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Pan H, Pan X, Gu D, Wang X. Effects of social support on vision-related quality of life in older adults with dry eye disease: the chain mediating role of illness perception and coping style. Front Psychol 2024; 15:1411661. [PMID: 39100556 PMCID: PMC11294252 DOI: 10.3389/fpsyg.2024.1411661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 07/08/2024] [Indexed: 08/06/2024] Open
Abstract
Objective This study explored the effects of social support, illness perception, coping style, and vision-related quality of life (VRQOL) in older patients with dry eye disease (DED) using a chain mediation model. Methods A total of 407 patients with DED from a tertiary hospital in Wuxi, Jiangsu Province, China, between June and December 2023 were selected as participants. A demographic questionnaire, the Social Support Rating Scale, the Brief Illness Perception Questionnaire, the Medical Coping Modes Questionnaire, and the National Eye Institute Visual Functioning questionnaire-25 were all given to them to complete. IBM SPSS (version 27.0) was used for data analysis, and Model 6 of the PROCESS Macro was used to test the predicted chain mediation model. Results The positive association between social support and VRQOL demonstrated the mediation role of illness perception and coping style. Social support affected VRQOL via three pathways: illness perception (effect = 0.190), confrontational coping style (effect = 0.103), and a combination of illness perception and confrontational coping style (effect = 0.067), accounted for 23.60%, 12.80%, and 8.32% of the total effect, respectively. Conclusion Social support in older patients with DED can significantly and positively predict the VRQOL. In addition to the independent mediating effect of illness perception and confrontational coping style, a chain-mediating effect exists between social support and VRQOL. The study serves as a valuable strategy for healthcare professionals to prevent and intervene in VRQOL for older patients with DED in the future.
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Affiliation(s)
- Haoran Pan
- Department of Ophthalmology, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China
- School of Wuxi Medical College, Jiangnan University, Wuxi, Jiangsu, China
| | - Xubin Pan
- Department of Ophthalmology, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China
| | - Danfeng Gu
- Nursing Department, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China
| | - Xiaobo Wang
- School of Wuxi Medical College, Jiangnan University, Wuxi, Jiangsu, China
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Fineide F, Magnø M, Dahlø K, Kolko M, Heegaard S, Vehof J, Utheim TP. Topical glaucoma medications - Possible implications on the meibomian glands. Acta Ophthalmol 2024. [PMID: 38822682 DOI: 10.1111/aos.16728] [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: 02/14/2024] [Accepted: 05/21/2024] [Indexed: 06/03/2024]
Abstract
One of the most common causes of blindness on a global scale is glaucoma. There is a strong association between glaucoma and increased intraocular pressure (IOP). Because of this, adequate IOP-lowering is the most important treatment strategy, mostly through topical eyedrops. Well-functioning meibomian glands are paramount for maintaining a stable tear film, and their dysfunction is the most common cause of dry eye disease. There is a growing concern that both topical glaucoma medications themselves and their added preservatives damage the meibomian glands, and consequently, the ocular surface. Preserved topical glaucoma medications appear to cause dysfunction and atrophy of the meibomian glands. Upon comparison, preserved formulations caused more symptoms of dry eye, tear film instability, inflammatory changes and meibomian gland dropout than the preservative-free counterpart. However, although seemingly less detrimental, unpreserved alternatives may diminish glandular efficacy, and, depending on the active ingredient, lead to glandular death. This negatively impacts quality of life, adherence to treatment regimens and prognosis. In this review, we explore the available evidence regarding the effects of IOP-lowering eye drops on the meibomian glands.
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Affiliation(s)
- Fredrik Fineide
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
- The Norwegian Dry Eye Clinic, Oslo, Norway
- Department of Computer Science, Oslo Metropolitan University, Oslo, Norway
- SimulaMet, Oslo, Norway
| | - Morten Magnø
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
- Department of Ophthalmology, Sørlandet Hospital Arendal, Arendal, Norway
- Department of Plastic and Reconstructive Surgery, Oslo University Hospital, Oslo, Norway
- Department of Ophthalmology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Kristian Dahlø
- Department of Ophthalmology, Oslo University Hospital, Oslo, Norway
| | - Miriam Kolko
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
- Department of Ophthalmology, Copenhagen University Hospital, Rigshospitalet, Glostrup, Denmark
| | - Steffen Heegaard
- Department of Ophthalmology, Copenhagen University Hospital, Rigshospitalet, Glostrup, Denmark
| | - Jelle Vehof
- Department of Twin Research & Genetic Epidemiology, King's College London, St Thomas' Hospital, London, UK
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Department of Ophthalmology, Vestfold Hospital Trust, Tønsberg, Norway
| | - Tor Paaske Utheim
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
- The Norwegian Dry Eye Clinic, Oslo, Norway
- Department of Ophthalmology, Sørlandet Hospital Arendal, Arendal, Norway
- Department of Plastic and Reconstructive Surgery, Oslo University Hospital, Oslo, Norway
- Department of Ophthalmology, Oslo University Hospital, Oslo, Norway
- Department of Ophthalmology, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Ophthalmology, Stavanger University Hospital, Oslo, Norway
- Department of Ophthalmology, Vestre Viken Hospital Trust, Drammen, Norway
- Department of Maxillofacial Surgery, Oslo University Hospital, Oslo, Norway
- Department of Research and Development, Oslo Metropolitan University, Oslo, Norway
- Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Bergen, Norway
- Department of Quality and Health Technology, The Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
- Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway
- Department of Optometry, Radiography and Lighting Design, National Centre for Optics, Vision and Eye Care, Faculty of Health Sciences, University of South-Eastern Norway, Kongsberg, Norway
- Department of Health and Nursing Science, the Faculty of Health and Sport Sciences, University of Agder, Grimstad, Norway
- Department of Ophthalmology, Faculty of Life Course Sciences and Medicine, King's College London, London, UK
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Ye X, Yang J, Hu C, Dong J, Tang H, Zhou B, Wen B, Xiao Z, Zhu M, Cai J, Zhou J. Multi-biomarker combination detection system for diagnosis and classification of dry eye disease by imaging of a multi-channel metasurface. Biosens Bioelectron 2024; 248:115933. [PMID: 38171220 DOI: 10.1016/j.bios.2023.115933] [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: 10/07/2023] [Revised: 11/30/2023] [Accepted: 12/13/2023] [Indexed: 01/05/2024]
Abstract
Dry eye disease (DED) is one of the most common ocular surface diseases, characterized by unstable tear film and ocular inflammation, affecting hundreds of millions of people worldwide. Currently, the clinical diagnosis of DED mainly relies on physical methods such as optical microscopy and ocular surface interferometric imaging, but classifying DED is still difficult. Here, we propose a compact and portable immune detection system based on the direct imaging of a nanophotonic metasurface with gradient geometry, for fast and ultra-sensitive detection of multiple biomarkers (i.e. Matrix metalloproteinase-9 (MMP-9), Lipocalin-1 (LCN-1), Lactoferrin (LTF)) in tears for the diagnosis and classification of DED. This centimeter-scale concentric nanophotonic metasurface, which consists of millions of unique metallic nanostructures, was fabricated through a cost-effective nanoimprint lithography (NIL) process. The immune detection system based on the antibody-modified metasurface shows favorable detection selectivity, an ultra-high sensitivity (3350 pixels/Refractive Index Unit (RIU)) and low limit of detection (LOD) (0.3 ng/mL for MMP-9, 1 ng/mL for LTF, and 0.5 ng/mL for LCN-1). Further clinical sampling and detection results demonstrated that this multi-biomarker detection system enabled accurate determination and symptom classification of DED, manifesting high correlation and consistency with clinical diagnosis results. The advantages such as low sample consumption, one-step detection, simple operation, and simultaneous detection of multiple biomarkers make the platform promising for screening and detecting a broader range of biomarker combinations in clinical practice.
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Affiliation(s)
- Xiangyi Ye
- School of Biomedical Engineering, Shenzhen Campus of Sun Yat-sen University, Shenzhen, 518107, PR China; Key Laboratory of Sensing Technology and Biomedical Instruments of Guangdong Province, School of Biomedical Engineering, Sun Yat-sen University, Guangzhou, 510275, PR China
| | - Ji Yang
- School of Biomedical Engineering, Shenzhen Campus of Sun Yat-sen University, Shenzhen, 518107, PR China; Key Laboratory of Sensing Technology and Biomedical Instruments of Guangdong Province, School of Biomedical Engineering, Sun Yat-sen University, Guangzhou, 510275, PR China
| | - Chao Hu
- School of Biomedical Engineering, Shenzhen Campus of Sun Yat-sen University, Shenzhen, 518107, PR China; Key Laboratory of Sensing Technology and Biomedical Instruments of Guangdong Province, School of Biomedical Engineering, Sun Yat-sen University, Guangzhou, 510275, PR China
| | - Jianpei Dong
- School of Biomedical Engineering, Shenzhen Campus of Sun Yat-sen University, Shenzhen, 518107, PR China; Key Laboratory of Sensing Technology and Biomedical Instruments of Guangdong Province, School of Biomedical Engineering, Sun Yat-sen University, Guangzhou, 510275, PR China
| | - Hao Tang
- School of Biomedical Engineering, Shenzhen Campus of Sun Yat-sen University, Shenzhen, 518107, PR China; Key Laboratory of Sensing Technology and Biomedical Instruments of Guangdong Province, School of Biomedical Engineering, Sun Yat-sen University, Guangzhou, 510275, PR China
| | - Bin Zhou
- School of Biomedical Engineering, Shenzhen Campus of Sun Yat-sen University, Shenzhen, 518107, PR China; Key Laboratory of Sensing Technology and Biomedical Instruments of Guangdong Province, School of Biomedical Engineering, Sun Yat-sen University, Guangzhou, 510275, PR China
| | - Baohua Wen
- School of Biomedical Engineering, Shenzhen Campus of Sun Yat-sen University, Shenzhen, 518107, PR China; Key Laboratory of Sensing Technology and Biomedical Instruments of Guangdong Province, School of Biomedical Engineering, Sun Yat-sen University, Guangzhou, 510275, PR China
| | - Zihan Xiao
- School of Biomedical Engineering, Shenzhen Campus of Sun Yat-sen University, Shenzhen, 518107, PR China; Key Laboratory of Sensing Technology and Biomedical Instruments of Guangdong Province, School of Biomedical Engineering, Sun Yat-sen University, Guangzhou, 510275, PR China
| | - Minyi Zhu
- Department of Ophthalmology, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, 518107, PR China
| | - Jingxuan Cai
- School of Biomedical Engineering, Shenzhen Campus of Sun Yat-sen University, Shenzhen, 518107, PR China; Key Laboratory of Sensing Technology and Biomedical Instruments of Guangdong Province, School of Biomedical Engineering, Sun Yat-sen University, Guangzhou, 510275, PR China.
| | - Jianhua Zhou
- School of Biomedical Engineering, Shenzhen Campus of Sun Yat-sen University, Shenzhen, 518107, PR China; Key Laboratory of Sensing Technology and Biomedical Instruments of Guangdong Province, School of Biomedical Engineering, Sun Yat-sen University, Guangzhou, 510275, PR China.
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Bartol-Puyal FDA, Chacón González M, Arias-Peso B, García Navarro D, Méndez-Martínez S, Ruiz del Tiempo MP, Sáez Comet L, Pablo Júlvez L. Vision-Related Quality of Life in Patients with Systemic Lupus Erythematosus. Healthcare (Basel) 2024; 12:540. [PMID: 38470651 PMCID: PMC10931292 DOI: 10.3390/healthcare12050540] [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: 12/09/2023] [Revised: 01/22/2024] [Accepted: 02/21/2024] [Indexed: 03/14/2024] Open
Abstract
PURPOSE To assess vision-related quality of life (VRQoL) in patients with systemic lupus erythematosus (SLE) under treatment with hydroxychloroquine (HCQ), and to find the influencing factors. METHODS Cross-sectional study enrolling SLE patients for less than ten years (Group 1), SLE patients for more than ten years (Group 2), and healthy controls (Group 3). SLE patients should be under treatment with HCQ but without ophthalmological affection. Schirmer test, best-corrected visual acuity (BCVA), axial length (AL) with optical biometry, and swept-source optical coherence tomography-angiography (OCTA) Triton (Topcon) were performed. All participants fulfilled the Impact of Visual Impairment questionnaire, and SLE patients answered the Lupus Impact Tracker (LIT) questionnaire. Additional data were obtained from clinical records. RESULTS A totals of 41 eyes (41 patients), 31 eyes (31 patients) and 45 eyes (45 volunteers) were enrolled in the study groups. The mean ages were 41.09 ± 9.56, 45.06 ± 8.47 and 40.25 ± 10.83 years, respectively (p = 0.10). The LIT outcomes were 33.49 ± 20.74 and 35.98 ± 22.66 (p = 0.63), respectively. Group 3 referred to a better VRQoL than Group 2 in all categories and than Group 1 in some of them. A linear regression analysis showed that serum ferritin, SLE activity scales, body-mass index (BMI), age, and BCVA influenced VRQoL. The LIT questionnaire was correlated to two categories of the Impact of Visual Impairment questionnaire (IVI). CONCLUSIONS Despite no ophthalmological affection, SLE patients refer to poorer VRQoL because of disease activity and a low health-related quality of life, which has a negative influence on VRQoL. This masks the effect of other ophthalmological conditions such as dry eyes. Other variables influencing VRQoL are age and BMI, and BCVA, to a lesser extent.
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Affiliation(s)
- Francisco de Asís Bartol-Puyal
- Ophthalmology Department, Miguel Servet University Hospital, 50009 Zaragoza, Spain
- Miguel Servet Ophthalmology Research Group (GIMSO), Aragón Institute for Health Research (IIS Aragón), 50009 Zaragoza, Spain
- Surgery Department, Universidad de Zaragoza, 50018 Zaragoza, Spain
| | - María Chacón González
- Ophthalmology Department, Miguel Servet University Hospital, 50009 Zaragoza, Spain
- Miguel Servet Ophthalmology Research Group (GIMSO), Aragón Institute for Health Research (IIS Aragón), 50009 Zaragoza, Spain
| | - Borja Arias-Peso
- Ophthalmology Department, Miguel Servet University Hospital, 50009 Zaragoza, Spain
- Miguel Servet Ophthalmology Research Group (GIMSO), Aragón Institute for Health Research (IIS Aragón), 50009 Zaragoza, Spain
| | - Damián García Navarro
- Ophthalmology Department, Miguel Servet University Hospital, 50009 Zaragoza, Spain
- Miguel Servet Ophthalmology Research Group (GIMSO), Aragón Institute for Health Research (IIS Aragón), 50009 Zaragoza, Spain
| | - Silvia Méndez-Martínez
- Ophthalmology Department, Miguel Servet University Hospital, 50009 Zaragoza, Spain
- Miguel Servet Ophthalmology Research Group (GIMSO), Aragón Institute for Health Research (IIS Aragón), 50009 Zaragoza, Spain
| | - María Pilar Ruiz del Tiempo
- Ophthalmology Department, Miguel Servet University Hospital, 50009 Zaragoza, Spain
- Miguel Servet Ophthalmology Research Group (GIMSO), Aragón Institute for Health Research (IIS Aragón), 50009 Zaragoza, Spain
| | - Luis Sáez Comet
- Internal Medicine Department, Miguel Servet University Hospital, 50009 Zaragoza, Spain
| | - Luis Pablo Júlvez
- Ophthalmology Department, Miguel Servet University Hospital, 50009 Zaragoza, Spain
- Miguel Servet Ophthalmology Research Group (GIMSO), Aragón Institute for Health Research (IIS Aragón), 50009 Zaragoza, Spain
- Surgery Department, Universidad de Zaragoza, 50018 Zaragoza, Spain
- Biotech Vision SLP, University of Zaragoza, 50009 Zaragoza, Spain
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5
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Shahraki T, Baradaran-Rafii A, Ayyala R, Arabi A, Jarstad J, Memar F. New advances in medical management of dry eye: optimizing treatment strategies for enhanced relief. Int Ophthalmol 2024; 44:49. [PMID: 38337030 DOI: 10.1007/s10792-024-02978-1] [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: 05/13/2023] [Accepted: 10/29/2023] [Indexed: 02/12/2024]
Abstract
PURPOSE Dry eye disease (DED) is a prevalent ocular surface disease that is conventionally characterized by tear film hyperosmolarity and instability. This review presents a summarized classification of DED, followed by a comprehensive discussion of the most recent topical and systemic medications and clinical recommendations for selecting the most appropriate option for each patient. METHODS An extensive literature search was conducted on electronic databases, such as PubMed, Scopus, and Web of Science, using keywords including "dry eye syndrome," "ocular surface disease," "medical management," "artificial tears," "topical immunomodulators," and "meibomian gland dysfunction." RESULTS The underlying reasons for DED can range from insufficient aqueous tear production to increased tear evaporation. Recent literature has provided a more in-depth understanding of the pathophysiology of DED by examining the tear film's lipid, aqueous, and mucin layers. However, despite these advancements, medical management of patients with symptomatic DED has not fully reflected this modernized knowledge of its pathophysiology. CONCLUSION To develop a rationalized strategy for treating DED, it is crucial to have updated knowledge of therapeutic options, their mechanisms of actions, and indications based on the DED type and underlying causes.
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Affiliation(s)
- Toktam Shahraki
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, No. 23, Paidarfard St., Boostan 9 St., Pasdaran Ave, Tehran, Iran.
| | - Alireza Baradaran-Rafii
- Department of Ophthalmology, University of South Florida, Morsani College of Medicine, Tampa, FL, USA
| | - Ramesh Ayyala
- Department of Ophthalmology, University of South Florida, Morsani College of Medicine, Tampa, FL, USA
| | - Amir Arabi
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, No. 23, Paidarfard St., Boostan 9 St., Pasdaran Ave, Tehran, Iran
| | - John Jarstad
- Department of Ophthalmology, University of South Florida, Morsani College of Medicine, Tampa, FL, USA
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Stang A, Schmidt B, Schramm S, Kowall B, Jöckel KH, Erbel R, Kuss O, Geerling G. Synergism between coexisting eye diseases and sex in increasing the prevalence of the dry eye syndrome. Sci Rep 2024; 14:314. [PMID: 38172608 PMCID: PMC10764946 DOI: 10.1038/s41598-023-50871-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 12/27/2023] [Indexed: 01/05/2024] Open
Abstract
The aim was to investigate prevalence of dry eye syndrome (DES) in a population-based sample in Germany. The association between coexisting eye diseases and DES was also of interest. We recontacted participants of the Heinz Nixdorf Recall study between 2018 and 2021 by postal questionnaire that included the Women's Health Study questionnaire on DES. We estimated prevalence of DES and examined DES-associated factors among 2095 participants aged 62-91 years. We performed interaction analyses between sex and coexisting eye diseases in relation to the DES prevalence and performed bias analyses to examine the robustness of the results. The DES prevalence was 31.5% (34-36% after correction for potential non-response bias, 24.1% after correction for outcome misclassification) and it was almost 2.1-times higher in women than in men (women 42.3%, men 20.4%). Among DES subjects, 70.3% had received treatment in the previous 12 months. There was synergism between female sex and coexisting eye diseases (cataract, glaucoma, macular degeneration) in terms of DES prevalence. The extrapolated numbers of patients aged 62-91 years with DES in Germany are 1.1-1.3 million men and 6.1-6.8 million women. The observed synergism may be explained by differences in ocular physiology, subjective perception and response behavior. Women with eye diseases (cataract, glaucoma, macula degeneration) appear to have a markedly higher susceptibility to suffer from DES than men, so that a diagnostic workup of DES symptoms is particularly justified in women with these eye diseases.
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Affiliation(s)
- Andreas Stang
- Institute of Medical Informatics, Biometry and Epidemiology, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany.
- School of Public Health, Department of Epidemiology, Boston University, Boston, USA.
| | - Börge Schmidt
- Institute of Medical Informatics, Biometry and Epidemiology, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - Sara Schramm
- Institute of Medical Informatics, Biometry and Epidemiology, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - Bernd Kowall
- Institute of Medical Informatics, Biometry and Epidemiology, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - Karl-Heinz Jöckel
- Institute of Medical Informatics, Biometry and Epidemiology, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - Raimund Erbel
- Institute of Medical Informatics, Biometry and Epidemiology, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - Oliver Kuss
- Institute for Biometrics and Epidemiology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany
- Centre for Health and Society, Faculty of Medicine, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Gerd Geerling
- Department of Ophthalmology, University Hospital Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
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Ajouz L, Hallak J, Naik R, Nguyen A, Zhao C, Robinson MR, Nichols KK. Evaluation of the Impact of Meibomian Gland Dysfunction Using a Novel Patient-Reported Outcome Instrument. J Ocul Pharmacol Ther 2024; 40:48-56. [PMID: 37910805 PMCID: PMC10890943 DOI: 10.1089/jop.2023.0080] [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: 06/30/2023] [Accepted: 09/25/2023] [Indexed: 11/03/2023] Open
Abstract
Purpose: This study was intended to characterize the impact of meibomian gland dysfunction (MGD) on patients' quality of life. Methods: In this prospective, multicenter, noninterventional clinical study (NCT01979887), eligible individuals (age ≥40 years; absence of uncontrolled ocular/systemic disease) were categorized, based on composite grading of ocular symptoms, Schirmer score, and meibum quality, into (1) non-MGD, (2) mild/moderate MGD, or (3) severe MGD cohorts. The MGD Impact Questionnaire (MGD IQ), a 10-item patient-reported outcome measure, was self-administered at clinic visit on day 1, and readministered on day 22 to assess intervisit agreement regarding MGD IQ responses. Results: In total, 75 subjects were assigned to the study cohorts (25 per cohort). Across cohorts, MGD IQ item scores rose incrementally with increasing MGD severity. The severe MGD cohort experienced greater difficulty with reading and performance of leisure activities, greater time on eye care, and greater bother with eye care and eye appearance than the mild/moderate MGD cohort (all P < 0.05). Compared with the non-MGD cohort, the mild/moderate MGD cohort had greater difficulty working on computer, whereas the severe MGD cohort had greater difficulty reading, driving, and performing leisure activities, more frequent difficulty with outdoor activities, more time on eye care, and greater bother with eye care (all P < 0.05). Intervisit agreement between MGD IQ responses was fair to moderate (weighted kappa statistic 0.33‒0.58). Conclusions: Vision-related activities are negatively impacted by increasing severity of MGD. The MGD IQ instrument can help characterize disease severity and amplify the patient's voice in patient-centric clinical research. ClinicalTrials.gov NCT01979887.
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Affiliation(s)
- Layla Ajouz
- Allergan (an AbbVie company), Irvine, California, USA
| | - Joelle Hallak
- Allergan (an AbbVie company), Irvine, California, USA
| | - Rupali Naik
- Noesis Healthcare Technologies, Redwood City, California, USA
| | - Ashley Nguyen
- Allergan (an AbbVie company), Irvine, California, USA
| | - Cathy Zhao
- Allergan (an AbbVie company), Irvine, California, USA
| | | | - Kelly K. Nichols
- School of Optometry, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Fineide FA, Tashbayev B, Elgstøen KBP, Sandås EM, Rootwelt H, Hynne H, Chen X, Ræder S, Vehof J, Dartt D, Jensen JL, Utheim TP. Tear and Saliva Metabolomics in Evaporative Dry Eye Disease in Females. Metabolites 2023; 13:1125. [PMID: 37999221 PMCID: PMC10673540 DOI: 10.3390/metabo13111125] [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: 09/28/2023] [Revised: 10/25/2023] [Accepted: 10/27/2023] [Indexed: 11/25/2023] Open
Abstract
Accurate diagnosis of dry eye disease (DED) is challenging, and even today there is no gold standard biomarker of DED. Hypothesis-free global metabolomic studies of tears from DED patients have great potential to discover metabolites and pathways affected in the pathophysiology of DED, and to identify possible future biomarkers. These metabolites and biomarkers could be important for diagnosing and monitoring disease as well as for new therapeutic targets and strategies. As DED is associated with dry mouth, this study aimed to perform metabolomic analyses of tears and saliva from patients with decreased tear film break-up time but normal Schirmer test, and age-matched controls with both tear production and stability within physiological range. We applied strict inclusion criteria to reduce sampling bias in the metabolomic analyses and selected only age-matched females with Schirmer test values between 10-15 mm/5 min. The tear film analysis arm included 19 patients (with tear film break-up time 0-5 s) and 12 controls (with tear film break-up time 10-30 s), while the salivary analysis arm consisted of a subset which included 18 patients and six controls. Metabolomic analyses were performed using liquid chromatography and high-resolution mass spectrometry. Analyses using a global database search detected a total of 56 metabolites in tear samples that were significantly different between the groups. Of these, several have known associations with DED. These metabolites are present in meibum and have anti-oxidative characteristics or associations with the ocular microbiome, and altered concentrations suggest that they may play a significant role in DED associated with decreased tear film stability. In saliva, hypotaurine levels were lower among patients with tear film instability. In this pilot study, we found different levels of several metabolites in patients with decreased tear film break-up time that may have associations with DED. Future studies are required to replicate our findings and clarify the exact roles of these metabolites.
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Affiliation(s)
- Fredrik A. Fineide
- The Norwegian Dry Eye Clinic, 0366 Oslo, Norway
- Department of Medical Biochemistry, Oslo University Hospital, 0450 Oslo, Norway
- Department of Computer Science, Oslo Metropolitan University, 0130 Oslo, Norway
| | - Behzod Tashbayev
- The Norwegian Dry Eye Clinic, 0366 Oslo, Norway
- Department of Oral Surgery and Oral Medicine, Faculty of Dentistry, University of Oslo, 0313 Oslo, Norway
| | | | - Elise M. Sandås
- Department of Medical Biochemistry, Oslo University Hospital, 0450 Oslo, Norway
| | - Helge Rootwelt
- Department of Medical Biochemistry, Oslo University Hospital, 0450 Oslo, Norway
| | - Håvard Hynne
- Department of Oral Surgery and Oral Medicine, Faculty of Dentistry, University of Oslo, 0313 Oslo, Norway
| | - Xiangjun Chen
- Department of Oral Surgery and Oral Medicine, Faculty of Dentistry, University of Oslo, 0313 Oslo, Norway
- Department of Ophthalmology, Drammen Hospital Trust, 3004 Drammen, Norway
- Department of Ophthalmology, Sørlandet Hospital Trust, 4838 Arendal, Norway
| | - Sten Ræder
- The Norwegian Dry Eye Clinic, 0366 Oslo, Norway
- Department of Medical Biochemistry, Oslo University Hospital, 0450 Oslo, Norway
- Department of Ophthalmology, Oslo University Hospital, 0450 Oslo, Norway
| | - Jelle Vehof
- Departments of Ophthalmology and Epidemiology, University Medical Center Groningen, 9713 Groningen, The Netherlands
| | - Darlene Dartt
- Schepens Eye Research Institute/Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, 20 Staniford St., Boston, MA 02114, USA
| | - Janicke L. Jensen
- Department of Oral Surgery and Oral Medicine, Faculty of Dentistry, University of Oslo, 0313 Oslo, Norway
| | - Tor P. Utheim
- Department of Medical Biochemistry, Oslo University Hospital, 0450 Oslo, Norway
- Department of Ophthalmology, Oslo University Hospital, 0450 Oslo, Norway
- Department of Oral Biology, Faculty of Dentistry, University of Oslo, 0313 Oslo, Norway
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Zhang Y, Zhang XJ, Yuan N, Wang YM, Ip P, Chen LJ, Tham CC, Pang CP, Yam JC. Secondhand smoke exposure and ocular health: A systematic review. Surv Ophthalmol 2023; 68:1166-1207. [PMID: 37479063 DOI: 10.1016/j.survophthal.2023.07.001] [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: 01/18/2023] [Revised: 07/04/2023] [Accepted: 07/10/2023] [Indexed: 07/23/2023]
Abstract
The toxicology of secondhand smoke (SHS), along with the harm of its exposure to human health, has been generally acknowledged; however, specific evidence is lacking on the association between SHS exposure and ocular health. In this systematic review (PROSPERO registration number: CRD42022247992), we included 55 original articles published by 12 May 2023, which dealt with SHS exposure and ocular disorders, such as eye irritation, conjunctivitis, dry eye diseases, uveitis, myopia, astigmatism, contact lens discomfort, age-related macular degeneration, glaucoma, and thyroid eye disease that addressed the ocular neurovascular structures of the macular, retinal nerve fiber layer, choroid, and corneal biomechanical parameters. We found compelling correlational evidence for eye irritation, conjunctivitis, and dry eye symptoms-supporting that SHS exposure was positively associated with inflammatory and allergic changes in the eyes. Yet, evidence about the associations between SHS exposure and other ocular disorders, structures, and parameters is still limited or controversial. Given the limitations of existing literature, more investigations with high quality and rigorous design are warranted to elucidate the potentially harmful effects of SHS exposure on ocular health.
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Affiliation(s)
- Youjuan Zhang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China; The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Xiu Juan Zhang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China; Joint Shantou International Eye Center, Shantou University, Shantou, China
| | - Nan Yuan
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China; Kunming Bright Eye Hospital, Kunming, China
| | - Yu Meng Wang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China; Department of Neurobiology, Interdisciplinary Center for Neurosciences (IZN), Heidelberg University, Heidelberg, Germany
| | - Patrick Ip
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Li Jia Chen
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China; Joint Shantou International Eye Center, Shantou University, Shantou, China; Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong SAR, China; Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Clement C Tham
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China; Joint Shantou International Eye Center, Shantou University, Shantou, China; Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong SAR, China; Hong Kong Eye Hospital, Hong Kong SAR, China; Department of Ophthalmology, Hong Kong Children's Hospital, Hong Kong SAR, China; Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Chi Pui Pang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China; Joint Shantou International Eye Center, Shantou University, Shantou, China; Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jason C Yam
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China; Joint Shantou International Eye Center, Shantou University, Shantou, China; Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong SAR, China; Hong Kong Eye Hospital, Hong Kong SAR, China; Department of Ophthalmology, Hong Kong Children's Hospital, Hong Kong SAR, China; Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China.
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10
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Rafay A, Asghar Z, Manzoor H, Hussain W. EyeCNN: exploring the potential of convolutional neural networks for identification of multiple eye diseases through retinal imagery. Int Ophthalmol 2023; 43:3569-3586. [PMID: 37291412 DOI: 10.1007/s10792-023-02764-5] [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: 01/20/2023] [Accepted: 05/21/2023] [Indexed: 06/10/2023]
Abstract
BACKGROUND The eyes are the most important part of the human body as these are directly connected to the brain and help us perceive the imagery in daily life whereas, eye diseases are mostly ignored and underestimated until it is too late. Diagnosing eye disorders through manual diagnosis by the physician can be very costly and time taking. OBJECTIVE Thus, to tackle this, a novel method namely EyeCNN is proposed for identifying eye diseases through retinal images using EfficientNet B3. METHODS A dataset of retinal imagery of three diseases, i.e. Diabetic Retinopathy, Glaucoma, and Cataract is used to train 12 convolutional networks while EfficientNet B3 was the topperforming model out of all 12 models with a testing accuracy of 94.30%. RESULTS After preprocessing of the dataset and training of models, various experimentations were performed to see where our model stands. The evaluation was performed using some well-defined measures and the final model was deployed on the Streamlit server as a prototype for public usage. The proposed model has the potential to help diagnose eye diseases early, which can facilitate timely treatment. CONCLUSION The use of EyeCNN for classifying eye diseases has the potential to aid ophthalmologists in diagnosing conditions accurately and efficiently. This research may also lead to a deeper understanding of these diseases and it may lead to new treatments. The webserver of EyeCNN can be accessed at ( https://abdulrafay97-eyecnn-app-rd9wgz.streamlit.app/ ).
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Affiliation(s)
- Abdul Rafay
- Department of Computer Science, School of Systems and Technology, University of Management and Technology, Lahore, Pakistan
| | - Zaeem Asghar
- Department of Computer Science, School of Systems and Technology, University of Management and Technology, Lahore, Pakistan
| | - Hamza Manzoor
- Department of Computer Science, School of Systems and Technology, University of Management and Technology, Lahore, Pakistan
| | - Waqar Hussain
- Department of Artificial Intelligence, School of Systems and Technology, University of Management and Technology, Lahore, Pakistan.
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Møller-Hansen M. Mesenchymal stem cell therapy in aqueous deficient dry eye disease. Acta Ophthalmol 2023; 101 Suppl 277:3-27. [PMID: 37840443 DOI: 10.1111/aos.15739] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
ENGLISH SUMMARY Dry eye disease (DED) is characterized by ocular dryness, irritation and blurred vision and has a significant impact on the patient's quality of life. This condition can be particularly severe in patients with aqueous deficient dry eye disease (ADDE) due to Sjögren's syndrome (SS), an autoimmune disease that affects the lacrimal and salivary glands. Current treatments for ADDE are often limited to symptomatic relief. A literature review was conducted to explore the current surgical interventions used or tested in humans with ADDE (I). These interventions include procedures involving the eyelids and tear ducts, transplantation of amniotic membrane or salivary glands, injections around the tear ducts and cell-based injections into the lacrimal gland (LG). Each treatment has its advantages and disadvantages; however, treating dry eyes in patients with SS presents a particular challenge due to the systemic nature of the disease. Moreover, there is a need for new therapeutic options. Mesenchymal stem cells (MSCs) are a type of stem cell that have shown promise in regenerating damaged tissue and reducing inflammation in various diseases. Previous studies in animal models have suggested that MSCs could be effective in treating ADDE. Thus, this thesis aims to investigate the safety and efficacy of injecting MSCs into the LG as a treatment option for patients with ADDE secondary to SS. The study also aims to see this treatment in light of existing and novel investigational treatment options. The clinical studies conducted for this thesis are the first of their kind in humans. MSCs derived from healthy donors' adipose tissue (ASCs) were cultured in a laboratory, frozen and thawed ready for use. In the safety study, we performed the first human trial involving the administration of a single injection of ASCs into the LG of one eye in seven patients suffering from severe ADDE (II). The primary objective was to test the safety of this treatment, while the secondary objective was to assess improvements in subjective and objective signs of dry eye. The results of the trial showed no serious side effects within 4 months of follow-up after treatment. On average, there was a 40% reduction in dry eye symptoms assessed with the Ocular Surface Disease Index (OSDI) questionnaire. Additionally, in the treated eye, there was a significant decrease in tear osmolarity, an increase in tear film stability and an increase in tear production. To further investigate the efficacy of this treatment, our research group performed a clinical, randomized study aiming to compare the ASC injection into the LG with the injection of a vehicle (the excipient in which the ASCs are dissolved) and observation (no intervention) (III). The study involved 20 subjects receiving ASC injection, 20 subjects receiving vehicle injection and 14 patients being observed without intervention. The subjects were examined to assess the outcomes with a 12-month follow-up after treatment. Both intervention groups showed a significant reduction in subjective dry eye symptoms of approximately 40%. This improvement was evident at the 1-week follow-up and persisted until the 12-month follow-up. The observation group did not experience any change in OSDI score. The ASCs group exhibited a significant mean increase in non-invasive tear break-up time (NIKBUT) of 6.48 s (149%) at the four-week follow-up, which was significantly higher than that in the vehicle group (p = 0.04). Moreover, the ASCs group showed a significant increase in NIKBUT compared to that in the observation group at the 12-month follow-up (p = 0.004). In both the ASCs and vehicle group, a significant increase in Schirmer test scores at the 4-month follow-up and the 12-month follow-up was observed. In conclusion, this thesis contributes valuable findings with a new treatment option for patients with dry eye disease. Injection of ASCs into the LG was shown to be safe and to improve subjective dry eye symptoms and specifically the tear film stability in patients with ADDE due to SS. Compared to other treatment modalities of ADDE, this treatment has greater potential, as ASCs could potentially be used as an anti-inflammatory therapeutic option for managing DED of other causes as well. RESUMÉ (DANISH SUMMARY): Tørre øjne, karakteriseret ved tørhedsfornemmelse og irritation af øjnene samt sløret syn, har en betydelig indvirkning på patientens livskvalitet. Denne tilstand kan vaere saerligt alvorlig hos patienter med nedsat tåreproduktion (ADDE) som følge af Sjögrens syndrom (SS), en autoimmun sygdom, der påvirker tårekirtlerne og spytkirtlerne. Nuvaerende behandlinger for ADDE er ofte begraenset til symptomlindring. Vi gennemførte en litteraturgennemgang for at undersøge, hvilke nuvaerende kirurgiske behandlingsmetoder, der anvendes eller testes hos patienter med ADDE (I). Disse interventioner inkluderer procedurer, der involverer øjenlåg og tårekanaler, transplantation af amnionhinde eller spytkirtler, injektioner omkring tårekanalerne samt cellebaserede injektioner i tårekirtlen. Hver behandling har sine fordele og ulemper, men behandling af tørre øjne hos patienter med SS udgør en saerlig udfordring på grund af sygdommens systemiske udbredning, og der er behov for nye behandlingsmuligheder. Mesenkymale stamceller (MSCs) er en type stamcelle, der har vist lovende resultater med hensyn til at regenerere beskadiget vaev og reducere inflammation i forskellige sygdomme. Tidligere undersøgelser i dyremodeller har indikeret, at MSCs kan vaere en effektiv behandling af ADDE. Denne afhandling har til formål at undersøge sikkerheden og effekten af injektion af MSCs i tårekirtlen som en mulig behandling til patienter med ADDE som følge af SS. Afhandlingen sigter også mod at sammenligne denne behandling med andre eksisterende, kirurgiske behandlingsmuligheder af ADDE. Som led i dette projekt udførte vi de første kliniske forsøg af sin art i mennesker. MSCs fra raske donorers fedtvaev (ASCs) blev dyrket i et laboratorium, frosset ned og er optøet klar til brug. Det første mål var at teste sikkerheden ved denne behandling og sekundaert at undersøge behandlingens effekt. For at undersøge dette modtog syv forsøgspersoner med svaer ADDE én injektion med ASCs i tårekirtlen på det ene øje (II). Resultaterne af forsøget viste ingen alvorlige bivirkninger inden for fire måneders opfølgning efter behandlingen. I gennemsnit fandt vi yderligere en 40% reduktion i symptomer på tørre øjne vurderet med et spørgeskema, og en markant stigning i tåreproduktionen og af tårefilmens stabilitet i det behandlede øje. For yderligere at undersøge effekten af denne behandling udførte vi et klinisk, randomiseret forsøg med det formål at sammenligne injektion af ASCs i tårekirtlen med injektion af en kontrolopløsning (vaesken, hvor stamcellerne var opløst) og observation (ingen intervention) (III). Studiet omfattede 20 forsøgspersoner, der modtog ASC-injektion, 20 forsøgspersoner, der modtog injektion af kontrolopløsningen, og 14 forsøgspersoner i observationsgruppen. Forsøgspersonerne blev undersøgt med en opfølgningstid på 12 måneder efter behandling. Begge interventionsgrupper viste en betydelig reduktion på ca. 40% i subjektive symptomer på tørre øjne. Denne forbedring var betydelig allerede ved opfølgning efter en uge og varede ved 12 måneder efter behandling. Observationsgruppen oplevede ingen betydelig aendring i symptomer. ASCs gruppen viste desuden en signifikant stigning i tårefilmsstabiliteten (NIKBUT) på 6,48 sekunder (149%) ved opfølgning efter fire uger, hvilket var markant højere end efter injektion af kontrolopløsning (p = 0,04). Desuden viste ASCs gruppen en betydelig stigning i NIKBUT sammenlignet med observationsgruppen ved opfølgning efter 12 måneder (p = 0,004). Både injektion af ASCs og kontrolopløsning medførte en betydelig stigning i tåreproduktionen ved opfølgning fire måneder og 12 måneder efter behandling. Denne afhandling bidrager med vigtige resultater inden for en ny behandlingsmulighed af tørre øjne. Injektion af ASCs i tårekirtlen viste sig at vaere sikker, forbedrede subjektive symptomer på tørre øjne og øgede saerligt tårfilmens stabilitet hos patienter med ADDE på grund af SS. Sammenlignet med andre behandlingsmuligheder for ADDE har denne behandling vist et stort potentiale. ASCs kan muligvis også bruges som en anti-inflammatorisk behandling af tørre øjne af andre årsager i fremtiden.
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Affiliation(s)
- Michael Møller-Hansen
- Department of Ophthalmology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- University of Copenhagen, Copenhagen, Denmark
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12
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Magno MS, Moschowits E, Morthen MK, Beining MW, Jansonius NM, Hammond CJ, Utheim TP, Vehof J. Greater adherence to a mediterranean diet is associated with lower C-reactive protein (CRP) levels, but not to lower odds of having dry eye disease. Ocul Surf 2023; 30:196-203. [PMID: 37783428 DOI: 10.1016/j.jtos.2023.09.013] [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: 06/01/2023] [Revised: 08/09/2023] [Accepted: 09/29/2023] [Indexed: 10/04/2023]
Abstract
PURPOSE To investigate the hypothesis that a Mediterranean diet is associated with a lower risk of having dry eye disease (DED) in the general population. METHODS DED was assessed using the Women's Health Study (WHS) dry eye questionnaire in 58,993 participants from the Dutch Lifelines Cohort with complete available dietary data (20-94 years, 60% female). Level of adherence to a traditional Mediterranean diet was assessed using the modified Mediterranean Diet Score (mMDS). High-sensitivity C-reactive Protein (hsCRP) was included as a marker of whole-body inflammation. Logistic regressions were used to examine the relationship between WHS-defined DED and mMDS, corrected for age, sex, BMI, education, income, and 48 potentially confounding comorbidities. The association between mMDS and hsCRP, and hsCRP and DED, was further explored in separate regressions. RESULTS Of all participants, 9.1% had DED. In contrast to the hypothesis, higher mMDS levels were associated with greater odds of DED, corrected for demographics, smoking status, BMI, and comorbidities (OR 1.034, 95%CI: 1.015 to 1.055, P = 0.001). Moreover, there was a highly significant relationship between increasing mMDS and lower circulating hsCRP levels; however, there was no significant relationship between hsCRP and DED. CONCLUSIONS Stronger adherence to a Mediterranean diet does not appear to be associated with lower odds of having DED in the general population. Furthermore, there was no association between hsCRP and DED in this study. However, the previously described link between a Mediterranean diet and lower hsCRP was confirmed in this large population-based study.
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Affiliation(s)
- Morten Schjerven Magno
- Department of Ophthalmology, Sørlandet Hospital Arendal, Arendal, Norway; Department of Plastic and Reconstructive Surgery, Oslo University Hospital, Oslo, Norway; Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway; Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Emily Moschowits
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
| | - Mathias Kaurstad Morthen
- Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | | | - Nomdo M Jansonius
- Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Christopher J Hammond
- Department of Twin Research & Genetic Epidemiology, King's College London, St Thomas' Hospital, London, United Kingdom; Department of Ophthalmology, King's College London, St Thomas' Hospital, London, United Kingdom
| | - Tor P Utheim
- Department of Ophthalmology, Sørlandet Hospital Arendal, Arendal, Norway; Department of Plastic and Reconstructive Surgery, Oslo University Hospital, Oslo, Norway; Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway; Department of Ophthalmology, Oslo University Hospital, Oslo, Norway; Department of Ophthalmology, Faculty of Life Course Sciences and Medicine, King's College London, London, UK
| | - Jelle Vehof
- Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; Dutch Dry Eye Clinic, Velp, the Netherlands; Department of Ophthalmology, Vestfold Hospital Trust, Tønsberg, Norway.
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13
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Wan W, Chen Z, Xun Y, Yi K, Zhu Y, Pu Y, Su G, Zhou C, Wang Y, Yang P. Comprehensive evaluation of functional vision, quality of life, and cognitive ability in pediatric uveitis. BMC Ophthalmol 2023; 23:381. [PMID: 37723468 PMCID: PMC10507833 DOI: 10.1186/s12886-023-03117-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 08/29/2023] [Indexed: 09/20/2023] Open
Abstract
BACKGROUND Pediatric uveitis may cause severe impairment of vision in children and affect their quality of life as well as cognitive ability. This study aims to evaluate the functional vision, visual-related and health-related quality of life, and cognitive ability in pediatric uveitis. METHODS Children with uveitis aged 5-16 years old completed six validated instruments to assess functional visual ability with Cardiff Visual Ability Questionnaire for Children (CVAQC), vision-related quality of life with Impact of Vision Impairment for Children (IVI-C), health-related quality of life with Pediatric Quality of Life Inventory (PedsQL), cognitive ability with Chinese Wechsler Intelligence Scale for Children (C-WISC), and depression and anxiety evaluation with Hospital Anxiety and Depression Scale (HAD). RESULTS The CVAQC, IVI-C, and PedsQL scores of pediatric uveitis were significantly lower than that of normal levels. Full-scale intelligence quotient (IQ) and performance IQ were significantly lower in pediatric uveitis patients with impaired vision in their best eye (visual acuity < 0.3) compared to those with a vision equal to or better than 0.3. Verbal IQ was significantly lower in male pediatric uveitis patients with impaired vision compared to those with a vision equal to or better than 0.3. Additionally, parents of pediatric uveitis patients with impaired vision generally had lower educational levels than parents of those with a vision equal to or better than 0.3. CONCLUSIONS Impaired vision caused by pediatric uveitis has a significant impact on children's functional visual ability and quality of life. The development of cognitive function in pediatric uveitis is also significantly hindered.
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Grants
- CSTC, 2008CA5003 Chongqing Key Laboratory of Ophthalmology
- CSTC, 2008CA5003 Chongqing Key Laboratory of Ophthalmology
- CSTC, 2008CA5003 Chongqing Key Laboratory of Ophthalmology
- CSTC, 2008CA5003 Chongqing Key Laboratory of Ophthalmology
- CSTC, 2008CA5003 Chongqing Key Laboratory of Ophthalmology
- CSTC, 2008CA5003 Chongqing Key Laboratory of Ophthalmology
- CSTC, 2008CA5003 Chongqing Key Laboratory of Ophthalmology
- CSTC, 2008CA5003 Chongqing Key Laboratory of Ophthalmology
- CSTC, 2008CA5003 Chongqing Key Laboratory of Ophthalmology
- CSTC, 2008CA5003 Chongqing Key Laboratory of Ophthalmology
- cstc2014pt-sy10002 Chongqing Science & Technology Platform and Base Construction Program
- cstc2014pt-sy10002 Chongqing Science & Technology Platform and Base Construction Program
- cstc2014pt-sy10002 Chongqing Science & Technology Platform and Base Construction Program
- cstc2014pt-sy10002 Chongqing Science & Technology Platform and Base Construction Program
- cstc2014pt-sy10002 Chongqing Science & Technology Platform and Base Construction Program
- cstc2014pt-sy10002 Chongqing Science & Technology Platform and Base Construction Program
- cstc2014pt-sy10002 Chongqing Science & Technology Platform and Base Construction Program
- cstc2014pt-sy10002 Chongqing Science & Technology Platform and Base Construction Program
- cstc2014pt-sy10002 Chongqing Science & Technology Platform and Base Construction Program
- cstc2014pt-sy10002 Chongqing Science & Technology Platform and Base Construction Program
- CSTC2021jscx-gksb-N0010 Key Project of Chongqing Science and Technology Bureau
- CSTC2021jscx-gksb-N0010 Key Project of Chongqing Science and Technology Bureau
- CSTC2021jscx-gksb-N0010 Key Project of Chongqing Science and Technology Bureau
- CSTC2021jscx-gksb-N0010 Key Project of Chongqing Science and Technology Bureau
- CSTC2021jscx-gksb-N0010 Key Project of Chongqing Science and Technology Bureau
- CSTC2021jscx-gksb-N0010 Key Project of Chongqing Science and Technology Bureau
- CSTC2021jscx-gksb-N0010 Key Project of Chongqing Science and Technology Bureau
- CSTC2021jscx-gksb-N0010 Key Project of Chongqing Science and Technology Bureau
- CSTC2021jscx-gksb-N0010 Key Project of Chongqing Science and Technology Bureau
- CSTC2021jscx-gksb-N0010 Key Project of Chongqing Science and Technology Bureau
- 81970832 National Natural Science Foundation of China
- 81970832 National Natural Science Foundation of China
- 81970832 National Natural Science Foundation of China
- 81970832 National Natural Science Foundation of China
- 81970832 National Natural Science Foundation of China
- 81970832 National Natural Science Foundation of China
- 81970832 National Natural Science Foundation of China
- 81970832 National Natural Science Foundation of China
- 81970832 National Natural Science Foundation of China
- 81970832 National Natural Science Foundation of China
- cstc2021jcyj-msxmX0967 Natural Science Foundation of Chongqing Science and Technology Bureau
- cstc2021jcyj-msxmX0967 Natural Science Foundation of Chongqing Science and Technology Bureau
- cstc2021jcyj-msxmX0967 Natural Science Foundation of Chongqing Science and Technology Bureau
- cstc2021jcyj-msxmX0967 Natural Science Foundation of Chongqing Science and Technology Bureau
- cstc2021jcyj-msxmX0967 Natural Science Foundation of Chongqing Science and Technology Bureau
- cstc2021jcyj-msxmX0967 Natural Science Foundation of Chongqing Science and Technology Bureau
- cstc2021jcyj-msxmX0967 Natural Science Foundation of Chongqing Science and Technology Bureau
- cstc2021jcyj-msxmX0967 Natural Science Foundation of Chongqing Science and Technology Bureau
- cstc2021jcyj-msxmX0967 Natural Science Foundation of Chongqing Science and Technology Bureau
- cstc2021jcyj-msxmX0967 Natural Science Foundation of Chongqing Science and Technology Bureau
- 2019 Chongqing Outstanding Scientists Project
- 2019 Chongqing Outstanding Scientists Project
- 2019 Chongqing Outstanding Scientists Project
- 2019 Chongqing Outstanding Scientists Project
- 2019 Chongqing Outstanding Scientists Project
- 2019 Chongqing Outstanding Scientists Project
- 2019 Chongqing Outstanding Scientists Project
- 2019 Chongqing Outstanding Scientists Project
- 2019 Chongqing Outstanding Scientists Project
- 2019 Chongqing Outstanding Scientists Project
- 2018 the Chongqing Chief Medical Scientist Project
- 2018 the Chongqing Chief Medical Scientist Project
- 2018 the Chongqing Chief Medical Scientist Project
- 2018 the Chongqing Chief Medical Scientist Project
- 2018 the Chongqing Chief Medical Scientist Project
- 2018 the Chongqing Chief Medical Scientist Project
- 2018 the Chongqing Chief Medical Scientist Project
- 2018 the Chongqing Chief Medical Scientist Project
- 2018 the Chongqing Chief Medical Scientist Project
- 2018 the Chongqing Chief Medical Scientist Project
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Affiliation(s)
- Wenjuan Wan
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Lab of Ophthalmology, Chongqing Branch of National Clinical Research Center for Ocular Diseases, Chongqing Eye Institute, Chongqing, P. R. China
| | - Zhijun Chen
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Lab of Ophthalmology, Chongqing Branch of National Clinical Research Center for Ocular Diseases, Chongqing Eye Institute, Chongqing, P. R. China
| | - Yan Xun
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Lab of Ophthalmology, Chongqing Branch of National Clinical Research Center for Ocular Diseases, Chongqing Eye Institute, Chongqing, P. R. China
| | - Kun Yi
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Lab of Ophthalmology, Chongqing Branch of National Clinical Research Center for Ocular Diseases, Chongqing Eye Institute, Chongqing, P. R. China
| | - Ying Zhu
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Lab of Ophthalmology, Chongqing Branch of National Clinical Research Center for Ocular Diseases, Chongqing Eye Institute, Chongqing, P. R. China
| | - Yanlin Pu
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Lab of Ophthalmology, Chongqing Branch of National Clinical Research Center for Ocular Diseases, Chongqing Eye Institute, Chongqing, P. R. China
| | - Guannan Su
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Lab of Ophthalmology, Chongqing Branch of National Clinical Research Center for Ocular Diseases, Chongqing Eye Institute, Chongqing, P. R. China
| | - Chunjiang Zhou
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Lab of Ophthalmology, Chongqing Branch of National Clinical Research Center for Ocular Diseases, Chongqing Eye Institute, Chongqing, P. R. China
| | - Yao Wang
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Lab of Ophthalmology, Chongqing Branch of National Clinical Research Center for Ocular Diseases, Chongqing Eye Institute, Chongqing, P. R. China
| | - Peizeng Yang
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Lab of Ophthalmology, Chongqing Branch of National Clinical Research Center for Ocular Diseases, Chongqing Eye Institute, Chongqing, P. R. China.
- The First Affiliated Hospital of Chongqing Medical University, Youyi Road 1, 400016, Chongqing, P.R. China.
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Morthen MK, Magno MS, Utheim TP, Hammond CJ, Vehof J. The work-related burden of dry eye. Ocul Surf 2023; 28:30-36. [PMID: 36690155 DOI: 10.1016/j.jtos.2023.01.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 01/09/2023] [Accepted: 01/19/2023] [Indexed: 01/22/2023]
Abstract
PURPOSE To investigate the relationship between dry eye disease (DED) and work functioning, unemployment, absenteeism, and worry about job loss. METHODS DED and unemployment, absenteeism, and 'worry about job loss' were assessed in 71,067 subjects (18-65 years, 60% female) from the Dutch population-based Lifelines cohort using the Women's Health study questionnaire and single-item questions, respectively. Work functioning was assessed in 32,475 participants using the Work role functioning questionnaire 2.0. The relationships between DED and work measures were assessed with logistic regression models, corrected for age, sex, BMI, income, educational level, smoking, and 48 comorbidities. RESULTS 8.3% of participants had DED and had more impaired work functioning compared to those without DED (49.2% vs 41.1%, OR 1.21, 95% CI 1.10-1.32, corrected for demographics, smoking and 48 comorbidities). DED carried a similar risk of impaired work functioning as rheumatoid arthritis. For participants with highly symptomatic dry eye impaired work functioning was even higher (59.1%) and similar to that of depression. The impaired work functioning seen with increasing symptoms were greater in undiagnosed subjects versus diagnosed subjects (P = 0.03). After correction for comorbidities, DED remained tied to absenteeism and increased worry about job loss, but not unemployment. CONCLUSION DED was linked to impaired work functioning and absence, but not unemployment. DEDs impact on work functioning is comparable to that of other severe chronic disorders, and undiagnosed subjects may be more affected. This highlights the importance of recognizing DED as a severe disorder and of screening for dry eye in the workplace to aid with diagnosis and treatment.
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Affiliation(s)
- Mathias Kaurstad Morthen
- Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, Postbus 30.001, Groningen, the Netherlands; Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
| | - Morten Schjerven Magno
- Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, Postbus 30.001, Groningen, the Netherlands; Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway; Department of Plastic and Reconstructive Surgery, Oslo University Hospital, Oslo, Norway; Department of Ophthalmology, Sørlandet Hospital Arendal, Arendal, Norway
| | - Tor Paaske Utheim
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway; Department of Plastic and Reconstructive Surgery, Oslo University Hospital, Oslo, Norway
| | - Christopher J Hammond
- Department of Twin Research & Genetic Epidemiology, King's College London, St Thomas' Hospital, Lambeth Palace Road, Waterloo, London, SE1 7EH, United Kingdom; Department of Ophthalmology, King's College London, St Thomas' Hospital, Westminster Bridge Road, Waterloo, London, SE1 7EH, London, United Kingdom
| | - Jelle Vehof
- Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, Postbus 30.001, Groningen, the Netherlands; Department of Epidemiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, Postbus 30.001, Groningen, the Netherlands; Department of Twin Research & Genetic Epidemiology, King's College London, St Thomas' Hospital, Lambeth Palace Road, Waterloo, London, SE1 7EH, United Kingdom; Department of Ophthalmology, Vestfold Hospital Trust, Tønsberg, Norway.
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15
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Nguyen L, Magno MS, Utheim TP, Hammond CJ, Vehof J. The relationship between sedentary behavior and dry eye disease. Ocul Surf 2023; 28:11-17. [PMID: 36621639 DOI: 10.1016/j.jtos.2023.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 12/30/2022] [Accepted: 01/04/2023] [Indexed: 01/07/2023]
Abstract
PURPOSE Sedentary behavior (SB) has been linked with low-grade systemic inflammation, which could play a role in the development of dry eye disease (DED). This cross-sectional study aims to investigate the association between SB and DED. METHODS We assessed 48,418 participants from the population-based Lifelines cohort (58% female, 18-96 years). Women's Health Study (WHS)-defined DED was the primary outcome. SB was assessed using the Marshall Sitting Questionnaire. The relationship between DED and SB was analyzed using logistic regressions, corrected for age, sex, BMI, smoking status, demographics, and 48 comorbidities. Any potential modifying effect of physical activity (PA) was also assessed, and the analyses were repeated excluding the most computer-intensive domains, investigating SB independent from screen exposure. RESULTS WHS-defined DED was present in 9.1% of participants. Greater SB was associated with an increased risk of DED (odds ratio (OR) 1.015 per hour/day, 95%CI 1.005-1.024, P = 0.004). The association between SB and DED was only significant for those with less than WHO-recommended PA (OR 1.022, 95%CI 1.002-1.042, P = 0.027), and not in participants meeting WHO's recommendation (OR 1.011, 95%CI 0.999-1.023, P = 0.076). Lastly, when excluding computer-related sitting, the relationship between SB and DED was attenuated, and no longer significant (OR 1.009, 95%CI 0.996-1.023, P = 0.19). CONCLUSIONS Greater sedentary time was tied to an increased risk of DED, especially for those with lower PA levels than WHO recommendations. However, as there was no significant association when computer-intensive sitting time was excluded, screen use could explain the observed relationship and should be noted as a possible key confounder.
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Affiliation(s)
- Long Nguyen
- Department of Plastic and Reconstructive Surgery, Oslo University Hospital, Oslo, Norway
| | - Morten Schjerven Magno
- Department of Plastic and Reconstructive Surgery, Oslo University Hospital, Oslo, Norway; Department of Ophthalmology, Sørlandet Hospital Arendal, Arendal, Norway; Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway; Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Tor P Utheim
- Department of Ophthalmology, Sørlandet Hospital Arendal, Arendal, Norway; Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway; Department of Ophthalmology, Oslo University Hospital, Oslo, Norway; Department of Ophthalmology, Vestfold Hospital Trust, Tønsberg, Norway
| | - Christopher J Hammond
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway; Department of Twin Research & Genetic Epidemiology, King's College London, St Thomas' Hospital, London, United Kingdom; Department of Ophthalmology, King's College London, St Thomas' Hospital, London, London, United Kingdom
| | - Jelle Vehof
- Dutch Dry Eye Clinic, Velp, the Netherlands; Departments of Ophthalmology and Epidemiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, Postbus 30.001, Groningen, the Netherlands; Department of Ophthalmology, Vestfold Hospital Trust, Tønsberg, Norway.
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16
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Qiu C, Fang Y. The Prevalence of Symptomatic Dry Eye Disease Among Coal Workers in Huainan Region of China. Int J Gen Med 2023; 16:203-209. [PMID: 36699343 PMCID: PMC9869694 DOI: 10.2147/ijgm.s396670] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 01/05/2023] [Indexed: 01/19/2023] Open
Abstract
Purpose To investigate the prevalence and influencing factors of symptomatic dry eye disease (DED) in Chinese coal workers. Methods The prevalence of symptomatic DED in coal workers was investigated by using the questionnaire of Ocular Surface Disease Index (OSDI) and the influencing factors were explored. Results The prevalence of symptomatic DED was 50.7% in coal workers. Of the influencing factors of symptomatic DED, the level of dust exposure had an odds ratio (OR) of 1.26, the time of dust exposure had an OR of 1.02, and the age had an OR of 1.03. Conclusion There was a high morbidity of symptomatic DED among coal workers and the level and the time of dust exposure and the age of coal workers had important effects.
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Affiliation(s)
- Cui Qiu
- First Affiliated Hospital of Anhui University of Science and Technology (Huainan First People’s Hospital) Tianjia ‘an District, Huainan City, People’s Republic of China,Anhui University of Science and Technology Medical College Tianjia ‘an District, Huainan City, People’s Republic of China,Institute of Ophthalmology, Anhui University of Science and Technology Tianjia ‘an District, Huainan City, People’s Republic of China
| | - Yan Fang
- First Affiliated Hospital of Anhui University of Science and Technology (Huainan First People’s Hospital) Tianjia ‘an District, Huainan City, People’s Republic of China,Anhui University of Science and Technology Medical College Tianjia ‘an District, Huainan City, People’s Republic of China,Institute of Ophthalmology, Anhui University of Science and Technology Tianjia ‘an District, Huainan City, People’s Republic of China,Correspondence: Yan Fang, Tel +8613721126292, Fax +8605543320706, Email
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17
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Uwimana A, Ma C, Ma X. Concurrent Rising of Dry Eye and Eye Strain Symptoms Among University Students During the COVID-19 Pandemic Era: A Cross-Sectional Study. Risk Manag Healthc Policy 2022; 15:2311-2322. [PMID: 36518997 PMCID: PMC9743979 DOI: 10.2147/rmhp.s388331] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 11/23/2022] [Indexed: 10/20/2023] Open
Abstract
PURPOSE Students spend extended hours using electronic devices due to online teaching. Digital eye strain (DES) and dry eye disease (DED) symptoms are both associated with prolonged screen exposure time and may co-occur. This study aimed to evaluate the correlation between DES and DED symptoms and determine the prevalence of DED according to the severity of DES. PATIENTS AND METHODS This cross-sectional study was conducted among international students in Chinese universities. The survey was built using Wenjuan Mini Program and distributed using the WeChat platform. The questionnaire assessed participants' screen exposure, the 20-20-20 rule, ED practices, and DED awareness. Computer Vision Syndrome Questionnaire (CVS-Q) and Dry Eye Questionnaire (DEQ-5) were used to diagnose DES and DED symptoms, respectively. RESULTS 498 students completed the survey, but 452 were considered for the study. Predictors of DES and DED symptoms were conjunctivitis, eye allergy, glares, tired eye, neck pain, back pain, PhD students, and daily spending > 9h on screen (P < 0.05 for all). We observed that an increase in DES scores also exponentially increases DED scores. Among students diagnosed with DES symptoms, 26.5% had mild to moderate DED symptoms, and 8.2% had severe DED symptoms. In contrast, only 8.4% and 0.9% of those with asymptomatic DES had mild to moderate and severe DED symptoms, respectively (P < 0.000). A strong and significant positive correlation (r = 0.695, P < 0.000) between DES and DED scores was found. CONCLUSION We found an extremely high prevalence of DES and DED symptoms compared to the previous studies with a similar population group. We believe that the prevalence of DED may be underestimated in the young population. Training about proper ED practices is mandatory to prevent these deleterious ocular surface conditions.
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Affiliation(s)
- Alexandre Uwimana
- Department of Ophthalmology, the First Affiliated Hospital of Dalian Medical University, Dalian, People’s Republic of China
| | - Cong Ma
- Department of Ophthalmology, the First Affiliated Hospital of Dalian Medical University, Dalian, People’s Republic of China
| | - Xiang Ma
- Department of Ophthalmology, the First Affiliated Hospital of Dalian Medical University, Dalian, People’s Republic of China
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18
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Hynnekleiv L, Magno M, Vernhardsdottir RR, Moschowits E, Tønseth KA, Dartt DA, Vehof J, Utheim TP. Hyaluronic acid in the treatment of dry eye disease. Acta Ophthalmol 2022; 100:844-860. [PMID: 35514082 PMCID: PMC9790727 DOI: 10.1111/aos.15159] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 04/05/2022] [Accepted: 04/18/2022] [Indexed: 12/31/2022]
Abstract
Dry eye disease (DED) is a highly prevalent and debilitating condition affecting several hundred million people worldwide. Hyaluronic acid (HA) is a naturally occurring glycosaminoglycan commonly used in the treatment of DED. This review aims to critically evaluate the literature on the safety and efficacy of artificial tears containing HA used in DED treatment. Literature searches were conducted in PubMed, including MEDLINE, and in Embase via Ovid with the search term: "(hyaluronic acid OR hyaluronan OR hyaluronate) AND (dry eye OR sicca)". A total of 53 clinical trials are included in this review, including eight placebo-controlled trials. Hyaluronic acid concentrations ranged from 0.1% to 0.4%. Studies lasted up to 3 months. A broad spectrum of DED types and severities was represented in the reviewed literature. No major complications or adverse events were reported. Artificial tears containing 0.1% to 0.4% HA were effective at improving both signs and symptoms of DED. Two major gaps in the literature have been identified: 1. no study investigated the ideal drop frequency for HA-containing eyedrops, and 2. insufficient evidence was presented to recommend any specific HA formulation over another. Future investigations assessing the optimal drop frequency for different concentrations and molecular weights of HA, different drop formulations, including tonicity, and accounting for DED severity and aetiology are essential for an evidence-based, individualized approach to DED treatment.
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Affiliation(s)
- Leif Hynnekleiv
- Department of Plastic and Reconstructive SurgeryOslo University HospitalOsloNorway,Department of OphthalmologyHaukeland University HospitalBergenNorway,Department of Twin Research & Genetic EpidemiologyKing's College LondonSt Thomas' HospitalLondonUK
| | - Morten Magno
- Department of Plastic and Reconstructive SurgeryOslo University HospitalOsloNorway,Department of Medical BiochemistryOslo University HospitalOsloNorway,Department of Ophthalmology and EpidemiologyUniversity Medical Center GroningenUniversity of GroningenGroningenThe Netherlands,Faculty of MedicineInstitute of Clinical MedicineUniversity of OsloOsloNorway
| | | | - Emily Moschowits
- Department of Medical BiochemistryOslo University HospitalOsloNorway
| | - Kim Alexander Tønseth
- Department of Plastic and Reconstructive SurgeryOslo University HospitalOsloNorway,Faculty of MedicineInstitute of Clinical MedicineUniversity of OsloOsloNorway
| | - Darlene A. Dartt
- Schepens Eye Research Institute/Massachusetts Eye and EarDepartment of OphthalmologyHarvard Medical SchoolBostonMassachusettsUSA
| | - Jelle Vehof
- Department of Twin Research & Genetic EpidemiologyKing's College LondonSt Thomas' HospitalLondonUK,Department of Ophthalmology and EpidemiologyUniversity Medical Center GroningenUniversity of GroningenGroningenThe Netherlands,Department of OphthalmologyVestfold Hospital TrustTønsbergNorway
| | - Tor P. Utheim
- Department of Plastic and Reconstructive SurgeryOslo University HospitalOsloNorway,Department of Medical BiochemistryOslo University HospitalOsloNorway,Department of OphthalmologySørlandet Hospital ArendalArendalNorway,Department of OphthalmologyStavanger University HospitalOsloNorway,Department of OphthalmologyVestre Viken HospitalDrammenNorway
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19
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Moxibustion with Walnut Shell Spectacles Could Improve the Objective Symptoms and Tear Film Stability of Patients with Dry Eye Disease: A Randomized Controlled Trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:1773444. [PMID: 36506807 PMCID: PMC9729042 DOI: 10.1155/2022/1773444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 09/22/2022] [Indexed: 12/05/2022]
Abstract
Objectives This study aims to evaluate the efficacy and acceptability of moxibustion with walnut shell spectacles in treating dry eye disease (DED) patients and to provide treatment options. Methods 126 DED patients were randomly allocated into the moxibustion group (treated by moxibustion with walnut shell spectacles, 64 cases) and the artificial tears group (treated with sodium hyaluronate eye drops, 62 cases). Evaluate the changes in the ocular surface disease index (OSDI), the visual analogue scale (VAS) of ocular discomfort, the tear film break-up time (TBUT), corneal fluorescein staining (CFS), and the Schirmer I test during the trial at baseline and after 1-week, 2-week, 3-week, and 4-week treatment. Evaluate the OSDI scale and the ocular symptom VAS scale one month after the end of treatment. Results There were no significant differences in baseline characteristics between the two groups. For OSDI scores, the results showed that the efficacy of the moxibustion group was no less than that of the artificial tear group. For VAS of ocular discomfort, both groups significantly reduced their score compared with baseline, and for the moxibustion group, the decrease was more significant. For TBUT, FAS, and PPS, results showed that the efficacy of the moxibustion group was significant in both eyes after 4 weeks of treatment, but the right eye was in the artificial tear group. For CFS and Schirmer I test scores, there was no significant effect for both groups. Conclusion Moxibustion with walnut shell spectacles could improve the clinical symptoms and tear film stability of DED patients; however, it has no significant efficacy on improving corneal injury and tear secretion, just the same as sodium hyaluronate eye drops. Nevertheless, moxibustion with walnut shell spectacles may have better effects on the self-assessment of ocular discomfort than sodium hyaluronate eye drops.
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Wirta DL, Senchyna M, Lewis AE, Evans DG, McLaurin EB, Ousler GW, Hollander DA. A randomized, vehicle-controlled, Phase 2b study of two concentrations of the TRPM8 receptor agonist AR-15512 in the treatment of dry eye disease (COMET-1). Ocul Surf 2022; 26:166-173. [PMID: 35970431 DOI: 10.1016/j.jtos.2022.08.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 08/05/2022] [Accepted: 08/09/2022] [Indexed: 12/14/2022]
Abstract
PURPOSE Dry eye disease (DED) symptoms can negatively impact quality of life (QoL). AR-15512, a transient receptor potential melastatin 8 (TRPM8) agonist, was evaluated as a potential therapy for DED. METHODS In a Phase 2b study, patients with DED were randomized 1:1:1 to 0.0014% AR-15512, 0.003% AR-15512, or vehicle twice daily for 12 weeks. Eligibility criteria included DED signs and symptoms of prespecified severity levels. Outcomes assessed were DED signs (Schirmer score ± anesthetic, ocular surface staining, hyperemia), symptoms (Ocular Discomfort [ODS-VAS], Symptoms Assessment iN Dry Eye [SANDE], Eye Dryness-VAS, Ocular Pain-VAS), QoL-VAS, and adverse events. Co-primary endpoints were changes from baseline in ODS-VAS and anesthetized Schirmer score at Day 28. RESULTS 0.003% AR-15512 (n = 122) was associated with early and sustained improvements in unanesthetized Schirmer score (Days 1 and 14, p < 0.0001), as well as improvements in ocular surface staining (Days 14 and 84, p ≤ 0.0365) and hyperemia (Day 84, p < 0.0215). Statistically significant improvements in symptoms were observed for the 0.003% concentration on SANDE (Days 14, 28, and 84, p ≤ 0.0254), ODS-VAS (Day 84, p = 0.0281), Eye Dryness-VAS (Day 84, p = 0.0302), and multiple QoL measures (Days 14, 28, and 84, p < 0.05). There were no significant differences between active and vehicle groups for the co-primary endpoints. The most common adverse events were burning and stinging upon instillation. CONCLUSIONS Although predefined co-primary study endpoints were not met, AR-15512 demonstrated statistically significant improvements in DED signs, symptoms, and disease-related QoL.
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21
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Bhandari M, Nguyen S, Yazdani M, Utheim TP, Hagesaether E. The Therapeutic Benefits of Nanoencapsulation in Drug Delivery to the Anterior Segment of the Eye: A Systematic Review. Front Pharmacol 2022; 13:903519. [PMID: 35645827 PMCID: PMC9136980 DOI: 10.3389/fphar.2022.903519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 04/25/2022] [Indexed: 11/30/2022] Open
Abstract
Background: Although numerous nanoparticle formulations have been developed for ocular administration, concerns are being raised about a possible mismatch between potential promises made by the field of nanoparticle research and demonstration of actual therapeutic benefit. Therefore, the primary focus of this present review was to critically assess to what extent nanoencapsulation of ocular drugs improved the therapeutic outcome when treating conditions in the anterior segment of the eye. Methods: A systematic search was conducted using Medline, PubMed, and Embase databases as well as Google Scholar for published peer-reviewed articles in English focusing on conventional nanoparticles used as drug delivery systems to the anterior segment of the eye in in vivo studies. The major therapeutic outcomes were intraocular pressure, tear secretion, number of polymorphonuclear leucocytes and pupil size. The outcome after encapsulation was compared to the non-encapsulated drug. Results: From the search, 250 results were retrieved. Thirty-eight studies met the inclusion criteria. Rabbits were used as study subjects in all but one study, and the number of animals ranged from 3 to 10. Coated and uncoated liposomes, lipid-based and polymeric nanoparticles, as well as micelles, were studied, varying in both particle size and surface charge, and encapsulating a total of 24 different drugs, including 6 salts. The majority of the in vivo studies demonstrated some improvement after nanoencapsulation, but the duration of the benefit varied from less than 1 h to more than 20 h. The most common in vitro methods performed in the studies were drug release, transcorneal permeation, and mucin interaction. Discussion: Nanoparticles that are small and mucoadhesive, often due to positive surface charge, appeared beneficial. Although in vitro assays can unravel more of the hidden and sophisticated interplay between the encapsulated drug and the nanoparticle structure, they suffered from a lack of in vitro—in vivo correlation. Therefore, more research should be focused towards developing predictive in vitro models, allowing rational design and systematic optimization of ocular nanoparticles with minimal animal experimentation.
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Affiliation(s)
- Madhavi Bhandari
- Department of Life Sciences and Health, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- *Correspondence: Madhavi Bhandari,
| | - Sanko Nguyen
- Department of Life Sciences and Health, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Mazyar Yazdani
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
| | - Tor Paaske Utheim
- Department of Life Sciences and Health, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
- Department of Ophthalmology, Oslo University Hospital, Oslo, Norway
| | - Ellen Hagesaether
- Department of Life Sciences and Health, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
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Comparison of Trehalose/Hyaluronic Acid (HA) vs. 0.001% Hydrocortisone/HA Eyedrops on Signs and Inflammatory Markers in a Desiccating Model of Dry Eye Disease (DED). J Clin Med 2022; 11:jcm11061518. [PMID: 35329844 PMCID: PMC8948919 DOI: 10.3390/jcm11061518] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 02/28/2022] [Accepted: 03/07/2022] [Indexed: 12/17/2022] Open
Abstract
Background: Dry eye disease (DED) is a multifactorial disease where ocular surface inflammation and damage play key etiological roles. Purpose: To compare a combination of 3% trehalose (T) and 0.15% hyaluronic acid (HA) (Thealoz duo®, T/HA) with a tear substitute containing 0.001% hydrocortisone (I) and 0.2% HA (Idroflog®, I/HA), with respect to changes on signs and inflammatory markers in a mouse DED model. Methods: Thirty 12-week-old C57BL/6 mice were exposed in a controlled-environment chamber as a desiccating stress model of DED for 35 days. At day 14 (T1), administration of 5 µL T or I in the right eye (RE) or NaCl 0.9% in the left eye (LE) started, twice a day. Animals were sacrificed after 7 (T2), 14 (T3), 21 (T4, endpoint) days from the beginning of treatment. Corneal fluorescein staining ratio (Image J), histological and histochemical assessment of ocular surface tissues (goblet cell GC density and characterization —PAS, Alcian blue pH 2.5, pH 1.0, and MUC4 expression—in the superior and inferior conjunctiva), and levels of inflammatory markers HLA-DR, IL-1β and TNF-α in cornea and conjunctiva were measured. Results: No animal fully recovered from DED signs at the endpoint. Difference between arms was observed at T3 and T4, with T treated eyes showing a higher corneal damage reduction, PAS-positive GC recovery, lower inflammatory marker expression as compared to the I treated ones. Conclusions: Data suggest that 21 days of treatment with T/HA improved signs, GC recovery and inflammatory markers in a DED mouse model, to a greater extent as compared to I/HA. Data suggest that 21 days of treatment with T/HA improved signs, GC recovery and inflammatory markers in a DED mouse model, to a greater extent as compared to I/HA.
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