Lyndon Jones
- Centre for Ocular Research & Education (CORE), School of Optometry & Vision Science, University of Waterloo, Waterloo, Ontario, Canada; Centre for Eye and Vision Research (CEVR), 17W Hong Kong Science Park, Hong Kong
| | - Jason J Nichols
- The University of Alabama at Birmingham, School of Optometry, Birmingham, AL, 35233, USA.
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Xu L, Wu Y, Song Y, Zhang Q, Qin G, Yang L, Ma J, Palme C, Moore JE, Pazo EE, He W. Comparison Between Heated Eye Mask and Intense Pulsed Light Treatment for Contact Lens-Related Dry Eye. Photobiomodul Photomed Laser Surg 2022; 40:189-197. [PMID: 35298282 DOI: 10.1089/photob.2021.0094] [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: 11/13/2022] Open
Abstract
Background: Contact lens-related dry eye (CLDE) is common in contact lens (CL) wearers and can lead to ocular pain, decreased visual quality, and reduced quality of life. Objective: The purpose of this prospective, randomized, examiner masked study was to compare the effectiveness of intense pulsed light (IPL) and heated eye mask (HEM) for relieving CLDE. Methods: The final analysis included 60 patients (30 in the IPL group and 30 in the HEM group) who were using CL and had been suffering contact lens discomfort for more than a year. The IPL treatment group had two IPL treatments spaced 3 weeks apart, whereas the HEM group received HEM daily for 6 weeks (42 days). Non-invasive tear break-up time (NITBUT), tear-film lipid layer (TFLL), conjunctival fluorescein staining, meibum gland quality and expression, conjunctival redness score, ocular surface disease index (OSDI), best-corrected visual acuity, endothelial cell count, and intraocular pressure were assessed at baseline: first visit (V1), second visit (V2), and third visit (V3). Results: The mean age of the IPL group was 28.6 ± 4.3 years (16 females, 53%) and that of the HEM group was 28.6 ± 4.2 years (16 females, 53%). Mean NITBUT for the IPL group at V2 was 5.53 ± 0.77 sec (p < 0.001) and at V3 was 7.72 ± 0.88 sec (p < 0.001); the IPL group demonstrated a clinically and statistically significant improvement in mean NITBUT. In addition, the HEM group showed a clinically and statistically significant improvement in mean NITBUT at V3 (5.86 ± 0.76 sec, p < 0.001). At V3, the C-OSDI, TFLL score, and meibum gland quality and expressibility all increased considerably (p < 0.05) in both groups. Conclusions: Our results imply that IPL or HEM treatment of CLDE can be safely used to relieve symptoms of CLDE. In addition, IPL treatment is more effective in improving the general stability of the tear-film and decreasing the need for artificial tears in CLDE.
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Affiliation(s)
- Ling Xu
- Department of Ophthalmology, He Eye Specialist Hospital, Shenyang, China
| | - Yi Wu
- Department of Ophthalmology, He Eye Specialist Hospital, Shenyang, China.,The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Yilin Song
- Department of Ophthalmology, He Eye Specialist Hospital, Shenyang, China.,The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Qing Zhang
- Department of Ophthalmology, He Eye Specialist Hospital, Shenyang, China.,The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Guanghao Qin
- Department of Ophthalmology, He Eye Specialist Hospital, Shenyang, China.,The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Lanting Yang
- Department of Ophthalmology, He Eye Specialist Hospital, Shenyang, China.,The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Jinfei Ma
- Breast Cancer, Zhejiang University School of Medicine First Affiliated Hospital, Hangzhou, China
| | - Christoph Palme
- Department of Ophthalmology and Optometry, Medical University of Innsbruck, Innsbruck, Austria
| | - Jonathan E Moore
- Cathedral Eye Clinic, Belfast, United Kingdom.,Aston University, Birmingham, United Kingdom
| | - Emmanuel Eric Pazo
- Department of Ophthalmology, He Eye Specialist Hospital, Shenyang, China
| | - Wei He
- Department of Ophthalmology, He Eye Specialist Hospital, Shenyang, China
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Chen Q, Wei Z, Wang L, Xu X, Wei Z, Zheng P, Cao K, Zhang Z, Chen K, Liang Q. Dry Eye Disease in Patients With Schizophrenia: A Case-Control Study. Front Med (Lausanne) 2022; 9:831337. [PMID: 35223927 PMCID: PMC8864171 DOI: 10.3389/fmed.2022.831337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 01/04/2022] [Indexed: 11/16/2022] Open
Abstract
Objective To evaluate the clinical features and inflammatory cytokines of dry eye disease (DED) in patients with schizophrenia. Methods This is a case-control study. The modified self-rating depression scale (M-SDS) and the ocular surface disease index (OSDI) were used to evaluate the symptoms of depression and DED, respectively. Lipid layer thickness (LLT), partial blink rate (PBR), meibomian gland loss (MGL), tear break-up time (TBUT), corneal fluorescein staining, Schirmer I-test, and eyelid margin abnormalities were also measured. A multiplex ELISA Quantibody array was used to detect the inflammatory cytokines in the tears of all participants. Results Forty schizophrenic patients and 20 control subjects were included. The mean age was 45.0 ± 9.5 years (range, 22–63 years) in schizophrenic patients and 45.4 ± 16.2 years (range, 23–76 years) in controls (P = 0.914). The ratio of male to female was 1.1 in schizophrenic patients and 1.0 in controls (P = 0.914). Ten women (52.6%) with schizophrenia and 2 (20%) in the control group (P = 0.096) were menopausal or post-menopausal. The OSDI [0.0 (0.0–4.2) vs. 7.3 (2.1–14.6)] and TBUT [4.5 (3.0–6.0) vs. 10.0 (3.5–11.0)] were significantly lower in patients with schizophrenia than in controls (P = 0.003 and P = 0.009, respectively). The rate of MGL [36.5 (17.5–47.5) vs. 8.5 (0.0–17.5)] increased in schizophrenic patients (P < 0.001). Among pro-inflammatory cytokines, the levels of interleukin (IL)-1α, IL-6, IL-11, IL-12A, IL-15, IL-17A, and granulocyte colony-stimulating factor (G-CSF) in tears were elevated in the schizophrenia group (all P < 0.01). Most of the chemokines examined were at increased levels in the tears of schizophrenics (all P < 0.05). The levels of matrix metalloproteinases-9 (MMP-9) and intercellular adhesion molecule-1 (ICAM-1) were also higher in the schizophrenic patients (all P < 0.001). The concentrations of IL-1Ra, tissue-inhibitor of metalloproteinase-1 (TIMP-1), and TIMP-2 in the schizophrenia group were decreased (all P < 0.001). In schizophrenic patients, the level of CCL2 in tears was positively correlated with OSDI (R = 0.34, P = 0.03). The increasing TIMP-1 and decreasing IL-5 were correlated with increasing LLT (R = 0.33, P = 0.035; R = −0.35, P = 0.027, respectively). The level of ICAM-1 was then positively correlated with partial blink rate (PBR) (R = 0.33, P = 0.035). There was a negative correlation between IL-8 and the Schirmer I-test (R = −0.41, P = 0.009). Conclusions Patients with schizophrenia were more likely to experience asymptomatic DED, with mild symptoms and obvious signs. The inflammatory cytokines in the tears of schizophrenic patients differed greatly from that of non-schizophrenic patients.
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Affiliation(s)
- Qiankun Chen
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing, China
| | - Zhengjiang Wei
- Beijing Miyun Mental Health Prevention and Treatment Hospital, Beijing, China
| | - Leying Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing, China
| | - Xizhan Xu
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing, China
| | - Zhenyu Wei
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing, China
| | - Panpan Zheng
- National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Kai Cao
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing, China
| | - Zijun Zhang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing, China
| | - Kexin Chen
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing, China
| | - Qingfeng Liang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing, China
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Yu H, Zeng W, Zhao G, Hong J, Feng Y. Response of tear cytokines following intense pulsed light combined with meibomian gland expression for treating meibomian gland dysfunction-related dry eye. Front Endocrinol (Lausanne) 2022; 13:973962. [PMID: 36187125 PMCID: PMC9520485 DOI: 10.3389/fendo.2022.973962] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 08/29/2022] [Indexed: 11/13/2022] Open
Abstract
PURPOSE This study compared the changes in tear inflammatory cytokine levels after intense pulsed light (IPL) combined with meibomian gland expression (MGX) (IPL group) and instant warm compresses combined with MGX (physiotherapy group) as treatments for meibomian gland dysfunction (MGD)-related dry eye disease (DED) to explore their similarities and differences in therapeutic mechanisms. METHODS This study was a post-hoc analysis of a randomized controlled trial. Thirteen patients with MGD-related DED were enrolled in each group and received three treatments correspondingly with 3-week intervals. The levels of 20 tear cytokines, namely, TNF-α, IL-6, MMP-9, CXCL8/IL-8, CXCL10/IP-10, IL-10, EGF, IL-6R, IL-1β, IFN-γ, lactoferrin, Fas ligand, IL-17A, LT-α, S100A9, LCN2/NGAL, IL-13, IL-12/IL-23p40, Fas, and CCL11/Eotaxin, were measured at baseline, before the second and third treatments, and 3 weeks after the third treatment. The primary outcome was the difference in cytokine levels between baseline and the last measurement, and the trends were analyzed at each measurement point. RESULTS At the last measurement, a significant decrease was observed in all tear cytokines for both IPL and physiotherapy groups compared with baseline. The IPL group showed greater reductions in IL-6, IL-6R, IL-1β, IL-13, and CCL11/Eotaxin than the physiotherapy group. TNF-α, CXCL8/IL-8, CXCL10/IP-10, IL-10, EGF, IL-1β, IFN-γ, and Lipocalin-2/NGAL levels continued to decrease with treatment time. Important interactions were found in the changes of IL-6 and IL-13 levels, where the levels first decreased and then slightly increased in the physiotherapy group after treatment, while they continued to decrease in the IPL group. CONCLUSIONS The mechanisms of IPL and physiotherapy in treating MGD-related DED were both associated with reducing inflammation, and the superiority of IPL could be attributed to its better inhibitory effect on inflammatory cytokines like IL-6. In addition, several cytokines were on a downward trend during treatment, suggesting that the vicious cycle of DED was suppressed.
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Affiliation(s)
| | | | | | - Jing Hong
- *Correspondence: Jing Hong, ; Yun Feng,
| | - Yun Feng
- *Correspondence: Jing Hong, ; Yun Feng,
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