1
|
Hosoda Y, Matsuyama H, Akimoto M, Miyazaki C. Surgical outcomes of endoscopic dacryocystorhinostomy for eyes with nasolacrimal duct obstruction via tear meniscus height evaluation. Int Ophthalmol 2024; 44:14. [PMID: 38321290 DOI: 10.1007/s10792-024-02972-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 12/04/2023] [Indexed: 02/08/2024]
Abstract
PURPOSE To evaluate the association of tear meniscus height (TMH) with clinical outcomes of patients who underwent endonasal dacryocystorhinostomy. METHODS We recruited 304 patients from two institutes. The TMH was measured using anterior segment optical coherence tomography before surgery. All patients underwent endoscopic DCR with lacrimal intubation stent insertion. The lacrimal stent was removed 2 months after surgery. The TMH was measured at 2 months and 12 months after surgery. Improvements in epiphora were assessed using a visual analogue scale (range, 0-2). Recurrence was determined based on lacrimal irrigation and endoscopic evaluation results. RESULTS All patients experienced improvements in subjective symptoms 2 months after surgery. The mean TMH also decreased significantly compared with that before surgery. During the follow-up period, four patients experienced recurrence. The mean TMH 12 months after surgery was significantly lower than that before surgery. The rate of change in the TMH was significantly associated with the use of a dacryoendoscope during sheath-guided lacrimal stent intubation at all time points. Of the 251 patients who were followed up at 12 months after surgery, three reported recurrences, and 17 reported mild improvement of epiphora. The rate of change in the TMH was significantly associated with epiphora improvement. Height was also associated with epiphora improvement. CONCLUSIONS Endoscopic DCR is an acceptable surgical procedure for managing nasolacrimal duct obstruction. Sheath-guided lacrimal stent intubation using a dacryoendoscope resulted in a greater reduction in postoperative TMH compared to the blind insertion technique, which may lead to favorable clinical outcomes.
Collapse
Affiliation(s)
- Yoshikatsu Hosoda
- Department of Ophthalmology, Japanese Red Cross Society Osaka Hospital, Osaka, Japan
| | - Hiroko Matsuyama
- Department of Ophthalmology, Japanese Red Cross Society Osaka Hospital, Osaka, Japan.
| | - Masayuki Akimoto
- Department of Ophthalmology, Japanese Red Cross Society Osaka Hospital, Osaka, Japan
| | - Chika Miyazaki
- Department of Ophthalmology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| |
Collapse
|
2
|
Oganov A, Yazdanpanah G, Jabbehdari S, Belamkar A, Pflugfelder S. Dry eye disease and blinking behaviors: A narrative review of methodologies for measuring blink dynamics and inducing blink response. Ocul Surf 2023; 29:166-174. [PMID: 37257694 DOI: 10.1016/j.jtos.2023.05.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 04/28/2023] [Accepted: 05/28/2023] [Indexed: 06/02/2023]
Abstract
Dry eye disease (DED) is a leading cause of ophthalmology clinical encounters with prevalence ranging from 8.7% to 64% in various populations. Blinking is an endogenous process to refresh the tear film, clear debris and maintain quality vision. Altered blinking behavior is a common feature of DED and is implicated in the pathology of the disease. However, lack of a comprehensive review on the relationship between altered blinking behavior and DED is notable in the literature. Blinking behavior may be an effect of DED due to an unstable tear film sensitizing a motor response or be its cause due to destabilization of the tear film in conditions such as benign essential blepharospasm. In this comprehensive review, we summarize the current models and theories of tear film dynamics and blinking behavior to better understand their connection to DED and introduce contemporary technologies and measurement tools used in the evaluation and induction of blinking behavior. We also describe future directions of research to better understand the relationship between DED and blinking and explore therapies that address the abnormal blinking component of DED.
Collapse
Affiliation(s)
- Anthony Oganov
- Department of Ophthalmology, Renaissance School of Medicine, Stony Brook, NY, USA
| | - Ghasem Yazdanpanah
- Illinois Eye and Ear Infirmary, Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Illinois, USA
| | - Sayena Jabbehdari
- Jones Eye Institute, University of Arkansas for Medical Sciences, Arkansas, USA
| | - Aditya Belamkar
- Indiana University School of Medicine, Indianapolis, IN, USA
| | | |
Collapse
|
3
|
Merino ML, Belmonte J, Rosas J, Acosta MC, Gallar J, Belmonte C. Maximal tear secretion evoked by controlled stimulation of corneal sensory nerves in healthy individuals and dry eye subjects. Ocul Surf 2023; 27:80-88. [PMID: 36396021 DOI: 10.1016/j.jtos.2022.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 11/10/2022] [Accepted: 11/10/2022] [Indexed: 11/16/2022]
Abstract
PURPOSE To measure, the tear flow changes evoked in healthy subjects and dry eye disease (DED) patients by controlled sensory stimulation of the eye surface with i-Onion™, a new stimulation device. METHODS Sensory corneal nerves were stimulated with an instrument (i-Onion™) that ejects puffs of CO2 gas (99.9%) at 200 ml·min-1 for 3s, delivered 5 mm from the cornea. Using Schirmer test strips, tear volumes were measured over 3 min in the cornea of one eye before (basal tear volume -BTV) and in the other eye after stimulation of the sensory nerves with CO2 (stimulated tear volume -STV). These measurements were obtained from a control group of adults of either sex (17 students aged 20-30 and 29 subjects without signs of dry eye aged 25-61), a cohort of DED patients (aged 34-75) that included 12 asymptomatic, suspected DED subjects (Schirmer <7 mm and/or TBUT <10s), and 30 Sjögren's syndrome (SS) patients. RESULTS CO2 stimulation significantly increased the tear volume (BTV = 14.6 ± 1.0 mm, STV = 19.0 ± 1.1 mm: n = 46) in 78% of control subjects, reflecting a mean tear reserve volume (TRV = STV-BTV) of 4.4 ± 0.8 mm. Individual differences were wide, and while no increase in reflex tearing was evoked in 30% of subjects with a BTV >10 mm, the remaining 70% responded vigorously to stimulation, even those with a BTV >18 mm. Asymptomatic DED subjects displayed weaker responses to CO2 stimulation, with lower STVs. Both the BTV and STV of SS patients were low, significantly below those of the healthy controls. CONCLUSIONS Measuring the rise in reflex tearing volume evoked by controlled corneal stimulation provides objective information about the tear glands' secretory capacity in health and disease.
Collapse
Affiliation(s)
- María L Merino
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, San Juan de Alicante, Spain; Oftalmología, Hospital de la Marina Baixa, Villajoyosa, Spain
| | - Javier Belmonte
- Oftalmología, Hospital General Universitario de Alicante, Alicante, Spain
| | - José Rosas
- Reumatología, Hospital de la Marina Baixa, Villajoyosa, Spain
| | - M Carmen Acosta
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, San Juan de Alicante, Spain
| | - Juana Gallar
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, San Juan de Alicante, Spain; Instituto de Investigación Biomédica y Sanitaria de Alicante, San Juan de Alicante, Spain
| | - Carlos Belmonte
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, San Juan de Alicante, Spain.
| |
Collapse
|
4
|
Singh S, Srivastav S, Mohamed A, Basu S. Non-invasive Tear Film Assessment in Normal Population: Effect of Age, Sex, and Interparametric Relationship. Front Med (Lausanne) 2022; 9:894184. [PMID: 35721069 PMCID: PMC9198354 DOI: 10.3389/fmed.2022.894184] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 04/29/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose: To investigate age- and sex-related differences in tear film parameters of normal Indian population and study interparametric relationships. Methods Healthy subjects with no ocular disease (median ocular surface disease index = 0) were subjected to an automated evaluation of tear meniscus height (TMH), non-invasive tear breakup time (NIBUT) using Keratograph 5M (OCULUS GmbH, Wetzlar, Germany), and tear osmolarity using the TearLab Osmolarity System (TearLab Corporation, California, USA). A mixed-effects model with random intercepts at the patient level was used to evaluate the relationships between explanatory (age, gender, and tear osmolarity) and outcome variables (TMH and NIBUT). Results A total of 237 subjects (474 eyes; 150 males) were enrolled with a mean age of 40 ± 17 years (range, 10-78 years). The mean values (± standard deviation) of TMH, NIBUT, and tear osmolarity were 0.34 ± 0.07 mm, 10.95 ± 2.02 s and 289.0 ± 5.8 mOsm/L, respectively. Age had a significant positive relationship with TMH (p < 0.0001; 0.002 mm/year; r = 0.12), but there was no effect on NIBUT (p = 0.26) and tear osmolarity (p = 0.27). There were no sex-based differences in tear film parameters. Interparametric relationship revealed no significant association between TMH and NIBUT (p = 0.12) or tear osmolarity and TMH (p = 0.83) or tear osmolarity and NIBUT values (p = 0.48). Conclusions In a normal Indian population, TMH is weakly affected by age and is independent of sex, NIBUT, and tear osmolarity. Tear breakup time and osmolarity show no significant age- and sex-related variation.
Collapse
Affiliation(s)
- Swati Singh
- Centre for Ocular Regeneration, L V Prasad Eye Institute, Hyderabad, India.,Ophthalmic Plastic Surgery Services, L V Prasad Eye Institute, Hyderabad, India
| | - Saumya Srivastav
- Centre for Ocular Regeneration, L V Prasad Eye Institute, Hyderabad, India
| | - Ashik Mohamed
- Ophthalmic Biophysics Laboratory, L V Prasad Eye Institute, Hyderabad, India
| | - Sayan Basu
- Centre for Ocular Regeneration, L V Prasad Eye Institute, Hyderabad, India.,The Cornea Institute, L V Prasad Eye Institute, Hyderabad, India
| |
Collapse
|
5
|
Measurement of the Lower Lid Margin Thickness by Oculus Keratograph. Eye Contact Lens 2021; 47:341-346. [PMID: 33813586 DOI: 10.1097/icl.0000000000000782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To investigate the lower lid margin thickness (LLMT) from the posterior lash line to the anterior edge of tear meniscus with Oculus Keratograph 4 (K4). METHODS This was a prospective, single-center, observational study. A total of 90 volunteers aged 18 to 79 years with no ocular diseases were included in this study. The LLMT of 90 subjects was measured twice by the same person with K4. To determine the reliability of K4, measuring the LLMT of 30 normal subjects was separately performed by two operators. RESULTS The LLMT measurements with K4 between two operators demonstrated a good reproducibility (0.94±0.18 vs. 0.96±0.16 mm; intraclass correlation coefficient=0.88; P=0.18). The mean age of 90 volunteers (42 men and 48 women) was 45.5±14.1 years. The LLMT was 0.95±0.17 mm, which was a significant positive correlation with age (rs=0.57; P<0.001). In addition, there was no significant difference in the LLMT between genders (0.97±0.16 vs. 0.93±0.18 mm; P=0.32). CONCLUSIONS We found that K4 was a reliable tool in the LLMT measurements, and the LLMT seemed to be closely related to age but not to gender.
Collapse
|
6
|
Galletti JG, de Paiva CS. The ocular surface immune system through the eyes of aging. Ocul Surf 2021; 20:139-162. [PMID: 33621658 PMCID: PMC8113112 DOI: 10.1016/j.jtos.2021.02.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 02/04/2021] [Accepted: 02/16/2021] [Indexed: 02/06/2023]
Abstract
Since the last century, advances in healthcare, housing, and education have led to an increase in life expectancy. Longevity is accompanied by a higher prevalence of age-related diseases, such as cancer, autoimmunity, diabetes, and infection, and part of this increase in disease incidence relates to the significant changes that aging brings about in the immune system. The eye is not spared by aging either, presenting with age-related disorders of its own, and interestingly, many of these diseases have immune pathophysiology. Being delicate organs that must be exposed to the environment in order to capture light, the eyes are endowed with a mucosal environment that protects them, the so-called ocular surface. As in other mucosal sites, immune responses at the ocular surface need to be swift and potent to eliminate threats but are at the same time tightly controlled to prevent excessive inflammation and bystander damage. This review will detail how aging affects the mucosal immune response of the ocular surface as a whole and how this process relates to the higher incidence of ocular surface disease in the elderly.
Collapse
Affiliation(s)
- Jeremias G Galletti
- Innate Immunity Laboratory, Institute of Experimental Medicine (IMEX), CONICET-National Academy of Medicine, Buenos Aires, Argentina.
| | - Cintia S de Paiva
- Ocular Surface Center, Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, TX, 77030, USA.
| |
Collapse
|
7
|
Normalized ocular surface temperature models for tear film characteristics and dry eye disease evaluation. Ocul Surf 2020; 19:74-82. [PMID: 32298795 DOI: 10.1016/j.jtos.2020.04.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 02/25/2020] [Accepted: 04/04/2020] [Indexed: 11/21/2022]
Abstract
PURPOSE To construct normalized ocular surface temperature (NOST) models for different tear film characteristics and evaluate its potential in dry-eyes screening. METHODS We included 227 right eyes of 227 patients. Tear film characteristics were categorized into 4 types according to fluorescein tear film breakup time (FTBUT) and Schirmer test results, namely type 1: FTBUT >5 s and Schirmer >5 mm; type 2: FTBUT ≤5 s and Schirmer >5 mm; type 3: FTBUT ≤5 s and Schirmer ≤5 mm; and type4: FTBUT >5 s and Schirmer ≤5 mm. Ocular surface temperature was measured by a video-thermographer. Mean temperatures of the central cornea were calculated from the videos of each frame during the 4-s blink interval. We first constructed individual NOST model for every tear characteristic. Participants were included for further analysis when their OSDI was ≥23, FTBUT ≤5 s, and Schirmer >5 mm. They were subdivided into short-BUT and short BUT with SPK subgroups according to the absence or presence of corneal fluorescein-stain. The NOST models of the normal, short-BUT and short BUT with SPK groups were separately constructed and the potential of screening analyzed via ROC curves. RESULTS Each tear film type had a different NOST model. At 3 s after blinking, the order of NOST was type 4 >type 1 >type 3 >type 2. In dry-eye screening, the NOST was normal > short-BUT > short BUT with SPK. The NOST displayed a sensitivity 0.87, specificity 0.80, and AUC 0.88 for diagnosing short BUT with SPK. CONCLUSION NOST models are useful in differentiating tear film characteristics and screening dry-eyes. It alleviates the discomfort and inconvenience encountered during conventional dry-eye diagnosis.
Collapse
|
8
|
Alam J, de Paiva CS, Pflugfelder SC. Immune - Goblet cell interaction in the conjunctiva. Ocul Surf 2020; 18:326-334. [PMID: 31953222 DOI: 10.1016/j.jtos.2019.12.006] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 11/24/2019] [Accepted: 12/15/2019] [Indexed: 02/06/2023]
Abstract
The conjunctiva is a goblet cell rich mucosal tissue. Goblet cells are supported by tear growth factors and IL-13 produced by resident immune cells. Goblet cell secretions are essential for maintaining tear stability and ocular surface homeostasis. In addition to producing tear stabilizing mucins, they also produce cytokines and retinoic acid that condition monocyte-derived phagocytic cells in the conjunctiva. Aqueous tear deficiency from lacrimal gland disease and systemic inflammatory conditions results in goblet cell loss that amplifies dry eye severity. Reduced goblet cell density is correlated with more severe conjunctival disease, increased IFN-γ expression and antigen presenting cell maturation. Sterile Alpha Motif (SAM) pointed domain epithelial specific transcription factor (Spdef) gene deficient mice that lack goblet cells have increased infiltration of monocytes and dendritic cells with greater IL-12 expression in the conjunctiva. Similar findings were observed in the conjunctiva of aged mice. Reduced retinoic acid receptor (RXRα) signaling also increases conjunctival monocyte infiltration, IFN-γ expression and goblet cell loss. Evidence suggests that dry eye therapies that suppress IFN-γ expression preserve conjunctival goblet cell number and function and should be considered in aqueous deficiency.
Collapse
Affiliation(s)
- Jehan Alam
- Department of Ophthalmology, Baylor College of Medicine, Houston, TX, United States
| | - Cintia S de Paiva
- Department of Ophthalmology, Baylor College of Medicine, Houston, TX, United States
| | - Stephen C Pflugfelder
- Department of Ophthalmology, Baylor College of Medicine, Houston, TX, United States.
| |
Collapse
|
9
|
Arita R, Yabusaki K, Hirono T, Yamauchi T, Ichihashi T, Fukuoka S, Morishige N. Automated Measurement of Tear Meniscus Height with the Kowa DR-1α Tear Interferometer in Both Healthy Subjects and Dry Eye Patients. Invest Ophthalmol Vis Sci 2019; 60:2092-2101. [PMID: 31091317 DOI: 10.1167/iovs.18-24850] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To develop and assess a method for quantitation of lower tear meniscus height (TMH) with the Kowa DR-1α tear interferometer. Methods Sixty-nine eyes of 49 men and 20 women (36 healthy volunteers, 33 patients with aqueous-deficient dry eye [ADDE]; mean age ± SD, 50.0 ± 14.0 years) were enrolled. TMH of each subject was measured by two observers both with DR-1α and newly developed software and with anterior-segment swept-source optical coherence tomography (SS-OCT). Intraoperator repeatability and interoperator and intersession reproducibility of measurements were assessed based on the within-subject SD (Sw), coefficient of variation (CV), and intraclass correlation coefficient (ICC). Agreement between the two devices was assessed by regression and Bland-Altman analysis. Results The CV for system repeatability of DR-1α was <2.0%. The CV for intraoperator repeatability and interoperator and intersession reproducibility for DR-1α measurements was ≤9.6%, ≤4.5%, and ≤4.4% in healthy subjects, respectively, and ≤16.8%, ≤9.8%, and ≤10.3% in ADDE patients. All corresponding ICC values were ≥0.87 in healthy subjects and ≥0.48 in ADDE patients. Bland-Altman plots indicated a high level of agreement between the two devices. Schirmer test value was significantly correlated with interferometric TMH in both healthy subjects (β = 0.59, P < 0.001) and ADDE patients (β = 0.47, P = 0.017). Conclusions Tear interferometry allows measurement of TMH as reliably as does SS-OCT. DR-1α may inform not only the diagnosis of dry eye disease but also identification of disease subtype.
Collapse
Affiliation(s)
- Reiko Arita
- Itoh Clinic, Saitama, Japan.,Lid and Meibomian Gland Working Group (LIME), Tokyo, Japan
| | | | | | | | | | - Shima Fukuoka
- Lid and Meibomian Gland Working Group (LIME), Tokyo, Japan.,Omiya Hamada Eye Clinic, Saitama, Japan
| | - Naoyuki Morishige
- Lid and Meibomian Gland Working Group (LIME), Tokyo, Japan.,Division of Cornea and Ocular Surface, Ohshima Eye Hospital, Fukuoka, Japan
| |
Collapse
|
10
|
Lam AK, Tai SK, Chan JK, Ng RW. Lower Tear Meniscus Height Measurements Using Keratography and Swept-Source Optical Coherence Tomography and Effect of Fluorescein Instillation Methods. Curr Eye Res 2019; 44:1203-1208. [PMID: 31184506 DOI: 10.1080/02713683.2019.1629598] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Purpose: The first aim of this study was to compare inferior tear meniscus height (TMH) measured by keratography and swept-source optical coherence tomography (OCT). Effect of locations of fluorescein instillation and subjects' subjective sensation, and the TMH results were also investigated.Methods: Forty-one eyes from 41 healthy adults had TMH randomly measured by keratography (K5M, Oculus, Germany) and swept-source OCT (Casia SS-1000, Tomey Corp, Japan) at baseline, followed by touching either the inferior bulbar or inferior palpebral conjunctiva, randomly assigned, with a moistened fluorescein strip. Two-way analysis of variance (ANOVA) was used to compare TMH obtained from the two devices and three measurement conditions. Subjective sensation of conjunctival touch was obtained through a 4-point scale with zero representing no sensation, and one to three representing ocular sensation in an ascending order.Results: Two-way ANOVA revealed no significant difference in TMH between keratography and swept-source OCT (Factor (devices): F = 0.579, p = .451) while there was a significant difference among fluorescein instillations (Factor (conditions): F = 10.146, p < .001). Baseline TMH was around 0.25 mm, and increased to around 0.28 mm after instillation of fluorescein sodium. Ocular sensation was similar between the two conjunctival touch, and TMH was not significantly associated with ocular sensation.Conclusions: Keratography and swept-source OCT provided similar TMH results. Applying fluorescein sodium through moistened fluorescein strip could over-estimate TMH by around 0.03 mm. Applying moistened fluorescein strip at bulbar or palpebral conjunctival led to similar subjective sensations and did not affect TMH measurement.
Collapse
Affiliation(s)
- Andrew Kc Lam
- Laboratory of Experimental Optometry, School of Optometry, The Hong Kong Polytechnic University, Hong Kong, China
| | - Shirley Ky Tai
- Laboratory of Experimental Optometry, School of Optometry, The Hong Kong Polytechnic University, Hong Kong, China
| | - Jacky Kt Chan
- Laboratory of Experimental Optometry, School of Optometry, The Hong Kong Polytechnic University, Hong Kong, China
| | - Raymond Wc Ng
- Laboratory of Experimental Optometry, School of Optometry, The Hong Kong Polytechnic University, Hong Kong, China
| |
Collapse
|
11
|
Rooibos (Aspalathus linearis) extract, containing eriodictyol-6-C-β-d-glucoside as the active component, stimulates exocrine glands via the M3 muscarinic acetylcholine receptor. J Funct Foods 2019. [DOI: 10.1016/j.jff.2019.02.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
|
12
|
Lee SM, Chung SJ, Park JS, Lew H. Changes in Tear Meniscus Height Following Lower Blepharoplasty as Measured by Optical Coherence Tomography. KOREAN JOURNAL OF OPHTHALMOLOGY 2018; 32:344-352. [PMID: 30311456 PMCID: PMC6182218 DOI: 10.3341/kjo.2017.0125] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 01/26/2018] [Indexed: 11/28/2022] Open
Abstract
Purpose The lower eyelid serves important roles in tear distribution and drainage. The purpose of this study was to measure the tear meniscus height (TMH) with anterior segment optical coherence tomography after lower blepharoplasty. Methods A total of 52 eyes from 26 patients treated between July 2012 and June 2015 were included in the study. A transcutaneous or transconjunctival approach was performed, depending on whether (1) the supportive lower lid orbicularis oculi muscle was tightened, (2) the middle lamella was elongated, (3) minimal fat was removed or transpositioned, and (4) lateral canthal support was established. Marginal reflex distance 2 and marginal nose distance were analyzed with Image J software. TMH was measured with anterior segment optical coherence tomography. A paired t-test and Wilcoxon signed-rank test were used for statistical comparisons. Results Marginal reflex distance 2 decreased and marginal nose distance increased with both surgical techniques. TMH decreased from 337.3 ± 117.9 to 289.3 ± 69.1 µm (p = 0.024) in patients who had transcutaneous lower blepharoplasty, but increased from 186.5 ± 35.5 to 274.8 ± 58.3 µm (p = 0.000) in patients who had transconjunctival lower blepharoplasty. Medial and lateral TMHs decreased significantly from 228.8 ± 80.7 to 152.7 ± 42.1 µm (p = 0.008) in patients with transcutaneous lower blepharoplasty. TMH was significantly restored after lower blepharoplasty with either approach. Conclusions Enhancing the lower eyelid position combined with orbicularis muscle tightening and lateral canthal support can normalize the TMH following lower eyelid blepharoplasty.
Collapse
Affiliation(s)
- Sang Min Lee
- Department of Ophthalmology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Sok Joong Chung
- Department of Ophthalmology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Jong Seo Park
- Department of Ophthalmology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Helen Lew
- Department of Ophthalmology, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
| |
Collapse
|
13
|
Tear Meniscus and Corneal Sub-basal Nerve Plexus Assessment in Primary Sjögren Syndrome and Sicca Syndrome Patients. Cornea 2018; 38:221-228. [DOI: 10.1097/ico.0000000000001800] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
|
14
|
Ang M, Baskaran M, Werkmeister RM, Chua J, Schmidl D, Aranha dos Santos V, Garhöfer G, Mehta JS, Schmetterer L. Anterior segment optical coherence tomography. Prog Retin Eye Res 2018; 66:132-156. [DOI: 10.1016/j.preteyeres.2018.04.002] [Citation(s) in RCA: 216] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 02/20/2018] [Accepted: 04/04/2018] [Indexed: 02/03/2023]
|
15
|
Choi YJ, Kim SJ, Yoo JM, Seo SW. Efficacy of Intraoperative Mitomycin C Eye Drops during and after Dacryocystorhinostomy for Canalicular Obstruction. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2018. [DOI: 10.3341/jkos.2018.59.10.899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Yu-Jin Choi
- Department of Ophthalmology, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Seong Jae Kim
- Department of Ophthalmology, Gyeongsang National University School of Medicine, Jinju, Korea
- Gyeongsang Institute of Health Science, Gyeongsang National University, Jinju, Korea
| | - Ji Myong Yoo
- Department of Ophthalmology, Gyeongsang National University School of Medicine, Jinju, Korea
- Gyeongsang Institute of Health Science, Gyeongsang National University, Jinju, Korea
| | - Seong Wook Seo
- Department of Ophthalmology, Gyeongsang National University School of Medicine, Jinju, Korea
- Gyeongsang Institute of Health Science, Gyeongsang National University, Jinju, Korea
| |
Collapse
|
16
|
Sung Y, Park JS, Lew H. Measurement of lacrimal punctum using spectralis domain anterior optical coherence tomography. Acta Ophthalmol 2017; 95:e619-e624. [PMID: 28029231 DOI: 10.1111/aos.13322] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 10/07/2016] [Indexed: 11/29/2022]
Abstract
PURPOSE Anterior segment optical coherence tomography (AS-OCT) was used to image the lacrimal punctum and establish normal punctal parameters including the tear volume inside the punctum. METHODS This study included totally 67 eyes from 38 normal subjects. Punctal parameters and tear meniscus height (TMH) were measured using spectralis OCT anterior-segment scans. Outer punctal diameter (OPD), punctal depth, tear well diameter (TWD), tear well depth, punctal reserve (PR) and lower eyelid TMH were assessed. Authors defined a 'tear well' as a pool of standing tears in the punctum. Punctal reserve was defined as the difference between punctal depth and tear well depth. RESULTS Outer punctal diameter was 614.6 ± 195.6 μm, the punctal depth was 545.8 ± 270.1 μm, TWD was 229.9 ± 133.8 μm, the tear well depth was 434.9 ± 247.8 μm, the PR was 110.9 ± 72.9 μm, the PR ratio was 0.20 ± 0.17, and the TMH was 222.9 ± 88.8 μm. The punctal depth decreased significantly according to the patient's age (correlation coefficient = -0.352, respectively). CONCLUSION AS-OCT is useful for improving anatomical understanding of the lacrimal punctal structure. Quantitative punctum and tear well measurements were correlated with TMH.
Collapse
Affiliation(s)
- Youngje Sung
- Department of Ophthalmology; Bundang CHA Hospital; CHA University; College of Medicine; Seongnam Republic of Korea
| | - Jong Seo Park
- Department of Ophthalmology; Bundang CHA Hospital; CHA University; College of Medicine; Seongnam Republic of Korea
| | - Helen Lew
- Department of Ophthalmology; Bundang CHA Hospital; CHA University; College of Medicine; Seongnam Republic of Korea
| |
Collapse
|
17
|
TFOS DEWS II Diagnostic Methodology report. Ocul Surf 2017; 15:539-574. [DOI: 10.1016/j.jtos.2017.05.001] [Citation(s) in RCA: 836] [Impact Index Per Article: 119.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2017] [Accepted: 05/01/2017] [Indexed: 01/09/2023]
|
18
|
Imamura H, Tabuchi H, Nakakura S, Nagasato D, Baba H, Kiuchi Y. Usability and reproducibility of tear meniscus values generated via swept-source optical coherence tomography and the slit lamp with a graticule method. Int Ophthalmol 2017; 38:679-686. [PMID: 28393321 PMCID: PMC5932105 DOI: 10.1007/s10792-017-0517-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 04/04/2017] [Indexed: 12/16/2022]
Abstract
Purpose To investigate the usability and the reproducibility of the tear meniscus values via swept-source optical coherence tomography (SS-OCT) and the conventional slit lamp microscope method with a graticule. Methods The right eye was examined in 90 healthy adult subjects who were grouped according to age (group 1: 20–39 years; group 2: 40–59 years; group 3: ≥60 years). The tear meniscus height (TMH) and tear meniscus area were measured using SS-OCT and TMH by the slit lamp microscope method. The reproducibility of each method was calculated using intraclass correlation coefficients (ICCs) in additionally enrolled 30 healthy young subjects. We also evaluated TMH at 3 mm from the corneal center in both temporal and nasal directions using SS-OCT. Results The mean of the TMH values measured by SS-OCT was significantly higher than those measured by the slit lamp method (328 vs. 212 μm, P < 0.001, respectively). High reproducibility was observed for each method (ICC > 0.75 for both). No statistically significant differences were found in TMH among the age groups using both SS-OCT and slit lamp methods (P = 0.985, 0.380, respectively). TMH values at both sides of the corneal center were significantly smaller than those at the corneal center (P < 0.0001). Conclusions TMH values obtained by the slit lamp method were lower than those obtained by SS-OCT. However, both methods yielded highly reproducible TMH measurements, suggesting that they are clinically useful. Tear meniscus values did not vary by age but by measurement points in our cohort.
Collapse
Affiliation(s)
- Hitoshi Imamura
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, 68-1, Aboshi Waku, Himeji, 671-1227, Japan. .,Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
| | - Hitoshi Tabuchi
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, 68-1, Aboshi Waku, Himeji, 671-1227, Japan
| | - Shunsuke Nakakura
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, 68-1, Aboshi Waku, Himeji, 671-1227, Japan
| | - Daisuke Nagasato
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, 68-1, Aboshi Waku, Himeji, 671-1227, Japan
| | - Hiroaki Baba
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, 68-1, Aboshi Waku, Himeji, 671-1227, Japan
| | - Yoshiaki Kiuchi
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| |
Collapse
|
19
|
Raj A, Dhasmana R, Nagpal RC. Anterior Segment Optical Coherence Tomography for Tear Meniscus Evaluation and its Correlation with other Tear Variables in Healthy Individuals. J Clin Diagn Res 2016; 10:NC01-4. [PMID: 27437253 DOI: 10.7860/jcdr/2016/18717.7722] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 03/01/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Dry eye is one of the most common ocular diseases in this cyber era. Despite availability of multiple tests, no single test is accurate for the diagnosis of dry eye. Anterior segment optical coherence tomography is the recent tool which can be added in the armentarium of dry eye tests. AIM To evaluate tear meniscus with anterior segment optical coherence tomography and its correlation with other tear variables in normal healthy individuals. MATERIALS AND METHODS In this prospective cross-sectional observational study, right eye of 203 consecutive patients were studied. All the patients were divided into three groups Group 1, 2 and 3 according to their age ≤20 years, 21-40 years and >40 years respectively. All patients underwent routine ophthalmologic examinations along with slit-lamp bio-microscopy for tear meniscus height measurement, tear film break up time, Schirmer's I test (with anaesthesia) and optical coherence tomography imaging of inferior tear meniscus height. After focusing of the instrument with a Cross Line (CL) centered on lower tear meniscus at 6'0 clock of cornea, a 6 mm long scan was obtained. The tear meniscus height (μm) and tear meniscus area (mm(2)) were measured manually with help of callipers by joining upper corneo-meniscus junction to the lower lid-meniscus junction and tear meniscus height and area within the plotted line respectively and calculated by using the integrated analysis available in the custom software. RESULTS There was significant decrease in the all tear variables with the increase in the age. According to age groups in group 1, the mean Schirmer's (24.0±4.9)mm, tear film break up time (11.1±1.9) sec, tear meniscus height on slit lamp (600.2±167.3)mm were higher but decreased in group 2 (21.5±5.4,10.8±1.4, 597.5±186.3) and group 3 (19.8 ± 5.1, 10.2 ± 1.6, 485.6 ± 157.7) respectively. Schirmer's test values and tear film break up time were similar in both sexes (p=0.1 and p= 0.9). Tear meniscus height on slit lamp and Optical coherence based tear meniscus area were similar in both sexes (p=0.5 and p=0.1). However, tear meniscus height on optical coherence tomography was significantly higher in females (p=0.04). Value of Schirmer's and tear film break up time (r =0.2; p= 0.001) and Schirmer's and tear meniscus height on slit lamp (r=0.6; p<0.001) had positive correlation. Tear meniscus height and tear meniscus area on optical coherence tomography had positive correlation (r =.9; p<0.001). CONCLUSION On optical coherence tomography tear meniscus height and area significantly correlated. Despite higher values of Schirmer's, tear film break up time, Slit lamp based tear meniscus height in younger age group the tear meniscus height and tear meniscus area with optical coherence tomography were lower.
Collapse
Affiliation(s)
- Anuradha Raj
- Assistant Professor, Department of Ophthalmology, HIMS, Swami Rama Himalayan University , Swami Ram Nagar, Jolly Grant, Dehradun, Uttarakhand, India
| | - Renu Dhasmana
- Professor, Department of Ophthalmology, HIMS, Swami Rama Himalayan University , Swami Ram Nagar, Jolly Grant, Dehradun, Uttarakhand, India
| | - Ramesh Chander Nagpal
- Professor, Department of Ophthalmology, HIMS, Swami Rama Himalayan University , Swami Ram Nagar, Jolly Grant, Dehradun, Uttarakhand, India
| |
Collapse
|
20
|
Repeatability and Reproducibility of Noninvasive Keratograph 5M Measurements in Patients with Dry Eye Disease. J Ophthalmol 2016; 2016:8013621. [PMID: 27190639 PMCID: PMC4844888 DOI: 10.1155/2016/8013621] [Citation(s) in RCA: 104] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Accepted: 03/30/2016] [Indexed: 12/02/2022] Open
Abstract
Purpose. To determine the intraexaminer repeatability and interexaminer reproducibility of tear meniscus height (TMH) and noninvasive Keratograph tear breakup time (NIKBUT) measurements obtained with the Keratograph 5M (K5M) in a sample of healthy and dry eye populations. Methods. Forty-two patients with dry eye disease (DED group) and 42 healthy subjects (healthy group) were recruited in this prospective study. In all subjects, each eye received 3 consecutive measurements using the K5M for the TMH and NIKBUTs (NIKBUT-first and NIKBUT-average). And then a different examiner repeated the measurements. The repeatability and reproducibility of measurements were assessed by the coefficient of variation (CV) and intraclass correlation coefficient (ICC). Results. The repeatability and reproducibility of TMH and NIKBUTs were good in both DED and healthy groups (CV% ≤ 26.1% and ICC ≥ 0.75 for all measurements). Patients with DED showed better intraexaminer repeatability for NIKBUTs, but worse for TMH than healthy subjects. Average TMH, NIKBUT-first, and NIKBUT-average were significantly lower in DED group than in healthy group (all P values < 0.05). Conclusions. Measurements of TMH and NIKBUTs obtained with the K5M may provide a simple, noninvasive screening test for dry eye with acceptable repeatability and reproducibility. The NIKBUTs were more reliable, but TMH was less reliable in patients with DED.
Collapse
|
21
|
|
22
|
You IC, Bian F, Volpe EA, de Paiva CS, Pflugfelder SC. Age-Related Conjunctival Disease in the C57BL/6.NOD-Aec1Aec2 Mouse Model of Sjögren Syndrome Develops Independent of Lacrimal Dysfunction. Invest Ophthalmol Vis Sci 2015; 56:2224-33. [PMID: 25758816 DOI: 10.1167/iovs.14-15668] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
PURPOSE To investigate parameters of ocular surface disease in C57BL/6.NOD-Aec1Aec2 (Aec) mice with aging and their correlation with development of Sjögren syndrome (SS)-like lacrimal gland (LG) disease. METHODS Aec and C57BL/6 wild-type (B6) female mice were evaluated at 4, 12, and 20 weeks of age. Whole LG and eyes and adnexa were excised for histology and gene expression analysis and evaluated by flow cytometry and immunohistochemistry. Tear volume and goblet cell density was measured. Quantitative PCR evaluated T-cell-related cytokine expression in cornea and conjunctiva. RESULTS Both strains showed age-related conjunctival goblet cell loss that was more pronounced in the Aec strain and significantly greater than in B6 mice at 12 weeks. This was accompanied by CD4+ T-cell infiltration of the conjunctiva that was greater in Aec strain at 20 weeks. Aec mice had higher levels of IL-17A, IL-17R, IL-1α, IL-1β, and TNF-α in the conjunctiva, and they significantly increase with aging. Aec mice had greater lymphocytic infiltration of the LG and conjunctiva at 20 weeks that consisted of a mixture of CD4+ and CD8+ cells. Flow cytometry showed a significant increase in CD4+ T cells in Aec LG compared to B6 mice. Tear volume was significantly increased in both strains at 20 weeks. CONCLUSIONS Aec mice developed greater conjunctival goblet cell loss associated with lymphocytic infiltration of the LG and conjunctiva with aging. Increased expression of certain T helper or inflammatory cytokines in these tissues was observed in Aec mice. The conjunctival disease appeared to be due to inflammation and not a decrease in tear volume.
Collapse
Affiliation(s)
- In-Cheon You
- Department of Ophthalmology, Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute, Chonbuk National University Hospital, Jeonju, Jeonbuk, Korea 2Ocular Surface Center, Department of Ophthalmology, Cullen Eye
| | - Fang Bian
- Ocular Surface Center, Department of Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, United States
| | - Eugene A Volpe
- Ocular Surface Center, Department of Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, United States
| | - Cintia S de Paiva
- Ocular Surface Center, Department of Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, United States
| | - Stephen C Pflugfelder
- Ocular Surface Center, Department of Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, United States
| |
Collapse
|
23
|
Abstract
Prostaglandins are approved by the European Glaucoma Society guidelines as first-line treatment for glaucoma. This review focuses on latanoprost, an ester prodrug of prostaglandin (PG) F2α, which was the first of the currently available topical PGF2α analogs to be launched for glaucoma or ocular hypertension and which still accounts for the majority of prescriptions. It is better absorbed than the parent compound through the cornea, and peak concentration of the active drug is in the aqueous humor 1–2 hours after topical dosing (15–30 ng/mL). Metabolism occurs mainly in the liver. Latanoprost (0.005%) has been very well studied in clinical trials and meta-analyses that show it to be generally as effective as the other PG analogs (bimatoprost, travoprost, and tafluprost) and more effective than timolol, dorzolamide, and brimonidine. Latanoprost has good short- and long-term safety and tolerability profiles. In common with other prostaglandins, it lacks systemic effects, but can cause ocular adverse events such as conjunctival hyperemia, pigmentation of the iris, periocular skin or eyelashes, hypertrichosis, and ocular surface effects or irritation. Latanoprost is significantly better tolerated than either bimatoprost or travoprost. Patients treated with latanoprost have better compliance and persist with therapy longer than those that are given other drugs. An improved formulation of latanoprost without the preservative benzalkonium chloride has recently been developed. It is as effective as conventional latanoprost, has a lower incidence of hyperemia, and can be stored at room temperature. In conclusion, latanoprost has the best efficacy–tolerability ratio of the PG analogs available for glaucoma treatment, and has good compliance and persistence. These factors should be improved further by the recent development of preservative-free latanoprost.
Collapse
Affiliation(s)
- Albert Alm
- Department of Neuroscience, Ophthalmology, University Hospital, Uppsala, Sweden
| |
Collapse
|
24
|
Shao C, Fu Y, Lu L, Chen J, Shen Q, Zhu H, Fan X. Dynamic changes of tear fluid after cosmetic transcutaneous lower blepharoplasty measured by optical coherence tomography. Am J Ophthalmol 2014; 158:55-63.e1. [PMID: 24709809 DOI: 10.1016/j.ajo.2014.03.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Revised: 03/27/2014] [Accepted: 03/28/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE To investigate the dynamic changes of tear fluid after cosmetic transcutaneous lower blepharoplasty. DESIGN Prospective, observational case series study. METHODS A total of 60 eyes of 30 patients with transcutaneous lower blepharoplasty were involved in the study. All subjects completed the Ocular Surface Disease Index questionnaire and underwent tear film break-up time measurements and the Schirmer test before surgery and 1 week, 1 month, and 3 months after surgery. Tear meniscus parameters measured by optical coherence tomography were recorded. Lower lid margin reflex distance was also measured. At each time point after surgery, these parameters were compared with the baseline parameters. The incidence of dry eye and chemosis after surgery was assessed. RESULTS The Ocular Surface Disease Index score increased significantly 1 week after surgery (P < .01). The Schirmer test values were significantly decreased 1 week postoperatively (P < .01), and they returned to baseline by 3 months. There was no significant change in tear film break-up time before and after surgery. The tear meniscus height, depth, and cross section area values were significantly increased at 1 week postoperatively, decreased at 1 month (P < .01), and returned to baseline at 3 months (P > .05). The cornea-lower eyelid angle significantly decreased at 1 week postoperatively (P < .01), increased at 1 month (P < .01), and returned to baseline by 3 months (P > .05). The lower lid margin reflex distance was increased 1 week after surgery (P < .01), and gradually recovered but had not returned to the baseline 3 months after surgery (P < .01). The increased tear meniscus height had a positive correlation with lower lid margin reflex distance. The incidence of dry eye and chemosis at 1 week postoperatively was 16.7% and 15%, respectively. CONCLUSIONS Cosmetic transcutaneous lower blepharoplasty affects ocular surface and tear fluid, which leads to dryness, tearful eyes, and chemosis. However, this influence is temporary after surgery, and the symptoms resolve within 3 months. A positive correlation between tear meniscus height and lower lid margin reflex distance was observed. Assessment of the tear meniscus with optical coherence tomography provided a quick, noninvasive, and quantitative method to investigate the dynamic changes of the tear fluid after blepharoplasty.
Collapse
|
25
|
McClellan AJ, Volpe EA, Zhang X, Darlington GJ, Li DQ, Pflugfelder SC, de Paiva CS. Ocular surface disease and dacryoadenitis in aging C57BL/6 mice. THE AMERICAN JOURNAL OF PATHOLOGY 2014; 184:631-43. [PMID: 24389165 DOI: 10.1016/j.ajpath.2013.11.019] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Revised: 10/30/2013] [Accepted: 11/04/2013] [Indexed: 11/17/2022]
Abstract
Dry eye in humans displays increased prevalence in the aged and in women. Here, we investigated the ocular surfaces and lacrimal glands of aged mice of both sexes. We surveyed three different ages [young, middle-aged (6 to 9 months), and elderly] by investigating severity markers of dry eye disease (DED). We observed an age-dependent dry eye phenotype as early as 6 to 9 months: increased corneal surface irregularity, increased corneal barrier disruption, conjunctival CD4(+) T-cell infiltration, and loss of mucin-filled goblet cells. Expression of interferon-γ, IL-17 mRNA transcripts was increased in the conjunctiva and IL-17A, matrix metallopeptidase 9, and chemokine ligand 20 in the corneas of elderly mice. Elderly male mice develop more of a skewed response of type 1 T helper cell, whereas female mice have a bias toward type 17 T helper cell in the conjunctiva. In the lacrimal gland, an increase in CD4(+) and CD8(+) T cells and B cells and a decrease in activated dendritic cells were observed. Adoptive transfer of CD4(+) T cells isolated from elderly mice transferred DED into young immunodeficient recipients, which was more pronounced from male donors. Our findings show the development of DED in aging mice. Pathogenic CD4(+) T cells that develop with aging are capable of transferring DED from older mice to naive immunodeficient recipients. Taken together, our results indicate that age-related autoimmunity contributes to development of DED with aging.
Collapse
Affiliation(s)
- Andrew J McClellan
- Department of Ophthalmology, Ocular Surface Center, Cullen Eye Institute, Houston, Texas
| | - Eugene A Volpe
- Department of Ophthalmology, Ocular Surface Center, Cullen Eye Institute, Houston, Texas
| | - Xiaobo Zhang
- Department of Ophthalmology, Ocular Surface Center, Cullen Eye Institute, Houston, Texas; Shenyang He Eye Hospital, Shenyang, Liaoning Province, China
| | | | - De-Quan Li
- Department of Ophthalmology, Ocular Surface Center, Cullen Eye Institute, Houston, Texas
| | - Stephen C Pflugfelder
- Department of Ophthalmology, Ocular Surface Center, Cullen Eye Institute, Houston, Texas
| | - Cintia S de Paiva
- Department of Ophthalmology, Ocular Surface Center, Cullen Eye Institute, Houston, Texas.
| |
Collapse
|
26
|
Doughty M. Comparative Anatomy and Physiology of the Cornea and Conjunctiva. OCULAR SURFACE 2012. [DOI: 10.1201/b13153-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
|
27
|
|