1
|
Singh G, Bhinder HS. Relationship of Symptomatology with Closed Chamber Infrared Thermometry and Humidity in Dry Eyes. Eur J Ophthalmol 2018; 15:186-95. [PMID: 15812758 DOI: 10.1177/112067210501500202] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose To evaluate the relationship of symptoms of dry eye with closed chamber infrared thermometry and humidity measurements. Methods The authors studied 54 patients (108 eyes) with dry eye disorders of different grades of clinical severity (mean age 35.75±14.37 years), 31 cases (62 eyes) with normal eyes (mean age 33.68±14.42 years), and 10 cases (20 eyes) with epidemic conjunctivitis (mean age 33.68±14.42 years). The symptoms and the clinical tests (Schirmer-1 test, fluorescein tear break up time, Lissamine green stain; closed chamber infrared thermometry and humidity) were used to establish the diagnosis of dry eyes. The closed chamber humidity difference was used to classify the groups of dry eye. Results The authors noted no temperature difference from closed to open eye position in dry eyes as compared to 0.10±0.00 °C difference in normal eyes and epidemic conjunctivitis. Four groups of cases were identified by difference in values of humidity: Group 1 = <0.9 relative humidity (RH)% to 1 RH%; Group 2 = >1 RH% to 1.5 RH%; Group 3 = >1.5 RH% to 2 RH %; and Group 4 = >2 RH%. The symptomatology was measured in the eyes using Oxford scale (0–4) and correlated with the humidity groups. The grading of symptoms with the humidity showed a statistically significant relationship (p<0.0001) in each group. The severity of the symptoms showed an increase in frequency and severity from Group 1 to Group 4, which was statistically significant (p<0.0001). The mean sum total of global symptomatology score was statistically significant (p<0.0001): 3.43±0.31 in Group 1, 4.65±0.42 in Group 2, 8.56±0.78 in Group 3, and 13.35±1.21 in Group 4. However, total symptomatology score in epidemic conjunctivitis did not show a statistically significant value (p=0.20). Conclusions The closed chamber humidity and thermometry measurements showed statistical correlation in all four groups of dry eyes to total mean symptomatology score (p<0.001) and showed an increase in value with increasing severity of symptoms. However, all individual symptoms fail to show any conclusive relationship.
Collapse
Affiliation(s)
- G Singh
- Guru Gobind Singh International Eye Research and Cure Centre, New Delhi--India.
| | | |
Collapse
|
2
|
Nassiri N, Zhou XY, Rodriguez Torres Y, Meyer Z, Beyer MA, Mehregan CA, Vellaichamy G, Chungfat N, Hwang FS. Current and emerging therapy of dry eye disease. Part B: non-pharmacological modalities. EXPERT REVIEW OF OPHTHALMOLOGY 2017. [DOI: 10.1080/17469899.2017.1344552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Nariman Nassiri
- Department of Ophthalmology, School of Medicine, Wayne State University, Kresge Eye Institute, Detroit, MI, USA
| | - Xiao Yi Zhou
- Department of Ophthalmology, School of Medicine, Wayne State University, Kresge Eye Institute, Detroit, MI, USA
| | - Yasi Rodriguez Torres
- Department of Ophthalmology, School of Medicine, Wayne State University, Kresge Eye Institute, Detroit, MI, USA
| | - Zachary Meyer
- Department of Ophthalmology, School of Medicine, Wayne State University, Kresge Eye Institute, Detroit, MI, USA
| | - Michael A. Beyer
- Department of Ophthalmology, School of Medicine, Wayne State University, Kresge Eye Institute, Detroit, MI, USA
| | - Christian A. Mehregan
- Department of Ophthalmology, School of Medicine, Wayne State University, Kresge Eye Institute, Detroit, MI, USA
| | - Gautham Vellaichamy
- Department of Ophthalmology, School of Medicine, Wayne State University, Kresge Eye Institute, Detroit, MI, USA
| | - Neil Chungfat
- Department of Ophthalmology, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Frank S. Hwang
- Department of Ophthalmology, School of Medicine, Wayne State University, Kresge Eye Institute, Detroit, MI, USA
| |
Collapse
|
3
|
Carpenter PA, Kitko CL, Elad S, Flowers MED, Gea-Banacloche JC, Halter JP, Hoodin F, Johnston L, Lawitschka A, McDonald GB, Opipari AW, Savani BN, Schultz KR, Smith SR, Syrjala KL, Treister N, Vogelsang GB, Williams KM, Pavletic SZ, Martin PJ, Lee SJ, Couriel DR. National Institutes of Health Consensus Development Project on Criteria for Clinical Trials in Chronic Graft-versus-Host Disease: V. The 2014 Ancillary Therapy and Supportive Care Working Group Report. Biol Blood Marrow Transplant 2015; 21:1167-87. [PMID: 25838185 DOI: 10.1016/j.bbmt.2015.03.024] [Citation(s) in RCA: 143] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 03/27/2015] [Indexed: 12/26/2022]
Abstract
The 2006 National Institutes of Health (NIH) Consensus paper presented recommendations by the Ancillary Therapy and Supportive Care Working Group to support clinical research trials in chronic graft-versus-host disease (GVHD). Topics covered in that inaugural effort included the prevention and management of infections and common complications of chronic GVHD, as well as recommendations for patient education and appropriate follow-up. Given the new literature that has emerged during the past 8 years, we made further organ-specific refinements to these guidelines. Minimum frequencies are suggested for monitoring key parameters relevant to chronic GVHD during systemic immunosuppressive therapy and, thereafter, referral to existing late effects consensus guidelines is advised. Using the framework of the prior consensus, the 2014 NIH recommendations are organized by organ or other relevant systems and graded according to the strength and quality of supporting evidence.
Collapse
Affiliation(s)
- Paul A Carpenter
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.
| | - Carrie L Kitko
- Blood and Marrow Transplantation Program, University of Michigan Comprehensive Cancer Center, Ann Arbor, Michigan
| | - Sharon Elad
- Division of Oral Medicine, Eastman Institute for Oral Health and Wilmot Cancer Center, University of Rochester Medical Center, Rochester, New York
| | - Mary E D Flowers
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Juan C Gea-Banacloche
- Center for Cancer Research National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Jörg P Halter
- Department of Hematology, University Hospital Basel, Basel, Switzerland
| | - Flora Hoodin
- Department of Psychology, Eastern Michigan University, Ypsilanti, Michigan
| | - Laura Johnston
- Department of Blood and Marrow Transplantation, Stanford University Medical Center, Stanford, California
| | - Anita Lawitschka
- St. Anna Children's Hospital, Medical University, Vienna, Austria
| | - George B McDonald
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Anthony W Opipari
- Department of Obstetrics and Gynecology, University of Michigan Health System, Ann Arbor, Michigan
| | - Bipin N Savani
- Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Kirk R Schultz
- Michael Cuccione Childhood Cancer Research Program, BC Children's Hospital and University of BC, Vancouver, British Columbia
| | - Sean R Smith
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, Michigan
| | - Karen L Syrjala
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Nathaniel Treister
- Division of Oral Medicine and Dentistry, Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts
| | - Georgia B Vogelsang
- Oncology Department, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Kirsten M Williams
- Center for Cancer Research National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Steven Z Pavletic
- Center for Cancer Research National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Paul J Martin
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Stephanie J Lee
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Daniel R Couriel
- Blood and Marrow Transplantation Program, University of Michigan Comprehensive Cancer Center, Ann Arbor, Michigan
| |
Collapse
|
4
|
Moshirfar M, Pierson K, Hanamaikai K, Santiago-Caban L, Muthappan V, Passi SF. Artificial tears potpourri: a literature review. Clin Ophthalmol 2014; 8:1419-33. [PMID: 25114502 PMCID: PMC4124072 DOI: 10.2147/opth.s65263] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Numerous brands and types of artificial tears are available on the market for the treatment of dysfunctional tear syndrome. Past literature has focused on comparing the components of these products on patient’s clinical improvement. The wide array of products on the market presents challenges to both clinicians and patients when trying to choose between available tear replacement therapies. Different formulations affect patients based on etiology and severity of disease. In order to provide an unbiased comparison between available tear replacement therapies, we conducted a literature review of existing studies and National Institutes of Health clinical trials on commercially available, brand name artificial tears. Outcomes evaluated in each study, as well as the percent of patients showing clinical and symptomatic improvement, were analyzed. Fifty-one studies evaluating different brands of artificial tears, and their efficacy were identified. Out of the 51 studies, 18 were comparison studies testing brand name artificial tears directly against each other. Nearly all formulations of artificial tears provided significant benefit to patients with dysfunctional tear syndrome, but some proved superior to others. From the study data, a recommended treatment flowchart was derived.
Collapse
Affiliation(s)
- Majid Moshirfar
- Department of Ophthalmology, John A Moran Eye Center, University of Utah, Salt Lake City, UT, USA
| | - Kasey Pierson
- University of Arizona College of Medicine, Phoenix, Phoenix, AZ, USA
| | - Kamalani Hanamaikai
- A T Still University, School of Osteopathic Medicine in Arizona, Mesa, AZ, USA
| | - Luis Santiago-Caban
- Department of Ophthalmology, John A Moran Eye Center, University of Utah, Salt Lake City, UT, USA
| | - Valliammai Muthappan
- Department of Ophthalmology, John A Moran Eye Center, University of Utah, Salt Lake City, UT, USA
| | - Samuel F Passi
- Department of Ophthalmology, John A Moran Eye Center, University of Utah, Salt Lake City, UT, USA
| |
Collapse
|
5
|
Abstract
Allogeneic hematopoietic stem cell transplantation (HSCT) has evolved over the past two decades to become the standard of care for hematologic and lymphoid malignancies. Major ocular complications after allogeneic HSCT have been increasing in number and severity. Graft-versus-host disease (GVHD) remains a major cause of ocular morbidity after allogeneic HSCT. The main objective of this review is to elucidate the ocular complications in patients developing GVHD following HSCT. Ocular complications secondary to GVHD are common and include dry eye syndrome, acquisition of ocular allergy from donors with allergic disorders. Eyelid changes may occur in GVHD leading to scleroderma-like changes. Patients may develop poliosis, madarosis, vitiligo, lagophthalmos, and entropion. The cornea may show filamentary keratitis, superficial punctate keratitis, corneal ulcers, and peripheral corneal melting which may lead to perforation in severe cases. Scleritis may also occur which can be anterior or posterior. Keratoconjunctivis sicca appears to be the most common presentation of GVHD. The lacrimal glands may be involved with mononuclear cell infiltration of both the major and accessory lacrimal glands and decrease in tear production. Severe dry eye syndrome in patients with GVHD may develop conjunctival scarring, keratinization, and cicatrization of the conjunctiva. Therapy of GVHD includes systemic immunosuppression and local therapy. Surgical treatment in refractory cases includes surgical intervention to improve the manifestation of GVHD of the eye. This may include tarsorrhapy, prose lenses, punctal occlusions and corneal transplantation.
Collapse
Affiliation(s)
- Amr Nassar
- Adult Hematology/HSCT, King Faisal Cancer Center, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia
| | - Khalid F. Tabbara
- The Eye Center and The Eye Foundation for Research in Ophthalmology, Riyadh, Saudi Arabia
| | - Mahmoud Aljurf
- Research Center, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia
| |
Collapse
|
6
|
Qin J, Zhang L, Cai ZG, Mao C, Liu XJ, Lv L, Zou LH, Peng X, Su JZ, Wu J, Yu GY. Microvascular autologous transplantation of partial submandibular gland for severe keratoconjunctivitis sicca. Br J Ophthalmol 2013; 97:1123-8. [DOI: 10.1136/bjophthalmol-2013-303280] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
7
|
Nguyen T, Latkany R. Review of hydroxypropyl cellulose ophthalmic inserts for treatment of dry eye. Clin Ophthalmol 2011; 5:587-91. [PMID: 21654886 PMCID: PMC3102590 DOI: 10.2147/opth.s13889] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2011] [Indexed: 12/02/2022] Open
Abstract
Dry eye syndrome is a prevalent disease that affects visual acuity, activities of daily living, and quality of life. A number of contributory factors affect the severity of dry eye syndrome, including autoimmune disease, environmental surroundings, contact lens use, hormonal changes, anatomical features, chronic inflammation, infections, and iatrogenic factors, such as medications or surgery. Symptoms may include intermittent or constant blurry vision, discomfort, burning, foreign body sensation, hyperemia, dryness, and photophobia. The severity of dry eye syndrome can range from very mild disease to extremely severe cases with vision-threatening consequences. A variety of dry eye treatment modalities exist to address the different causes, symptoms, and consequences of ocular surface disease, including artificial tears, lubricating gels, ophthalmic inserts, anti-inflammatory drops, and surgical procedures. In this paper, an assortment of literature pertaining to the treatment of dry eye syndrome, in particular hydroxypropyl cellulose ophthalmic inserts, is reviewed. These inserts can be used effectively as monotherapy, or in conjunction with other therapies, and should be considered in the treatment of dry eye syndrome.
Collapse
Affiliation(s)
- Theresa Nguyen
- Dry Center, Physician Eyecare of New York, New York, NY, USA
| | - Robert Latkany
- Dry Center, Physician Eyecare of New York, New York, NY, USA
| |
Collapse
|
8
|
Long-Term Use of Hydroxypropyl Cellulose Ophthalmic Insert to Relieve Symptoms of Dry Eye in a Contact Lens Wearer: Case-Based Experience. Eye Contact Lens 2011; 37:39-44. [DOI: 10.1097/icl.0b013e3181f84f92] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
9
|
Improved signs, symptoms, and quality of life associated with dry eye syndrome: hydroxypropyl cellulose ophthalmic insert patient registry. Eye Contact Lens 2010; 36:170-6. [PMID: 20351555 DOI: 10.1097/icl.0b013e3181db352f] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES To evaluate the acceptability, ease of use, and efficacy of hydroxypropyl cellulose ophthalmic inserts in reducing signs and symptoms of moderate-to-severe dry eye syndrome (DES), and improving quality of life (QoL) and activities of daily living (ADL). METHODS The multicenter, prospective, open-label, 4-week registry comprised 520 patients with bilateral DES and a history of artificial tear use, or a desire to use artificial tears within the previous week. Visit 1 encompassed a clinical evaluation and symptom and QoL questionnaires, including the Ocular Surface Disease Index. Patients were trained to use inserts, which were used once daily, thereafter, as monotherapy or with existing therapy. At visit 2, clinical evaluation and questionnaires evaluated changes in signs, symptoms, ADL, and QoL. Adverse events were monitored throughout the registry. RESULTS There were 418 (80.4%) completers. Statistically significant improvements in discomfort, burning, dryness, grittiness, stinging, and light sensitivity, as well as clinical signs of keratitis, conjunctival staining, and tear volume were seen (P<0.05). Mean Ocular Surface Disease Index total scores improved by 21.3% (P<0.05). Blurred vision, affecting 8.7% of patients, was the most commonly reported adverse event leading to discontinuation. CONCLUSIONS Hydroxypropyl cellulose ophthalmic inserts significantly improved signs and symptoms of moderate-to-severe DES, as well as ADL and QoL. Benefits were additive to those seen with patients' existing care.
Collapse
|
10
|
Drug transport in HEMA conjunctival inserts containing precipitated drug particles. J Colloid Interface Sci 2010; 347:31-42. [DOI: 10.1016/j.jcis.2010.03.037] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2010] [Revised: 03/16/2010] [Accepted: 03/17/2010] [Indexed: 11/19/2022]
|
11
|
Wander AH, Koffler BH. Extending the Duration of Tear Film Protection in Dry Eye Syndrome: Review and Retrospective Case Series Study of the Hydroxypropyl Cellulose Ophthalmic Insert. Ocul Surf 2009; 7:154-62. [DOI: 10.1016/s1542-0124(12)70310-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
12
|
Ancillary and supportive care in chronic graft-versus-host disease. Best Pract Res Clin Haematol 2008; 21:291-307. [DOI: 10.1016/j.beha.2008.02.014] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
13
|
Couriel D, Carpenter PA, Cutler C, Bolaños-Meade J, Treister NS, Gea-Banacloche J, Shaughnessy P, Hymes S, Kim S, Wayne AS, Chien JW, Neumann J, Mitchell S, Syrjala K, Moravec CK, Abramovitz L, Liebermann J, Berger A, Gerber L, Schubert M, Filipovich AH, Weisdorf D, Schubert MM, Shulman H, Schultz K, Mittelman B, Pavletic S, Vogelsang GB, Martin PJ, Lee SJ, Flowers MED. Ancillary therapy and supportive care of chronic graft-versus-host disease: national institutes of health consensus development project on criteria for clinical trials in chronic Graft-versus-host disease: V. Ancillary Therapy and Supportive Care Working Group Report. Biol Blood Marrow Transplant 2006; 12:375-96. [PMID: 16545722 DOI: 10.1016/j.bbmt.2006.02.003] [Citation(s) in RCA: 270] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2006] [Accepted: 02/07/2006] [Indexed: 12/23/2022]
Abstract
The Ancillary Therapy and Supportive Care Working Group had 3 goals: (1) to establish guidelines for ancillary therapy and supportive care in chronic graft-versus-host disease (GVHD), including treatment for symptoms and recommendations for patient education, preventive measures, and appropriate follow-up; (2) to provide guidelines for the prevention and management of infections and other common complications of treatment for chronic GVHD; and (3) to highlight the areas with the greatest need for clinical research. The definition of "ancillary therapy and supportive care" embraces the most frequent immunosuppressive or anti-inflammatory interventions used with topical intent and any other interventions directed at organ-specific control of symptoms or complications resulting from GVHD and its therapy. Also included in the definition are educational, preventive, and psychosocial interventions with this same objective. Recommendations are organized according to the strength and quality of evidence supporting them and cover the most commonly involved organs, including the skin, mouth, female genital tract, eyes, gastrointestinal tract, and lungs. Recommendations are provided for prevention of infections, osteoporosis, and steroid myopathy and management of neurocognitive and psychosocial adverse effects related to chronic GVHD. Optimal care of patients with chronic GVHD often requires a multidisciplinary approach.
Collapse
Affiliation(s)
- Daniel Couriel
- University of Texas MD Anderson Cancer Center, Houston, 77030, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
14
|
Yu GY, Zhu ZH, Mao C, Cai ZG, Zou LH, Lu L, Zhang L, Peng X, Li N, Huang Z. Microvascular autologous submandibular gland transfer in severe cases of keratoconjunctivitis sicca. Int J Oral Maxillofac Surg 2004; 33:235-9. [PMID: 15287305 DOI: 10.1006/ijom.2002.0438] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The objective is to evaluate the technique of microvascular autologous submandibular gland transfer for the treatment of severe keratoconjunctivitis sicca. From August 1999 to April 2002, 38 patients with severe keratoconjunctivitis sicca were treated by autologous submandibular gland transfer to the temporal region of the skull. The related vessels were anastomosed to the superficial temporal artery and vein. When the vein was too small, venous bridging was applied. Prior to cutting off the gland, the facial artery was preserved and infused with heparin in normal saline after the gland had been freed to allow inspection of the blood oozing from the three veins. This would be helpful in the selection of a relevant vein for anastomosis. Wharton's duct was transplanted to the upper lateral conjunctiva fornix, and the gland was left denervated. Postoperative scintigraphy with Tc99m pertechnetate, follow-up studies, and management of complications were performed. The transplantations were successful in 33 cases, their symptoms of xerophthalmia disappeared. The discomfort resulting from bright light and wind was also relieved. These patients could stop applying artificial tears. In five patients the transplanted glands did not survive. Epiphora occurred in eight cases. They were successfully treated by reducing the size of the graft. Obliteration of Wharton's duct took place in two cases and was treated by the reconstruction of the duct or duct orifice. Microvascular autologous submandibular gland transfer is a lasting and effective solution for severe cases of keratoconjunctivitis sicca.
Collapse
Affiliation(s)
- G Y Yu
- Department of Oral and Maxillofacial Surgery, Peking University School of Stomatology, Beijing, 100081, China.
| | | | | | | | | | | | | | | | | | | |
Collapse
|