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Fadel D. Medmont Meridia™: Much More Than a Corneal Topographer. CLINICAL OPTOMETRY 2023; 15:283-301. [PMID: 38054029 PMCID: PMC10695145 DOI: 10.2147/opto.s433899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 11/08/2023] [Indexed: 12/07/2023]
Abstract
In recent years, advanced diagnostic instruments have become widely available in optometric practices, offering various functions that optimize clinical information gathering. This article focuses on the Medmont Meridia™, a state-of-the-art multipurpose diagnostic device with corneal topography and cutting-edge features. Corneal topography is pivotal in the early diagnosis of corneal disorders, determining baseline ocular surface assessment, helping in contact lens fitting, and monitoring ocular health over time. The Medmont Meridia boasts Placido-disc-based imaging with extensive corneal coverage. Furthermore, the Meridia accurately measures the horizontal visible iris diameter, pupil diameter, and palpebral fissure width, which assists in making contact lens parameter decisions. Additionally, it offers sagittal height data for scleral lens design and first lens selection, streamlining the fitting process. Beyond its topography capabilities, the Meridia excels as a comprehensive dry eye assessment tool. With features like tear meniscus height, tear film surface quality, and meibography capabilities, it aids in diagnosing dry eye and monitoring its progression. The device also provides customizable dry eye reports with integrated grading scales and questionnaires, making dry eye management, patient education, and compliance more accessible. In conclusion, the Medmont Meridia consolidates a multitude of examination tools in a single instrument, enhancing practice efficiency and elevating patient care and communication. Its versatility and accuracy make it an invaluable asset in optometric practices worldwide.
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Affiliation(s)
- Daddi Fadel
- Center for Ocular Research & Education (CORE), School of Optometry & Vision Science, University of Waterloo, Waterloo, ON, Canada
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Muñoz-Villegas PDC, Sánchez-Ríos A, Olvera-Montaño O. The Effect of Sodium Hyaluronate Eye Drops 2, 4 or 6 Times a Day on Signs and Symptoms of Dry Eye Disease. Clin Ophthalmol 2023; 17:2945-2955. [PMID: 37822327 PMCID: PMC10563771 DOI: 10.2147/opth.s433709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 09/29/2023] [Indexed: 10/13/2023] Open
Abstract
Purpose A randomized clinical trial was run to evaluate the effectiveness of a preservative-free 0.4% sodium hyaluronate eye drop (LOF) in different dosage schemes to alleviate signs and symptoms of dry eye disease (DED). Methods A total of 116 subjects with mild-to-moderate DED were included, and 111 completed the study (from which 67.6% were female and 65.3% were users of oral contraceptives). Patients were randomly assigned to instill a drop of LOF either 2 (BID), 4 (QID) or 6 (6TD) times a day (at least 3 hours apart) for 30 days. The clinical parameters and symptom endpoints were Ocular Surface Disease Index (OSDI), tear break-up time (TBUT), ocular surface staining, and conjunctival hyperemia. Other parameters evaluated were chemosis, best corrected visual acuity, and the incidence of adverse events (AE). Results There was a significant reduction in OSDI scores by day 30 in all groups. The recovery of the OSDI score back to normal values was observed in 51.4% of patients treated (50%, 48.6%, and 55.6% in BID, QID, and 6TD, respectively, p = 0.822). Similar improvement was observed for TBUT, 50.5% of patients increased this variable to >10 seconds (39.5%, 51.4%, and 61.1%, p = 0.175), and for ocular surface staining, ≥72% showed Grade 0. There were no significant differences among posology groups regarding ocular surface staining, conjunctival hyperemia, or any safety parameters. No overall improvement in OSDI and TBUT to normal values was noted for 31 patients (21 were female and 71.4% users of contraceptive drugs). Conclusion The ophthalmic use of preservative free LOF, 2, 4 or 6 times a day, may alleviate clinical parameters and symptoms in 50% of patients with mild-to-moderate DED after a one-month treatment. This improvement seemed to be less ubiquitous in patients within reproductive age and using oral contraceptives. Trial Registration This trial is registered at clinicaltrials.gov (NCT0704531).
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Affiliation(s)
- Patricia del Carmen Muñoz-Villegas
- Regional Medical Affairs Department, Laboratorios Sophia, S.A. de C.V, Zapopan, Jalisco, Mexico
- Centro de Investigación en Matemáticas A.C. (CIMAT), Unidad Aguascalientes, Aguascalientes, Mexico
| | - Alejandra Sánchez-Ríos
- Regional Medical Affairs Department, Laboratorios Sophia, S.A. de C.V, Zapopan, Jalisco, Mexico
| | - Oscar Olvera-Montaño
- Regional Medical Affairs Department, Laboratorios Sophia, S.A. de C.V, Zapopan, Jalisco, Mexico
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赵 雨, 张 啸, 杨 必, 刘 陇. [Application of Deep Learning Algorithm in the Grading Assessment of Corneal Fluorescein Staining]. SICHUAN DA XUE XUE BAO. YI XUE BAN = JOURNAL OF SICHUAN UNIVERSITY. MEDICAL SCIENCE EDITION 2023; 54:908-914. [PMID: 37866945 PMCID: PMC10579063 DOI: 10.12182/20230960104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Indexed: 10/24/2023]
Abstract
Objective To explore the application value of applying deep learning (DL) algorithm in the grading assessment of corneal fluorescein staining. Methods A cross-sectional study was carried out, covering 600 corneal fluorescein staining photos acquired in the Contact Lens Clinic, West China Hospital, Sichuan University between 2020 and 2022. Out of the 600 photos, 500 were used to construct the algorithm and the remaining 100 were used for the validation of the algorithm and a comparative analysis of the difference in grading accuracy (ACC) and the length of diagnostic time between artificial intelligence (AI) and optometry students. One month after finishing the first grading analysis, assessment by AI and optometry students was conducted for a second time and results from the two rounds of assessment were compared to examine the intrarater agreement ( kappa value) of the two analyses. The grading analysis results of 3 experienced optometrists were used as the gold standard in the study. Results Findings of the cross validation with the complete dataset, the training dataset, and the test dataset showed that ResNet34 had the highest predictive accuracy among four DL models. ResNet34 DL model achieved an accuracy of 93.0%, sensitivity of 89.5%, and specificity of 89.6% in the grading of corneal staining. In the comparison of the grading accuracy of AI and two optometry students, AI showed better accuracy, with the respective grading accuracy being 87.0%, 78.0%, and 52.0% for AI, student 1, and student 2 ( P ACC=0.001). In addition, the average diagnostic time of AI was shorter than that of optometry students ( t AI=1.00 s, t S1=11.86 s, t S2=13.25 s, P t =0.001). In the comparative analysis of the intrarater agreement between the two assessments, AI ( kappa AI=0.658, P AI=0.001) achieved better consistency than the two optometry students did ( kappa S1=0.575, P S1=0.001; kappa S2=0.609, P S2=0.001). Conclusion Applying deep learning algorithms in the grading assessment of corneal fluorescein staining has considerable feasibility and clinical value. In the performance comparison between AI and optometry students, AI achieved higher accuracy and better consistency, which indicates that AI has potential application value for assisting optometrists to make clinical decisions with speed and accuracy.
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Affiliation(s)
- 雨暄 赵
- 四川大学华西临床医学院 眼视光学系 (成都 610041)Department of Optometry and Vision Sciences, West China School of Medicine, Sichuan University, Chengdu 610041, China
| | - 啸云 张
- 四川大学华西临床医学院 眼视光学系 (成都 610041)Department of Optometry and Vision Sciences, West China School of Medicine, Sichuan University, Chengdu 610041, China
| | - 必 杨
- 四川大学华西临床医学院 眼视光学系 (成都 610041)Department of Optometry and Vision Sciences, West China School of Medicine, Sichuan University, Chengdu 610041, China
- 四川大学计算机学院 计算机科学与技术系 (成都 610065)College of Computer Science, Sichuan University, Chengdu 610065, China
- 四川大学华西医院 眼视光学与视觉科学研究室 (成都 610041)Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University, Chengdu 610041, China
| | - 陇黔 刘
- 四川大学华西临床医学院 眼视光学系 (成都 610041)Department of Optometry and Vision Sciences, West China School of Medicine, Sichuan University, Chengdu 610041, China
- 四川大学计算机学院 计算机科学与技术系 (成都 610065)College of Computer Science, Sichuan University, Chengdu 610065, China
- 四川大学华西医院 眼视光学与视觉科学研究室 (成都 610041)Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University, Chengdu 610041, China
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Silva-Viguera MC, Pérez-Barea A, Bautista-Llamas MJ. Tear film layers and meibomian gland assessment in patients with type 1 diabetes mellitus using a noninvasive ocular surface analyzer: a cross-sectional case–control study. Graefes Arch Clin Exp Ophthalmol 2022; 261:1483-1492. [PMID: 36512089 PMCID: PMC10148784 DOI: 10.1007/s00417-022-05934-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 11/24/2022] [Accepted: 11/27/2022] [Indexed: 12/15/2022] Open
Abstract
Abstract
Purpose
To assess the tear film layers and Meibomian glands by a noninvasive ocular surface analyzer in patients with and without type 1 diabetes mellitus (T1DM).
Methods
Eighty-eight participants were enrolled in this study: 44 patients with T1DM without diabetic retinopathy, and 44 patients as a control group, between 18 and 49 years old. Limbal and bulbar redness classification, lipid layer thickness (LLT), tear meniscus height (TMH), first and mean noninvasive tear break-up time (FNIBUT and MNIBUT, respectively), and Meibomian glands loss (MGL) were assessment through the ICP Ocular Surface Analyzer (OSA). Schirmer’s I test (SIT), the fluorescein tear break-up time test (TFBUT), OSDI and SPEED questionnaires, and percentage of glycosylated hemoglobin (HbA1c) were also tested.
Results
The T1DM group showed higher limbal and bulbar redness (p = 0.010) and lower LLT (p < 0.001), TMH (p < 0.001), FNIBUT (p < 0.001), MNIBUT (p < 0.001), SIT (p = 0.001), and TFBUT (p < 0.001) than the control group. A higher percentage of MGL was found in the T1DM group in the upper (p = 0.097) and lower (p < 0.001) eyelids. No significant differences were found in dry eye symptoms across the OSDI and SPEED questionnaires between the two groups.
Conclusion
Patients with T1DM without signs of retinopathy showed involvement of the mucoaqueous and lipid layers of the tear film, as well as a higher percentage of MGL, using a noninvasive analyzer. Dry eye disease in people with T1DM cannot be ruled out by anamnesis and subjective symptom questionnaires alone; therefore, these patients should undergo regular anterior pole examinations.
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Affiliation(s)
- María-Carmen Silva-Viguera
- Department of Physics of Condensed Matter, Optics Area, Physics Faculty, University of Seville, Reina Mercedes St, Seville, Spain
- Vision Research Group (CIVIUS), University of Seville, Seville, Spain
| | - Alicia Pérez-Barea
- Department of Physics of Condensed Matter, Optics Area, Physics Faculty, University of Seville, Reina Mercedes St, Seville, Spain
| | - María-José Bautista-Llamas
- Department of Physics of Condensed Matter, Optics Area, Physics Faculty, University of Seville, Reina Mercedes St, Seville, Spain.
- Vision Research Group (CIVIUS), University of Seville, Seville, Spain.
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Short-term results of a pulsed therapy with hydrocortisone eye drops to treat moderate to severe dry eye in primary Sjögren syndrome patients. Graefes Arch Clin Exp Ophthalmol 2022; 261:1029-1036. [PMID: 36192456 DOI: 10.1007/s00417-022-05840-1] [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: 04/15/2022] [Revised: 09/03/2022] [Accepted: 09/16/2022] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND We investigated the safety and efficacy of short-term treatment with topical low-dose hydrocortisone sodium phosphate 0.335% (PFH) in patients with moderate to severe primary Sjögren syndrome (SS)-related dry eye disease (DED). METHODS A retrospective single-centre interventional study. All patients received PFH for 6 days with a pulsed posology: three times daily for 2 days, twice daily for 2 days, and once daily for 2 days. This scheme was repeated for 3 consecutive months and then alternated for 3 months. Data were collected at baseline, 3 months, and 6 months of follow-up. RESULTS A total of 40 SS patients were enrolled. Conjunctival hyperaemia and corneal-conjunctival stain significantly improved (p < 0.001). Ocular Surface Disease Index score reduced significantly between baseline and 3 months and between baseline and 6 months (p < 0.001). The tear film osmolarity lowered significantly in each eye from baseline to 3 months and from baseline to 6 months (p = 0.002 and p = 0.037, respectively). Comparing results at 3 and 6 months, the Ocular Surface Disease Index score (p = 1.000), the frequency of lacrimal substitutes installation (p = 0.632), and tear film osmolarity (right eye p = 0.518, left eye p = 1.000) did not change significantly. Intraocular pressure did not change during the study period. CONCLUSION PFH eye drops with a pulsed posology improve signs and symptoms, not affecting the intraocular pressure in SS-related DED. Therefore, this pulsed treatment is safe and efficacious.
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Sánchez-González MC, Capote-Puente R, García-Romera MC, De-Hita-Cantalejo C, Bautista-Llamas MJ, Silva-Viguera C, Sánchez-González JM. Dry eye disease and tear film assessment through a novel non-invasive ocular surface analyzer: The OSA protocol. Front Med (Lausanne) 2022; 9:938484. [PMID: 36035382 PMCID: PMC9399399 DOI: 10.3389/fmed.2022.938484] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 07/21/2022] [Indexed: 11/18/2022] Open
Abstract
We describe the role of OSA as a new instrument in the study of dry eye, and we recommend a protocol for conducting the tests as well as describe the advantages and disadvantages compared with other instruments. A comparison with other ocular surface devices (Tearscope Plus, Keratograph 5M, anterior-segment ocular coherence tomography, Easy Tear View-Plus, LipiView, IDRA, and LacryDiag) were presented due to manual or automatic procedure and objective or subjective measurements. The purpose of this study was to describe the OSA as new non-invasive dry eye disease diagnostic device. The OSA is a device that can provide accurate, non-invasive and easy-to-use parameters to specifically interpret distinct functions of the tear film. This OSA protocol proposed a lesser to higher non-invasive ocular surface dry eye disease tear film diagnostic methodology. A complete and exhaustive OSA and OSA Plus examination protocol was presented within the subjective questionnaire (Dry Eye Questionnaire 5, DEQ5), limbal and bulbar redness classification (within the Efron grade Scale, interferometry lipid layer thickness (LLT) (according to Guillon pattern), tear meniscus height (manually or automatic), first and mean non-invasive break up time (objective and automatic) and meibomian gland (MG) dysfunction grade and percentage (objective and automatic). The OSA and OSA Plus devices are novel and relevant dry eye disease diagnostic tools; however, the automatization and objectivity of the measurements can be increased in future software or device updates. The new non-invasive devices supposed represent a renewal in the dry eye disease diagnosis and introduce a tendency to replace the classic invasive techniques that supposed less reliability and reproducibility.
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López-López M, Regueiro U, Bravo SB, Chantada-Vázquez MDP, Pena C, Díez-Feijoo E, Hervella P, Lema I. Shotgun Proteomics for the Identification and Profiling of the Tear Proteome of Keratoconus Patients. Invest Ophthalmol Vis Sci 2022; 63:12. [PMID: 35551575 PMCID: PMC9123485 DOI: 10.1167/iovs.63.5.12] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose The qualitative approach followed in this study aims to obtain an extensive view of the keratoconus (KC) tear proteome, which could highlight proteins previously undetected and enlarge our knowledge of the disease's pathophysiology. Methods Twenty-five patients diagnosed with KC and 25 control subjects were studied in a prospective, cross-sectional study. KC screening examinations, including clinical and tomographic examinations, were performed on all participants. Tear samples were collected using Schirmer strips and analyzed by liquid chromatography-tandem mass spectrometry in a data-dependent workflow. A spectral count was used as a semiquantification tool. The tear proteomes of both groups were identified and profiled, and the functional interactions and biological characterization of differential proteins were analyzed using in silico tools. Results We identified a total of 232 proteins, of whom 133 were expressed in both groups’ samples; 41 were observed only in control samples and 58 were identified just in tears of patients with KC. A semiquantitative analysis showed the dysregulation of 17 proteins in the KC samples. An in silico analysis linked proteins only expressed in KC samples to oxidative stress, skin development, and apoptosis. The dysregulation of proteins involved in iron transport, inflammation, oxidative stress, and protease inhibition was observed in the semiquantitative results. Conclusions A shotgun analysis showed that the tear proteome of patients with KC differed from controls by more than one-third of the total proteins identified, highlighting the relationship of the proteins only expressed in KC tears with processes of cell death, oxidative damage, and inflammation. The underexpression of proteins involved in iron pathways might support the iron imbalance as a contributing factor to cellular damage and death in KC disease.
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Affiliation(s)
- Maite López-López
- Corneal Neurodegeneration Group (RENOIR), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.,Department of Surgery and Medical-Surgical Specialties, Faculty of Optics and Optometry, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Uxía Regueiro
- Corneal Neurodegeneration Group (RENOIR), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.,Department of Surgery and Medical-Surgical Specialties, Faculty of Optics and Optometry, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Susana Belén Bravo
- Proteomic Unit, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | | | - Carmen Pena
- Proteomic Unit, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Elío Díez-Feijoo
- Corneal Neurodegeneration Group (RENOIR), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.,Department of Surgery and Medical-Surgical Specialties, Faculty of Optics and Optometry, University of Santiago de Compostela, Santiago de Compostela, Spain.,Galician Institute of Ophthalmology (INGO), Conxo Provincial Hospital, Santiago de Compostela, Spain
| | - Pablo Hervella
- Neuroimaging and Biotechnology Group (NOBEL), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Isabel Lema
- Corneal Neurodegeneration Group (RENOIR), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.,Department of Surgery and Medical-Surgical Specialties, Faculty of Optics and Optometry, University of Santiago de Compostela, Santiago de Compostela, Spain.,Galician Institute of Ophthalmology (INGO), Conxo Provincial Hospital, Santiago de Compostela, Spain
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Rodriguez-Garcia A, Babayan-Sosa A, Ramirez-Miranda A, Santa Cruz-Valdes C, Hernandez-Quintela E, Hernandez-Camarena JC, Ramos-Betancourt N, Velasco-Ramos R, Ruiz-Lozano RE. A Practical Approach to Severity Classification and Treatment of Dry Eye Disease: A Proposal from the Mexican Dry Eye Disease Expert Panel. Clin Ophthalmol 2022; 16:1331-1355. [PMID: 35520107 PMCID: PMC9061212 DOI: 10.2147/opth.s351898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 04/13/2022] [Indexed: 11/23/2022] Open
Abstract
Dry eye disease (DED) has a higher prevalence than many important systemic disorders like cardiovascular disease and diabetes mellitus, representing a significant quality of life burden for the affected patients. It is a common reason for consultation in general eye clinics worldwide. Nowadays, the diagnostic and therapeutic approach at the high corneal and ocular surface specialty level should be reserved for cases of severe and chronic dry eye disease associated with systemic autoimmune diseases or complicated corneal and ocular surface pathologies. In such cases, the diagnostic and therapeutic approach is often complex, elaborate, time-consuming, and costly due to the use of extensive dry eye questionnaires, noninvasive electronic diagnostic equipment, and clinical laboratory and ancillary tests. However, other eye care specialists attend a fair amount of DED cases; therefore, its diagnosis, classification, and management should be simple, practical, achievable, and effective. Considering that many patients attending non-specialized dry eye clinics would benefit from better ophthalmological attention, we decided to elaborate a practical DED classification system based on disease severity to help clinicians discriminate cases needing referral to subspecialty clinics from those they could attend. Additionally, we propose a systematic management approach and general management considerations to improve patients' therapeutic outcomes according to disease severity.
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Affiliation(s)
- Alejandro Rodriguez-Garcia
- Tecnologico de Monterrey, School of Medicine and Health Sciences, Institute of Ophthalmology and Visual Sciences, Cornea and External Disease Service, Monterrey, Mexico
| | - Alejandro Babayan-Sosa
- Cornea and Refractive Surgery Service, Fundación Hospital Nuestra Señora de la Luz, I. A. P, Universidad Nacional Autonoma de Mexico, Mexico City, Mexico
| | - Arturo Ramirez-Miranda
- Cornea and Refractive Surgery Service, Instituto de Oftalmología Conde de Valenciana, I.A.P, Universidad Nacional Autonoma de Mexico, Mexico City, Mexico
| | - Concepcion Santa Cruz-Valdes
- Cornea and Refractive Surgery Service, Instituto de Oftalmología Conde de Valenciana, I.A.P, Universidad Nacional Autonoma de Mexico, Mexico City, Mexico
| | | | - Julio C Hernandez-Camarena
- Tecnologico de Monterrey, School of Medicine and Health Sciences, Institute of Ophthalmology and Visual Sciences, Cornea and External Disease Service, Monterrey, Mexico
| | | | - Regina Velasco-Ramos
- Cornea and Refractive Surgery Service, Fundación Hospital Nuestra Señora de la Luz, I. A. P, Universidad Nacional Autonoma de Mexico, Mexico City, Mexico
| | - Raul E Ruiz-Lozano
- Tecnologico de Monterrey, School of Medicine and Health Sciences, Institute of Ophthalmology and Visual Sciences, Cornea and External Disease Service, Monterrey, Mexico
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Dermenoudi M, Matsou A, Keskini C, Anastasopoulos E. Ocular Surface Disease Signs and Symptoms in Patients with Pseudoexfoliative Glaucoma: A Case—Control Study. Vision (Basel) 2022; 6:vision6010011. [PMID: 35225970 PMCID: PMC8883900 DOI: 10.3390/vision6010011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 02/04/2022] [Accepted: 02/07/2022] [Indexed: 11/24/2022] Open
Abstract
Purpose: The present study evaluates the differences in the prevalence of the signs and symptoms of ocular surface disease (OSD) in patients with PEX glaucoma (PEXG), compared to other glaucoma types (non-PEXG). Methods: Patients with non-PEXG and PEXG were prospectively examined for the presence and severity of OSD signs and questioned for symptoms using the OSDI (ocular surface disease index) questionnaire. Results: 116 patients were prospectively enrolled (58 non-PEXG and 58 PEXG). PEXG subjects who were older, had lower central corneal thickness (CCT) values, at a more advanced glaucoma stage and required more IOP lowering drops. OSD signs were prevalent in both groups: conjunctival hyperemia (74.5% non-PEXG vs. 94.8% PEXG), eyelid redness (70.7% vs. 96.6%), conjunctival (74.1% vs. 93.1%) and corneal fluorescein staining (81% vs. 93.1%) and abnormal TFBUT (82.8% vs. 87.9%). When adjusted for potential confounders, (older age, thinner CCT, more advanced glaucoma in PEXG) eyelid redness remained the only parameter significantly associated with PEXG, being 11 times more likely to occur in this group (p = 0.037). Conclusion: Subjects with PEXG presented a higher frequency of signs of OSD compared to other glaucoma types. When accounting for confounding factors, the only difference between the groups was the significantly higher presence (11 times more likely) of eyelid redness in PEXG, suggesting, in addition to glaucoma treatment, the impact of PEX on ocular surface integrity.
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Affiliation(s)
| | - Artemis Matsou
- Ophthalmology Department, Queen Victoria Hospital NHS Foundation Trust, East Grinstead RH19 3DZ, UK;
| | - Christina Keskini
- 1st Department of Ophthalmology, Aristotle University of Thessaloniki, 54621 Thessaloniki, Greece;
| | - Eleftherios Anastasopoulos
- 2nd Department of Ophthalmology, Aristotle University of Thessaloniki, 56403 Thessaloniki, Greece
- Correspondence: ; Tel.: +30-231-3323675; Fax: +30-231-0444105
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Cheng C, Zhu M, Lin T, Chen Z, Zeng W, Li K, Xue R, Duan F, Wu K. Recharacterization of superior limbic keratoconjunctivitis via a subdividing grading method in 236 Chinese patients. Graefes Arch Clin Exp Ophthalmol 2022; 260:2291-2298. [PMID: 35113250 DOI: 10.1007/s00417-022-05575-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 01/17/2022] [Accepted: 01/21/2022] [Indexed: 11/04/2022] Open
Abstract
PURPOSE Superior limbic keratoconjunctivitis (SLK) is an uncommon and often overlooked chronic ocular surface disease. This retrospective consecutive case series study on Chinese patients aimed to characterize the features of this disease, including those undescribed in previous literature. METHODS Two hundred thirty-six patients diagnosed with SLK were enrolled into this consecutive case study from 2016 to 2019. The demographics, symptoms, Ocular Surface Disease Index, and ocular signs were collected and analyzed. A scoring system (SLK scale index, SSI) that integrated five major sign scores was applied to evaluate SLK severity. RESULTS Of the 236 SLK patients, dryness was the most common complaint (59.3%). Of 459 SLK eyes, superior limbus/conjunctival staining (SCS) was present in 98% eyes, followed by the superior tarsal conjunctival alterations (85.2%) and superior bulbar conjunctiva hyperemia (80.8%). Approximately 63% of eyes were accompanied by corneal staining. Superior bulbar conjunctivochalasis was a relatively rare sign (41.6%). Among the five major signs, only the prevalence of SCS gradually increased with its severity. In addition, fluorescein staining at the inferior limbus and adjacent conjunctiva (ICS) was found positive in 163 eyes of 84 patients (36%) who had significantly higher SSI than those without ICS (p = 0.013). CONCLUSIONS We found that SCS is the most common out of the 5 typical signs of SLK. ICS, a new sign, occurred in one-third of patients. SCS, a simple marker of SLK, as well as SSI, an integrated evaluation system, had the advantage of evaluating the severity and objectively characterizing SLK in clinical practice.
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Affiliation(s)
- Chao Cheng
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, People's Republic of China
| | - Minyi Zhu
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, People's Republic of China.,Department of Ophthalmology, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, People's Republic of China
| | - Tianlan Lin
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, People's Republic of China
| | - Ziyan Chen
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, People's Republic of China
| | - Weiting Zeng
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, People's Republic of China
| | - Kunke Li
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, People's Republic of China
| | - Ran Xue
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, People's Republic of China
| | - Fang Duan
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, People's Republic of China
| | - Kaili Wu
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, People's Republic of China.
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11
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Ahn H, Kim BY, Kim J, Ji YW, Jun I, Kim TI, Lee HK, Seo KY. How Long to Continue Eyelid Hygiene to Treat Meibomian Gland Dysfunction. J Clin Med 2022; 11:jcm11030529. [PMID: 35159982 PMCID: PMC8837031 DOI: 10.3390/jcm11030529] [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: 11/25/2021] [Revised: 01/04/2022] [Accepted: 01/18/2022] [Indexed: 02/01/2023] Open
Abstract
To determine the efficacy duration of eyelid hygiene for meibomian gland dysfunction (MGD) treatment, a total of 1015 participants with primary MGD, followed for at least 6 months, were enrolled. The participants were classified into the eyelid hygiene group and the control group. The participants who had stopped eyelid hygiene at any point in the observation period after the initial 2 months were classified into the withdrawal group. Analysis was conducted with a generalized linear mixed model. Treatment group, age, sex, ocular surface inflammation, anti-inflammatory treatments, and baseline MGD subtype were considered as fixed effects, and the individual factor was considered as a random effect. The MGD stage decreased significantly for the observational period in the eyelid hygiene group (p < 0.001). Approximately 40.1% of the participants continuously maintained eyelid hygiene throughout the observational period. The MGD stage in the eyelid hygiene group continued to decrease for 6 months and was maintained thereafter. After 4 months of stopping eyelid hygiene, the MGD stage in the withdrawal group was worse than in the eyelid hygiene group (p < 0.001) and similar to that in the control group (p = 0.762). Maintaining eyelid hygiene was significantly effective in MGD treatment. Efficacy increased with treatment for 6 months, and the efficacy duration was maintained for 4 months even after stopping eyelid hygiene. Therefore, we recommend that patients with MGD maintain eyelid hygiene, and compliance should be checked continuously.
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Affiliation(s)
- Hyunmin Ahn
- Department of Ophthalmology, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea; (H.A.); (B.Y.K.); (Y.W.J.); (I.J.); (T.-i.K.); (H.K.L.)
- Department of Medicine, Armed Forces Daegu Hospital, Daegu 38427, Korea;
| | - Bo Yi Kim
- Department of Ophthalmology, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea; (H.A.); (B.Y.K.); (Y.W.J.); (I.J.); (T.-i.K.); (H.K.L.)
| | - Jinyoung Kim
- Department of Medicine, Armed Forces Daegu Hospital, Daegu 38427, Korea;
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Yong Woo Ji
- Department of Ophthalmology, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea; (H.A.); (B.Y.K.); (Y.W.J.); (I.J.); (T.-i.K.); (H.K.L.)
| | - Ikhyun Jun
- Department of Ophthalmology, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea; (H.A.); (B.Y.K.); (Y.W.J.); (I.J.); (T.-i.K.); (H.K.L.)
| | - Tae-im Kim
- Department of Ophthalmology, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea; (H.A.); (B.Y.K.); (Y.W.J.); (I.J.); (T.-i.K.); (H.K.L.)
| | - Hyung Keun Lee
- Department of Ophthalmology, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea; (H.A.); (B.Y.K.); (Y.W.J.); (I.J.); (T.-i.K.); (H.K.L.)
| | - Kyoung Yul Seo
- Department of Ophthalmology, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea; (H.A.); (B.Y.K.); (Y.W.J.); (I.J.); (T.-i.K.); (H.K.L.)
- Correspondence: ; Tel.: +82-2-2228-3574; Fax: +82-2-312-0541
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12
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Mousavi M, Garaszczuk IK, De Jesus DA, Szczesna-Iskander DH, Armstrong RA, Nichols KK, Iskander DR. Tear Film Surface Quality in Modern Daily Disposable Contact Lens Wear. Eye Contact Lens 2021; 47:631-637. [PMID: 34797270 DOI: 10.1097/icl.0000000000000811] [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: 05/20/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES As reported previously, tear film surface quality (TFSQ) should be considered in contact lens (CL) fitting. This study followed noninvasive keratograph tear film break-up time (NIKBUT) in CL wearers for 12 months to validate its clinical utility in predicting CL performance. METHODS Fifty-five subjects (M/F=17/38) aged 26±4 years were prescribed silicone hydrogel or hydrogel CLs. The study included baseline measurements without CLs; 2 visits for CL fitting and control; follow-up after 3, 6, and 12 months of CL wear; and postwear visit without CLs. Ocular Surface Disease Index (OSDI), 8-Item Contact Lens Dry Eye Questionnaire (CLDEQ-8), first and mean NIKBUT (F/M-NIKBUT), fluorescein tear film break-up time (FBUT), and ocular surface staining were evaluated. RESULTS Post hoc analysis of each pair of visits showed differences between baseline and all CL visits for F-NIKBUT, M-NIKBUT, FBUT, and corneal staining. No difference was reported in symptoms. In addition, differences between baseline and postwear visits were noted in OSDI, M-NIKBUT, FBUT, and corneal staining, with three of the latter parameters showing a downward trend. CONCLUSIONS No changes in TFSQ and symptoms were reported over 12 months. Introducing NIKBUT as part of routine CL fitting is advised to improve CL fit and predict success.
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Affiliation(s)
- Maryam Mousavi
- Department of Biomedical Engineering (M.M., D.R.I.), Wroclaw University of Science and Technology, Poland ; School of Optometry (M.M., K.K.N.), University of Alabama at Birmingham, Birmingham, AL; Department of Optics and Optometry and Vision Sciences (I.K.G., D.H.S.-I.), University of Valencia, Valencia, Spain ; Department of Optics and Photonics (I.K.G.), Wroclaw University of Science and Technology, Wrocław, Poland; Biomedical Imaging Group Rotterdam (D.A.D.J.), Department of Radiology and Nuclear Medicine, The Netherlands; and Aston University School of Life and Health Sciences (R.A.A.), Birmingham, United Kingdom
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13
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Simpson T, Begley CG, Situ P, Feng Y, Nelson JD, Caffery B, Springs C, Connell SB. Canonical Grading Scales of Corneal and Conjunctival Staining Based on Psychophysical and Physical Attributes. Transl Vis Sci Technol 2021; 10:17. [PMID: 34403476 PMCID: PMC8374974 DOI: 10.1167/tvst.10.9.17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Purpose In this study, we apply psychophysical scaling principles based on physical (photometric) attributes of images to better understand the factors involved in clinician judgement of ocular surface staining and, using that knowledge, to develop photographic scales for the assessment of staining for dry eye (DE) and related conditions. Methods Subjects with noninfectious ocular surface staining were enrolled at five clinical sites. Following instillation of fluorescein, photographs of corneal staining were taken every 30 seconds for at least 5 minutes. The same procedure was followed for conjunctival staining after instillation of 2 µl of 1% lissamine green. A subset of the best corneal and bulbar conjunctival staining images were anonymized and a spectroradiometer measured photometric attributes (luminance and chromaticity). The images were scaled psychophysically by study investigators, who participated in constructing grading scales based on physical and psychophysical analyses. The final grading scales were refined following consultation with outside DE experts. Results Photographs were collected from 142 subjects (81% women), with an average age of 58 ± 17 years; 89% were diagnosed with DE. There was a monotonic relationship between between physical measurements and psychophysically scaled staining of both corneal (fluorescein) and bulbar (lissamine green) staining. Michelson contrast and u’ (chromaticity) accounted for 66% and 64% of the variability in the psychophysically scaled images of fluorescein corneal and lissamine green conjunctival staining, respectively. Translational Relevance This paper provides examples of the first ever clinically usable ocular surface staining scales validated using psychophysical scaling and the physical attributes (luminance and chromaticity) of the staining itself. In addition, it provides a generalizable method for the development of other clinical scales of ocular appearance.
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Affiliation(s)
- Trefford Simpson
- University of Waterloo, School of Optometry and Vision Science, Waterloo, Ontario, Canada
| | | | - Ping Situ
- Indiana University School of Optometry, Bloomington, IN, USA
| | - Yunwei Feng
- University of Waterloo, School of Optometry and Vision Science, Waterloo, Ontario, Canada
| | | | | | - Clark Springs
- Indiana University Department of Ophthalmology, Indianapolis, IN, USA
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14
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López-López M, Regueiro U, Bravo SB, Chantada-Vázquez MDP, Varela-Fernández R, Ávila-Gómez P, Hervella P, Lema I. Tear Proteomics in Keratoconus: A Quantitative SWATH-MS Analysis. Invest Ophthalmol Vis Sci 2021; 62:30. [PMID: 34431975 PMCID: PMC8399462 DOI: 10.1167/iovs.62.10.30] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Purpose To elucidate dysregulated proteins in keratoconus (KC) to provide a better understanding of the molecular mechanisms that lead to the development of the disease using sequential window acquisition of all theoretical mass spectra (SWATH-MS) as a protein quantification tool of the tear proteomic profile. Methods Prospective cross-sectional study that includes 25 keratoconic eyes and 25 healthy eyes. All participants underwent a clinical, tomographic, and aberrometric exam. Tear sample was collected using Schirmer strips and analyzed by liquid chromatography with tandem mass spectrometry. SWATH-MS was used as a quantification tool of the tear proteomic profile. The expression of the quantified proteins was compared between groups, and the biological and molecular functions of the dysregulated proteins as well as their functional relationships were studied by in silico analysis. Results A total of 203 proteins were quantified in tear samples of patients with KC and control participants, of which 18 showed differential expression between groups (P < 0.05). An increase in the expression of 7 proteins and a decrease in the expression of 11 proteins were observed. Protein–protein interactions and gene ontology analysis showed the involvement of these dysregulated proteins in structural, inflammatory-immune, iron homeostasis, oxidative stress, and extracellular matrix proteolysis processes. Conclusions Tear protein quantification has revealed the dysregulation of proteins involved in biological processes previously associated with KC. Among them, iron homeostasis should be highlighted as a relevant pathway in the KC pathophysiology, and it should be taken into account in the development of therapeutic targets to cope with tissue damage derived from iron accumulation and toxicity.
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Affiliation(s)
- Maite López-López
- Department of Surgery and Medical-Surgical Specialties. Faculty of Optics and Optometry, Universidade de Santiago de Compostela, Santiago de Compostela, Spain.,Clinical Neurosciences Research Laboratory, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Uxía Regueiro
- Department of Surgery and Medical-Surgical Specialties. Faculty of Optics and Optometry, Universidade de Santiago de Compostela, Santiago de Compostela, Spain.,Clinical Neurosciences Research Laboratory, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Susana B Bravo
- Proteomic Unit, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | | | - Rubén Varela-Fernández
- Clinical Neurosciences Research Laboratory, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.,Department of Pharmacology, Pharmacy and Pharmaceutical Technology. Universidade de Santiago de Compostela (USC), Campus Vida, Santiago de Compostela, Spain
| | - Paulo Ávila-Gómez
- Clinical Neurosciences Research Laboratory, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Pablo Hervella
- Clinical Neurosciences Research Laboratory, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Isabel Lema
- Department of Surgery and Medical-Surgical Specialties. Faculty of Optics and Optometry, Universidade de Santiago de Compostela, Santiago de Compostela, Spain.,Clinical Neurosciences Research Laboratory, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.,Instituto Galego de Oftalmoloxía (INGO), Hospital Provincial de Conxo, Santiago de Compostela, Spain
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15
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A soft and transparent contact lens for the wireless quantitative monitoring of intraocular pressure. Nat Biomed Eng 2021; 5:772-782. [PMID: 33941897 DOI: 10.1038/s41551-021-00719-8] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 03/22/2021] [Indexed: 02/02/2023]
Abstract
Continuous detection of raised intraocular pressure (IOP) could benefit the monitoring of patients with glaucoma. Current contact lenses with embedded sensors for measuring IOP are rigid, bulky, partially block vision or are insufficiently sensitive. Here, we report the design and testing in volunteers of a soft and transparent contact lens for the quantitative monitoring of IOP in real time using a smartphone. The contact lens incorporates a strain sensor, a wireless antenna, capacitors, resistors, stretchable metal interconnects and an integrated circuit for wireless communication. In rabbits, the lens provided measurements that match those of a commercial tonometer. In ten human participants, the lens proved to be safe, and reliably provided accurate quantitative measurements of IOP without inducing inflammation.
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16
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A Pilot Proteomic Study of Normal Human Tears: Leptin as a Potential Biomarker of Metabolic Disorders. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11125755] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The concentrations of insulin, leptin, active ghrelin, C-peptide and gastric inhibitory polypeptide (GIP) and their inter-day variations were examined in normal human tears. In addition, correlations between the concentrations of these metabolic proteins and ocular surface parameters were determined. Subjects with healthy ocular surfaces attended three visits, with 7-day intervals. Tear evaporation rate (TER) and non-invasive tear break-up time (NITBUT) were assessed, and a total of 2 µL tears were collected from all subjects. Tear fluid concentrations of insulin, leptin, active ghrelin, C-peptide and GIP were measured by multiplex bead analysis. Insulin was the most highly expressed metabolic protein, followed by leptin, C-peptide, active ghrelin and GIP. Of these, only active ghrelin had a significant inter-day variation (p < 0.05). There was no inter-day variation in the mean concentrations of the other metabolic proteins. Leptin had a strong intra-class reproducibility. No correlation was detected between tear metabolic protein concentrations and ocular surface parameters. This pilot study shows, for the first time, that active ghrelin and GIP are detectable in healthy tears. The strong intra-class reproducibility for leptin shows that it could be used as a potential tear fluid biomarker and, possibly, in determining the effects of metabolic disorders on the ocular surface.
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17
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Schlatter A, Hirn C, Palkovits S, Werkmeister RM, Findl O, Garhöfer G, Schmidl D. Anwendungsmöglichkeiten der optischen Kohärenztomographie beim trockenen Auge. SPEKTRUM DER AUGENHEILKUNDE 2021. [DOI: 10.1007/s00717-021-00490-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
ZusammenfassungDurch die stetige Weiterentwicklung und Verbesserung der Technik hat die optische Kohärenztomographie (OCT) in den letzten Jahren neue Möglichkeiten zur Beurteilung der Strukturen des vorderen Augenabschnittes eröffnet. Aufgrund der Darstellung kleinster Strukturen, wie beispielsweise des Tränenfilms, nimmt die OCT in der Diagnostik und Verlaufsbeurteilung des trockenen Auges eine immer wichtigere Rolle ein. Der vorliegende Beitrag gibt einen Überblick über die derzeitigen Einsatzmöglichkeiten der OCT beim trockenen Auge.
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18
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Fast versus gradual adaptation of soft monthly contact lenses in neophyte wearers. Cont Lens Anterior Eye 2021; 45:101469. [PMID: 34034960 DOI: 10.1016/j.clae.2021.101469] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 04/30/2021] [Accepted: 05/09/2021] [Indexed: 11/23/2022]
Abstract
AIM To determine if a gradual adaptation period is necessary for neophytes when fitted with modern hydrogel or silicone hydrogel reusable disposable contact lenses. METHOD Across four sites, 74 neophytes (18-28 years) were randomly assigned to a reusable lens cleaned nightly with Opti-Free® Puremoist® multi-purpose contact lens solution: Proclear® (hydrogel) or Biofinity® (silicone hydrogel) and an adaptation schedule: fast (10 h wear from the first day) or gradual (4 h on the first day, increasing their wear time by 2 h on each subsequent day until they had reached 10 h). Masked investigators graded ocular surface physiology and non-invasive tear breakup time (NIBUT) and a range of comfort, vision and lens handling subjective ratings (0-100 visual analogue scales) were recorded at the baseline visit and after 10 h of lens wear, 4-6 days and 12-14 days after lens fitting. Subjective scores were also repeated after 7 days. RESULTS There was no difference (p > 0.05) in ocular surface physiology or NIBUT between fast and gradual adaptation groups at any time point in either lens type with the exception of increased corneal staining (p = 0.019) in the silicone hydrogel fast adaptation group after 4-6 days, but was similar by 12-14 days. Subjective scores were also similar across the visits and lens types with the exception of 'lens awareness' (p = 0.019) which was less in the gradual versus the fast adaptation silicone hydrogel lens group at 12-14 days. CONCLUSION There seems to be no clinical benefit for recommending a gradual adaptation period in new wearers fitted with modern soft reusable disposable contact lenses. The findings of this work add to a growing body of evidence suggesting that such advice is unnecessary in regular soft contact lens wear, which has important ramifications for the initial clinical management of these patients.
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19
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Romano V, Steger B, Ahmad M, Coco G, Pagano L, Ahmad S, Zhao Y, Zheng Y, Kaye SB. Imaging of vascular abnormalities in ocular surface disease. Surv Ophthalmol 2021; 67:31-51. [PMID: 33992663 DOI: 10.1016/j.survophthal.2021.05.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 04/25/2021] [Accepted: 05/03/2021] [Indexed: 12/13/2022]
Abstract
The vascular system of the ocular surface plays a central role in infectious, autoimmune, inflammatory, traumatic and neoplastic diseases. The development, application, and monitoring of treatments for vascular abnormalities depends on the in vivo analysis of the ocular surface vasculature. Until recently, ocular surface vascular imaging was confined to biomicroscopic and color photographic assessment, both limited by poor reproducibility and the inability to image lymphatic vasculature in vivo. The evolvement and clinical implementation of innovative imaging modalities including confocal microscopy, intravenous, and optical coherence tomography-based angiography now allows standardized quantitative and functional vascular assessment with potential applicability to automated analysis algorithms and diagnostics.
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Affiliation(s)
- Vito Romano
- Corneal and External Eye Disease Service, The Royal Liverpool University Hospital, Liverpool, UK; Department of Eye and Vision Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK.
| | - Bernhard Steger
- Department of Ophthalmology, Medical University of Innsbruck, Innsbruck, Austria
| | - Mohammad Ahmad
- Corneal and External Eye Disease Service, The Royal Liverpool University Hospital, Liverpool, UK
| | - Giulia Coco
- Corneal and External Eye Disease Service, The Royal Liverpool University Hospital, Liverpool, UK; Department of Clinical Science and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Luca Pagano
- Corneal and External Eye Disease Service, The Royal Liverpool University Hospital, Liverpool, UK; Humanitas Clinical and Research, Rozzano (Mi) Italy
| | | | - Yitian Zhao
- Department of Eye and Vision Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK; Cixi Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, China
| | - Yalin Zheng
- Department of Eye and Vision Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| | - Stephen B Kaye
- Corneal and External Eye Disease Service, The Royal Liverpool University Hospital, Liverpool, UK; Department of Eye and Vision Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
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20
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Assessment of a Novel Lens Surface Treatment for Scleral Lens Wearers With Dry Eye. Eye Contact Lens 2021; 47:308-313. [PMID: 33156128 DOI: 10.1097/icl.0000000000000754] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To compare lens comfort and dry eye (DE) symptoms of DE scleral lens (SL) wearers fit with polyethylene glycol (PEG)-based surface-treated and untreated SLs. Dry eye signs, comfortable SL wearing time (WT), vision quality, and lens-related ocular surface changes were also assessed. METHODS Twenty-one SL wearers with DE and SL discomfort were enrolled in a double-masked crossover study. Participants were randomized to wear their untreated or PEG (Tangible Hydra-PEG, Tangible Science; Redwood, CA) surface-treated SL of the same parameters first for 30 days. Lens comfort, DE symptoms, and ocular surface assessments were measured at baseline, after the first test period, and after the crossover. Comfortable lens WT and frequency of foggy vision were recorded. Comparisons were assessed using paired t tests or Wilcoxon signed-rank tests. RESULTS Polyethylene glycol-treated SL wear resulted in significantly improved: lens comfort (P=0.003), DE symptoms (P=0.004), corneal sodium fluorescein staining (P=0.01), temporal conjunctival lissamine green staining (P=0.01), lid wiper epitheliopathy (P=0.002), conjunctival papillae (P=0.003), frequency of foggy vision (P=0.002), tear break-up time (TBUT) (P=0.01), and comfortable lens WT (P=0.002) compared with untreated wear. There were no significant changes between treated and untreated lens wear for TBUT over the SL (P=0.14) and nasal conjunctival lissamine green staining (P=0.06). CONCLUSIONS Polyethylene glycol surface-treated SLs provided improved comfort, reduced DE symptoms, and reduced ocular surface compromise compared with untreated SLs for participants with DE.
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21
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Arroyo-Del Arroyo C, Fernández I, Novo-Diez A, Blanco-Vázquez M, López-Miguel A, González-García MJ. Contact Lens Discomfort Management: Outcomes of Common Interventions. Eye Contact Lens 2021; 47:256-264. [PMID: 32649388 DOI: 10.1097/icl.0000000000000727] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE To assess the consecutive implementation of habitual contact lens discomfort (CLD) management strategies: lid hygiene, daily disposable CL (DDCL) fitting, and artificial tear (AT) supplementation. METHODS Contact lens (CL) wearers with CLD symptoms (CLDEQ-8 ≥12 points) were included in the study. Subjects with Meibomian gland dysfunction (MGD) were instructed to perform lid hygiene. All participants were fitted with a DDCL (delefilcon A) and evaluated 1 month later. After, half of them were randomly assigned to use AT (Povidone-2%) at least three times/day, and all participants were evaluated 1 month later. Tests performed were: lower tear meniscus area (LTMA), bulbar, limbal, and tarsal hyperemia, noninvasive tear break-up time (NITBUT), and corneal and conjunctival staining. Weighted combined clinical scores (CS) were created to analyze signs. Changes in symptoms (CLDEQ-8) and CS were analyzed using linear mixed models. RESULTS Forty-two subjects (mean age: 23.2±4.9 years) completed the study. Two CS were created, CS 1 was composed of bulbar, limbal, and tarsal hyperemia and corneal staining, and CS 2 by NITBUT, LTMA, and conjunctival staining. CLDEQ-8 was reduced after lid hygiene (mean: -2.73±2.13; P=0.012) and DDCL use (mean: -10.1±3.54; P<0.01), but not after AT use (P=0.62). CS 1 did not change after any intervention. CS-2 was higher (P=0.04) in DGM subjects after lid hygiene, it decreased (P=0.04) after DDCL use. CONCLUSIONS Lid hygiene is effective for reducing CLD symptoms in MGD patients. Refitting subjects with delefilcon A is an effective intervention for CLD to reduce symptoms and achieve a healthier ocular surface. Simultaneous administration of AT did not further improve CLD.
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Affiliation(s)
- Cristina Arroyo-Del Arroyo
- Ocular Surface Group, Instituto Universitario de Oftalmobiología Aplicada (IOBA) (C.A.-d.A., I.F., A.N.-D., M.B.-V., A.L.-M., M.J.G.-G.), Universidad de Valladolid, Valladolid, Spain; Departamento de Física Teórica (C.A.-d.A., A.N.-D., M.J.G.-G.), Atómica y Óptica, Universidad de Valladolid, Valladolid, Spain; Networking Research Center on Bioengineering (I.F., M.J.G.-G.), Biomaterials and Nanomedicine (CIBER-BBN), Valladolid, Spain; and Redes Temáticas de Investigación Cooperativa en Salud (Oftared) (A.L.-M.), Instituto de Salud Carlos III, Madrid, Spain
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22
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Martin R, Nuñez L, Sastre J, De juan V, Rodriguez G. Constancy of the Orbscan acoustic factor to detect contact lens‐induced corneal swelling. Clin Exp Optom 2021; 94:352-60. [DOI: 10.1111/j.1444-0938.2010.00578.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Raul Martin
- IOBA‐Eye Institute and School of Optometry, Department of Physics TAO, University of Valladolid, Valladolid, Spain
E‐mail:
| | - Laura Nuñez
- IOBA‐Eye Institute and School of Optometry, Department of Physics TAO, University of Valladolid, Valladolid, Spain
E‐mail:
| | - Jesus Sastre
- IOBA‐Eye Institute and School of Optometry, Department of Physics TAO, University of Valladolid, Valladolid, Spain
E‐mail:
| | - Victoria De juan
- IOBA‐Eye Institute and School of Optometry, Department of Physics TAO, University of Valladolid, Valladolid, Spain
E‐mail:
| | - Guadalupe Rodriguez
- IOBA‐Eye Institute and School of Optometry, Department of Physics TAO, University of Valladolid, Valladolid, Spain
E‐mail:
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Bitton E, Courey C, Giancola P, Diaconu V, Wise J, Wittich W. Effects of LATISSE (bimatoprost 0.03 per cent topical solution) on the ocular surface. Clin Exp Optom 2021; 100:583-589. [DOI: 10.1111/cxo.12507] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Revised: 09/13/2016] [Accepted: 10/13/2016] [Indexed: 11/28/2022] Open
Affiliation(s)
- Etty Bitton
- École d'optométrie, Université de Montréal, Montreal, Quebec, Canada,
| | - Claudine Courey
- École d'optométrie, Université de Montréal, Montreal, Quebec, Canada,
| | | | - Vasile Diaconu
- École d'optométrie, Université de Montréal, Montreal, Quebec, Canada,
| | - Jack Wise
- École d'optométrie, Université de Montréal, Montreal, Quebec, Canada,
| | - Walter Wittich
- École d'optométrie, Université de Montréal, Montreal, Quebec, Canada,
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24
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Efron N, Pritchard N, Brandon K, Copeland J, Godfrey R, Hamlyn B, Vrbancic V. How optometrists record corneal staining. Clin Exp Optom 2021; 94:82-6. [DOI: 10.1111/j.1444-0938.2010.00542.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Nathan Efron
- Institute of Health and Biomedical Innovation and School of Optometry, Queensland University of Technology, Brisbane, Queensland, Australia
E‐mail:
| | - Nicola Pritchard
- Institute of Health and Biomedical Innovation and School of Optometry, Queensland University of Technology, Brisbane, Queensland, Australia
E‐mail:
| | - Kady Brandon
- Institute of Health and Biomedical Innovation and School of Optometry, Queensland University of Technology, Brisbane, Queensland, Australia
E‐mail:
| | - Joanne Copeland
- Institute of Health and Biomedical Innovation and School of Optometry, Queensland University of Technology, Brisbane, Queensland, Australia
E‐mail:
| | - Roslyn Godfrey
- Institute of Health and Biomedical Innovation and School of Optometry, Queensland University of Technology, Brisbane, Queensland, Australia
E‐mail:
| | - Benjamin Hamlyn
- Institute of Health and Biomedical Innovation and School of Optometry, Queensland University of Technology, Brisbane, Queensland, Australia
E‐mail:
| | - Vanessa Vrbancic
- Institute of Health and Biomedical Innovation and School of Optometry, Queensland University of Technology, Brisbane, Queensland, Australia
E‐mail:
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25
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Brennan NA, Coles MLC, Ang JHB. An evaluation of silicone‐hydrogel lenses worn on a daily wear basis. Clin Exp Optom 2021; 89:18-25. [PMID: 16430436 DOI: 10.1111/j.1444-0938.2006.00003.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To examine the clinical performance of two brands of silicone-hydrogel lenses when worn on a daily wear basis. METHODS Fifty-six subjects with no ocular disease were enrolled at multiple sites in Australasia. Contact lenses made from galyfilcon A or lotrafilcon A were randomly assigned to each eye of the subject and the lenses were worn on a daily wear basis for a period of two weeks. Subjects did not know the identity of the lenses they wore. Clinical data and patient responses to a questionnaire were gathered at an initial visit and after two weeks of wear. RESULTS For both lenses, the degree of limbal hyperaemia and bulbar conjunctival hyperaemia decreased significantly over the two-week wearing period. The eyes wearing galyfilcon A lenses showed an increase in conjunctival staining compared to the baseline measures. On average, galyfilcon A lenses decentred more and moved less than the lotrafilcon A lenses. The lotrafilcon A lenses showed a greater loss of wettability, as judged by practitioner grading, than the galyfilcon A lenses over the two-week period. The subjective responses showed strong preference for the galyfilcon A lens across 26 of 27 questions relating to comfort, vision, handling, preference and other subjective outcomes. DISCUSSION The results show that different silicone-hydrogel lenses have different performance characteristics on the eye, when worn on a daily wear basis. Striving for high oxygen transmissibility at the expense of other properties may lead to a range of undesirable performance characteristics.
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26
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Chan B, Cho P, Cheung SW. Orthokeratology practice in children in a university clinic in Hong Kong*. Clin Exp Optom 2021; 91:453-60. [DOI: 10.1111/j.1444-0938.2008.00259.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- Ben Chan
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China
E‐mail:
| | - Pauline Cho
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China
E‐mail:
| | - Sin Wan Cheung
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China
E‐mail:
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27
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Affiliation(s)
- Ben Chan
- School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China
| | - Pauline Cho
- School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China
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28
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Damage of the ocular surface from indoor suntanning-Insights from in vivo confocal microscopy. Cont Lens Anterior Eye 2021; 44:101438. [PMID: 33840575 DOI: 10.1016/j.clae.2021.03.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 03/12/2021] [Accepted: 03/22/2021] [Indexed: 12/25/2022]
Abstract
PURPOSE To evaluate the ocular surface at the microstructural level of adults who habitually undertake indoor-suntanning utilising in vivo confocal microscopy. METHODS Participants were prospectively recruited and enrolled into either а study group (n = 75) with a history UV indoor tanning, or a control group (n = 75) with no prior history of artificial tanning. The study group participated in voluntary tanning sessions performed with standard equipment and maintained their usual routine for eye protection. Slit lamp biomicroscopy and in vivo confocal microscopy were performed at baseline before undertaking a series of suntanning sessions (10 sessions of 10 min duration over a 15 day period), within three days after the last session, and four weeks after the last session. Control group participants were examined at baseline and 8 weeks later and did not participate in tanning sessions. RESULTS All participants were female with a mean age of 25 ± 4 years and 24 ± 4 years in the study and control groups, respectively. No clinically significant changes were observed in either group over time using slit lamp biomicroscopy (all p ≥ 0.05), however, statistically significant differences were observed between the study and the control group for all corneal layers imaged using confocal microscopy (all p ≤ 0.03). Characteristic cystic conjunctival lesions with dark centres and bright borders were observed in 95% of the study group before and in 100% after the suntanning sessions. CONCLUSION Indoor suntanning resulted in statistically significant microstructural changes in the cornea and the bulbar conjunctiva that are undetectable with slit lamp biomicroscopy.
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29
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Wolffsohn JS, Dumbleton K, Huntjens B, Kandel H, Koh S, Kunnen CME, Nagra M, Pult H, Sulley AL, Vianya-Estopa M, Walsh K, Wong S, Stapleton F. CLEAR - Evidence-based contact lens practice. Cont Lens Anterior Eye 2021; 44:368-397. [PMID: 33775383 DOI: 10.1016/j.clae.2021.02.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 02/01/2021] [Indexed: 12/15/2022]
Abstract
Evidence-based contact lens -->practice involves finding, appraising and applying research findings as the basis for patient management decisions. These decisions should be informed by the strength of the research study designs that address the question, as well as by the experience of the practitioner and the preferences and environment of the patient. This reports reviews and summarises the published research evidence that is available to inform soft and rigid contact lens history and symptoms taking, anterior eye health examination (including the optimised use of ophthalmic dyes, grading scales, imaging techniques and lid eversion), considerations for contact lens selection (including the ocular surface measurements required to select the most appropriate lens parameter, lens modality and material selection), evaluation of lens fit, prescribing (teaching self-application and removal, adaptation, care regimen and cleaning instructions, as well as -->minimising risks of lens wear through encouraging compliance) and an aftercare routine.
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Affiliation(s)
| | - Kathy Dumbleton
- School of Optometry, University of California, Berkeley, CA, USA
| | - Byki Huntjens
- Division of Optometry and Visual Sciences at City, University of London, London, UK
| | - Himal Kandel
- Save Sight Institute, Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Shizuka Koh
- Department of Innovative Visual Science, Osaka University Graduate School of Medicine, Japan
| | | | - Manbir Nagra
- Vision and Eye Research Institute, ARU, Cambridge, UK
| | - Heiko Pult
- Optometry and Vision Research, Weinheim, Germany
| | | | - Marta Vianya-Estopa
- Department of Vision and Hearing Sciences Research Centre, Anglia Ruskin University, Cambridge, UK
| | - Karen Walsh
- Centre for Ocular Research & Education, School of Optometry & Vision Science, University of Waterloo, Waterloo, Canada
| | - Stephanie Wong
- Centre for Ocular Research & Education, School of Optometry & Vision Science, University of Waterloo, Waterloo, Canada
| | - Fiona Stapleton
- School of Optometry and Vision Science, UNSW Sydney, Australia
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30
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Dolar-Szczasny J, Toro MD, Dworzańska A, Wójtowicz T, Korona-Glowniak I, Sawicki R, Boguszewska A, Polz-Dacewicz M, Tomasiewicz K, Załuska W, Rejdak R, Bagnoli P, Rusciano D. Ocular Involvement of SARS-CoV-2 in a Polish Cohort of COVID-19-Positive Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2916. [PMID: 33809199 PMCID: PMC8001647 DOI: 10.3390/ijerph18062916] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/01/2021] [Accepted: 03/08/2021] [Indexed: 12/25/2022]
Abstract
The coronavirus SARS-CoV-2 responsible for the current human COVID-19 pandemic has shown tropism toward different organs with variable efficiency, eyes included. The purpose of this study has been to investigate the presence of detectable SARS-CoV-2 infection in ocular swabs in patients affected by COVID-19. A consecutive series of 74 COVID-19-positive patients (age 21-89) were enrolled at two Polish COVID-19 hospitals for 4 months and were characterized by PCR for the presence of the SARS-CoV-2 genetic material in nasopharyngeal (NP) and ocular swabs, while their respiratory and ocular symptoms were noted. Almost 50% of them presented with severe/critical respiratory involvement, and some degree of eye disease. No tight correlation was observed between the presence of ocular and respiratory symptoms. Three male patients presenting with severe/critical lung disease tested positive in ocular swab, however with mild/moderate ocular symptoms. In conclusion, our study lends further support to the view that overt ocular infection by the SARS-CoV-2 virus is not such a frequent occurrence.
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Affiliation(s)
- Joanna Dolar-Szczasny
- Department of General Ophthalmology, Medical University of Lublin, 20-079 Lublin, Poland; (J.D.-S.); (M.D.T.); (R.R.)
| | - Mario D. Toro
- Department of General Ophthalmology, Medical University of Lublin, 20-079 Lublin, Poland; (J.D.-S.); (M.D.T.); (R.R.)
- Faculty of Medical Sciences, Collegium Medicum, Cardinal Stefan Wyszyński University, 01-815 Warsaw, Poland
| | - Anna Dworzańska
- Department of Infectious Diseases, Medical University of Lublin, 20-059 Lublin, Poland; (A.D.); (K.T.)
| | - Tomasz Wójtowicz
- Department of Ophthalmology, Specialist Hospital of Radom, 26-610 Radom, Poland;
| | - Izabela Korona-Glowniak
- Department of Pharmaceutical Microbiology, Medical University of Lublin, 20-059 Lublin, Poland;
| | - Rafał Sawicki
- Department of Biochemistry and Biotechnology, Medical University of Lublin, 20-059 Lublin, Poland;
| | - Anastazja Boguszewska
- Department of Virology with SARS Laboratory, Medical University of Lublin, 20-059 Lublin, Poland; (A.B.); (M.P.-D.)
| | - Małgorzata Polz-Dacewicz
- Department of Virology with SARS Laboratory, Medical University of Lublin, 20-059 Lublin, Poland; (A.B.); (M.P.-D.)
| | - Krzysztof Tomasiewicz
- Department of Infectious Diseases, Medical University of Lublin, 20-059 Lublin, Poland; (A.D.); (K.T.)
| | - Wojciech Załuska
- Department of Nephrology, Medical University of Lublin, 20-059 Lublin, Poland;
| | - Robert Rejdak
- Department of General Ophthalmology, Medical University of Lublin, 20-079 Lublin, Poland; (J.D.-S.); (M.D.T.); (R.R.)
| | - Paola Bagnoli
- Department of Biology, University of Pisa, 56126 Pisa, Italy;
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Regueiro U, López-López M, Hervella P, Sobrino T, Lema I. Corneal and conjunctival alteration of innate immune expression in first-degree relatives of keratoconus patients. Graefes Arch Clin Exp Ophthalmol 2021; 259:459-467. [PMID: 32949300 DOI: 10.1007/s00417-020-04929-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 09/01/2020] [Accepted: 09/10/2020] [Indexed: 01/18/2023] Open
Abstract
PURPOSE The innate immune toll-like receptors 2 (TLR2) and 4 (TLR4) may play a key role in the physiopathology of keratoconus (KC). Therefore, the aim of this study was to compare TLR2/TLR4 expression in corneal and conjunctival epithelial cells between healthy first-degree relatives of patients with KC and healthy controls as well as KC patients. METHODS Case-control study in 72 healthy eyes of 36 control subjects, 53 eyes of 27 first-degree relatives, and 109 eyes with KC (60 patients). All participants were subjected to a clinical, topographic, aberrometric, and tomographic examination with extraction of corneal and conjunctival epithelial cells through scraping. TLR2/TLR4 expression was measured by flow cytometry, and was compared among controls, first-degree relatives, and KC patients. The relationship between TLR expression and epidemiological-clinical variables or topographic-aberrometric-tomographic parameters was also analyzed. RESULTS Mean TLR2/TLR4 expression showed a significant gradual increase among groups: controls < first-degree relatives < KC patients. Mean expression of TLR2 in corneal epithelial cells and both TLR2/TLR4 in conjunctival epithelial cells were significantly higher in relatives than in controls (p = 0.026, p < 0.001, and p = 0.031, respectively). Sex, age, allergic disease, eye itching, rubbing, and topographic-aberrometric-tomographic parameters were not associated to TLR2/TLR4 expression in relatives. TLR2 conjunctival expression was independently associated to relatives (OR 1.001; CI 95% 1.000-1.002, p = 0.043) after adjustment by sex, age, and rubbing. CONCLUSION TLR2 and TLR4 are overexpressed in corneal and conjunctival epithelial cells of KC relatives compared with controls. Both biomarkers may monitor early ocular changes in first-degree relatives who not show any abnormal clinical-topographic-aberrometric-tomographic parameters.
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Affiliation(s)
- Uxía Regueiro
- Clinical Neurosciences Research Laboratory, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.,Facultade de Óptica e Optometría, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Maite López-López
- Facultade de Óptica e Optometría, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Pablo Hervella
- Clinical Neurosciences Research Laboratory, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Tomás Sobrino
- Clinical Neurosciences Research Laboratory, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.
| | - Isabel Lema
- Clinical Neurosciences Research Laboratory, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain. .,Facultade de Óptica e Optometría, Universidade de Santiago de Compostela, Santiago de Compostela, Spain. .,Instituto Galego de Oftalmoloxía (INGO), Hospital Provincial de Conxo, Santiago de Compostela, Spain.
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32
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Debarun D, Wolffsohn JS. Effect of large diameter and plasma coating on the initial adaptation of gas permeable contact lens fitting for neophytes. Cont Lens Anterior Eye 2021; 44:76-80. [DOI: 10.1016/j.clae.2020.08.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 08/24/2020] [Accepted: 08/27/2020] [Indexed: 12/16/2022]
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Schulze MM, Ng A, Yang M, Panjwani F, Srinivasan S, Jones LW, Senchyna M. Bulbar Redness and Dry Eye Disease: Comparison of a Validated Subjective Grading Scale and an Objective Automated Method. Optom Vis Sci 2021; 98:113-120. [PMID: 33534379 DOI: 10.1097/opx.0000000000001638] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
SIGNIFICANCE In this study, assessments of conjunctival redness were performed to evaluate whether patients with or without dry eye disease (DED) could be discriminated based on this measure. Our findings suggest that subjectively grading redness by quadrant, as opposed to automated en face measurements, may be more suitable for this purpose. PURPOSE This study aimed to quantify bulbar redness using the validated bulbar redness (VBR) grading scale and an automated objective method (Oculus Keratograph 5M; K5M) in participants with DED and non-DED controls. METHODS Participants with DED (Ocular Surface Disease Index score ≥20 and Oxford scale corneal staining ≥2) and controls (Ocular Surface Disease Index score ≤10 and corneal staining ≤1) attended two study visits. In part 1A of visit 1, baseline bulbar redness was graded with the VBR scale in each conjunctival quadrant of both eyes, followed by automated measurements of temporal and nasal redness with the K5M. This was immediately followed by part 1B, during which a topical vasoconstrictor was instilled into both eyes. Redness assessments were repeated 5 and 30 minutes after instillation with both instruments. Participants returned 14 days later for visit 2, where the same assessments as for visit 1A were repeated. RESULTS Seventy-four participants (50 DED and 24 controls) completed the study. There were statistically significant differences in redness between the DED and control groups when assessed with the VBR scale (14/16 comparisons; all, P < .05), whereas no significant differences in K5M-derived redness between the DED and non-DED groups were found at any location or time point. Both subjective and objective instruments detected statistically significant reductions in redness 5 and 30 minutes after instillation of the vasoconstrictor (all, P < .01). CONCLUSIONS Although both subjective and objective instruments were sensitive to detecting changes in redness induced by vasoconstriction, statistically significant differences in redness between DED and control groups were only found using the VBR scale.
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Affiliation(s)
- Marc-Matthias Schulze
- Centre for Ocular Research & Education (CORE), School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Alison Ng
- Centre for Ocular Research & Education (CORE), School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Mike Yang
- Centre for Ocular Research & Education (CORE), School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | | | | | - Lyndon W Jones
- Centre for Ocular Research & Education (CORE), School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
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Abstract
A biomarker is a "characteristic that is measured as an indicator of normal biological processes, pathogenic processes, or responses to an exposure or intervention, including therapeutic interventions." Recently, calls for biomarkers for ocular surface diseases have increased, and advancements in imaging technologies have aided in allowing imaging biomarkers to serve as a potential solution for this need. This review focuses on the state of imaging biomarkers for ocular surface diseases, specifically non-invasive tear break-up time (NIBUT), tear meniscus measurement and corneal epithelial thickness with anterior segment optical coherence tomography (OCT), meibomian gland morphology with infrared meibography and in vivo confocal microscopy (IVCM), ocular redness with grading scales, and cellular corneal immune cells and nerve assessment by IVCM. Extensive literature review was performed for analytical and clinical validation that currently exists for potential imaging biomarkers. Our summary suggests that the reported analytical and clinical validation state for potential imaging biomarkers is broad, with some having good to excellent intra- and intergrader agreement to date. Examples of these include NIBUT for dry eye disease, ocular redness grading scales, and detection of corneal immune cells by IVCM for grading and monitoring inflammation. Further examples are nerve assessment by IVCM for monitoring severity of diabetes mellitus and neurotrophic keratitis, and corneal epithelial thickness assessment with anterior segment OCT for the diagnosis of early keratoconus. However, additional analytical validation for these biomarkers is required before clinical application as a biomarker.
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35
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Bertens CJF, Dunker SL, Dias AJAA, van den Biggelaar FJHM, Nuijts RMMA, Gijs M. Safety and Comfort of an Innovative Drug Delivery Device in Healthy Subjects. Transl Vis Sci Technol 2021; 9:35. [PMID: 33384889 PMCID: PMC7757610 DOI: 10.1167/tvst.9.13.35] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 11/18/2020] [Indexed: 02/07/2023] Open
Abstract
Purpose The aim of this study was to investigate safety and comfort of two versions of a placebo-microsphere filled ocular coil (straight and curved) in healthy subjects. Methods The study was a single-center intervention study. One ocular coil was placed in the inferior conjunctival fornix for the intended duration of 28 days. Forty-two healthy adult subjects were included. At baseline, 30 minutes, 8 hours, 24 hours, 48 hours, 7 days, 14 days, 21 days, and 28 days after insertion, examinations were performed, including slit lamp evaluation to score ocular redness, intraocular pressure measurement, visual acuity, tear secretion test, and questionnaires. Results The straight and curved ocular coils had a median retention time of 5 days and 12 days, respectively. After 48 hours, 57% and 81% subjects retained the straight and curved ocular coil, respectively. Four (19%) subjects with the straight coil and six (29%) with the curved coil completed the entire study period. Minor changes in ocular hyperemia were observed in both groups. On day 7, the straight coil was more comfortable than the curved coil with a visual analogue scale (VAS) score of 77 ± 21 compared to 94 ± 11 (P = 0.028), respectively. No other ocular adverse events were observed. Conclusions Comfort and safety of the straight and curved ocular coil are high. Because the retention time is too short for long-term sustained drug release, the use in the perioperative or immediate postoperative period could prove to be more valuable. Translational Relevance The ocular coil is a noninvasive, comfortable and safe short-term drug delivery device.
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Affiliation(s)
- Christian J F Bertens
- Chemelot Institute for Science and Technology (InSciTe), GS Maastricht, The Netherlands
| | - Suryan L Dunker
- University Eye Clinic Maastricht, Maastricht University Medical Center+ (MUMC+), HX Maastricht, The Netherlands.,Maastricht University, School for Mental Health and Neuroscience, University Eye Clinic Maastricht, ER Maastricht, The Netherlands
| | - Aylvin J A A Dias
- Chemelot Institute for Science and Technology (InSciTe), GS Maastricht, The Netherlands.,Eyegle bv. Gerbergaplantsoen 11, Maastricht, The Netherlands
| | - Frank J H M van den Biggelaar
- Chemelot Institute for Science and Technology (InSciTe), GS Maastricht, The Netherlands.,University Eye Clinic Maastricht, Maastricht University Medical Center+ (MUMC+), HX Maastricht, The Netherlands
| | - Rudy M M A Nuijts
- Chemelot Institute for Science and Technology (InSciTe), GS Maastricht, The Netherlands.,University Eye Clinic Maastricht, Maastricht University Medical Center+ (MUMC+), HX Maastricht, The Netherlands
| | - Marlies Gijs
- Chemelot Institute for Science and Technology (InSciTe), GS Maastricht, The Netherlands
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36
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Crooke A, Martínez-Alberquilla I, García-Montero M, Rico-Del-Viejo L, Ruiz-Alcocer J, Madrid-Costa D. Impact of contact lens wear on NLRP3 gene expression: Implications for ocular frailty in middle-aged adults. Exp Eye Res 2020; 202:108356. [PMID: 33197452 DOI: 10.1016/j.exer.2020.108356] [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: 04/11/2020] [Revised: 10/15/2020] [Accepted: 11/09/2020] [Indexed: 11/30/2022]
Abstract
The inflammatory process plays a crucial role in frailty syndrome, which can appear in middle age and is associated with a poor health outcome. Consequently, gerontologists recommend screening inflammatory biomarkers in middle-aged adults to detect frailty and, therefore, prevent chronic diseases and mortality. External factors could be a risk factor for frailty because they can generate and extend the inflammatory process. For these reasons, we analysed the effect of long-term contact lens wear on mRNA level of genes linked to inflammation (IL-6, NLRP3, NK1R, CD73, MUC16 and TRPV1 genes) in conjunctival cells of middle-aged individuals, by quantitative PCR. Middle-aged contact lens wearers presented a significant increase of NLRP3 and MUC16 mRNA level as well as a decrease of CD73 mRNA level, in comparison with non-contact lens wearers. Additionally, we checked for a potential correlation between these transcript levels and clinical changes of the participants' ocular surface. Unlike molecular analysis, clinical examination fails to detect inflammation in contact lens wearers. These data suggest that long-term contact lens wear could trigger an inflammatory response in middle age orchestrated by NLRP3 inflammasome and modulated by CD73 and MUC16 proteins. Further studies are needed to confirm our gene expression findings at the protein level as well as to investigate the potential role of long-term CL wear in the onset of ocular frailty.
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Affiliation(s)
- Almudena Crooke
- Department of Biochemistry and Molecular Biology, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain.
| | - Irene Martínez-Alberquilla
- Department of Optometry and Vision, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
| | - María García-Montero
- Department of Optometry and Vision, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
| | - Laura Rico-Del-Viejo
- Department of Optometry and Vision, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
| | - Javier Ruiz-Alcocer
- Department of Optometry and Vision, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
| | - David Madrid-Costa
- Department of Optometry and Vision, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
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Arroyo-Del Arroyo C, Novo-Diez A, Blanco-Vázquez M, Fernández I, López-Miguel A, González-García MJ. Does placebo effect exist in contact lens discomfort management? Cont Lens Anterior Eye 2020; 44:101370. [PMID: 33071184 DOI: 10.1016/j.clae.2020.09.003] [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: 05/21/2020] [Revised: 09/18/2020] [Accepted: 09/28/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE To study the effect of daily disposable contact lens (DDCL) refitting in monthly contact lens (CL) wearers suffering from contact lens discomfort (CLD), and to assess if there is a placebo effect associated with this CLD intervention. METHODS Symptomatic CL wearers, according to the Contact Lens Dry Eye Questionnaire 8 (CLDEQ-8 ≥ 12 points), were divided into two groups. The study group was provided with DDCLs (delefilcon A) and the control group with a masked pair of their habitual monthly CLs (placebo effect) and were assessed after one month. Then, the control group was provided with the same DDCLs and evaluated one month later. The symptoms were recorded with the CLDEQ-8 and global rating of change scale (GRCS). Non-invasive tear break-up time (NITBUT), conjunctival hyperaemia, fluorescein staining, and lid wiper epitheliopathy (LWE) were evaluated. Changes between visits, groups, and the effect of each intervention were analysed. RESULTS Thirty-one participants (mean age: 23.2 ± 5.3 years) were recruited. The study group (n = 14) showed an improvement of -39.6 ± 25.8 % (p < 0.001) in CLDEQ-8 and 31.3 ± 14.6 points in GRCS (p < 0.001) after one month of DDCL use, while no changes in clinical tests were found. In the control group (n = 17), symptoms improved significantly after wearing the masked monthly CL (CLDEQ-8: -26.1 ± 31.0 %, p = 0.03; GRCS: 14.9 ± 17.0, p = 0.002), however a worsening in bulbar (26.5 ± 40.0 %; p = 0.02) and limbal hyperaemia (21.6 ± 34.7 %, p = 0.02) and an improvement of -19.1 ± 37.0 % (p = 0.049) in LWE was found. When the control group was fitted with the DDCL, improvements in GRCS (20.5 ± 25.5, p = 0.02), NITBUT (37.9 ± 42.3 %, p = 0.002), and conjunctival staining (-47.1 ± 59.9 %, p = 0.005) were noted. CONCLUSIONS Refitting symptomatic monthly CL wearers with Delefilcon A DDCL is effective in reducing symptoms related to CLD. However, clinicians and researchers must be aware of the existence of a placebo effect when assessing the effectiveness of any CL refitting.
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Affiliation(s)
- Cristina Arroyo-Del Arroyo
- Instituto Universitario de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain; Departamento de Física Teórica, Atómica y Óptica, Universidad de Valladolid, Valladolid, Spain
| | - Andrea Novo-Diez
- Instituto Universitario de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain; Departamento de Física Teórica, Atómica y Óptica, Universidad de Valladolid, Valladolid, Spain
| | - Marta Blanco-Vázquez
- Instituto Universitario de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain
| | - Itziar Fernández
- Instituto Universitario de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain; Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Valladolid, Spain
| | - Alberto López-Miguel
- Instituto Universitario de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain; Redes temáticas de investigación cooperativa en salud (Oftared), Instituto de Salud Carlos III, Madrid, Spain.
| | - María Jesús González-García
- Instituto Universitario de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain; Departamento de Física Teórica, Atómica y Óptica, Universidad de Valladolid, Valladolid, Spain; Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Valladolid, Spain
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Vianya-Estopa M, Nagra M, Cochrane A, Retallic N, Dunning D, Terry L, Lloyd A, Wolffsohn JS, Alderson A, Mouat G, McDonnell C, Murphy O, Huntjens B, Mayhem M, Martin E, Sweeney L, Evans K, Naroo S, Conway R, Simo L, Maldonado-Codina C, Mallon C, Underwood J, Trivedy K, Joshi M. Optimising subjective anterior eye grading precision. Cont Lens Anterior Eye 2020; 43:489-492. [DOI: 10.1016/j.clae.2020.03.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 03/11/2020] [Accepted: 03/11/2020] [Indexed: 10/24/2022]
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Regueiro U, Pérez-Mato M, Hervella P, Campos F, Sobrino T, Lema I. Toll-like receptors as diagnostic targets in pellucid marginal degeneration. Exp Eye Res 2020; 200:108211. [PMID: 32890481 DOI: 10.1016/j.exer.2020.108211] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 08/06/2020] [Accepted: 08/31/2020] [Indexed: 12/30/2022]
Abstract
The main purpose of this study is to evaluate the diagnostic role of Toll-like receptors 2 (TLR2) and 4 (TLR4) expression in corneal and conjunctival epithelial cells of eyes with pellucid marginal degeneration (PMD) compared to keratoconus patients (KC) and control subjects. A prospective case-control study in 29 PMD eyes, 109 KC eyes and 72 healthy eyes was done. All participants were subjected to a clinical, topographic, aberrometric and tomographic exam with extraction of corneal and conjunctival epithelial cells through scraping. The TLR2 and TLR4 expression was measured with flow cytometry. Receiver operating characteristic (ROC) curve analysis was used to determine the most appropriate cutoff point for predicting the risk of PMD and KC. Correlations between TLR2/TLR4 expression and the severity of PMD/KC were evaluated. A TLRs follow-up review was made 19 ± 4 months after to the first review. As result, mean expression of TLR2 and TLR4 in both corneal and conjunctival epithelial cells was significantly higher in eyes with corneal ectasia (PMD and KC) than in control eyes (all p < 0.05). Conjunctival TLR4 expression showed the highest capacity to diagnose the existence of PMD (odd ratio 42.84; 95% confidence interval:6.20-296.20; p < 0.0001) after adjusting by eye rubbing and steeper corneal meridian. Moreover, we found an association between the TLR2/TLR4 overexpression with the severity of the PMD and KC measured by corneal topographic, aberrometric and tomographic quantitative parameters (all p < 0.05). Differences on TLR2/TLR4 expression between study groups were maintained during the follow-up period. In conclusion, the TLR2/TLR4 overexpression in corneal and conjunctival epithelial cells of PMD and KC patients compared to healthy control subjects have demonstrated their role as diagnostic target in both corneal ectatic disorders.
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Affiliation(s)
- Uxía Regueiro
- Clinical Neurosciences Research Laboratory, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain; Facultade de Óptica e Optometría, Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - María Pérez-Mato
- Clinical Neurosciences Research Laboratory, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Pablo Hervella
- Clinical Neurosciences Research Laboratory, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Francisco Campos
- Clinical Neurosciences Research Laboratory, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Tomás Sobrino
- Clinical Neurosciences Research Laboratory, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.
| | - Isabel Lema
- Clinical Neurosciences Research Laboratory, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain; Facultade de Óptica e Optometría, Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain; Instituto Galego de Oftalmoloxía (INGO), Hospital Provincial de Conxo, Santiago de Compostela, Spain.
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Colorado LH, Edwards K, Chinnery HR, Bazan HE. In vivo immune cell dynamics in the human cornea. Exp Eye Res 2020; 199:108168. [PMID: 32846151 DOI: 10.1016/j.exer.2020.108168] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 06/26/2020] [Accepted: 07/21/2020] [Indexed: 01/24/2023]
Abstract
In vivo confocal microscopy (IVCM) allows the evaluation of the living human cornea at the cellular level. The non-invasive nature of this technique longitudinal, repeated examinations of the same tissue over time. Image analysis of two-dimensional time-lapse sequences of presumed immune cells with and without visible dendrites at the corneal sub-basal nerve plexus in the eyes of healthy individuals was performed. We demonstrated evidence that cells without visible dendrites are highly dynamic and move rapidly in the axial directions. A number of dynamic cells were observed and measured from three eyes of different individuals. The total average displacement and trajectory speeds of three cells without visible dendrites (N = 9) was calculated to be 1.12 ± 0.21 and 1.35 ± 0.17 μm per minute, respectively. One cell with visible dendrites per cornea was also analysed. Tracking dendritic cell dynamics in vivo has the potential to significantly advance the understanding of the human immune adaptive and innate systems. The ability to observe and quantify migration rates of immune cells in vivo is likely to reveal previously unknown insights into corneal and general pathophysiology and may serve as an effective indicator of cellular responses to intervention therapies.
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Affiliation(s)
- Luisa H Colorado
- Institute of Health and Biomedical Innovation, School of Optometry and Vision Science, Queensland University of Technology, Kelvin Grove, QLD, 4069, Australia.
| | - Katie Edwards
- Institute of Health and Biomedical Innovation, School of Optometry and Vision Science, Queensland University of Technology, Kelvin Grove, QLD, 4069, Australia
| | - Holly R Chinnery
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, VIC, 3052, Australia
| | - Haydee E Bazan
- Department of Ophthalmology and Neuroscience Center of Excellence, School of Medicine, Louisiana State University Health New Orleans, 2020 Gravier St., Suite D, New Orleans, LA, 70112, USA
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Ren Q, Yang B, Liu L, Cho P. Orthokeratology in adults and factors affecting success: Study design and preliminary results. Cont Lens Anterior Eye 2020; 43:595-601. [PMID: 32371038 DOI: 10.1016/j.clae.2020.03.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 03/25/2020] [Accepted: 03/25/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To report the study design and one month's preliminary results of a randomized, single-masked, one-year prospective study of orthokeratology (ortho-k) in adults wearing lenses of different compression factors. METHODS Adults aged 18-38 years, with myopia of -0.75 to -5.00 D and astigmatism < 1.50 D, were recruited and randomly assigned into two groups: a conventional compression factor or Jessen Factor (CCF) group (compression factor = 0.75 D) and an increased (extra 1.00D) compression factor (ICF) group. Clinical outcomes, including spherical equivalent refraction (SER) reduction, visual acuity, corneal hysteresis (CH) and corneal resistance factor (CRF), and signs and symptoms were collected at the one-month follow-up visit. Indicators of the level of satisfaction and quality of life after commencing treatment were determined via a satisfaction questionnaire and the NEI-RQL-42 questionnaire. RESULTS Baseline data from 26 CCF and 24 ICF participants were analysed and no significant differences were observed between the two groups (p > 0.05). The first fit success rates were 90 % for CCF group and 83 % for the ICF group, SER reductions were 97 % and 95 % for the CCF and ICF group, respectively, with uncorrected high-contrast visual acuity of -0.06 (-0.18 to 0.42) and 0.00 (-0.16 to 0.52), respectively (p > 0.05) at the 1-month visit. Overall, the incidence of corneal staining was 77 % in the CCF and 79 % in ICF group; central corneal staining was 15 % and 33 %, respectively. However, the differences of corneal staining between the groups did not reach significance in any visit (p > 0.05). The main complaint from participants was glare (both groups). No significant differences in CRF and CH were found in the first month (p > 0.05). Both groups recorded high scores in the level of satisfaction questionnaire, with no significant differences between groups (p > 0.05). Compared with baseline scores, 1-month NEI-RQL-42 subscales of dependence on correction, appearance, and satisfaction with correction significantly increased, and the glare score significantly decreased in both groups (all p < 0.05). CONCLUSIONS The majority of participants were satisfied with the treatment and no serious corneal adverse effects were observed. These results demonstrate that ortho-k lenses of default and increased compression factor (1D) demonstrated similar clinical performance and ortho-k can be a safe and well-accepted option for myopia correction in adults, but long-term observation is warranted.
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Affiliation(s)
- Qiangemai Ren
- Department of Optometry and Visual Science, West China School of Medicine, Sichuan University, Chengdu, China.
| | - Bi Yang
- Department of Optometry and Visual Science, West China School of Medicine, Sichuan University, Chengdu, China
| | - Longqian Liu
- Department of Optometry and Visual Science, West China School of Medicine, Sichuan University, Chengdu, China
| | - Pauline Cho
- School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
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A 12-month Prospective Study of Tear Osmolarity in Contact Lens Wearers Refitted with Daily Disposable Soft Contact Lenses. Optom Vis Sci 2020; 97:178-185. [PMID: 32168240 DOI: 10.1097/opx.0000000000001488] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
SIGNIFICANCE Tear osmolarity has been reported as one of the best diagnostic tests for dry eye disease and its management. Contact lens wear is thought to influence tear homeostasis. Understanding how regular wear of contact lenses and their type affect tear osmolarity is important. PURPOSE The purpose of this study was to assess changes in tear osmolarity and ocular symptoms over a period of 12 months following refitting contact lens wearers with daily disposable contact lenses. METHODS Fifty subjects aged (mean ± SD) 26 ± 4 years were refitted with either silicone-hydrogel (delefilcon A, SiHy, n = 34) or hydrogel (omafilcon A, Hy, n = 16) daily disposable soft contact lenses. Study included seven visits: baseline measurements without contact lenses; two visits for contact lens fit and selection; follow-up measurements after 3, 6, and 12 months of contact lens wear; and a post-study visit without contact lenses. Lens type selection was based on a set of objective measurements. Subjects were instructed to follow strict wearing rules. Impedance-based osmometer was used to collect samples from the lower tear meniscuses. The Ocular Surface Disease Index (OSDI) and the eight-item Contact Lens Dry Eye Questionnaire were used to assess subject-reported ocular symptoms and contact lens discomfort, respectively. RESULTS Downward trend of tear osmolarity was noted over the time course of study. Statistically significant differences were noted in tear osmolarity (Friedman test, χ = 21.91 [P < .001], and χ = 13.89 [P = .003]) for the right and left eyes, respectively. A statistically significant decrease in tear osmolarity was apparent only for initially symptomatic subjects (for OSDI ≥13: χ = 26.25, P < .001; for OSDI <13: χ = 5.65, P = .13). Statistically significant differences were not noted in OSDI and the eight-item Contact Lens Dry Eye Questionnaire between the baseline and 12-month visit (χ = 5.92 [P = .12] and R = 0.015 [P = .87], respectively). There was a difference between baseline and post-study visits (P = .002) in OSDI, showing lower score at the latter visit. CONCLUSIONS Refitting with daily disposable contact lenses was demonstrated to lower tear osmolarity.
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Nguyen BN, Chung AW, Lopez E, Silvers J, Kent HE, Kent SJ, Downie LE. Meibomian gland dropout is associated with immunodeficiency at HIV diagnosis: Implications for dry eye disease. Ocul Surf 2020; 18:206-213. [PMID: 32081622 DOI: 10.1016/j.jtos.2020.02.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Revised: 01/05/2020] [Accepted: 02/14/2020] [Indexed: 11/17/2022]
Abstract
AIM To characterize anterior eye health and tear film characteristics in individuals with human immunodeficiency virus (HIV) undergoing anti-retroviral therapy. METHODS This cross-sectional study involved 35 adults, categorized as healthy controls (n = 18) or as HIV-positive patients (n = 17), with no history of opportunistic infection or current ocular fundus abnormalities. Participants underwent a comprehensive anterior eye assessment. Primary outcome measures were dry eye symptoms (Ocular Surface Disease Index survey), tear film osmolarity, and extent of meibomian gland dropout. Secondary outcomes measures were ocular redness, tear film stability, and ocular surface staining. Levels of 36 cytokines were assayed from basal tears using a multiplex bead array. RESULTS The HIV-positive group showed more extensive meibomian gland dropout relative to controls (mean ± SD, controls: 29.6 ± 5.8 versus 37.0 ± 13.9%, p = 0.045). The extent of meibomian gland dropout was negatively correlated with blood CD4 T-cell count (a marker of immunodeficiency) at diagnosis (r = -0.69, p = 0.006). All other tests of anterior ocular health, including dry eye symptom levels, were not significantly different between the groups. There were no significant inter-group differences for the 36 cytokines assayed in the tear film. CONCLUSIONS We find greater meibomian gland dropout in HIV-positive individuals that is related to disease severity at diagnosis. Given this feature predisposes to dry eye disease, it suggests the need for long-term studies of anterior eye health in people with HIV.
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Affiliation(s)
- Bao N Nguyen
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Australia
| | - Amy W Chung
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Parkville, Australia
| | - Ester Lopez
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Parkville, Australia
| | - Julie Silvers
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia
| | - Helen E Kent
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia
| | - Stephen J Kent
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Parkville, Australia; Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia
| | - Laura E Downie
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Australia.
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González-García MJ, Murillo GM, Pinto-Fraga J, García N, Fernández I, Maldonado MJ, Calonge M, Enríquez-de-Salamanca A. Clinical and tear cytokine profiles after advanced surface ablation refractive surgery: A six-month follow-up. Exp Eye Res 2020; 193:107976. [PMID: 32081669 DOI: 10.1016/j.exer.2020.107976] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 02/07/2020] [Accepted: 02/14/2020] [Indexed: 12/14/2022]
Abstract
Neuropathic dry eye is one of the most frequently seen complications after corneal refractive surgery, however, its incidence decreases in a significant manner along the first six months postoperative, reaching between 10 and 45% incidence. However, little is known on the inflammatory status of the ocular surface during this recovery process. We aim to analyze the clinical and tear molecule concentration changes along six months after advanced surface ablation for myopia correction, in a prospective study including 18 eyes of 18 subjects who bilaterally underwent advanced surface ablation corneal refractive surgery. Clinical variables (uncorrected distance visual acuity, symptoms, conjunctival hyperemia, tear osmolarity, tear stability, corneal fluorescein staining, conjunctival lissamine staining, Schirmer test, and corneal esthesiometry) and a panel of 23 pro and anti-inflammatory cytokines/chemokines concentration in tears preoperatively and at 1, 3 and 6 months postoperatively were evaluated. We found that uncorrected distance visual acuity improved significantly from baseline at 1-month visit, symptoms improved and tear osmolarity decreased significantly from baseline at 3-month visit and there was a decrease in mechanical corneal threshold between 1-month and 3- and 6-month visits. Regarding tear molecules, IL-4, IL-5, IL-6, IL-13, IL-17A, and IFN-γ tear levels were significantly increased at all the three visits, compared to preoperative levels at V0; IL-2 and VEGF were also significantly increased at 1-month and 6-month visits, but not at 3-month visit, whereas IL-9 IL-10 and IL-12 were only significantly increased at 6-month visit. Although we found that there is a recovery in clinical variables at 6 months postoperatively (i.e. neuropathic dry eye was not developed in the sample), ocular surface homeostasis is not completely restored, as it can be seen by the changes in concentration of some pro and anti-inflammatory molecules measured in tears.
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Affiliation(s)
- María J González-García
- IOBA (Institute of Applied Ophthalmobiology), University of Valladolid, Campus Miguel Delibes, Paseo de Belén 17, 47011, Valladolid, Spain; CIBER-BBN (Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine), Valladolid, Spain.
| | - Giovanna M Murillo
- IOBA (Institute of Applied Ophthalmobiology), University of Valladolid, Campus Miguel Delibes, Paseo de Belén 17, 47011, Valladolid, Spain
| | - José Pinto-Fraga
- IOBA (Institute of Applied Ophthalmobiology), University of Valladolid, Campus Miguel Delibes, Paseo de Belén 17, 47011, Valladolid, Spain
| | - Noelia García
- IOBA (Institute of Applied Ophthalmobiology), University of Valladolid, Campus Miguel Delibes, Paseo de Belén 17, 47011, Valladolid, Spain
| | - Itziar Fernández
- IOBA (Institute of Applied Ophthalmobiology), University of Valladolid, Campus Miguel Delibes, Paseo de Belén 17, 47011, Valladolid, Spain; CIBER-BBN (Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine), Valladolid, Spain
| | - Miguel J Maldonado
- IOBA (Institute of Applied Ophthalmobiology), University of Valladolid, Campus Miguel Delibes, Paseo de Belén 17, 47011, Valladolid, Spain
| | - Margarita Calonge
- IOBA (Institute of Applied Ophthalmobiology), University of Valladolid, Campus Miguel Delibes, Paseo de Belén 17, 47011, Valladolid, Spain; CIBER-BBN (Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine), Valladolid, Spain
| | - Amalia Enríquez-de-Salamanca
- IOBA (Institute of Applied Ophthalmobiology), University of Valladolid, Campus Miguel Delibes, Paseo de Belén 17, 47011, Valladolid, Spain; CIBER-BBN (Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine), Valladolid, Spain
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Colorado LH, Edwards K, Dinh L, Ha S, Liu D, Luu A, Trang S, Yu-Ting TH, Schmid KL. Associations between the menstrual cycle, lifestyle factors and clinical assessment of the ocular surface: a prospective observational study. BMC WOMENS HEALTH 2020; 20:23. [PMID: 32033559 PMCID: PMC7006113 DOI: 10.1186/s12905-020-0894-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 01/29/2020] [Indexed: 12/15/2022]
Abstract
Background Little is known about the ocular surface changes over the menstrual cycle in young women and the interactions with lifestyle factors. Therefore, the purpose of this study was to explore the associations between modifiable lifestyle factors and menstrual cycle phases on the ocular signs and symptoms of dry eye in young healthy women. Methods This was a prospective 1-month observational study. Thirty young healthy women with regular, 24 to 32-day menstrual cycles were recruited. Participants attended three visits at day 7, 14, and 21 (± 1) of their menstrual cycle. At baseline, general health questionnaire was conducted. At each visit, symptomology was quantified using Ocular Surface Disease Index (OSDI) and overall ocular comfort (OOC, visual analogue scale). Ocular signs were assessed using Efron scales, tear break-up time (TBUT) and phenol red thread (PRT). Pearson’s correlation was used to determine associations between variables at each visit. Results A total of 26 participants (mean age = 22.3 ± 3.7 years) with an average menstrual cycle of 28.3 ± 1.3 days completed the 3 visits. The interaction between signs/symptoms and lifestyle factors changed over the cycle. At the follicular phase (day 7), lifestyle factors such diet and levels of stress were correlated with PRT and OSDI, (r = − 0.4, p = 0.022; r = 0.4, p = 0.045 respectively). At the ovulation phase (day 14), the general health score was correlated with OOC scores (r = 0.4, p = 0.047). At day 14, exercise frequency correlated with PRT (r = − 0.4, p = 0.028) and caffeine intake was positively correlate with both; TBUT (r = 0.5, p = 0.020) and PRT (r = 0.5, p = 0.014). At the luteal phase (day 21), we found no correlations between lifestyle factors and dry eye signs or symptoms. Conclusions The associations between lifestyle factors and objective and subjective ocular surface assessment appeared to be more pronounced during the ovulation phase of the menstrual cycle compared to the follicular and luteal phases. Misalignment of these factors with the ocular health during the luteal phase could be attributed to central sensitization and changes in levels of luteinising hormone. Natural hormonal changes during menstrual cycle should be considered for diagnosis and treatment of dry eye in young healthy women.
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Affiliation(s)
- Luisa H Colorado
- Institute of Health and Biomedical Innovation, School of Optometry and Vision Science, Queensland University of Technology, Room Q-504, Level 5, Kelvin Grove, Queensland, 4059, Australia.
| | - Katie Edwards
- Institute of Health and Biomedical Innovation, School of Optometry and Vision Science, Queensland University of Technology, Room Q-504, Level 5, Kelvin Grove, Queensland, 4059, Australia
| | - Lynne Dinh
- Institute of Health and Biomedical Innovation, School of Optometry and Vision Science, Queensland University of Technology, Room Q-504, Level 5, Kelvin Grove, Queensland, 4059, Australia
| | - Sarah Ha
- Institute of Health and Biomedical Innovation, School of Optometry and Vision Science, Queensland University of Technology, Room Q-504, Level 5, Kelvin Grove, Queensland, 4059, Australia
| | - Danica Liu
- Institute of Health and Biomedical Innovation, School of Optometry and Vision Science, Queensland University of Technology, Room Q-504, Level 5, Kelvin Grove, Queensland, 4059, Australia
| | - Annie Luu
- Institute of Health and Biomedical Innovation, School of Optometry and Vision Science, Queensland University of Technology, Room Q-504, Level 5, Kelvin Grove, Queensland, 4059, Australia
| | - Shona Trang
- Institute of Health and Biomedical Innovation, School of Optometry and Vision Science, Queensland University of Technology, Room Q-504, Level 5, Kelvin Grove, Queensland, 4059, Australia
| | - Tina H Yu-Ting
- Institute of Health and Biomedical Innovation, School of Optometry and Vision Science, Queensland University of Technology, Room Q-504, Level 5, Kelvin Grove, Queensland, 4059, Australia
| | - Katrina L Schmid
- Institute of Health and Biomedical Innovation, School of Optometry and Vision Science, Queensland University of Technology, Room Q-504, Level 5, Kelvin Grove, Queensland, 4059, Australia
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Abstract
SIGNIFICANCE The Bifocal & Atropine in Myopia (BAM) study aims to determine whether combining 0.01% atropine and +2.50-diopter add center-distance soft bifocal contact lenses (SBCL) slows myopia progression more than SBCL alone. The results could provide significant information on the myopia control effect of combining optical and pharmacological treatments. PURPOSE This article describes the subject characteristics at baseline, the study methods, and the short-term effects of this combination treatment on visual acuity (VA) and vision-related outcomes. METHODS Subjects from the BAM study who met the baseline eligibility criteria were dispensed the combination treatment for 2 weeks to determine final eligibility. Outcome measures included VA at near and distance (Bailey-Lovie logMAR charts), near phoria (modified Thorington), accommodative lag (Grand Seiko WAM-5500), and pupil size (NeurOptics VIP-200 Pupillometer). Compliance was monitored using surveys. Two subgroups in the Bifocal Lenses In Nearsighted Kids study, single-vision contact lens wearers and those who wore +2.50-diopter add SBCL, will serve as the age-matched historical controls for BAM study. RESULTS Forty-nine BAM subjects (9.6 ± 1.4 years) were enrolled; mean spherical equivalent cycloplegic autorefraction was -2.33 ± 1.03 diopters. After 2 weeks of treatment, the best-corrected low-contrast (10% Michelson) distance VA was reduced (pre-treatment, +0.09 ± 0.07; post-treatment, +0.16 ± 0.08; P < .0001), but the high-contrast VA at near or distance was unaffected. Near phoria increased by approximately 2 in the exo direction (P = .01), but the accommodative lag was unchanged. The pupil size was not significantly different between pre-treatment and post-treatment of either the photopic or mesopic condition. Surveys indicated that the subjects wore SBCL 77 ± 22% of waking hours and used atropine 6.4 ± 0.7 days per week. CONCLUSIONS Two weeks of combination treatment reduced low-contrast distance VA and increased near exophoria slightly, but the subjects were compliant and tolerated the treatment well.
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Topical Low Dose Preservative-Free Hydrocortisone Reduces Signs and Symptoms in Patients with Chronic Dry Eye: A Randomized Clinical Trial. Adv Ther 2020; 37:329-341. [PMID: 31741283 DOI: 10.1007/s12325-019-01137-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Indexed: 02/06/2023]
Abstract
PURPOSE Dry eye disease (DED) is a highly prevalent ocular condition with a significant burden on affected patients. Regardless of the underlying etiology, DED is associated with increased ocular surface inflammation. We investigated the safety and efficacy of a short-term treatment with topical low dose hydrocortisone in patients with chronic DED and ocular surface inflammation. METHODS A total of 60 patients (mean age 51 ± 14 years) with chronic DED and conjunctival hyperemia greater than grade 2 on the Efron scale were included. Patients were randomized to receive either preservative-free hydrocortisone 0.335% (Softacort, Laboratories Thea, France) for 12 days four times daily followed by 2 days twice daily instillation (intense treatment group) or 8 days three times daily followed by 3 days twice daily treatment (standard treatment group). Ocular redness was assessed at baseline, day 14, and day 28. Measurement of intraocular pressure (IOP) and clinical tests to assess signs and symptoms of DED were performed. RESULTS Conjunctival hyperemia and Ocular Surface Disease Index (OSDI) significantly decreased in both treatment groups (p < 0.001 each) after hydrocortisone treatment. A significant increase in tear film thickness was seen 4 weeks after treatment start (p = 0.03 and p = 0.04, respectively). IOP did not change in either of the two treatment groups (p = 0.45). CONCLUSION Treatment with low dose hydrocortisone 0.335% reduced ocular inflammation and decreased OSDI score. No change in IOP was observed in either of the two treatment schedules. Because of its good safety profile, low dose hydrocortisone may be an interesting alternative to standard corticosteroid treatment in DED. FUNDING Laboratories Thea. TRIAL REGISTRATION Clinicaltrials.gov registry: NCT03907865.
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Cardona G, Esterich N. Awareness of treatment: A source of bias in subjective grading of ocular complications. PLoS One 2019; 14:e0226960. [PMID: 31877190 PMCID: PMC6932789 DOI: 10.1371/journal.pone.0226960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 12/10/2019] [Indexed: 11/22/2022] Open
Abstract
PURPOSE Bias has been described as one important obstacle in scientific research. The aim of this study was to explore "awareness of treatment" as a possible source of bias in subjective grading of ocular complications. METHODS Thirty subjects with similar, basic experience with grading scales participated in the study. The Efron grading scales were used to grade 24 images of three different ocular conditions (eight images each of bulbar hyperaemia, limbal vascularization and corneal staining). Three consecutive, two weeks apart, grading sessions were scheduled, in which the same images were graded, although in the third session images were deceptively labelled as either "treated" or "untreated". Grading results from the first and second sessions were compared to determine grading reliability and discrepancies with the third session informed of grading bias originating from "awareness of treatment". RESULTS Moderate to good test-retest reliability was found for all conditions, with median intraclass correlation values of 0.80 (0.62-0.84) for bulbar hyperaemia, 0.68 (0.65-0.77) for limbal vascularization and 0.68 (0.66-0.74) for corneal staining. Grading values from the first and third sessions evidenced negative and positive systematic errors (bias) for "treated" and "untreated" conditions, respectively. Statistically significant differences were found between the average grading discrepancies of session 1 and session 2 and those of session 1 and session 3 (all p<0.001). CONCLUSIONS "Awareness of treatment" may be considered a source of bias of subjective grading of ocular complications, although the actual effect of bias is unlikely to be of clinical significance.
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Affiliation(s)
- Genis Cardona
- Optics and Optometry Department, Universitat Politècnica de Catalunya, Terrassa, Spain
| | - Noelia Esterich
- Optics and Optometry Department, Universitat Politècnica de Catalunya, Terrassa, Spain
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A Gutiérrez M, Giuliani D, A Porta A, Andrinolo D. Relationship between Ocular Surface Alterations and Concentrations of Aerial Particulate Matter. J Ophthalmic Vis Res 2019; 14:419-427. [PMID: 31875096 PMCID: PMC6825693 DOI: 10.18502/jovr.v14i4.5441] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 06/11/2019] [Indexed: 12/18/2022] Open
Abstract
Purpose To evaluate ocular surface alterations in two populations at different exposure levels to particulate matter (PM) in their living and work environments. Methods A cross-sectional study was conducted, including 78 volunteers from Argentina who lived and worked under different pollution levels in an urban (U; n = 44) or industrial zone (I; n = 34). Mean exposure level to PM was evaluated. Responses to the Ocular Symptom Disease Index and McMonnies questionnaire were obtained from all subjects. Subsequently, an assessment through the Schirmer I test (ST), slit lamp microscopy, vital staining, and tear breakup time was conducted. Statistical analyses with Chi-square and Bartlett's tests, as well as Student's t-tests and principal component analysis (PCA), were performed. Results Particles of size < 2.5 μm (PM2.5) level was significantly higher in the I group than the U group (P = 0.04). Ocular surface parameters including bulbar redness, eyelid redness, and the degree of vital staining with fluorescein (SF) and lissamine green (SLG) exhibited difference between the groups. With regards to the tear film, statistically significant differences in the ST value and meibomian gland dysfunction between the groups were detected (P = 0.003 and P = 0.02, respectively). Conjunctival SF and SLG, and ST values were identified as factors which could distinguish groups exposed to different PM levels. Conclusion Subjects exposed to higher levels of PM in the outdoor air presented greater ocular surface alterations. Thus, ST, SF, and SLG values could be used as convenient indicators of adverse health effects due to exposure to air pollution.
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Affiliation(s)
- María A Gutiérrez
- University Extension Environmental Programme (PAEU), Faculty of Exact Sciences, National University of La Plata, Buenos Aires, Argentina.,Center for Environmental Research (CIM), UNLP - CONICET, Buenos Aires, Argentina
| | - Daniela Giuliani
- Center for Environmental Research (CIM), UNLP - CONICET, Buenos Aires, Argentina
| | - Atilio A Porta
- Center for Environmental Research (CIM), UNLP - CONICET, Buenos Aires, Argentina
| | - Darío Andrinolo
- University Extension Environmental Programme (PAEU), Faculty of Exact Sciences, National University of La Plata, Buenos Aires, Argentina
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Lau JK, Wan K, Cheung SW, Vincent SJ, Cho P. Weekly Changes in Axial Length and Choroidal Thickness in Children During and Following Orthokeratology Treatment With Different Compression Factors. Transl Vis Sci Technol 2019; 8:9. [PMID: 31360614 PMCID: PMC6656409 DOI: 10.1167/tvst.8.4.9] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 05/13/2019] [Indexed: 12/13/2022] Open
Abstract
Purpose To determine the influence of compression factor upon changes in axial length and choroidal thickness during and following orthokeratology treatment. Methods Orthokeratology lenses of different compression factors (one eye with 0.75 D and the fellow eye with 1.75 D) were randomly assigned to 28 subjects (median [range] age: 9.3 [7.8–11.0] years). Ocular biometrics were measured weekly for 1 month of lens wear and after lens cessation until the refraction stabilized (mean duration: 2.8 ± 0.4 weeks). Changes between eyes, and the associations between axial shortening and choroidal thickening with other ocular biometrics were analyzed. Results There were no significant between-eye differences in the changes of ocular biometrics (all P > 0.05). After adjusting for paired-eye data, axial length initially decreased by 26 ± 41 μm (P = 0.03) at week 1, then gradually returned to its original length. An approximate antiphase relationship of choroidal thickness (mean change: 9 ± 12 μm, P < 0.001) with axial length was observed. A significant rebound in axial length, but not choroidal thickness, occurred during the cessation period. Central corneal thinning and choroidal thickening accounted for 70% of initial axial shortening. Conclusions Increasing the compression factor by 1.00 D did not affect changes in ocular biometrics in short-term orthokeratology. Significant axial shortening and choroidal thickening were observed during early treatment period. Axial shortening could not be entirely explained by central corneal thinning and choroidal thickening, which warrants further investigation. Translational Relevance Initial axial shortening in orthokeratology is transient and therefore axial length remains useful for long-term monitoring of axial elongation in children.
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Affiliation(s)
- Jason K Lau
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China
| | - Kin Wan
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China
| | - Sin-Wan Cheung
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China
| | - Stephen J Vincent
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Australia
| | - Pauline Cho
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China
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