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Chao C, Skidmore K, Tomiyama ES, Wolffsohn JS, Richdale K. Soft toric contact lens wear improves digital performance and vision-A randomised clinical trial. Ophthalmic Physiol Opt 2023; 43:25-34. [PMID: 36169043 DOI: 10.1111/opo.13053] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 08/21/2022] [Accepted: 08/22/2022] [Indexed: 12/27/2022]
Abstract
PURPOSE To compare objective and subjective digital near visual performance and comfort in low to moderate astigmatic participants fitted with toric versus spherical equivalent silicone hydrogel daily disposable contact lenses. METHODS This was a double-masked, randomised, crossover study. Participants aged 18 to 39 years with astigmatism of -0.75 to -1.50 D were recruited and fitted with toric and spherical contact lenses, in random order. Outcomes were measured at baseline and after 1 week of wear with each contact lens type after the follow-up visits. High- and low-contrast near logMAR visual acuity, automated visual acuity, zoom (%), contrast (%), reading distance (cm), critical print size (logMAR) and reading speed were assessed. Participants also completed the validated Near Activity Visual Questionnaire (NAVQ) and Contact Lens Dry Eye Questionnaire 8 (CLDEQ-8) for each correction type. RESULTS Twenty-three participants completed the study (74% female, average age 24.4 ± 4.2 years). When participants wore toric contact lenses, near high- and low-contrast visual acuity and automated visual acuity improved by 3-4 letters (all p < 0.03) and participants were able to read faster on an iPad (p = 0.02). Participants were also able to read with 8% less contrast on the iPad with toric lenses (p = 0.01). Participants reported better subjective vision on the overall NAVQ (p = 0.001) and better comfort on the CLDEQ-8 (p = 0.02) with toric lenses. Fewer participants reported difficulty with maintaining focus at near, reading small print, reading labels/instructions, reading the computer display/keyboard and reading post/mail with toric correction. CONCLUSIONS Toric contact lenses improve comfort, subjective and objective visual performance with digital devices and other near tasks compared with the spherical equivalent correction in participants with low to moderate astigmatism.
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Affiliation(s)
- Cecilia Chao
- College of Optometry, University of Houston, Houston, Texas, USA
| | - Kelsea Skidmore
- College of Optometry, University of Houston, Houston, Texas, USA
| | - Erin S Tomiyama
- College of Optometry, University of Houston, Houston, Texas, USA
| | | | - Kathryn Richdale
- College of Optometry, University of Houston, Houston, Texas, USA
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2
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Contact Lens Wear Induces Alterations of Lactoferrin Functionality in Human Tears. Pharmaceutics 2022; 14:pharmaceutics14102188. [PMID: 36297623 PMCID: PMC9612143 DOI: 10.3390/pharmaceutics14102188] [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: 09/09/2022] [Revised: 10/10/2022] [Accepted: 10/12/2022] [Indexed: 11/06/2022] Open
Abstract
The tear film is a complex matrix composed of several molecular classes, from small metal ions to macromolecules. Contact lens (CL) wear can affect the protein homeostasis of the tear film, by accumulating deposits on the CL surface and/or altering their structural and functional properties. This work investigates the effect of CL wear on lactoferrin (Lf), one of the most abundant tear proteins, known as an unspecific biomarker of inflammation. Tears from eight volunteers were collected and analyzed after alternated periods of CL wear and without CL. The experimental approach is to probe Lf into unprocessed human tears by the peculiar fluorescence emission originating from complex formation of Lf with terbium (Tb3+) at the iron-binding sites. The experimental data indicate that CL wear does not significantly affect the total amount of Lf. On the other hand, Lf affinity for Tb3+ is reduced upon CL wear, suggesting relevant changes in Lf structure and possible alterations of protein functionality. Future studies based on this approach will help define CL features (material, lens-care solution, wearing time, etc.) with minimal effects on tear protein activity, in order to obtain more biocompatible and comfortable devices.
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Suárez-Cortés T, Merino-Inda N, Benitez-Del-Castillo JM. Tear and ocular surface disease biomarkers: A diagnostic and clinical perspective for ocular allergies and dry eye disease. Exp Eye Res 2022; 221:109121. [PMID: 35605673 DOI: 10.1016/j.exer.2022.109121] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/30/2022] [Accepted: 05/16/2022] [Indexed: 11/04/2022]
Abstract
Validated biomarkers to be used as biological tools for managing ocular surface diseases (OSDs) are still an unmet need in daily clinical practice. Many studies have contributed to the already extensive list of candidate biomarkers for these disorders. Dry eye (DE) and ocular allergy (OA) are complex and multifactorial diseases, often coexisting and with overlapping symptoms. The purpose of this review is to present a comprehensive updated revision of the most relevant biomarkers of DE and OA, with an emphasis on quantitative analyses and correlations with clinical parameter data. Analysis of biomarkers common for these pathologies has highlighted an important physiological process. Namely, the interleukin proteins (IL-1α, IL-1β and IL-17), tumour necrotic factor (TNFα) and interferon gamma (IFNγ; Th1-Th7 pathway) and IL-4, IL-5 and IL-13 (Th2 pathway) seem to represent similar inflammatory mechanisms. Moreover, changes in the levels of mucins (MUC1, MUC2, MUC4, MUC5 and MUC16) are common alterations in the tear film mucous layer. We also examine the current state of medical devices and the main limitations to their use in clinical practice. Translational research in biomarkers for clinical practice depends on a feasible transition from the laboratory to the point-of-care. This requires large-scale, coordinated clinical validation campaigns to select the biomarkers with the highest specificity and sensitivity and significant correlation with clinical parameters. Moreover, technical limitations of multiplexed quantitation systems must be overcome to detect and measure the levels of several biomarkers in very small samples. To ensure the future of biomarker research, significant progress is necessary in a number of fields. There is an urgent need for global unification of clinical classification and diagnostics criteria. Widespread integration of proteomic and transcriptomic data is paramount for performing meaningful analyses using appropriate bioinformatics tools and artificial intelligence systems.
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4
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Jones G, Lee TJ, Glass J, Rountree G, Ulrich L, Estes A, Sezer M, Zhi W, Sharma S, Sharma A. Comparison of Different Mass Spectrometry Workflows for the Proteomic Analysis of Tear Fluid. Int J Mol Sci 2022; 23:2307. [PMID: 35216421 PMCID: PMC8875482 DOI: 10.3390/ijms23042307] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 02/01/2022] [Accepted: 02/15/2022] [Indexed: 12/17/2022] Open
Abstract
The tear film is a multi-layer fluid that covers the corneal and conjunctival epithelia of the eye and provides lubrication, nutrients, and protection from the outside environment. Tear fluid contains a high concentration of proteins and has thus been recognized as a potential source of biomarkers for ocular disorders due to its proximity to disease sites on the ocular surface and the non-invasive nature of its collection. This is particularly true in the case of dry eye disease, which directly impacts the tear film and its components. Proteomic analysis of tear fluid is challenging mainly due to the wide dynamic range of proteins and the small sample volumes. However, recent advancements in mass spectrometry have revolutionized the field of proteomics enabling unprecedented depth, speed, and accuracy, even with small sample volumes. In this study using the Orbitrap Fusion Tribrid mass spectrometer, we compared four different mass spectrometry workflows for the proteomic analysis of tear fluid collected via Schirmer strips. We were able to establish a method of in-strip protein digestion that identified >3000 proteins in human tear samples from 11 healthy subjects. Our method offers a significant improvement in the number of proteins identified compared to previously reported methods without pooling samples.
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Affiliation(s)
- Garrett Jones
- Center for Biotechnology and Genomic Medicine, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | - Tae Jin Lee
- Center for Biotechnology and Genomic Medicine, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | - Joshua Glass
- Center for Biotechnology and Genomic Medicine, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | - Grace Rountree
- Center for Biotechnology and Genomic Medicine, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | - Lane Ulrich
- Department of Ophthalmology, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | - Amy Estes
- Department of Ophthalmology, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | - Mary Sezer
- Department of Ophthalmology, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | - Wenbo Zhi
- Center for Biotechnology and Genomic Medicine, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | - Shruti Sharma
- Center for Biotechnology and Genomic Medicine, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
- Department of Ophthalmology, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | - Ashok Sharma
- Center for Biotechnology and Genomic Medicine, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
- Department of Ophthalmology, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
- Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
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Ramamoorthy P, Khanal S, J Nichols J. Inflammatory proteins associated with contact lens-related dry eye. Cont Lens Anterior Eye 2021; 45:101442. [PMID: 33824065 DOI: 10.1016/j.clae.2021.101442] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 03/17/2021] [Accepted: 03/26/2021] [Indexed: 12/31/2022]
Abstract
PURPOSE To evaluate the levels and regulation of tear film inflammatory proteins in contact lens-related dry eye (CLDE). METHODS One hundred healthy, daily wear (non-overnight), experienced soft contact lens wearers were classified into normal (n = 50) and CLDE (n = 50) groups based on Contact Lens and Dry Eye Questionnaire scores, tear break-up times, and comfort (a two-hour difference between total and comfortable daily lens wear hours). Tear samples (up to 5 μL) were collected by capillary extraction from the inferior meniscus of each eye, and pooled tear samples (10 per group) were tested using a customized Quantibody array. Mann Whitney tests with the Benjamini-Hochberg procedure with a 5% false discovery rate were used to compare the normal and CLDE groups. RESULTS Relative to the normal group, the CLDE group showed a significantly increased tear concentration of several inflammatory mediators, including interleukin (IL)-7 (p = 0.001), IL-8 (p = 0.001), IL-13 (p = 0.001), IL-15 (p = 0.001), IL-12 p70 (p = 0.002), growth-related oncogene-alpha/ chemokine (CXC motif) ligand 1 (p = 0.003), granulocyte-colony stimulating factor (p = 0.005), IL-11 (p = 0.008), epidermal growth factor receptor (p = 0.01), IL-1 receptor antagonist (RA) (p = 0.013), macrophage colony-stimulating factor (p = 0.013), Eotaxin/CC motif chemokine ligand 11 (CCL11) (p = 0.016), and IL-2 (p = 0.016). The following cytokines were increased three-fold or more in the CLDE group: IL-13 (p = 0.001), Eotaxin/CCL11 (p = 0.016), and IL-1RA (p = 0.013). CONCLUSIONS Several inflammatory markers, including interleukins, were increased in tears of subjects with CLDE. These results support a growing body of evidence that suggests a potential role of inflammation in CLDE.
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Affiliation(s)
| | - Safal Khanal
- Department of Optometry and Vision Science, School of Optometry, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jason J Nichols
- Department of Optometry and Vision Science, School of Optometry, University of Alabama at Birmingham, Birmingham, AL, USA.
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CLEAR - Contact lens wettability, cleaning, disinfection and interactions with tears. Cont Lens Anterior Eye 2021; 44:157-191. [DOI: 10.1016/j.clae.2021.02.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 02/01/2021] [Indexed: 12/15/2022]
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7
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CLEAR - Contact lens complications. Cont Lens Anterior Eye 2021; 44:330-367. [DOI: 10.1016/j.clae.2021.02.010] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 02/01/2021] [Indexed: 12/20/2022]
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Anatomical and physiological considerations in scleral lens wear: Eyelids and tear film. Cont Lens Anterior Eye 2021; 44:101407. [PMID: 33468392 DOI: 10.1016/j.clae.2021.01.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 12/31/2020] [Accepted: 01/07/2021] [Indexed: 12/19/2022]
Abstract
Scleral lenses can affect a range of anterior segment structures including the eyelids and the tears. The eyelids, consisting of the outer skin layer, the middle tarsal plate, and the posterior palpebral conjunctiva, provide physical protection and house the meibomian glands and cilia which have important and unique functions. Tears consist of a mix of aqueous, mucus, and lipidomic components that serve vital functions of lubricity, protection, and nourishment to the ocular surface. Both the eyelids and the tear film interact directly with scleral lenses on the eye and can affect but also be impacted by scleral lens wear. The purpose of this paper is to review the anatomy and physiology of the eyelids and tear film, discuss the effects and impacts of the scleral lenses on these structures, and identify areas that require further research.
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Fernández I, López-Miguel A, Martín-Montañez V, Enríquez-de-Salamanca A, Calonge M, González-Méijome JM, González-García MJ. Inflammatory status predicts contact lens discomfort under adverse environmental conditions. Ocul Surf 2020; 18:829-840. [PMID: 32814157 DOI: 10.1016/j.jtos.2020.07.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Revised: 07/15/2020] [Accepted: 07/25/2020] [Indexed: 11/18/2022]
Abstract
PURPOSE To characterize and predict the clinical and tear molecular response of contact lens (CL) wearers exposed to a controlled adverse desiccating environment (CADE). METHODS Objective and subjective variables and tear cytokine levels were evaluated of monthly silicone hydrogel CL wearers pre- and post-90 min of CADE exposure. Unsupervised hierarchical agglomerative clustering based on relative change from baseline values was used to identify response profiles (clusters). A multiple logistic regression model was used to identify cluster membership predictors. RESULTS Forty-seven CL wearers were divided into 3 clusters having similar age (mean: 27.7 ± 7.7 years) and sex distribution. All of them showed a significant (p ≤ 0.05) increase in limbal hyperemia and staining after CADE exposure. Additionally, Cluster-1 (n = 22, 46.8%) membership was characterized by a significant (p ≤ 0.05) higher worsening of corneal and limbal staining, increased CL wear symptoms, and reduced epidermal-growth-factor and increased interleukin (IL)-4 and IL-6 tear levels. Cluster-2 (n = 22, 46.8%) showed no changes (p > 0.05) in symptoms after CADE; however, their IL-12p70, monocyte-chemoattractant-protein-1 and regulated-on-activation, normal-T-cell-expressed-and-secreted (RANTES) post-exposure tear levels significantly (p ≤ 0.05) increased. Finally, Cluster-3 (n = 3, 6.4%) mainly showed significant higher blink rate (78.1 ± 21.7) during CADE. Corneal staining and tear IL-12p70 levels were identified as Cluster-1 membership predictors. CONCLUSIONS Most of silicone hydrogel CL wearers exposed to CADE showed a worsening of the ocular surface integrity and an upregulated tear inflammatory status. However, only half of them reported worsening of CL wear symptoms. These CL wearers were detected based on corneal integrity and tear inflammatory status. These findings can help reduce CL wear discontinuation and drop out.
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Affiliation(s)
- Itziar Fernández
- Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Valladolid, Spain; IOBA (Instituto de Oftalmobiología Aplicada), Universidad de Valladolid, Valladolid, Spain
| | - Alberto López-Miguel
- IOBA (Instituto de Oftalmobiología Aplicada), Universidad de Valladolid, Valladolid, Spain; Red Temática de Investigación Collaborative en Oftalmología (OftaRed), Instituto de Salud Carlos III, Madrid, Spain.
| | | | - Amalia Enríquez-de-Salamanca
- Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Valladolid, Spain; IOBA (Instituto de Oftalmobiología Aplicada), Universidad de Valladolid, Valladolid, Spain
| | - Margarita Calonge
- Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Valladolid, Spain; IOBA (Instituto de Oftalmobiología Aplicada), Universidad de Valladolid, Valladolid, Spain
| | - José M González-Méijome
- Clinical and Experimental Optometry Research Laboratory, Center of Physics, University of Minho, Braga, Portugal
| | - María J González-García
- Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Valladolid, Spain; IOBA (Instituto de Oftalmobiología Aplicada), Universidad de Valladolid, Valladolid, Spain
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10
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López-de la Rosa A, García-Vázquez C, Fernández I, Arroyo-Del Arroyo C, Enríquez-de-Salamanca A, González-García MJ. Substance P Level in Tears as a Potential Biomarker for Contact Lens Discomfort. Ocul Immunol Inflamm 2019; 29:43-56. [PMID: 31600092 DOI: 10.1080/09273948.2019.1668024] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Purpose: To analyze the effects of contact lens (CL) wear, time of the day, and CL discomfort (CLD) on clinical signs, tear inflammatory mediators and substance P.Methods: Thirty symptomatic and 30 asymptomatic CL wearers attended two visits (morning and afternoon) on two days (non-CL and CL wearing days). Comfort, meniscus area, noninvasive breakup time (NIBUT), tear collection, hyperemia, lid parallel conjunctival folds, fluorescein staining, and sensitivity were performed. The tear levels of 23 inflammatory mediators and substance P were measured.Results: Comfort, meniscus area, NIBUT, and MMP-9 were lower while conjunctival staining and EGF higher (p ≤ 0.015) on the CL wearing day. Comfort, IL-8/CXCL8, and VEGF were lower while EGF, IP-10/CXCL10, and MCP-1/CCL2 higher (p ≤ 0.047) in the afternoon. Comfort was lower and substance P higher (p ≤ 0.006) in symptomatic wearers.Conclusion: Substance P may be implicated in CLD etiology; its role and potential application as a biomarker should be further studied.
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Affiliation(s)
- Alberto López-de la Rosa
- Institute of Applied Ophthalmobiology (IOBA), University of Valladolid, Valladolid, Spain.,Department of Theoretical Physics, Atomic and Optics, University of Valladolid, Valladolid, Spain
| | - Carmen García-Vázquez
- Institute of Applied Ophthalmobiology (IOBA), University of Valladolid, Valladolid, Spain
| | - Itziar Fernández
- Institute of Applied Ophthalmobiology (IOBA), University of Valladolid, Valladolid, Spain.,Networking Research Center on Bioengineering Biomaterials and Nanomedicine (CIBER-BBN), Valladolid, Spain
| | - Cristina Arroyo-Del Arroyo
- Institute of Applied Ophthalmobiology (IOBA), University of Valladolid, Valladolid, Spain.,Department of Theoretical Physics, Atomic and Optics, University of Valladolid, Valladolid, Spain
| | - Amalia Enríquez-de-Salamanca
- Institute of Applied Ophthalmobiology (IOBA), University of Valladolid, Valladolid, Spain.,Networking Research Center on Bioengineering Biomaterials and Nanomedicine (CIBER-BBN), Valladolid, Spain
| | - María J González-García
- Institute of Applied Ophthalmobiology (IOBA), University of Valladolid, Valladolid, Spain.,Department of Theoretical Physics, Atomic and Optics, University of Valladolid, Valladolid, Spain.,Networking Research Center on Bioengineering Biomaterials and Nanomedicine (CIBER-BBN), Valladolid, Spain
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11
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Willcox MD. Tear film, contact lenses and tear biomarkers. Clin Exp Optom 2019; 102:350-363. [PMID: 31119796 DOI: 10.1111/cxo.12918] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Revised: 03/30/2019] [Accepted: 04/05/2019] [Indexed: 01/09/2023] Open
Abstract
This article summarises research undertaken since 1993 in the Willcox laboratory at the University of New South Wales, Sydney on the tear film, its interactions with contact lenses, and the use of tears as a source of biomarkers for ocular and non-ocular diseases. The proteome, lipidome and glycome of tears all contribute to important aspects of the tear film, including its structure, its ability to defend the ocular surface against microbes and to help heal ocular surface injuries. The tear film interacts with contact lenses in vivo and interactions between tears and lenses can affect the biocompatibility of lenses, and may be important in mediating discomfort responses during lens wear. Suggestions are made for follow-up research.
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Affiliation(s)
- Mark Dp Willcox
- School of Optometry and Vision Science, The University of New South Wales, Sydney, New South Wales, Australia
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12
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Downie LE, Gad A, Wong CY, Gray JHV, Zeng W, Jackson DC, Vingrys AJ. Modulating Contact Lens Discomfort With Anti-Inflammatory Approaches: A Randomized Controlled Trial. Invest Ophthalmol Vis Sci 2019; 59:3755-3766. [PMID: 30046817 DOI: 10.1167/iovs.18-24758] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To assess the efficacy of anti-inflammatory approaches, comprising a topical corticosteroid and omega-3 supplements, for modulating the inflammatory overlay associated with contact lens discomfort (CLD). Methods This randomized controlled trial involved 72 adults with CLD, randomized (1:1:1:1) to one of the following: placebo (oral olive oil), oral fish oil (900 mg/d eicosapentaenoic acid [EPA] + 600 mg/d docosohexaenoic acid [DHA]), oral combined fish+flaxseed oils (900 mg/d EPA + 600 mg/d DHA + 900 mg/d alpha-linolenic acid), or omega-3 eye-drops (0.025% EPA + 0.0025% DHA four times per day [qid]) for 12 weeks, with visits at baseline, weeks 4 and 12. At week 12, participants who received placebo were assigned a low-potency corticosteroid (fluorometholone [FML] 0.1%, drops, three times per day [tid]) for 2 weeks (week 14). Results Sixty-five participants completed the primary endpoint. At week 12, contact lens dry-eye questionnaire (CLDEQ-8) score was reduced from baseline with oral fish oil (-7.3 ± 0.8 units, n = 17, P < 0.05), compared with placebo (-3.5 ± 0.9 units, n = 16). FML produced significant reductions in tear IL-17A (-71.1 ± 14.3%, n = 12) and IL-6 (-47.6 ± 17.5%, n = 12, P < 0.05) relative to its baseline (week 12). At week 12, tear IL-17A levels were reduced from baseline in the oral fish oil (-63.2 ± 12.8%, n = 12, P < 0.05) and topical omega-3 (-76.2 ± 10.8%, n = 10, P < 0.05) groups, compared with placebo (-3.8 ± 12.7%, n = 12). Tear IL-6 was reduced with all omega-3 interventions, relative to placebo (P < 0.05) at week 12. Conclusions CLD was attenuated by oral long-chain omega-3 supplementation for 12 weeks. Acute (2 week) topical corticosteroids and longer-term (12 week) omega-3 supplementation reduced tear levels of the proinflammatory cytokines IL-17A and IL-6, demonstrating parallels in modulating ocular inflammation with these approaches.
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Affiliation(s)
- Laura E Downie
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Anne Gad
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Chinn Yi Wong
- Department of Microbiology and Immunology at the Peter Doherty Institute of Infection and Immunity, The University of Melbourne, Parkville, Victoria, Australia
| | - John Henry V Gray
- Department of Microbiology and Immunology at the Peter Doherty Institute of Infection and Immunity, The University of Melbourne, Parkville, Victoria, Australia
| | - Weiguang Zeng
- Department of Microbiology and Immunology at the Peter Doherty Institute of Infection and Immunity, The University of Melbourne, Parkville, Victoria, Australia
| | - David C Jackson
- Department of Microbiology and Immunology at the Peter Doherty Institute of Infection and Immunity, The University of Melbourne, Parkville, Victoria, Australia
| | - Algis J Vingrys
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia
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Gad A, Vingrys AJ, Wong CY, Jackson DC, Downie LE. Tear film inflammatory cytokine upregulation in contact lens discomfort. Ocul Surf 2018; 17:89-97. [PMID: 30321605 DOI: 10.1016/j.jtos.2018.10.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Revised: 10/05/2018] [Accepted: 10/11/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE To investigate the ocular inflammatory response, using clinical and immunological techniques, in people experiencing contact lens (CL) discomfort. METHODS This study involved 38 adults who were full-time, silicone-hydrogel CL wearers. Participants were categorized into groups based upon a validated CL dry-eye questionnaire (CLDEQ-8) (n = 17 'asymptomatic', CLDEQ-8 score <9; n = 21 'symptomatic', CLDEQ-8 score ≥13). Examinations were performed at two visits (one with, and one without, CL wear), separated by one-week. Testing included: tear osmolarity, ocular redness, tear stability, ocular surface staining, meibography, tear production and tear collection. Tear osmolarity was taken from the inferior-lateral and superior-lateral menisci. The 'Inferior-Superior Osmotic Difference', I-SOD, was the absolute osmolarity difference between these menisci. Concentrations of seven cytokines (IL-2, IL-4, IL-6, IL-10, IL-17A, IFN-gamma, TNF-alpha) were assayed from basal tears using multiplex cytometric bead array. RESULTS At baseline, there was no significant difference in key clinical signs between asymptomatic and symptomatic CL wearers (p > 0.05). The I-SOD was greater in symptomatic than asymptomatic CL wearers (23.1 ± 2.6 versus 11.3 ± 1.4 mOsmol/L, p = 0.001). People experiencing CL discomfort had higher tear IL-17A (122.6 ± 23.7 versus 44.0 ± 10.0 pg/mL, p = 0.02) and reduced tear stability (6.3 ± 1.1 versus 10.4 ± 1.6 s, p = 0.03) after several hours of CL wear. Tear IL-17A levels correlated with both the I-SOD (r = 0.43, p = 0.01) and CLDEQ-8 score (r = 0.40, p = 0.01). CONCLUSIONS CL discomfort occurs in individuals having no clinical dry eye signs, and is associated with higher tear levels of the pro-inflammatory cytokine IL-17A. These findings support an association between the discomfort response and low-grade, ocular surface inflammation.
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Affiliation(s)
- Anne Gad
- Department of Optometry and Vision Sciences, Australia
| | | | - Chinn Yi Wong
- Department of Microbiology and Immunology at the Peter Doherty Institute of Infection and Immunity, The University of Melbourne, Parkville, Victoria, 3010, Australia
| | - David Charles Jackson
- Department of Microbiology and Immunology at the Peter Doherty Institute of Infection and Immunity, The University of Melbourne, Parkville, Victoria, 3010, Australia
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Superficial Keratopigmentation: An Alternative Solution for Patients With Cosmetically or Functionally Impaired Eyes. Cornea 2018; 38:54-61. [DOI: 10.1097/ico.0000000000001753] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Shi Y, Hu L, Chen W, Qu D, Jiang H, Wang J. Evaluated Conjunctival Blood Flow Velocity in Daily Contact Lens Wearers. Eye Contact Lens 2018; 44 Suppl 1:S238-S243. [PMID: 28410281 PMCID: PMC5640452 DOI: 10.1097/icl.0000000000000389] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE This study examined conjunctival microvasculature development in long-term habitual contact lens (HCL) wearers after a night of sleep. METHODS Twenty HCL wearers (15 women and 5 men, aged 28.6±6.9 years, mean age±standard deviation) who had worn contact lenses on a daily basis for at least 3 years and 40 noncontact lens (NCL) wearers (23 women and 17 men, aged 36.5±6.6 years, mean age±standard deviation) participated in the study. A functional slitlamp biomicroscopy imaging system was used to image the temporal bulbar conjunctiva. Imaging was performed in the morning while the contact lens wearers were not wearing their lenses after a night of sleep. The conjunctival vessel diameters, blood flow velocities, and flow rates were measured. In addition, fractal analyses were performed to obtain the vessel network density (Dbox) and complexity (D0). RESULTS The average blood flow velocity in HCL wearers after a night of sleep was 0.59±0.19 mm/s, which was significantly higher than that in NCL wearers (0.48±0.17 mm/s, P<0.05). The microvessel network density and complexity levels (Dbox=1.64±0.05 and D0=1.71±0.05, respectively) in the HCL wearers were significantly higher than those in NCL wearers (Dbox=1.61±0.05 and D0=1.69±0.04, both P<0.05). The blood flow velocity was positively correlated with the duration of contact lens wear (r=0.46, P<0.05) and with the daily number of lens-wearing hours (r=0.49, P<0.05) in HCL wearers. CONCLUSIONS This study identified microvascular alterations in the conjunctiva in response to daily contact lens wear after a night of sleep in long-term daily contact lens wearers. The unrecovered changes may indicate that para-inflammation occurs on ocular surfaces because of contact lens wear and that overnight sleeping with no lenses may not sufficiently restore the ocular surface to an intact state.
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Affiliation(s)
- Yingying Shi
- Zhongshan Ophthalmic Centre, Sun Yat-sen University, Guangzhou, Guangdong, China
- Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA
| | - Liang Hu
- Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA
- School of Ophthalmology and Optometry, Wenzhou Medical College, Wenzhou, Zhejiang, China
| | - Wan Chen
- Zhongshan Ophthalmic Centre, Sun Yat-sen University, Guangzhou, Guangdong, China
- Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA
| | - Dongyi Qu
- Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA
| | - Hong Jiang
- Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA
| | - Jianhua Wang
- Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA
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Clinical Outcomes and Contact Lens Case Contamination Using a Povidone–Iodine Disinfection System. Eye Contact Lens 2018; 44 Suppl 1:S221-S227. [DOI: 10.1097/icl.0000000000000385] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hu L, Shi C, Jiang H, Shi Y, Sethi Z, Wang J. Factors Affecting Microvascular Responses in the Bulbar Conjunctiva in Habitual Contact Lens Wearers. Invest Ophthalmol Vis Sci 2018; 59:4108-4114. [PMID: 30098199 PMCID: PMC6088803 DOI: 10.1167/iovs.18-24216] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 07/20/2018] [Indexed: 12/20/2022] Open
Abstract
Purpose To investigate the factors affecting microvascular responses in the bulbar conjunctiva of habitual contact lens (HCL) wearers. Methods A functional slit-lamp biomicroscope (FSLB) was used to image the temporal bulbar conjunctiva of habitual contact lens (HCL) wearers and non-contact lens (NCL) wearers. The vessel diameters and blood flow velocities (BFVs) were measured. Fractal analysis using Dbox as vessel density and D0 as vessel complexity were used to quantitatively analyze the microvascular network. One eye each of 91 NCL wearers and 75 HCL wearers was imaged. Results The BFV of NCL wearers was 0.50 ± 0.14 mm/s, which was negatively correlated with age (r = -0.22, P < 0.05). The BFV, vessel diameter, Dbox, and D0 of HCL wearers was significantly higher than NCL wearers (P < 0.05). In these HCL wearers, BFVs were positively correlated with contact lens (CL) hours of wear per day and CL days of wear per week. BFV, Dbox, and D0 were not related to CL years of wear, CL power, CL base curve, and CL diameter (P > 0.05). Conclusions Vascular responses on the bulbar conjunctiva occurred in HCL wearers and appeared to be unrelated to sex or age, CL years of wear, and lens parameters, indicating that wearing a CL itself may be the predominant factor inducing these responses.
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Affiliation(s)
- Liang Hu
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Bascom Palmer Eye Institute, University of Miami, Miami, Florida, United States
| | - Ce Shi
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Bascom Palmer Eye Institute, University of Miami, Miami, Florida, United States
| | - Hong Jiang
- Bascom Palmer Eye Institute, University of Miami, Miami, Florida, United States
| | - Yingying Shi
- Bascom Palmer Eye Institute, University of Miami, Miami, Florida, United States
| | - Zubin Sethi
- School of Business Administration, University of Miami, Miami, Florida, United States
| | - Jianhua Wang
- Bascom Palmer Eye Institute, University of Miami, Miami, Florida, United States
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Wizert A, Iskander DR, Cwiklik L. Interaction of lysozyme with a tear film lipid layer model: A molecular dynamics simulation study. BIOCHIMICA ET BIOPHYSICA ACTA-BIOMEMBRANES 2017; 1859:2289-2296. [DOI: 10.1016/j.bbamem.2017.08.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 08/07/2017] [Accepted: 08/23/2017] [Indexed: 01/07/2023]
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Differences in Tear Film Biochemistry of Symptomatic and Asymptomatic Lens Wearers. Optom Vis Sci 2017; 94:914-918. [DOI: 10.1097/opx.0000000000001110] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Boost M, Cho P, Wang Z. Disturbing the balance: effect of contact lens use on the ocular proteome and microbiome. Clin Exp Optom 2017; 100:459-472. [PMID: 28771841 DOI: 10.1111/cxo.12582] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Revised: 05/29/2017] [Accepted: 06/05/2017] [Indexed: 12/17/2022] Open
Abstract
Contact lens wear is a popular, convenient and effective method for vision correction. In recent years, contact lens practice has expanded to include new paradigms, including orthokeratology; however, their use is not entirely without risk, as the incidence of infection has consistently been reported to be higher in contact lens wearers. The explanations for this increased susceptibility have largely focused on physical damage, especially to the cornea, due to a combination of hypoxia, mechanical trauma, deposits and solution cytotoxicity, as well as poor compliance with care routines leading to introduction of pathogens into the ocular environment. However, in recent years, with the increasing availability and reduced cost of molecular techniques, the ocular environment has received greater attention with in-depth studies of proteins and other components. Numerous proteins were found to be present in the tears and their functions and interactions indicate that the tears are far more complex than formerly presumed. In addition, the concept of a sterile or limited microbial population on the ocular surface has been challenged by analysis of the microbiome. Ocular microbiome was not considered as one of the key sites for the Human Microbiome Project, as it was thought to be limited compared to other body sites. This was proven to be fallacious, as a wide variety of micro-organisms were identified in the analyses of human tears. Thus, the ocular environment is now recognised to be more complicated and interference with this ecological balance may lead to adverse effects. The use of contact lenses clearly changes the situation at the ocular surface, which may result in consequences which disturb the balance in the healthy eye.
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Affiliation(s)
- Maureen Boost
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong.,Squina International Centre for Infection Control, Hong Kong
| | - Pauline Cho
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong.,Squina International Centre for Infection Control, Hong Kong
| | - Zhaoran Wang
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong
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Abstract
The members of the Tear Film Subcommittee reviewed the role of the tear film in dry eye disease (DED). The Subcommittee reviewed biophysical and biochemical aspects of tears and how these change in DED. Clinically, DED is characterized by loss of tear volume, more rapid breakup of the tear film and increased evaporation of tears from the ocular surface. The tear film is composed of many substances including lipids, proteins, mucins and electrolytes. All of these contribute to the integrity of the tear film but exactly how they interact is still an area of active research. Tear film osmolarity increases in DED. Changes to other components such as proteins and mucins can be used as biomarkers for DED. The Subcommittee recommended areas for future research to advance our understanding of the tear film and how this changes with DED. The final report was written after review by all Subcommittee members and the entire TFOS DEWS II membership.
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Deng Z, Wang J, Jiang H, Fadli Z, Liu C, Tan J, Zhou J. Lid Wiper Microvascular Responses as an Indicator of Contact Lens Discomfort. Am J Ophthalmol 2016; 170:197-205. [PMID: 27542928 DOI: 10.1016/j.ajo.2016.08.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 08/04/2016] [Accepted: 08/05/2016] [Indexed: 01/15/2023]
Abstract
PURPOSE To analyze quantitatively the alterations in the microvascular network of the upper tarsal conjunctiva, lid wiper, and bulbar conjunctiva relative to ocular discomfort after contact lens wear. DESIGN A prospective, crossover clinical study. METHODS Functional slit-lamp biomicroscopy was used to image the microvascular network of the upper tarsal conjunctiva, lid wiper, and bulbar conjunctiva. The microvascular network was automatically segmented, and fractal analyses were performed to yield the fractal dimension (Dbox) that represented vessel density. Sixteen healthy subjects (9 female and 7 male) with an average age of 35.5 ± 6.7 years (mean ± standard deviation) were recruited. The right eye was imaged at 9 AM and 3 PM at the first visit (day 1) when the subject was not wearing contact lenses. During the second visit (day 2), the right eye was fitted with a contact lens for 6 hours. Microvascular imaging was performed before (at 9 AM) and after lens wear (at 3 PM). Ocular comfort was rated using a 50-point visual analog scale before and after 6 hours of lens wear, and its relationships with microvascular parameters were analyzed. RESULTS There were no significant differences in Dbox among the upper tarsal conjunctiva, lid wiper, and bulbar conjunctiva among the measurements at 9 AM (day 1 and day 2) and 3 PM (day 1) when the subjects were not wearing the lenses (P > .05), whereas after 6 hours of lens wear, the microvascular network densities were increased in all 3 of these locations. Dbox of the lid wiper increased from 1.411 ± 0.116 to 1.548 ± 0.079 after 6 hours of contact lens wear (P < .01). Dbox of the tarsal conjunctiva was 1.731 ± 0.026 at baseline and increased to 1.740 ± 0.030 (P < .05). Dbox of the bulbar conjunctiva increased from 1.587 ± 0.059 to 1.632 ± 0.060 (P < .001). The decrease in ocular discomfort was strongly related to the Dbox change in the lid wiper (r = 0.61, P < .05). There were no correlations between the changes of ocular comfort and the microvascular network densities of either the tarsal or bulbar conjunctivas (P > .05). CONCLUSIONS This study is the first to show that the microvascular network of the lid wiper can be quantitatively analyzed in contact lens wearers. The microvascular responses of the lid wiper were significantly correlated with contact lens discomfort.
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