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Pena-Verdeal H, Garcia-Queiruga J, Sabucedo-Villamarin B, Giraldez MJ, García-Resúa C, Yebra-Pimentel E. Capability of the Inter-Eye Differences in Osmolarity, Break-Up Time and Corneal Staining on the Diagnostic of Dry Eye. Ocul Immunol Inflamm 2024; 32:1674-1681. [PMID: 38051590 DOI: 10.1080/09273948.2023.2285449] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 08/29/2023] [Accepted: 11/14/2023] [Indexed: 12/07/2023]
Abstract
PURPOSE Inter-eye variability is a recognized characteristic of Dry Eye Disease (DED) and has been proposed as a diagnostic indicator in clinical practice. This study aimed to assess the diagnostic potential of the absolute difference between eyes in three key diagnostic tests recommended by the Tear Film and Ocular Surface Society Dry Eye Workshop II (TFOS DEWS II) Diagnostic Methodology report: tear film osmolarity, Fluorescein Break-Up Time (FBUT), and ocular surface staining. METHODS A total of 180 participants were included in a cross-sectional study. Before a dry eye examination, participants completed an online self-administered OSDI questionnaire. The TFOS DEWS II diagnostic criteria for DED assessment were used: along with OSDI, osmolarity, FBUT and ocular surface staining were measured in all participants in both eyes following standardized methodology. Based on signs and symptoms, participants were diagnosed as having No DED or DED. After diagnosis, the parameters were computed as the right and left eyes' absolute inter-eye difference (|OD-OS|). RESULTS Receiver Operating Characteristics analyses for computed parameters were used based on the previous diagnosis. ROC analyses showed that Osmolarity|OD-OS| have a diagnostic capability to differentiate between No DED and DED participants with a cut-off value of 9.5 mOsm/L (AUC = 0.745 ± 0.052, p < 0.003), whereas FBUT|OD-OS| and Corneal Stainning|OD-OS| have not (AUC, both p ≥ 0.160). CONCLUSION The present study found that the Osmolarity|OD-OS| parameter could be used as a diagnostic indicator for DED assessment, while the FBUT|OD-OS| and the Corneal Staining|OD-OS| parameters do not have this capability.
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Affiliation(s)
- Hugo Pena-Verdeal
- Departamento de Física Aplicada (Área de Optometría), Facultade de Óptica e Optometría, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
- AC24 - Optometría, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Jacobo Garcia-Queiruga
- Departamento de Física Aplicada (Área de Optometría), Facultade de Óptica e Optometría, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Belen Sabucedo-Villamarin
- Departamento de Física Aplicada (Área de Optometría), Facultade de Óptica e Optometría, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Maria Jesus Giraldez
- Departamento de Física Aplicada (Área de Optometría), Facultade de Óptica e Optometría, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
- AC24 - Optometría, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Carlos García-Resúa
- Departamento de Física Aplicada (Área de Optometría), Facultade de Óptica e Optometría, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
- AC24 - Optometría, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Eva Yebra-Pimentel
- Departamento de Física Aplicada (Área de Optometría), Facultade de Óptica e Optometría, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
- AC24 - Optometría, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
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Aragona P, Barabino S, Akbas E, Ryan R, Landini L, Marini MG, Fiorencis A, Cappuccio A, Leonardi A, Vercesi A, Frisina R, Bandello F, Berchicci L, Aragona E, Semeraro F, Romano V, Di Carlo I, Reibaldi M, Ghilardi A, De Cillà S, Marchini G, Tognetto D, Fontana L, Versura P, D'Eliseo D, Mularoni A, Cagini C, Mencucci R, Coassin M, Di Zazzo A, Rizzo S, Fasciani R, Gualdi L, Cusumano A, Spadea L, Cantera E, Scorcia V, Giannaccare G, Rosa P, Troisi S, Provenzano A, Simonelli F, Marullo M, Ciracì L, Costagliola C, Primavera V, Gagliano C, Pinna A, Giovanni A, Boscia F, Gelso A, Mastropasqua L, Bonfiglio E, Rolando M, Bonini S. Utilising Narrative Medicine to Identify Key Factors Affecting Quality of Life in Dry Eye Disease: An Italian Multicentre Study. Ophthalmol Ther 2024:10.1007/s40123-024-01033-7. [PMID: 39340633 DOI: 10.1007/s40123-024-01033-7] [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: 06/26/2024] [Accepted: 09/05/2024] [Indexed: 09/30/2024] Open
Abstract
INTRODUCTION Despite an improved understanding of its pathogenesis, dry eye disease (DED) remains relatively underestimated and its treatment challenging. A better alignment between the clinical evaluation and the patient self-assessment also requires capturing the whole patient experience of DED. This project aimed to unveil this experience through narrative medicine (NM). METHODS The project involved 38 expert centres in Italy and one in San Marino, targeting adult patients with DED, their informal caregivers and their treating ophthalmologists. Written narratives and sociodemographic and quality of life (QoL)-related data were anonymously collected through the project's webpage. Narratives were analysed through MAXQDA (VERBI Software, Berlin, Germany), NM classifications and content analysis. RESULTS A total of 171 patients with DED, 37 informal caregivers and 81 ophthalmologists participated in the research. DED was defined as a disabling condition by 19% of patients and 35% of caregivers; 70% of patients reported that a therapeutic alliance is an integral part of DED treatment and 32% hope for more effective therapies. Forty-four per cent of patients assessed their own QoL as good; however, DED emerged as importantly impacting work performance and social events. DED physical, emotional and economic burden and the cruciality of a trusting care relationship represent the main themes that emerged across all narratives, while empathy and effective treatment are among the factors favouring coping with DED. CONCLUSION This project marked a pioneering initiative investigating the lived experience of patients with DED through NM, simultaneously involving all viewpoints involved in the care pathway. NM enabled the unveiling of factors favouring the ability to cope with DED and its associated QoL implications and provided valuable insights to improve the therapeutic alliance.
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Affiliation(s)
| | - Stefano Barabino
- Studio Oculistico, Milan, Italy.
- Ospedale L. Sacco, Università di Milano, Milan, Italy.
| | - Ertugrul Akbas
- Bausch + Lomb, 400 Somerset Corporate Boulevard, Bridgewater, NJ, USA
| | - Robert Ryan
- Bausch + Lomb, 400 Somerset Corporate Boulevard, Bridgewater, NJ, USA
| | - Linda Landini
- Bausch + Lomb, 400 Somerset Corporate Boulevard, Bridgewater, NJ, USA
| | | | | | | | - Andrea Leonardi
- UOC Clinica Oculistica, AO Università di Padova, Padua, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Carlo Cagini
- Ospedale Santa Maria della Misericordia, Perugia, Italy
| | | | - Marco Coassin
- Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | | | | | | | - Luca Gualdi
- Studio Oculistico Dott. Gualdi/Cusumano, Rome, Italy
| | | | | | | | | | | | - Pasquale Rosa
- Clinica Oculistica Universitaria Ruggi d'Aragona, Salerno, Italy
| | | | | | | | | | | | | | | | | | - Antonio Pinna
- Clinica Universitaria SS. Annunziata, Sassari, Italy
| | | | | | - Aldo Gelso
- Casa di Cura Villa dei Fiori, Naples, Italy
| | | | - Enza Bonfiglio
- Policlinico Universitario Paolo Giaccone, Palermo, Italy
| | | | - Stefano Bonini
- Department of Ophthalmology at the University of Rome Campus Bio-Medico, Rome, Italy.
- IRCCS Bietti Foundation, Rome, Italy.
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Sánchez Sevila JL, Rosas Gómez de Salazar J, Seguí Crespo M. Work Productivity and Activities of Daily Living in Working Patients with Uveitis. Ocul Immunol Inflamm 2024:1-8. [PMID: 38652637 DOI: 10.1080/09273948.2024.2343071] [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: 01/01/2024] [Accepted: 04/09/2024] [Indexed: 04/25/2024]
Abstract
PURPOSE To assess self-reported impairment of work productivity and activities of daily living and the indirect costs of absenteeism in a sample of working patients with uveitis and to examine their association with sociodemographic, occupational, and clinical variables. METHODS We conducted a cross-sectional, cross-association study. Participants completed the self-administered Work Productivity and Activity Impairment Questionnaire uveitis 2.0 to assess absenteeism, presenteeism, overall work impairment, and impairment in activities of daily living. Clinical data were collected from the patients' medical records or instruments used to evaluate clinical parameters in practice. Indirect costs of absenteeism were assessed by the "lost wages method." Two clinical groups were established for this study. Bivariate and multivariate analyses were performed to assess the associations between variables. RESULTS The final sample comprised 60 participants. Factors significantly associated with increased overall work impairment in the multivariate linear regression analysis were active uveitis (coefficient, 31.5; 95% confidence interval [CI], 16.1 to 46.9; p < 0.001) and presence of ocular comorbidities (coefficient for absence, -16.4; 95% CI, -31.1 to -1.8; p = 0.03). Factors significantly associated with increased impairment in activities of daily living were active uveitis (coefficient, 32.1; 95% CI, 18.2 to 46.0; p < 0.001), presence of ocular comorbidities (coefficient for absence, -23.5; 95% CI, -36.1 to -11.0; p < 0.001), and absence of nonocular comorbidities (coefficient 16.1; 95% CI, 3.9 to 28.3; p = 0.01). CONCLUSIONS Active uveitis and ocular comorbidities are significantly associated with increased overall work impairment and impairment in activities of daily living in working patients with uveitis.
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Affiliation(s)
| | | | - Mar Seguí Crespo
- Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
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Stapleton F, Velez FG, Lau C, Wolffsohn JS. Dry eye disease in the young: A narrative review. Ocul Surf 2024; 31:11-20. [PMID: 38070708 DOI: 10.1016/j.jtos.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 12/01/2023] [Accepted: 12/04/2023] [Indexed: 12/18/2023]
Abstract
Dry eye disease (DED), a multifactorial ocular disease that significantly impacts quality of life, is most commonly reported in adults. This review describes the prevalence, risk factors, diagnosis and management of DED in children. A literature search, conducted from January 2000-December 2022, identified 54 relevant publications. Using similar diagnostic criteria to those reported in adults, namely standardized questionnaires and evaluation of tear film homeostatic signs, the prevalence of DED in children ranged from 5.5% to 23.1 %. There was limited evidence for the influence of ethnicity in children, however some studies reported an effect of sex in older children. Factors independently associated with DED included digital device use, duration of digital device use, outdoor time and urban living, Rates of DED were higher in children with ocular allergy and underlying systemic diseases. Compared with similar studies in adults, the prevalence of a prior DED diagnosis or a diagnosis based on signs and symptoms was lower in children, but symptoms were commonly reported. Treatment options were similar to those in adults, including lifestyle modifications, blinking, management of lid disease and unpreserved lubricants in mild disease with escalating treatment with severity. Management requires careful exploration of symptoms, medical history and the diagnosis and management of ocular comorbidities such as allergy and anterior blepharitis. Appropriately powered population-based studies are required to understand the prevalence of and risk factors for DED in children. Development of age-appropriate thresholds for signs and symptoms of DED would support better diagnosis of disease and understanding of natural history.
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Affiliation(s)
- Fiona Stapleton
- School of Optometry and Vision Science, UNSW Sydney, New South Wales, Australia.
| | - Federico G Velez
- Department of Ophthalmology, University of California Los Angeles, Los Angeles, CA, USA; Department of Ophthalmology, Duke University, Durham, NC, USA
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Ji H, Yang Y, Lu Y, Kong X, Yang G, Liu J, Yang Y, Wang X, Ma X. Prevalence of dry eye during the COVID-19 pandemic: A systematic review and meta-analysis. PLoS One 2023; 18:e0288523. [PMID: 38091282 PMCID: PMC10718424 DOI: 10.1371/journal.pone.0288523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 06/28/2023] [Indexed: 12/18/2023] Open
Abstract
OBJECTIVE During the COVID-19 pandemic, many people devoted longer time to screen viewing due to the need for study, work, and online social activities, instead of outdoor activities, which may have led to an increase in dry eye symptoms. This study aimed to evaluate the prevalence of dry eye during the COVID-19 pandemic. METHODS PubMed, Cochrane Library, Embase, and Web of Science were searched from January 1, 2020 to October 20, 2022. Cross-sectional surveys on dry eye prevalence conducted after January 1, 2020 were included. Two review authors independently performed data extraction and assessed study quality. The random-effects model was used to analyze the prevalence of dry eye, and the odds ratio was used to assess the strength of the association between variables. Subgroup analysis was performed to detect heterogeneity, the leave-one-out method for sensitivity analysis, and the Egger test for publication bias. RESULTS A total of eleven studies with 15692 individuals met the eligibility criteria. The prevalence of dry eye during the COVID-19 pandemic was 61.0% (95%CI: 51.8%-70.2%) globally and 56.7% (95%CI: 45.3%-68.1%) in Asia. The prevalence of dry eye had significant differences in sex and visual display time, with higher prevalence among females and visual display time of more than 4 hours per day. Subgroup analysis was performed based on diagnostic tools, study population, and average age. A significant difference was found in diagnostic tools, but no significant change in heterogeneity (P<0.05). The leave-one-out method showed stable results, and the Egger test identified no significant publication bias. CONCLUSION The prevalence of dry eye during the COVID-19 pandemic is significantly higher than before, and a higher prevalence is found among females and those having a visual display time of more than 4 hours per day.
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Affiliation(s)
- Haiyang Ji
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yun Yang
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yunqiong Lu
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiehe Kong
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai, China
| | - Guang Yang
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai, China
| | - Jie Liu
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai, China
| | - Yanting Yang
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai, China
| | - Xuejun Wang
- Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Xiaopeng Ma
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai, China
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Cutrupi F, De Luca A, Di Zazzo A, Micera A, Coassin M, Bonini S. Real Life Impact of Dry Eye Disease. Semin Ophthalmol 2023; 38:690-702. [PMID: 37095685 DOI: 10.1080/08820538.2023.2204931] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/21/2023] [Accepted: 03/22/2023] [Indexed: 04/26/2023]
Abstract
Dry Eye Disease (DED) is an increasingly common condition that affects between 5% and 50% of the global population. Even though DED is most frequently diagnosed in older people, it has also been diagnosed in young adults and adolescents more frequently in recent years (employees, gamers). People can experience different types of symptoms and find it challenging to read, watch TV, cook, climb stairs, and meet friends. Mild and severe dry eye can reduce quality of life similarly to mild psoriasis and moderate-to-severe angina. Furthermore, DED patients experience serious difficulties driving vehicles, especially at night, and show a decrease in work productivity, which, when combined with the relevant indirect cost that this condition produces, poses a serious challenge in our days. In addition, DED patients are more likely to develop depression and suicidal ideations and experience frequent sleep disorders. Finally, it is discussed how lifestyle changes, such as increased physical activity, blinking exercises, and a proper diet, have positive implications for the management of this condition. Our aim is to draw attention to the negative effects of dry eye in real life, which are unique to each patient, especially as they relate to the non-visual symptoms experienced by DED patients.
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Affiliation(s)
- Francesco Cutrupi
- Ophthalmology Complex Operative Unit, University Campus Bio-Medico, Rome, Italy
| | - Andrea De Luca
- Ophthalmology Complex Operative Unit, University Campus Bio-Medico, Rome, Italy
| | - Antonio Di Zazzo
- Research Laboratories in Ophthalmology, IRCCS Bietti Foundation, Rome, Italy
| | - Alessandra Micera
- Research Laboratories in Ophthalmology, IRCCS Bietti Foundation, Rome, Italy
| | - Marco Coassin
- Ophthalmology Complex Operative Unit, University Campus Bio-Medico, Rome, Italy
| | - Stefano Bonini
- Ophthalmology Complex Operative Unit, University Campus Bio-Medico, Rome, Italy
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Morthen MK, Magno MS, Utheim TP, Hammond CJ, Vehof J. The work-related burden of dry eye. Ocul Surf 2023; 28:30-36. [PMID: 36690155 DOI: 10.1016/j.jtos.2023.01.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 01/09/2023] [Accepted: 01/19/2023] [Indexed: 01/22/2023]
Abstract
PURPOSE To investigate the relationship between dry eye disease (DED) and work functioning, unemployment, absenteeism, and worry about job loss. METHODS DED and unemployment, absenteeism, and 'worry about job loss' were assessed in 71,067 subjects (18-65 years, 60% female) from the Dutch population-based Lifelines cohort using the Women's Health study questionnaire and single-item questions, respectively. Work functioning was assessed in 32,475 participants using the Work role functioning questionnaire 2.0. The relationships between DED and work measures were assessed with logistic regression models, corrected for age, sex, BMI, income, educational level, smoking, and 48 comorbidities. RESULTS 8.3% of participants had DED and had more impaired work functioning compared to those without DED (49.2% vs 41.1%, OR 1.21, 95% CI 1.10-1.32, corrected for demographics, smoking and 48 comorbidities). DED carried a similar risk of impaired work functioning as rheumatoid arthritis. For participants with highly symptomatic dry eye impaired work functioning was even higher (59.1%) and similar to that of depression. The impaired work functioning seen with increasing symptoms were greater in undiagnosed subjects versus diagnosed subjects (P = 0.03). After correction for comorbidities, DED remained tied to absenteeism and increased worry about job loss, but not unemployment. CONCLUSION DED was linked to impaired work functioning and absence, but not unemployment. DEDs impact on work functioning is comparable to that of other severe chronic disorders, and undiagnosed subjects may be more affected. This highlights the importance of recognizing DED as a severe disorder and of screening for dry eye in the workplace to aid with diagnosis and treatment.
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Affiliation(s)
- Mathias Kaurstad Morthen
- Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, Postbus 30.001, Groningen, the Netherlands; Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
| | - Morten Schjerven Magno
- Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, Postbus 30.001, Groningen, the Netherlands; Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway; Department of Plastic and Reconstructive Surgery, Oslo University Hospital, Oslo, Norway; Department of Ophthalmology, Sørlandet Hospital Arendal, Arendal, Norway
| | - Tor Paaske Utheim
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway; Department of Plastic and Reconstructive Surgery, Oslo University Hospital, Oslo, Norway
| | - Christopher J Hammond
- Department of Twin Research & Genetic Epidemiology, King's College London, St Thomas' Hospital, Lambeth Palace Road, Waterloo, London, SE1 7EH, United Kingdom; Department of Ophthalmology, King's College London, St Thomas' Hospital, Westminster Bridge Road, Waterloo, London, SE1 7EH, London, United Kingdom
| | - Jelle Vehof
- Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, Postbus 30.001, Groningen, the Netherlands; Department of Epidemiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, Postbus 30.001, Groningen, the Netherlands; Department of Twin Research & Genetic Epidemiology, King's College London, St Thomas' Hospital, Lambeth Palace Road, Waterloo, London, SE1 7EH, United Kingdom; Department of Ophthalmology, Vestfold Hospital Trust, Tønsberg, Norway.
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Goya MC, Traipe L, Bahamondes R, Rodríguez C, López D, Salinas D, López R, León A. Adaptation culturally and linguistically to the Chilean population and validation the Dry Eye Questionnaire 5. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2023:S2173-5794(23)00034-8. [PMID: 36963486 DOI: 10.1016/j.oftale.2023.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 01/26/2023] [Indexed: 03/26/2023]
Abstract
BACKGROUND AND OBJECTIVE There are different methods for evaluating dry eye disease (DID), including questionnaires that analyze different aspects of its symptoms, which are important for its better understanding and therapeutic management. The Dry Eye Questionnaire 5 (DEQ-5), is unique in its kind, because in addition to its simplicity, it measures symptoms in 4 dimensions. the aim of this study is to adapt culturally and linguistically and validate this instrument to the Chilean population. MATERIAL AND METHODS for the adaptation, the translation and retro-translation of the original version was carried out, its linguistic analysis, the pilot test and the expert panel review (which included a linguistics specialist) were used. For the validation, a psychometric analysis of reliability and validity of the construct was incorporated. The sample in which it was validated was constituted by 205 people with dry eye disease. RESULTS 141 (69%) of the respondents were women, the mean of age was 48 years ± 16,7, and the median of the total score DEQ-5 was 13 points (R.I 8 - 15 points). The adapted version resulted in a Cronbach alpha of 0.8085, scoring that classified it as good. DISCUSSION the questionnaire DEQ-5, which was adapted and validated, was a good instrument to be used in populations with similar characteristics of those in the study. More so, the factor analysis enriched comprehension of the way in which people with dry eye disease relate their symptoms and which questions relate more between them, representing in a better way the aspects evaluated of the symptomatology of this disease.
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Affiliation(s)
- M C Goya
- Unidad de Lágrima y Superficie Ocular (ULSO), Clínica Las Condes. Departamento de Tecnología Médica, Facultad de Medicina, Universidad de Chile, Santiago, Chile; Departamento de Tecnología Médica, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - L Traipe
- Unidad de Lágrima y Superficie Ocular (ULSO), Clínica Las Condes, Santiago, Chile
| | - R Bahamondes
- Departamento de Lingüística, Centro de Recursos para la Enseñanza y el Aprendizaje Universitario, Facultad de Filosofía y Humanidades, Universidad de Chile, Santiago, Chile
| | - C Rodríguez
- Departamento de Tecnología Médica, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - D López
- Unidad de Lágrima y Superficie Ocular (ULSO), Clínica Las Condes. Departamento de Tecnología Médica, Facultad de Medicina, Universidad de Chile, Santiago, Chile; Departamento de Tecnología Médica, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - D Salinas
- Unidad de Lágrima y Superficie Ocular (ULSO), Clínica Las Condes, Santiago, Chile
| | - R López
- Instituto de Ciencias Biomédicas (ICBM), Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - A León
- Departamento de Tecnología Médica, Facultad de Medicina, Universidad de Chile, Santiago, Chile.
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Boboridis KG, Messmer EM, Benítez-Del-Castillo J, Meunier J, Sloesen B, O'Brien P, Quadrado MJ, Rolando M, Labetoulle M. Patient-reported burden and overall impact of dry eye disease across eight European countries: a cross-sectional web-based survey. BMJ Open 2023; 13:e067007. [PMID: 36931668 PMCID: PMC10030789 DOI: 10.1136/bmjopen-2022-067007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/19/2023] Open
Abstract
OBJECTIVE Dry eye disease (DED) is a multifactorial disease involving the tears and ocular surface. It impacts a patient's quality of life (QoL) and ability to perform daily activities. This study assessed the burden of self-reported DED among adults in eight European countries. DESIGN Online cross-sectional survey. SETTING General population in France, Italy, Germany, Greece, the Netherlands, Portugal, Spain and Sweden. PARTICIPANTS Adults aged ≥18 years with (n=6084) and without (n=6161) self-reported DED were recruited via emails and screened. MAIN OUTCOME MEASURES All participants completed National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ-25) and EuroQol-5 Dimension-5 Level Questionnaire (EQ-5D-5L). All DED participants completed the Eye Dryness Score (EDS) Visual Analogue Scale, and Ocular Comfort Index and Work Productivity and Activity Impairment Questionnaire: Specific Health Problem questionnaires. In addition, half of the respondents with DED completed Survey A (Impact of Dry Eye on Everyday Life) and the other half completed Survey B (Standard Patient Evaluation of Eye Dryness Questionnaire) and Dry Eye Questionnaire-5. RESULTS Participants with self-reported DED had lower functional vision and lower overall health status than participants without self-reported DED as measured by the NEI-VFQ and EQ-5D-5L, respectively.Increasing self-reported DED severity as measured by the EDS was shown to correspond with worse symptom severity/frequency, lower functional vision, higher impact on work productivity, daily activities and QoL. CONCLUSION This study showed that patients' reported burden of self-reported DED was similar across the eight European countries. Those with self-reported DED reported lower health status and functional vision compared to those without self-reported DED and these parameters worsen with increasing disease severity.
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Affiliation(s)
- Kostas G Boboridis
- Third Department of Ophthalmology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - José Benítez-Del-Castillo
- Hospital Clínico San Carlos, Clínica Rementería, Instituto Castroviejo, University Complutense, Madrid, Spain
| | | | - Brigitte Sloesen
- Department of Ophthalmology, HEOR, Novartis Pharma AG, Basel, Switzerland
| | | | - Maria Joao Quadrado
- Centro de Responsabilidade Integrado de Oftalmologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Maurizio Rolando
- Ocular Surface and Dry Eye Centre, ISPRE Ophthalmics, Genoa, Italy
| | - Marc Labetoulle
- Ophthalmology, Hôpital Bicêtre, APHP, Le Kremlin-Bicetre, France
- Center for Immunology of Viral and Auto-immune Disease (IMVA - IDMIt), Inserm U1184, Fontenay- aux-Roses, France
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O'Byrne C, O'Keeffe M. Omega-3 fatty acids in the management of dry eye disease-An updated systematic review and meta-analysis. Acta Ophthalmol 2022; 101. [PMID: 36147013 DOI: 10.1111/aos.15255] [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: 10/27/2021] [Revised: 08/31/2022] [Accepted: 09/03/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE The purpose of this study was to examine the effectiveness of omega-3 fatty acids in comparison to a placebo in the management of dry eye disease. METHODS A systematic literature search was performed including randomised controlled trials (RCTs) comparing omega-3 versus placebo in the management of dry eye disease in human subjects. There were no language or time restrictions. Eligible trials were assessed for bias and assigned a risk-of-bias score. Data extraction was carried out using a standardised data extraction form, and meta-analysis was performed using a random effects model for continuous data. The outcome measures were Ocular Surface Disease Index (OSDI) scores, tear breakup time (TBUT) measurements, corneal staining and Schirmer's score. Statistical heterogeneity was defined as substantial if the I2 test achieved a value >60%. RESULTS Eight parallel RCTs including 1107 subjects met eligibility criteria. None of the included studies achieved low risk of bias. Data synthesis demonstrated an improvement in the mean change in OSDI score from baseline to final assessment. Omega-3 supplementation conferred no evident improvement in corneal staining, TBUT or Schirmer's score. There was considerable statistical heterogeneity in all four outcome measures. CONCLUSIONS This updated systematic review and meta-analysis indicates that omega-3 supplementation improves subjective symptoms in patients with dry eye disease.
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Affiliation(s)
- Ciara O'Byrne
- Medical Retina Department, Moorfields Eye Hospital, London, UK
- Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland
| | - Michael O'Keeffe
- Institute of Eye Surgery, UPMC, Kildare Hospital, Kildare, Ireland
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11
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Jahangiri H, Kazemi R, Mokarami H, Smith A. Visual ergonomics, performance and the mediating role of eye discomfort: A structural equation modelling approach. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2022:1-5. [PMID: 35946090 DOI: 10.1080/10803548.2022.2111885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
The purpose of this study was to model the visual ergonomic factors affecting the performance in human computer interaction. A cross-sectional study using structural equation modelling was performed with a sample of 200 participants. The measuring instruments included Office Lighting Survey Questionnaire, performance assessment questionnaires, visual ergonomics assessment, and an eye discomfort assessment. The hypothetical model evaluated workplace lighting status and visual ergonomics as precursors, performance as the output, and eye discomfort as a mediator. The results showed that eye discomfort directly affected performance. Visual ergonomics also had a significant direct effect on eye discomfort. The final model suggested a significant new path between the quality of lighting and visual ergonomics. Also, the quality of lighting had an indirect effect on eye discomfort and performance, and the effect of visual ergonomics on performance was the same. Improving the lighting quality and visual ergonomics can reduce eye discomfort and increase performance.
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Affiliation(s)
- Hamid Jahangiri
- Student Research Committee, Shiraz University of Medical Sciences, Iran
| | - Reza Kazemi
- Department of Ergonomics, Shiraz University of Medical Sciences, Iran
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12
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An Y, Kim H. Sleep disorders, mental health, and dry eye disease in South Korea. Sci Rep 2022; 12:11046. [PMID: 35773440 PMCID: PMC9247087 DOI: 10.1038/s41598-022-14167-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 06/02/2022] [Indexed: 12/02/2022] Open
Abstract
Dry eye disease (DED) is a multifactorial disease of the ocular surface causing severe discomfort, mild ocular irritation, fatigue, pain, visual disturbance, and foreign body sensation. Stress, depression, and sleep disorders are risk factors for DED. We aimed to investigate the association between DED symptoms and composite factors related to mental health (combined sleep duration, psychological stress perception, and history of depressed mood) in Korean adults aged ≥ 20 years in a population-based study using the 2010-2012 Korea National Health and Nutrition Examination Survey data. Symptoms of DED and data on mental health were obtained using questionnaires. Multiple logistic regression analysis was conducted to examine the association between mental health and DED, and adjusted for possible covariates. Subjects with symptoms of DED were more likely to experience short sleep duration, psychological stress perception, and a history of depressed mood [odds ratio (OR) = 1.42, 95% confidence interval (CI) 1.06-1.90; OR = 1.71, 95% CI 1.37-2.14; and OR = 1.37, 95% CI 1.06-1.77, respectively] even after correcting for demographic factors, lifestyle factors, and medical factors. Additionally, participants with symptoms of DED were more likely to experience composite factors related to mental health (OR = 1.91, 95% CI 1.07-3.39). Therefore, ophthalmologists may report difficulties in both sleep and mental health in patients with DED.
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Affiliation(s)
- Youngju An
- Department of Optometry, Baekseok Culture University, Cheonan, 31065, Korea
| | - Hyojin Kim
- Department of Optometry, Division of Health Science, and Graduate School of Health and Welfare, Baekseok University, Cheonan, 31065, Korea.
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13
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Abdulmannan DM, Naser AY, Ibrahim OK, Mahmood AS, Alyoussef Alkrad J, Sweiss K, Alrawashdeh HM, Kautsar AP. Visual health and prevalence of dry eye syndrome among university students in Iraq and Jordan. BMC Ophthalmol 2022; 22:265. [PMID: 35698109 PMCID: PMC9192247 DOI: 10.1186/s12886-022-02485-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 06/08/2022] [Indexed: 11/10/2022] Open
Abstract
Dry eye syndrome (DES), is a multifactorial disease that affects the ocular surface and contributes to the ocular symptoms. The COVID-19 pandemic influenced the general population and university students' health in different ways. The pandemic forced many people including university students around the world to use virtual platforms on their digital devices, such as computers and smartphones, to work from a distance. This study aimed to explore the visual health and prevalence of dry eye syndrome among university students in Iraq and Jordan. This was a cross-sectional study that was conducted in Iraq and Jordan using online questionnaire tool for the duration between November 2021 and January 2022. University students in Jordan and Iraq were invited to participate in this study and formed the study population. No restrictions on study level or field of study were applied. A previously developed and validated questionnaire tools were used in this study (National Eye Institute Visual Functioning Questionnaire - 25 (VFQ-25) and the Women's Health Study Questionnaire (WHS), which was developed by Schaumberg et al.). A total of 1,431 university students were involved in this study (1,018 students from Iraq, 71.1%). Around one third the study participants (29.0%) reported that have been diagnosed by a clinician as having dry eye syndrome. Around15.3% of the total study participants reported that they feel their eyes are dry (not wet enough) and 17.3% reported that they feel their eyes are irritated. Based on Women's Health Study Questionnaire (WHS) criteria, a total of 479 participants (33.4%) are symptomatically diagnosed with DES. Students aged 27-29 years, those at their fifth year of study, and those who wear contact lenses are at higher risk of developing DYS compared to others. Dry eye syndrome is common health problem among university students. Further studies are required to identify other risk factors associated with DES. Future research should focus on identifying strategies that could help reduce the risk of developing DES as a result of the inevitability of long-term use of digital devices among many categories of society, including university students.
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Affiliation(s)
| | - Abdallah Y Naser
- Department of Applied Pharmaceutical Sciences and Clinical Pharmacy, Faculty of Pharmacy, Isra University, Amman, Jordan.
| | - Omar Khaleel Ibrahim
- Department of Applied Pharmaceutical Sciences and Clinical Pharmacy, Faculty of Pharmacy, Isra University, Amman, Jordan
| | | | - Jamal Alyoussef Alkrad
- Department of Applied Pharmaceutical Sciences and Clinical Pharmacy, Faculty of Pharmacy, Isra University, Amman, Jordan
| | - Kanar Sweiss
- Department of Basic Pharmaceutical Sciences, Faculty of Pharmacy, Isra University, Amman, Jordan
| | | | - Angga Prawira Kautsar
- Department of Health Sciences, Unit of Global Health, University of Groningen/University Medical Center Groningen, Groningen, the Netherlands
- Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, West Java, Indonesia
- Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, West Java, Indonesia
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14
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Hu MY, Zhang LJ, Kang M, Pan YC, Ge QM, Li QY, Yang L, Pei CG, Shao Y. Brain Activity in Different Brain Areas of Patients With Dry Eye During the Female Climacteric Period According to Voxel-Based Morphometry. Front Neurol 2022; 13:879444. [PMID: 35685738 PMCID: PMC9171137 DOI: 10.3389/fneur.2022.879444] [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: 02/19/2022] [Accepted: 04/26/2022] [Indexed: 11/13/2022] Open
Abstract
We aim to investigate potential morphological alterations of the brain in female climacteric patients with dry eye (DE) and their relationship to behavioral performances. Twenty-five female patients with DE disease during the female climacteric period and 25 age and education-matched healthy controls (HCs) underwent magnetic resonance imaging. Imaging data were analyzed using voxel-based morphometry (VBM) to identify group differences in DE patients and HCs. Compared with HCs, patients with DE during the female climacteric period had significantly decreased VBM in the Putamen_L, Thalamus_R, Precuneus_L, Frontal_Sup_R, Cingulum_Mid_L, and Frontal_Mid_L. There was increased VBM in the Temporal_Pole_Sup_R, Precentral_R and Insula_L. Receiver operating characteristic curve analysis indicated that the VBM method has clear potential for diagnosis of DE patients during the climacteric period. Correlation analysis found a negative correlation between the VBM values of the Putamen_L and the anxiety score (AS) and depression score (DS), a positive correlation was found between VBM values of the Temporal_Pole_Sup_R and AS. Moreover, VBM values in the Cingulum_Mid_L were positively correlated with AS and DS. These results revealed abnormal spontaneous activity in the brain regions of patients with DE during the climacteric period, which may indicate underlying pathological mechanisms. These results may help to advance clinical treatments.
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Affiliation(s)
- Meng-Yan Hu
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Province Ocular Disease Clinical Research Center, Nanchang, China
| | - Li-Juan Zhang
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Province Ocular Disease Clinical Research Center, Nanchang, China
| | - Min Kang
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Province Ocular Disease Clinical Research Center, Nanchang, China
| | - Yi-Cong Pan
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Province Ocular Disease Clinical Research Center, Nanchang, China
| | - Qian-Min Ge
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Province Ocular Disease Clinical Research Center, Nanchang, China
| | - Qiu-Yu Li
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Province Ocular Disease Clinical Research Center, Nanchang, China
| | - Lin Yang
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Province Ocular Disease Clinical Research Center, Nanchang, China
| | - Chong-Gang Pei
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Province Ocular Disease Clinical Research Center, Nanchang, China
| | - Yi Shao
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Province Ocular Disease Clinical Research Center, Nanchang, China
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OSDI Questions on Daily Life Activities Allow to Detect Subclinical Dry Eye in Young Contact Lens Users. J Clin Med 2022; 11:jcm11092626. [PMID: 35566752 PMCID: PMC9101005 DOI: 10.3390/jcm11092626] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/29/2022] [Accepted: 05/02/2022] [Indexed: 02/05/2023] Open
Abstract
Dry eye disease (DED) is difficult to detect in young contact lens (CL) wearers, who usually have no signs, mild symptoms and an ocular surface disease index (OSDI) below the DED diagnosis values (OSDI ≥ 13). We investigate if some of the 12 OSDI questions (OSDI A—ocular symptoms; OSDI B—vision-related functionality; OSDI C—environmental triggers) contribute the most to classify young CL as symptomatic. TBUT and tear volume are also measured. Age, gender and refraction error-matched eye glasses (EG) wearers participated as the control. CL and EG data were compared with t-test and z-test. Confusion matrices and logistic correlation analyses were performed to define the contribution of each OSDI question to classify symptomatic subjects. OSDI classified symptomatic CL better than the tear volume or TBUT values. In CL, only OSDI B and C values were significantly higher in symptomatic vs. asymptomatic subjects (p < 0.001), while values of all twelve OSDI questions were significantly higher in symptomatic vs. asymptomatic EG (p < 0.05−0.001). All OSDI questions contribute equally to identify symptomatic EG, while only OSDI B questions on daily life visual functions are significant to classify symptomatic CL wearers at risk to develop DED or at a subclinical stage. CL wearers scoring ≥ 2 on the OSDI B questions should be considered for preventive treatments, even if their clinical sings are scarce or absent.
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16
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Almutairi R, Algezlan S, Bayamin R, Alrumaih S, Almutairi R, Alkahtani R, Almazrou AA. The Association Between Dry Eye and Sleep Quality Among the Adult Population of Saudi Arabia. Cureus 2022; 14:e22736. [PMID: 35386485 PMCID: PMC8969758 DOI: 10.7759/cureus.22736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2022] [Indexed: 11/30/2022] Open
Abstract
Background and objective Dry eye disease (DED) is one of the most prevalent ocular diseases worldwide. DED symptoms can result from disturbances to the homeostasis of the middle tear film layer (aqueous layer), including inflammation, pain, and eye discomfort, which can have a negative impact on individuals’ quality of life and daily activities. Sleep disorders are highly prevalent among patients with DED, and the incidence of sleep disturbances in DED patients has been reported to be as high as 40%. Decreased sleep quality can aggravate dry eye symptoms by increasing tear osmolarity and decreasing tear production. In this study, we aimed to investigate the association between DED and sleep quality in the adult population of Saudi Arabia. Methods This cross-sectional study was conducted among adult patients aged 18 years and above in Saudi Arabia in August 2021. A validated Arabic version of the Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality, and the Ocular Surface Disease Index (OSDI) questionnaire was employed to diagnose DED. Data collection and analysis were performed using the SPSS Statistics software (IBM, Armonk, NY). Results A total of 234 subjects were analyzed, and 59.8% of the participants were women. Our tool suggested that 71.4% of the included participants had severe DED, 15% had moderate DED, and 13.7% had mild DED. However, 40.6% of the participants reported that they had not been diagnosed with DED previously and 34.6% had no previous DED symptoms. The mean total PSQI score was 8.63 ±2.23, with the highest score recorded for component 2: sleep latency (1.73) and the lowest score recorded for component 4: habitual sleep efficiency (0.20). Poor sleep quality as assessed by PSQI showed a significant positive correlation with the severity of DED as assessed by OSDI. Conclusion The significant positive correlation between poor sleep quality and DED indicated that patients with DED had a higher risk of poor sleep quality compared to healthy patients. Patients with DED should be educated about the steps and techniques to improve their sleep patterns.
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17
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Sivakumar GK, Patel J, Malvankar-Mehta MS, Mather R. Work productivity among Sjögren's Syndrome and non-Sjögren's dry eye patients: a systematic review and meta-analysis. Eye (Lond) 2021; 35:3243-3257. [PMID: 33479487 PMCID: PMC8602278 DOI: 10.1038/s41433-020-01282-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 10/30/2020] [Accepted: 11/02/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Dry eye disease (DED) is one of the most common conditions presenting to eye care providers and is increasingly recognized to have poor outcomes on quality of life, activities of daily living, and social and emotional well-being. Here, we aim to understand the association between dry eye symptoms and workplace productivity experienced by patients with non-Sjögren's dry eye and Sjögren's Syndrome. METHODS MEDLINE, PubMed, Embase, Cochrane Library, CINAHL, Healthstar, and PsycINFO were searched from inception to May 2019. RESULTS Thirty-one studies consisting of 50,446 study participants from 14 countries were included in this systematic review. Among non-Sjögren's dry eye patients, there was significant absenteeism (ES = 0.19; 95% CI: [0.04, 0.35]), presenteeism (ES = 0.25; 95% CI: [0.15. 0.35]), productivity impairment (ES = 0.24; 95% CI: [0.20, 0.27]), activity impairment (ES = 0.30; 95% CI: [0.21, 0.38]), and subjective difficulties at work (ES = 0.58; 95% CI: [0.40, 0.75]). Patients with Sjögren's Syndrome demonstrated significant absenteeism (ES = 0.13, 95% CI: [0.10, 0.17]), presenteeism (ES = 0.28, 95% CI: [0.24, 0.32]), productivity impairment (ES = 0.31, 95% CI: [0.27, 0.35]), and activity impairment (ES = 0.39, 95% CI: [0.32, 0.47]) in the workplace. In addition, patients with Sjögren's Syndrome demonstrated significantly lower employment rate (ES = 0.42, 95% CI: [0.34, 0.50]), decreased number of hours worked (SMD = -0.21, 95% CI: [-0.39, -0.02]), and increased work disability (ES = 0.18; 95% CI: [0.09, 0.27]). CONCLUSIONS This is the first systematic review and meta-analysis to demonstrate the negative association between DED and several work productivity measures.
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Affiliation(s)
- Gayathri K Sivakumar
- Department of Ophthalmology, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Janhavi Patel
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
| | - Monali S Malvankar-Mehta
- Ivey Eye Institute, Department of Ophthalmology, St. Joseph's Hospital, London, ON, Canada.
- Department of Epidemiology and Biostatistics, Western University, London, ON, Canada.
| | - Rookaya Mather
- Department of Ophthalmology, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
- Ivey Eye Institute, Department of Ophthalmology, St. Joseph's Hospital, London, ON, Canada
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18
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Holland EJ, Jackson MA, Donnenfeld E, Piccolo R, Cohen A, Barabino S, Rolando M, Figueiredo FC. Efficacy of Lifitegrast Ophthalmic Solution, 5.0%, in Patients With Moderate to Severe Dry Eye Disease: A Post Hoc Analysis of 2 Randomized Clinical Trials. JAMA Ophthalmol 2021; 139:1200-1208. [PMID: 34617974 PMCID: PMC8498931 DOI: 10.1001/jamaophthalmol.2021.3943] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Question What are post hoc treatment outcomes of lifitegrast by severity of dry eye disease (DED)? Findings In this post hoc analysis of 2 randomized clinical trials including 1429 patients, treatment with lifitegrast in the subgroup with an inferior corneal staining score of greater than 1.5 and eye dryness score of at least 60 at baseline (ie, moderate to severe DED) showed lifitegrast-treated participants had higher odds of achieving simultaneous improvement in clinical signs and symptoms than placebo-treated participants. Meaning The results of this post hoc analysis suggest that lifitegrast treatment may be associated with a response in the signs and symptoms of moderate to severe DED. Importance An investigation of the treatment effect of lifitegrast ophthalmic solution, 5.0%, in different subgroups by severity of dry eye disease (DED) seems warranted. Objective To explore the heterogeneity across different subgroups of DED and identify which participants were most likely to achieve clinically meaningful benefit with lifitegrast treatment. Design, Setting, and Participants This post hoc responder analysis was performed using the data from the phase 3 OPUS-2 and OPUS-3 studies, which were 12-week, prospective, double-masked, multicenter, placebo-controlled, randomized, parallel-arm clinical trials that previously demonstrated the efficacy of lifitegrast in DED. Pooled data were stratified into 4 subgroups based on severity of inferior corneal staining score (ICSS; ≤1.5 vs >1.5) and eye dryness score (EDS; <60 or ≥60) at baseline. Data were collected from December 7, 2012, to October 5, 2015, and post hoc analysis was performed from April 14, 2020, to July 30, 2021. Interventions Lifitegrast or placebo twice daily for 84 days. Main Outcomes and Measures Proportion of participants with (1) a clinically meaningful improvement in signs (ICSS or total corneal staining score [TCSS]) and symptoms (EDS or global visual analog scale [VAS]) and (2) a composite response for a given sign and symptom end point pair at day 84 were measured. Clinically meaningful improvement was defined as at least 30% improvement in symptoms (EDS or global VAS) and either at least a 1-point improvement in ICSS or at least a 3-point improvement in TCSS. For the composite responder analysis, the end point pairs were defined as at least a 30% reduction in EDS and at least a 1-point improvement in ICSS; at least a 30% reduction in EDS and at least a 3-point improvement in TCSS; at least a 30% improvement in global VAS and at least a 1-point improvement in ICSS; and at least a 30% improvement in global VAS and at least a 3-point improvement in TCSS. Results In total, 1429 participants (716 in the placebo group and 713 in the lifitegrast group) were analyzed (1087 women [76.1%]; mean [SD] age, 58.7 [14.3] years). For the overall pooled population, responder and composite responder rates favored lifitegrast vs placebo (odds ratio range, 1.29 [95% CI, 1.05-1.59] to 2.10 [95% CI, 1.68-2.61]; P ≤ .02). In the composite analysis, the subgroup with ICSS of greater than 1.5 and EDS of at least 60 at baseline (ie, moderate to severe DED) demonstrated a 1.70- to 2.11-fold higher odds of achieving clinically meaningful improvement with lifitegrast across all sign and symptom end point pairs (P ≤ .001). Conclusions and Relevance These post hoc findings suggest that lifitegrast ophthalmic solution, 5.0%, treatment may be associated with a response in participants with moderate to severe signs and symptoms of DED. Trial Registration ClinicalTrials.gov Identifier: NCT02284516
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Affiliation(s)
- Edward J Holland
- Cincinnati Eye Institute, University of Cincinnati, Cincinnati, Ohio
| | | | | | - Rebecca Piccolo
- Novartis Pharmaceuticals Corporation, East Hanover, New Jersey
| | - Alisa Cohen
- Novartis Pharmaceuticals Corporation, East Hanover, New Jersey
| | - Stefano Barabino
- Ocular Surface and Dry Eye Center, University of Milan, Milan, Italy
| | - Maurizio Rolando
- Ocular Surface Centre, ISPRE (Instituto di Medicina Oftalmica) Ophthalmic, Genoa, Italy
| | - Francisco C Figueiredo
- Department of Ophthalmology, Royal Victoria Infirmary and Biosciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, United Kingdom
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19
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Chan C, Ziai S, Myageri V, Burns JG, Prokopich CL. Economic burden and loss of quality of life from dry eye disease in Canada. BMJ Open Ophthalmol 2021; 6:e000709. [PMID: 34604535 PMCID: PMC8444260 DOI: 10.1136/bmjophth-2021-000709] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 09/03/2021] [Indexed: 11/12/2022] Open
Abstract
Objective To describe the direct and indirect cost estimates of dry eye disease (DED), stratified by disease severity, and the impact of DED on quality of life (QoL) in Canadian patients. Methods and analysis A prospective, multicentre, observational, cross-sectional study was conducted at six sites across Canada. Eligible patients completed a 20 min survey on demography, general health, disease severity, QoL and direct (resource utilisation and out-of-pocket expenses for the past 3–24 months) and indirect costs (absenteeism and presenteeism based on Work Productivity and Activity Impairment questionnaire responses). Subgroup analyses were performed according to DED severity and presence of Sjögren’s syndrome. Results Responses from 146 of 151 participants were included in the analysis. DED was rated as moderate or severe by 19.2% and 69.2% of patients, respectively. Total mean annual costs of DED were $C24 331 (Canadian dollars) per patient and increased with patient-reported disease severity. Mean (standard deviation [SD]) indirect costs for mild, moderate and severe disease were $C5961 ($C6275), $C16 525 ($C11 607), and $C25 485 ($C22,879), respectively. Mean (SD) direct costs were $C958 ($C1216), $C1303 ($C1574) and $C2766 ($C7161), respectively. QoL scores were lowest in patients with Sjögren’s syndrome (8.2% of cohort) and those with severe DED. Conclusion This study provides important insights into the negative impact of DED in a Canadian setting. Severe DED was associated with higher direct and indirect costs and lower QoL compared with those with mild or moderate disease. Increased costs and poorer QoL were also evident for patients with DED plus Sjögren’s syndrome versus DED alone.
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Affiliation(s)
- Clara Chan
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Setareh Ziai
- University of Ottawa Eye Institute, Ottawa, Ontario, Canada
| | - Varun Myageri
- IQVIA Solutions Canada Inc, Kirkland, Quebec, Canada
| | - James G Burns
- Novartis Pharmaceuticals Canada Inc, Dorval, Quebec, Canada
| | - C Lisa Prokopich
- Optometry & Vision Science, University of Waterloo, Waterloo, Ontario, Canada
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20
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Tóth N, Szalai E, Rák T, Lillik V, Nagy A, Csutak A. Reliability and clinical applicability of a novel tear film imaging tool. Graefes Arch Clin Exp Ophthalmol 2021; 259:1935-1943. [PMID: 33779800 PMCID: PMC8277647 DOI: 10.1007/s00417-021-05162-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 03/06/2021] [Accepted: 03/12/2021] [Indexed: 11/25/2022] Open
Abstract
PURPOSE The aim of our research was to investigate the reliability and clinical applicability of a modern tear film imaging tool by comparing the inter- and intragrader difference. The further goal was to compare the non-invasive tear break-up time (NIBUT) measured with the LacryDiag® device with traditional tear film break-up time (TBUT). METHODS Comprehensive ophthalmological examination was performed, including LacryDiag® (Quantel Medical, France) (lower tear meniscus height measuring (LTMH), superior and inferior eyelid meibography (MeibS MeibI), interferometry (INT), NIBUT), slit lamp examination, and TBUT. Two independent, well-trained graders selected and analyzed the LTMH, MeibI, MeibS, and INT. The second grader reanalyzed the data 1 month later. Intra- and inter-examiner reliabilities were evaluated using intraclass correlation coefficients (ICC), while for categorical variable, Cohen's kappa statistics were provided. The Bland-Altman plot was used for visualization of the agreement between measurements. RESULTS Fifty healthy volunteers were examined. For LTMH both the inter- and intragrader variabilities were excellent. Between two graders, the ICC of MeibI was poor; however, between two graders, the ICC of MeibS was good, and the intragrader variability in MeibI and MeibS was excellent. For the INT, both intra- and intergrading were in fair and moderate agreement, although the intragrader agreement was higher. Comparing the NIBUT and TBUT, the agreement was slight. CONCLUSION Based on our results, examination of a patient during follow-up should be performed by the same examiner, because of the slight agreement. The LacryDiag® is a non-invasive, easy-to-use device, which can examine the tear film and save the recordings for easier follow-up.
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Affiliation(s)
- Noémi Tóth
- Department of Ophthalmology, University of Pécs, Medical School, Akác u. 1, Pécs, 7623, Hungary
- Doctoral School of Clinical Medicine, University of Debrecen, Debrecen, 4032, Hungary
| | - Eszter Szalai
- Department of Ophthalmology, University of Pécs, Medical School, Akác u. 1, Pécs, 7623, Hungary
| | - Tibor Rák
- Department of Ophthalmology, University of Pécs, Medical School, Akác u. 1, Pécs, 7623, Hungary
| | - Veronika Lillik
- Department of Ophthalmology, University of Pécs, Medical School, Akác u. 1, Pécs, 7623, Hungary
- Medical School, University of Pécs, Pécs, 7624, Hungary
| | - Attila Nagy
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, 4028, Hungary
| | - Adrienne Csutak
- Department of Ophthalmology, University of Pécs, Medical School, Akác u. 1, Pécs, 7623, Hungary.
- Doctoral School of Clinical Medicine, University of Debrecen, Debrecen, 4032, Hungary.
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21
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Binyousef FH, Alruwaili SA, Altammami AF, Alharbi AA, Alrakaf FA, Almazrou AA. Impact of Dry Eye Disease on Work Productivity Among Saudi Workers in Saudi Arabia. Clin Ophthalmol 2021; 15:2675-2681. [PMID: 34211260 PMCID: PMC8239165 DOI: 10.2147/opth.s313158] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 05/26/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose To assess the impact of dry eye disease (DED) on work productivity in Saudi Arabia and investigate its effect on daily activities. Patients and Methods We conducted a cross-sectional study on male and female Saudi workers age 20 years or older. The data were collected via self-administered questionnaires distributed electronically through social media. We used the Ocular Surface Disease Index questionnaire to diagnose DED patients and assess their DED severity as mild, moderate, and severe. Results A total of 463 respondents qualified for the study. All patients in the DED groups reported a loss of work productivity. Most patients in the severe DED group (59%) reported difficulty focusing on work due to DED, whereas 17.1% of patients with mild DED and 22.7% with moderate DED reported the same. These findings indicate significantly worsening productivity as DED progresses in severity (p<0.05). Participants with severe DED reported significantly more affected work hours weekly (35.8%) than participants with moderate (6.1%) and mild DED (7.1%). Conclusion DED has a significant impact on work productivity, with the most pronounced effect among office workers. It is essential to screen office workers for DED and enhance the awareness of its effect on work productivity among the workforce and healthcare providers.
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Affiliation(s)
- Faris H Binyousef
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Shahad A Alruwaili
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Abdulaziz F Altammami
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Ahmed A Alharbi
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Feras A Alrakaf
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Abdulrhman A Almazrou
- Ophthalmology Department, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
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22
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Saldanha IJ, Petris R, Makara M, Channa P, Akpek EK. Impact of the COVID-19 pandemic on eye strain and dry eye symptoms. Ocul Surf 2021; 22:38-46. [PMID: 34133976 PMCID: PMC8462938 DOI: 10.1016/j.jtos.2021.06.004] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 03/03/2021] [Accepted: 06/03/2021] [Indexed: 01/21/2023]
Abstract
Purpose Among adult individuals with dry eye, assess the self-reported impact of the COVID-19 pandemic on (1) dry eye-related visual function, (2) reading efficiency, and (3) dry eye treatments used. Methods In June–July 2020, we conducted an online survey of adults with dry eye who spent at least somewhat more time at home during the pandemic than before. Consistent with TFOS DEWS II guidelines, we categorized respondents into mild, moderate, or severe dry eye based on treatment usage. Results We included 388 respondents: 97 respondents (25%) with mild, 80 (21%) with moderate, and 211 (54%) with severe dry eye. In all three groups, screen/reading time generally doubled during the pandemic. Reduced work-related efficiency was noted by a considerable proportion of respondents (moderate dry eye: 51%, mild: 39%, and severe: 38%). Compared with respondents with mild dry eye, respondents with moderate dry eye were considerably more likely to note worsening symptoms: eye pain (OR = 2.57, 95% CI 1.22–5.41), headache from eye symptoms (OR = 2.34, 95% CI 1.11–4.90), and difficulty concentrating because of eye symptoms (OR = 2.79, 95% CI 1.37–5.66). Respondents with moderate dry eye with Sjögren's syndrome were most likely to note these. Respondents with severe dry eye were more likely than respondents with mild dry eye to report losing access to dry eye-related treatments (OR = 2.62, 95% CI 1.36–5.03). Conclusions The COVID-19 pandemic-related eye strain may be impacting symptoms, performance, and ultimately employment, especially for those with moderate dry eye. This may be compounding the already-high dry eye-related societal burden.
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Affiliation(s)
- Ian J Saldanha
- Center for Evidence Synthesis in Health, Department of Health Services, Policy and Practice (Primary), Department of Epidemiology (Secondary), Brown University School of Public Health, Providence, RI, USA.
| | | | - Matthew Makara
- Director of Research and Scientific Affairs, Sjögren's Foundation Reston, Virginia, USA.
| | - Prabjot Channa
- Department of Ophthalmology, Brown University Warren Alpert Medical School, Providence, RI, USA.
| | - Esen K Akpek
- Ocular Surface Disease Clinic, The Wilmer Eye Institute, Johns Hopkins University School of Medicine Baltimore, Maryland, USA.
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23
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Srinivasan S, Manoj V. A Decade of Effective Dry Eye Disease Management with Systane Ultra (Polyethylene Glycol/Propylene Glycol with Hydroxypropyl Guar) Lubricant Eye Drops. Clin Ophthalmol 2021; 15:2421-2435. [PMID: 34135570 PMCID: PMC8200152 DOI: 10.2147/opth.s294427] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 04/23/2021] [Indexed: 11/29/2022] Open
Abstract
Dry eye disease (DED) is a multifactorial ocular condition characterized by a loss of homeostasis of the tear film resulting in ocular symptoms of discomfort, irritation, and visual disturbance, all of which significantly impact the patients’ social and occupational quality of life. While management of DED depends on the severity of symptoms and signs, use of artificial tear products (ATPs) that replace or supplement the deficient natural tear film is the mainstay treatment option. In this review, we present a decade of evidence on Systane Ultra® (polyethylene glycol [PEG]/propylene glycol [PG] with hydroxypropyl guar [HP guar]) in effectively managing DED. The active demulcents in Systane Ultra®—PEG, PG, along with HP guar gelling technology—provide optimal ocular surface protection and lubrication to heal damaged areas of the cornea caused by DED and, therefore, are recommended for patients with both aqueous and/or mucin layer deficiencies. Over the years, several clinical studies have shown that PEG/PG with HP guar provides long-lasting relief from dry eye and has often been chosen as a standard or comparator against other ATPs. Here, we describe the salient features of PEG/PG with HP guar—its constituents and their mechanisms of action. Furthermore, we summarize results from a systematic literature search that identified 23 relevant publications further emphasizing on the effectiveness and safety of PEG/PG with HP guar in alleviating the signs and symptoms of DED.
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Affiliation(s)
- Sruthi Srinivasan
- Clinical Development and Medical Affairs, Alcon Research, LLC, Johns Creek, GA, USA
| | - Venkiteshwar Manoj
- Clinical Development and Medical Affairs, Alcon Research, LLC, Johns Creek, GA, USA
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24
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Huang L, Gao H, Wang Z, Zhong Y, Hao L, Du Z. Combination Nanotherapeutics for Dry Eye Disease Treatment in a Rabbit Model. Int J Nanomedicine 2021; 16:3613-3631. [PMID: 34079253 PMCID: PMC8165218 DOI: 10.2147/ijn.s301717] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 04/16/2021] [Indexed: 12/24/2022] Open
Abstract
Purpose Anti-inflammation is essential for dry eye disease. Traditional anti-inflammation agent corticosteroids applied in dry eye disease (DED) treatment could result in high intraocular pressure, especially in long-term treatment. Thus, we have prepared a liposome loading 1-bromoheptadecafluorooctane and tetrandrine (PFOB@LIP-Tet) to treat DED via anti-inflammation that hardly affects intraocular pressure in this study, which provided another therapy strategy for dry eye disease. Methods We firstly detected the physicochemical properties of PFOB@LIP-Tet. Next, we tested the biosafety of synthesized liposomes for corneal epithelium. Then, we explored the accumulations and distribution of PFOB@LIP-Tet both in cellular and animal models. And then, we assessed the therapeutic effects of PFOB@LIP-Tet formulations by laboratory and clinical examinations. Last, we examined the changes in eye pressure before and after treatment. Results PFOB@LIP-Tet and Tet showed a characteristic absorption peak at 282 nm while PFOB@LIP did not. Large amounts of PFOB@LIP-Tet remained on the ocular surface and accumulated in the corneal epithelial cells in DED rabbits. Corneal staining scores of DED rabbits respectively treated by ATS, PFOB@LIP-ATS, Tet-ATS and PFOB@LIP-Tet-ATS for seven days were 3.7±0.5, 3.2±0.4, 1.5±0.5 and 0.5±0.5. The expressions of related cytokines were correspondingly downregulated significantly, indicating that the inflammation of DED was successfully suppressed. The intraocular pressure changes of DED rabbits before and after treatment by PFOB@LIP-Tet showed no statistical significance. Conclusion We successfully synthesized PFOB@LIP-Tet, and it could effectively treat dry eye disease via anti-inflammation but hardly affected the intraocular pressure.
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Affiliation(s)
- Liandi Huang
- Department of Ophthalmology, Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People's Republic of China.,State Key Laboratory of Ultrasound in Medicine and Engineering, Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People's Republic of China
| | - Huanhuan Gao
- Department of Ophthalmology, Third Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People's Republic of China
| | - Zhigang Wang
- State Key Laboratory of Ultrasound in Medicine and Engineering, Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People's Republic of China.,Chongqing Key Laboratory of Ultrasound Molecular Imaging, Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People's Republic of China
| | - Yixin Zhong
- Department of Radiology, Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People's Republic of China
| | - Lan Hao
- Chongqing Key Laboratory of Ultrasound Molecular Imaging, Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People's Republic of China
| | - Zhiyu Du
- Department of Ophthalmology, Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People's Republic of China
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25
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Pena‐verdeal H, García‐resúa C, Ramos L, Yebra‐pimentel E, Giráldez MJ. Diurnal variations in tear film break‐up time determined in healthy subjects by software‐assisted interpretation of tear film video recordings. Clin Exp Optom 2021; 99:142-8. [DOI: 10.1111/cxo.12324] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Revised: 03/20/2015] [Accepted: 04/06/2015] [Indexed: 01/23/2023] Open
Affiliation(s)
- Hugo Pena‐verdeal
- Departamento de Física Aplicada (Grupo de Optometría), Universidade de Santiago de Compostela, Santiago de Compostela, Spain,
| | - Carlos García‐resúa
- Departamento de Física Aplicada (Grupo de Optometría), Universidade de Santiago de Compostela, Santiago de Compostela, Spain,
| | - Lucía Ramos
- Departamento de Ciencias de la Computación (Grupo VARPA), Universidade de A Coruña, A Coruña, Spain,
| | - Eva Yebra‐pimentel
- Departamento de Física Aplicada (Grupo de Optometría), Universidade de Santiago de Compostela, Santiago de Compostela, Spain,
| | - Mª Jesús Giráldez
- Departamento de Física Aplicada (Grupo de Optometría), Universidade de Santiago de Compostela, Santiago de Compostela, Spain,
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26
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Akowuah PK, Adjei-Anang J, Nkansah EK, Fummey J, Osei-Poku K, Boadi P, Frimpong AA. Comparison of the performance of the dry eye questionnaire (DEQ-5) to the ocular surface disease index in a non-clinical population. Cont Lens Anterior Eye 2021; 45:101441. [PMID: 33836971 DOI: 10.1016/j.clae.2021.101441] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 03/22/2021] [Accepted: 03/24/2021] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To compare the performance of the dry eye questionnaire (DEQ-5) with the Ocular Surface Disease Index (OSDI) and further validate the DEQ-5 questionnaire. METHODS A population-based cross-sectional study conducted in Ghana. OSDI and DEQ-5 questionnaires were administered to participants. Cronbach's alpha was used to evaluate the reliability of the OSDI and DEQ-5 questionnaires. Analysis of variance was used to evaluate the discriminant validity of DEQ-5. Concurrent validity was evaluated using the Spearman correlation analysis. A receiver operating characteristic (ROC) curve was generated to describe the sensitivity and specificity of the DEQ-5 questionnaire for diagnosis of dry eye symptoms. Cohen Kappa was used to evaluate agreement between the two questionnaires. RESULTS The reliability of the overall OSDI and DEQ-5 scores were 0.919 and 0.819 respectively. The mean (SD) DEQ-5 scores for asymptomatic, mild, moderate and severe dry eye symptoms as defined by the OSDI grading were 3.05 (2.73), 5.13 (3.69), 7.65 (3.30) and 9.77 (4.16) respectively. There was a statistically significant correlation between total OSDI and total DEQ-5 scores (rs = 0.649, p < 0.0001). The area under the curve (AUC) of the ROC curve for DEQ-5 was 0.835 (95 % CI: 0.796 - 0.875). A DEQ-5 threshold of 5.5 yielded maximum sensitivity (0.712) and specificity (0.827). The Cohen kappa using a the DEQ-5 total score threshold of 5.5 was K = 0.539 (p < 0.0001). CONCLUSION In conclusion, performance of the DEQ-5 questionnaire in discriminating symptoms of dry eye is comparable to the OSDI questionnaire. The DEQ-5 questionnaire is a valid measure of dry eye symptoms and can be used as a dry eye symptoms assessment tool in both clinical and epidemiological studies.
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Affiliation(s)
- Prince Kwaku Akowuah
- Department of Optometry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana; College of Optometry, University of Houston, Houston, TX, USA.
| | - Joseph Adjei-Anang
- Department of Optometry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Ernest Kyei Nkansah
- Department of Optometry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Jeremiah Fummey
- Department of Optometry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Kofi Osei-Poku
- Department of Optometry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Prince Boadi
- Department of Optometry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Asafo Agyei Frimpong
- Department of Optometry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
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27
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Estarki F, Asharlous A, Mirzajani A, Abolghasemi J. Objective and subjective evaluation of tear film in machine carpet weavers. J Occup Health 2021; 63:e12237. [PMID: 34085344 PMCID: PMC8175290 DOI: 10.1002/1348-9585.12237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 04/22/2021] [Accepted: 05/16/2021] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES The present study was conducted to evaluate the status of tear film objectively and subjectively in machine carpet weavers. METHODS In this cross-sectional study, machine-made carpet weavers were compared with the controls who were selected from people working in other parts of the factory except for the production. A complete evaluation of ocular health was done for all participants. The blink rate, tear deformation Time (TDT), and ocular staining were evaluated as an objective assessment and the ocular surface disease index (OSDI) was used for a subjective assessment of the tear film status. The results were compared between the two groups using the SPSS software. RESULTS The results of 46 weavers (mean age: 38.43 ± 6.10 years) and 46 controls (mean age: 33.20 ± 8.40 years) were analyzed. The mean of blink rate and OSDI score were significantly higher in weavers (Blink rate: 20.67 ± 4.18 blink/min, OSDI: 22.59 ± 9.51) in comparison with controls (Blink rate: 14.00 ± 3.30 blink/min, OSDI: 6.22 ± 4.78, P < .001). The mean TDT value of the weavers was significantly lower compared with the controls (10.27 ± 3.01 and 16.58 ± 4.18 s respectively, P < .001). Ocular surface staining was seen among 60.9% of weavers while there was 6.5% in the controls (P < .001). Based on the TDT test and OSDI results together, the percentage of dry eye in the weavers was 43.5% and that in the non-weavers was 2.2%, which showed that the relationship between weaving and dry eyes was statistically significant (P < .001). CONCLUSIONS The results indicate that increased symptoms and decreased tear stability in weavers compared with non-weavers lead to more tear film abnormalities in these individuals.
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Affiliation(s)
- Fatemeh Estarki
- Department of OptometrySchool of Rehabilitation SciencesIran University of Medical SciencesTehranIran
| | - Amir Asharlous
- Department of OptometrySchool of Rehabilitation SciencesIran University of Medical SciencesTehranIran
| | - Ali Mirzajani
- Department of OptometrySchool of Rehabilitation SciencesIran University of Medical SciencesTehranIran
| | - Jamileh Abolghasemi
- Department of BiostatisticsSchool of Public HealthIran University of Medical SciencesTehranIran
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28
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Kobia-Acquah E, Ankamah-Lomotey S, Owusu E, Forfoe S, Bannor J, Koomson JA, Opoku M, Dzikpo DM, Mensah DNO, Amonoo JN, Akowuah PK. Prevalence and associated risk factors of symptomatic dry eye in Ghana: A cross-sectional population-based study. Cont Lens Anterior Eye 2021; 44:101404. [DOI: 10.1016/j.clae.2020.12.067] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 12/29/2020] [Accepted: 12/30/2020] [Indexed: 11/30/2022]
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29
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Prevalence of Dry Eye Disease in Africa: A Systematic Review and Meta-analysis. Optom Vis Sci 2020; 97:1089-1098. [DOI: 10.1097/opx.0000000000001610] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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30
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Nijm LM, De Benito-Llopis L, Rossi GC, Vajaranant TS, Coroneo MT. Understanding the Dual Dilemma of Dry Eye and Glaucoma: An International Review. Asia Pac J Ophthalmol (Phila) 2020; 9:481-490. [PMID: 33323704 DOI: 10.1097/apo.0000000000000327] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Glaucoma-related ocular surface disease (G-OSD) is a significant, yet often underdiagnosed, ocular co-morbidity affecting 40% to 59% of glaucoma patients worldwide. Although the use of topical glaucoma medications represents a proven strategy to control the untoward effects of high intraocular pressure, this treatment can profoundly disrupt the homeostasis of the tear film. The cumulative effect of medications, preservatives, and excipients alter underlying cellular structures which results in tear film abnormalities and instability of the ocular surface. Furthermore, these chronic inflammatory changes have been shown to impact efficacy of glaucoma treatment, patient compliance with therapy and overall quality of life. The pathogenesis of G-OSD is multifactorial and involves a vicious self-perpetuating cycle of inflammatory cytokines and proteins. The diagnosis of such disease is based on similar tests used in assessing traditional dry eye, taking into consideration findings specific to this patient population. The hallmark of treatment for these patients is to minimize the ocular surface inflammatory response by choosing glaucoma therapies that spare the ocular surface such as preservative free formulations and initiating dry eye treatment early in the course of care. In summary, glaucoma affects millions of patients around the world and chronic use of topical glaucoma medications may negatively impact the patient's ocular surface, symptoms, and vision. Understanding the pathogenesis of G-OSD, recognizing its risk factors and incorporating diagnostic and therapeutic strategies that restore and maintain ocular surface homeostasis will result in improved care for our patients.
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Affiliation(s)
- Lisa M Nijm
- Warrenville EyeCare & LASIK, Warrenville, IL
- Department of Ophthalmology and Visual Sciences, University of Illinois Eye and Ear Infirmary, Chicago, IL
| | | | | | | | - Minas Theodore Coroneo
- Department of Ophthalmology, Prince of Wales Hospital/University of New South Wales, Sydney, Australia
- NSW, Australia
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31
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van Setten GB, Baudouin C, Horwath-Winter J, Böhringer D, Stachs O, Toker E, Al-Zaaidi S, Benitez-del-Castillo JM, Beck R, Al-Sheikh O, Seitz B, Barabino S, Reitsamer HA, Müller-Lierheim WG. The HYLAN M Study: Efficacy of 0.15% High Molecular Weight Hyaluronan Fluid in the Treatment of Severe Dry Eye Disease in a Multicenter Randomized Trial. J Clin Med 2020; 9:jcm9113536. [PMID: 33147751 PMCID: PMC7693312 DOI: 10.3390/jcm9113536] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 10/23/2020] [Accepted: 10/31/2020] [Indexed: 01/22/2023] Open
Abstract
The aim of the HYLAN M study was to investigate if symptoms and/or signs of patients suffering from severe dry eye disease (DED) can be improved by substituting individually optimized artificial tear therapy by high molecular weight hyaluronan (HMWHA) eye drops. In this international, multicenter study, patients with symptoms of at least ocular surface disease index (OSDI) 33 and corneal fluorescein staining (CFS) of at least Oxford grade 3 were included. A total of 84 per-protocol patients were randomized in two study arms. The control group continued to use their individual optimum artificial tears over the study period of eight weeks; in the verum group, the artificial tears were substituted by eye drops containing 0.15% HMWHA. At the week 8 visit, the average OSDI of the verum group had improved by 13.5 as compared to the control group (p = 0.001). The best corrected visual acuity (BCVA) had improved by 0.04 logMAR (p = 0.033). CFS, tear film break-up time (TBUT), Schirmer I, lid wiper epitheliopathy (LWE), mucocutaneous junction (Yamaguchi score), and tear osmolarity were not significantly different between the verum and control groups (p > 0.050). We conclude that for most patients with severe DED, 0.15% HMWHA eye drops provide excellent improvement of symptoms without impairment of dry eye signs.
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Affiliation(s)
- Gysbert-Botho van Setten
- Karolinska Institutet, Department of Clinical Neuroscience, St. Eriks Eye Hospital, 11282 Stockholm, Sweden;
| | - Christophe Baudouin
- Quinze-Vingts National Eye Hospital & Vision Institute, IHU Foresight, 75571 Paris, France;
| | | | - Daniel Böhringer
- Eye Center, University Eye Hospital Freiburg and Medical Faculty, Albert Ludwigs University, 79106 Freiburg, Germany;
| | - Oliver Stachs
- Department of Ophthalmology, University Medical Center Rostock, 18057 Rostock, Germany; (O.S.); (R.B.)
| | - Ebru Toker
- Department of Ophthalmology, Marmara University School of Medicine, 34899 Istanbul, Turkey;
| | - Sultan Al-Zaaidi
- Department of Ophthalmology, PSMMC Prince Sultan Military Medical City, MSD Medical Services Department, MODA Ministry of Defense and Aviation, Riyadh 12233, Saudi Arabia;
| | | | - Ria Beck
- Department of Ophthalmology, University Medical Center Rostock, 18057 Rostock, Germany; (O.S.); (R.B.)
| | - Osama Al-Sheikh
- KKESH–King Khaled Eye Specialist Hospital, Riyadh 11462, Saudi Arabia;
| | - Berthold Seitz
- Department of Ophthalmology, Saarland University Medical Center, 66421 Homburg/Saar, Germany;
| | - Stefano Barabino
- Ocular Surface & Dry Eye Center, Ospedale L. Sacco, University of Milan, 20157 Milan, Italy;
| | - Herbert A. Reitsamer
- Department of Ophthalmology & Department of Experimental Ophthalmology and Glaucoma Research, University Clinic Salzburg, Paracelsus Medical University, 5020 Salzburg, Austria;
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32
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Greco G, Pistilli M, Asbell PA, Maguire MG. Association of Severity of Dry Eye Disease with Work Productivity and Activity Impairment in the Dry Eye Assessment and Management Study. Ophthalmology 2020; 128:850-856. [PMID: 33068617 DOI: 10.1016/j.ophtha.2020.10.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 09/15/2020] [Accepted: 10/01/2020] [Indexed: 12/19/2022] Open
Abstract
PURPOSE To evaluate the association of dry eye disease (DED) severity with work productivity and activity impairment. DESIGN Longitudinal, observational study within a randomized clinical trial. PARTICIPANTS People with moderate to severe DED who enrolled in the multicenter Dry Eye Assessment and Management (DREAM) study. METHODS Participants completed the Work Productivity and Activity Impairment questionnaire at 0, 6, and 12 months and were assessed in parallel for symptoms and signs (conjunctival and corneal staining, tear film break-up time [TBUT], and Schirmer test) of DED. Associations of work productivity and activity impairment with symptom and signs were evaluated with linear regression models using generalized estimating equations and controlling for demographics and comorbidities. MAIN OUTCOME MEASURES Work productivity (employment, absenteeism, presenteeism, overall work impairment) and activity impairment. RESULTS Among 535 participants at baseline, 279 (52%) were employed, and mean activity impairment was 24.5%. Among those employed, the mean score was 2% for absenteeism, 18% for presenteeism, and 19.6% for overall work impairment. Higher Ocular Surface Disease Index (OSDI) symptom scores were associated with greater absenteeism, presenteeism, and activity impairment. Overall work impairment and activity impairment were greater by 4.3% and 4.8%, respectively, per 10-unit difference in OSDI score (P < 0.001). Longitudinal increases (worsening) in OSDI scores were associated with increasing impairment in work and non-work-related activity: 2.0% and 3.1% per 10 units in OSDI, respectively (P < 0.01). Worse corneal staining and TBUT were associated with higher overall work impairment and activity level (P ≤ 0.04). However, longitudinal changes in these two signs were not associated with changes in work productivity or activity impairment. CONCLUSIONS Worse symptoms of DED are associated with decreased work productivity and activity level, both cross-sectionally (interindividually) and longitudinally within person (intraindividually). Corneal staining and TBUT are associated with interindividual differences but not intraindividual changes in work productivity and activity impairment.
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Affiliation(s)
- Giampaolo Greco
- Department of Population Health Science and Policy, Icahn School of Medicine at Mt. Sinai, New York, New York
| | - Maxwell Pistilli
- Department of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Penny A Asbell
- Hamilton Eye Institute, University of Tennessee Health Science Center (UTHSC), Memphis Tennessee
| | - Maureen G Maguire
- Department of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania.
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Zhu Y, Zhao Q, Jia H, Zhang H, Zhang Y. Acupuncture for the treatment of dry eye: Protocol for systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e21625. [PMID: 32769924 PMCID: PMC7593032 DOI: 10.1097/md.0000000000021625] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND As a common ophthalmic disease, dry eye (DE) may bring several adverse effects on the quality of life for patients. In recent years, Acupuncture (AC) is becoming increasingly popular for treating DE. Thus, we conceived this systematic review aims to evaluate the effectiveness and safety of AC for DE objectively. METHODS The search results are restricted to randomized controlled trials and human studies. We will establish the inclusion criteria through discussion and design a detailed literature search strategy for each database. Articles are searched from 4 English databases (the Cochrane Library, PubMed, Web of Science, and EMBASE) and 4 Chinese databases (Wangfang, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, and Chinese scientific and technical journals database). The relevant studies published from the date of database inception until January 2020 will be collected. We will also search (International Clinical Trials Registry Platform), PROSPERO, and potential gray literature. Two reviewers independently perform literature screening, information extraction, and assessment of study quality. The outcome measures include primary outcome measures (Schirmer I test and break-up time), secondary outcome measures (Ocular Surface Disease Index, corneal fluorescein staining, and tear osmolarity), and safety outcome measures. Assessment of bias risk and data processing are performed using RevMan 5.3 software ( the Nordic Cochrane Centre, Copenhagen, Denmark). RESULTS We will evaluate the curative effect of AC for DE comprehensively based on multiple outcome measures. CONCLUSION This systematic review will provide evidence for the effectiveness and safety of AC in the treatment of DE. PROSPERO NUMBER CRD42019144790.
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Affiliation(s)
| | | | - Hongling Jia
- Department of Acupuncture, The Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine
| | - Hongxing Zhang
- Department of Ophtalmology in Chinese medicine, Shandong Provincial Qianfoshan Hospital, Jinan, Shandong, China
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Correlation of corneal immune cell changes with clinical severity in dry eye disease: An in vivo confocal microscopy study. Ocul Surf 2020; 19:183-189. [PMID: 32504855 DOI: 10.1016/j.jtos.2020.05.012] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 04/17/2020] [Accepted: 05/26/2020] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate corneal immune dendritiform cell (DC) changes in dry eye disease (DED) using in vivo confocal microscopy (IVCM) and to correlate IVCM parameters with clinical severity. METHODS This was a retrospective, cross-sectional study including 300 eyes of 150 DED patients and 49 eyes of 49 age-matched controls. Severity of DED was based on the Dry Eye Workshop (DEWS) classification. IVCM images of subbasal layer of the central cornea were analyzed for DC density and morphology (including number of dendrites per DC, DC size and DC field). RESULTS DC density was significantly higher in DED compared to controls (93.4 ± 6.3 vs. 25.9 ± 3.9 cells/mm2; P < 0.001). Morphologically, number of dendrites, DC size and field were significantly larger in DED (3.3 ± 0.1, 106.9 ± 4.7 μm2, 403.8 ± 20.1 μm2 than controls (2.3 ± 0.1, 62.5 ± 5.7 μm2, 241.4 ± 24.4 μm2, P < 0.001). Significantly higher DC density compared to controls was observed as early as Level 1 DED severity (87 ± 10 cells/mm2, p < 0.001. Significant morphological changes in DC were detected for Levels 2 to 4 (p=<0.001, and p =< 0.05) for dendrites and DC field, respectively. Similarly, DC size showed significant increase at DED level 3-4. (p < 0.05). Linear regression analysis showed that both conjunctival and corneal staining were independently associated with DC density, while corneal staining was independently associated with DC morphology. CONCLUSION DC density and morphology correlated with clinical severity of DED. While, DC density is increased in mild DED, morphological changes are seen only in severe cases. IVCM may be a powerful tool to detect early immune changes and may complement clinical examination in DED.
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Loss of Concentration May Occur by Blink Inhibition in DED Simulation Models. Life (Basel) 2020; 10:life10050061. [PMID: 32414123 PMCID: PMC7281572 DOI: 10.3390/life10050061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 05/12/2020] [Accepted: 05/12/2020] [Indexed: 01/08/2023] Open
Abstract
Purpose: Patients with dry eye disease (DED) often suffer productivity loss and distress due to bothersome symptoms. The aim of this study was to objectively quantify and compare productivity-related emotional states obtained from brain waveforms in natural and simulated DED conditions. Method: 25 healthy adults (6 females and 19 males; mean age ± standard deviation, 22.6 ± 8.3 years) were recruited for the study, which included an electroencephalogram (EEG), measurements of interblinking time, and questionnaires. DED was simulated by suppressing blinking, while spontaneous blinking served as a control. Elements of concentration, stress, and alertness were extracted from the raw EEG waveforms and the values were compared during spontaneous and suppressed blinking. The relation with DED-related parameters was then explored. Written informed consent was obtained from all participants. Results: All participants successfully completed the experimental protocol. Concentration significantly decreased during suppressed blinking in 20 participants (80%), when compared with spontaneous blinking, whereas there were no or small differences in stress or alertness between spontaneous and suppressed blinking. The change in concentration was correlated with interblinking time (β = −0.515, p = 0.011). Conclusion: Loss of concentration was successfully captured in an objective manner using the EEG. The present study may enable us to understand how concentration is affected during blink suppression, which may happen in office work, particularly during computer tasks. Further study using detailed ocular evaluation is warranted to explore the effect of different interventions.
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Omega-3 Fatty Acids and Eye Health: Opinions and Self-Reported Practice Behaviors of Optometrists in Australia and New Zealand. Nutrients 2020; 12:nu12041179. [PMID: 32331489 PMCID: PMC7230711 DOI: 10.3390/nu12041179] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 04/16/2020] [Accepted: 04/16/2020] [Indexed: 12/20/2022] Open
Abstract
This study investigated optometrists’ attitudes and self-reported practice behaviors towards omega-3 fatty acids for eye health, and knowledge and understanding of their potential risks and benefits. An anonymous online survey was distributed to optometrists in Australia and New Zealand. Questions included practitioner demographics and practice modality; self-reported practices and recommendations relating to diet, nutritional supplements, and omega-3 fatty acids for age-related macular degeneration (AMD) and dry eye disease (DED); and practitioner knowledge about omega-3 fatty acids. Of 206 included surveys, most respondents (79%) indicated recommending for their patients to consume omega-3 fatty acids to improve their eye health. Sixty-eight percent of respondents indicated recommending omega-3-rich foods for AMD management, while 62% indicated recommending omega-3 supplements. Most respondents (78%) indicated recommending omega-3-rich foods or supplements for DED. For DED, recommended omega-3 supplement dosages were (median [inter-quartile range, IQR]) 2000 mg [1000–2750 mg] per day. The main sources of information reported by respondents to guide their clinical decision making were continuing education articles and conferences. In conclusion, optometrists routinely make clinical recommendations about diet and omega-3 fatty acids. Future education could target improving optometrists’ knowledge of differences in the evidence for whole-food versus supplement sources of omega-3 fatty acids in AMD. Further research is needed to address uncertainties in the evidence regarding optimal omega-3 dosage and formulation composition in DED.
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White DE, Zhao Y, Jayapalan H, Machiraju P, Periyasamy R, Ogundele A. Physician Satisfaction with Anti-Inflammatory Topical Medications for the Treatment of Dry Eye Disease. Clin Ophthalmol 2020; 14:931-938. [PMID: 32273677 PMCID: PMC7104108 DOI: 10.2147/opth.s237832] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 03/03/2020] [Indexed: 11/25/2022] Open
Abstract
Purpose Dry eye disease (DED) is one of the most common ophthalmic disorders. Pathogenesis of the disease includes inflammation of the ocular surface and lacrimal gland. Two anti-inflammatory prescription treatments are currently available: cyclosporine ophthalmic emulsion 0.05% (CYC) and lifitegrast 5% ophthalmic solution (LIF). The objective of this survey-based study was to assess physician satisfaction with CYC and LIF for the treatment of DED. Methods Physicians currently treating DED patients with CYC or LIF were asked to rate the experiences of their patients currently or formerly using CYC and LIF, and their own perspectives on the two treatments. Results Twenty-one physicians participated in the survey, providing responses on behalf of 210 patients. Overall, physicians reported low levels of satisfaction with onset of action of CYC and LIF, and fewer than half considered either drug to be effective in managing symptoms or improving patient quality of life (QoL). Burning sensation and dysgeusia were the most frequently reported side effects. Onset of action and effectiveness after onset were the main switching drivers. Although two-thirds of physicians were satisfied with the overall effectiveness of CYC and LIF, all physicians agreed that more DED treatment options are needed, with >50% strongly agreeing. Conclusion Physicians perceived a gap in DED management with currently available topical anti-inflammatory agents. Although satisfaction with CYC and LIF was high, few physicians considered these medications to be effective in managing symptoms or improving QoL.
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Affiliation(s)
| | - Yang Zhao
- Medical Affairs, Sun Pharmaceutical Industries, Princeton, NJ, USA
| | | | | | | | - Abayomi Ogundele
- Medical Affairs, Sun Pharmaceutical Industries, Princeton, NJ, USA
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White DE, Zhao Y, Jayapalan H, Machiraju P, Periyasamy R, Ogundele A. Treatment Satisfaction Among Patients Using Anti-Inflammatory Topical Medications for Dry Eye Disease. Clin Ophthalmol 2020; 14:875-883. [PMID: 32256045 PMCID: PMC7089601 DOI: 10.2147/opth.s233194] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 01/20/2020] [Indexed: 01/16/2023] Open
Abstract
Purpose To assess patient satisfaction among current and former users of the anti-inflammatory topical medications, cyclosporine A 0.05% (CYC) and lifitegrast 5.0% (LIF), for the management of dry eye disease (DED). Patients and Methods Patients with DED were recruited via physician referral to participate in a survey. Current users of CYC or LIF were asked to rate their experience in terms of satisfaction, side effects, and limitation of activities. Switchers of CYC to LIF or LIF to CYC were asked to rate the importance of potential reasons for switching. Results Surveys were completed by 207 patients currently treated with CYC (n=98), LIF (n=96), or other DED medications (n=13). Although overall satisfaction with current treatment was high, current users of CYC and LIF reported ineffective relief of DED symptoms (31% and 22%, respectively) and dissatisfaction with the time to onset of effect (29% and 11%). Substantial proportions of patients reported ‘sometimes’, “usually”, or ‘always’ experiencing the following side effects: burning sensation (72% CYC, 64% LIF), itching (43% CYC, 44% LIF), altered sensation of taste (21% CYC, 56% LIF), blurred vision (37% CYC, 50% LIF), and discharge (28% CYC, 30% LIF). Of the 30 switchers of CYC to LIF and 31 switchers of LIF to CYC, the majority reported inability to relieve DED symptoms as a very or extremely important switching reason. Despite switching, one in four patients were somewhat dissatisfied or dissatisfied with their current medication, with 37% of patients reporting ineffective symptom relief. Conclusion Although the rate of overall satisfaction was generally high with both LIF and CYC, many patients were unable to achieve effective symptom relief and commonly experienced side effects. The proportion of patients who were dissatisfied and/or unable to achieve effective symptom relief even after switching suggests the need for additional treatment options for managing DED.
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Affiliation(s)
| | - Yang Zhao
- Sun Pharmaceutical Industries, Inc., Princeton, NJ, USA
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Messmer E, Chan C, Asbell P, Johnson G, Sloesen B, Cook N. Comparing the needs and preferences of patients with moderate and severe dry eye symptoms across four countries. BMJ Open Ophthalmol 2019; 4:e000360. [PMID: 31909193 PMCID: PMC6936582 DOI: 10.1136/bmjophth-2019-000360] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 10/02/2019] [Accepted: 10/31/2019] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND/AIMS Understanding patients' perspectives of their disease can inform drug development and treatment decisions. In this study, we compared the preferences and needs of patients with moderate and severe dry eye symptoms from four different countries. METHODS A quantitative questionnaire was developed based on the self-explicated conjoint methodology and was administered to 160 patients with moderate or severe dry eye disease (DED) from Australia, Germany, UK and the USA. RESULTS Patients with moderate dry eye symptoms ranked 'treatment satisfaction' as the most important aspect, whereas 'symptom bother' was more relevant for those in the severe group. Both the moderate and severe groups classified treatment effectiveness as the most important treatment attribute. This result was consistent across the four countries, although US patients gave significantly higher scores than patients from other countries (p<0.001). Furthermore, patients from Australia ranked 'treatment experience' as significantly more important than the concern of side effects, whereas respondents from Germany exhibited the opposite trend (p<0.05 for both). The health burden of DED is reflected in the average European Quality of Life-5 Dimensions 5-level (EQ-5D) scores of 0.764 and 0.658 for patients with moderate and severe disease, respectively. CONCLUSION Our results confirm that across the countries in the study, moderate and severe DED has a major impact on patients' quality of life and daily activities. By providing insight into the patient perspective of DED, our study helps identify outcomes that are important to patients and may guide future drug development and clinical decision-making.
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Affiliation(s)
- Elisabeth Messmer
- Department of Ophthalmology, Ludwig Maximilians University, Munich, Germany
| | - Colin Chan
- Central Clinical School, University of Sydney Sydney Medical School, Sydney, New South Wales, Australia
| | - Penny Asbell
- Ophthalmology, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | | | | | - Nigel Cook
- Global Patient Access, Novartis Pharma AG, Basel, Switzerland
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Kuo YK, Lin IC, Chien LN, Lin TY, How YT, Chen KH, Dusting GJ, Tseng CL. Dry Eye Disease: A Review of Epidemiology in Taiwan, and its Clinical Treatment and Merits. J Clin Med 2019; 8:E1227. [PMID: 31443274 PMCID: PMC6722537 DOI: 10.3390/jcm8081227] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 08/06/2019] [Accepted: 08/08/2019] [Indexed: 12/11/2022] Open
Abstract
Dry eye disease (DED) has become common on a global scale in recent years. There is a wide prevalence of DED in different countries based on various ethnicities and environment. DED is a multifactorial ocular disorder. In addition to advanced age and gender, such factors as living at high altitude, smoking, pterygium, prolonged use of consumer electronics or overingesting of caffeine or multivitamins are considered to be the major risk factors of DED. We report the DED epidemiology in Taiwan firstly in this article. According to the pathophysiological factors and changes inthe composition of the tear film in DED, it can be categorized into several subtypes, including lipid anomaly dry eye, aqueous tear deficiency, allergic and toxic dry eye among others. Each subtype has its own cause and disease management; therefore, it is important for ophthalmologists to identify the type through literature review and investigation. The management of DED, relies not only on traditional medications such as artificial tears, gels and ointments, but also newer treatment options such as acupuncture, SYL1001, and nanomedicine therapy. We also conducted a comprehensive literature review including common subtypes and treatment of DED. Clearly, more clinical trials are needed to assess the efficacy and safety of the various treatments and common subtypes of DED.
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Affiliation(s)
- Yu-Kai Kuo
- School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - I-Chan Lin
- Department of Ophthalmology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan
- Department of Ophthalmology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Li-Nien Chien
- School of Health Care Administration, College of Management, , Taipei Medical University, Taipei 11031, Taiwan
- Health and Clinical Data Research Center, College of Public Health, Taipei Medical University, Taipei 11031, Taiwan
| | - Tzu-Yu Lin
- Department of Ophthalmology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan
- Department of Ophthalmology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Ying-Ting How
- Graduate Institute of Biomedical Materials & Tissue Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 11031, Taiwan
| | - Ko-Hua Chen
- Department of Ophthalmology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
- Department of Ophthalmology, Taipei Veterans General Hospital, Taipei 11217, Taiwan
| | - Gregory J Dusting
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, VIC 3002, Australia
- Ophthalmology, Department of Surgery, University of Melbourne, East Melbourne, VIC 3002, Australia
| | - Ching-Li Tseng
- Graduate Institute of Biomedical Materials & Tissue Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 11031, Taiwan.
- Institute of International PhD Program in Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 11031, Taiwan.
- Research Center of Biomedical Device, College of Biomedical Engineering, Taipei Medical University, Taipei 11031, Taiwan.
- International PhD Program in Cell Therapy and Regenerative Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan.
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Abstract
PURPOSE OF REVIEW The prevalence and burden of dry eye disease continues to grow at a rapid pace, creating an increased need for new therapies. In a sector once limited to only a handful of treatments, clinicians now have multiple options available for patients who fail traditional therapies. This review summarizes the various treatment options available to clinicians treating complex dry eye disease patients. RECENT FINDINGS As we better understand the multifactorial mechanisms leading to dry eye disease, treatments increasingly focus on the amelioration of the underlying deficiencies and inflammation, rather than on transient symptomatic relief alone. Most topical medications seek to replace deficient growth factors and/or decrease inflammation on the ocular surface. The majority of new devices and procedures seek to treat meibomian gland dysfunction, with one new device stimulating tear production through utilizing the nasolacrimal reflex pathway. SUMMARY Clinicians have more options at their disposal in the treatment of dry eye disease than ever before, including topical medications and devices.
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The relationship between occupation and dry eye. Ocul Surf 2019; 17:484-490. [PMID: 30951831 DOI: 10.1016/j.jtos.2019.04.004] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 03/08/2019] [Accepted: 04/01/2019] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Environmental factors play an important aetiological role in dry eye. This cross-sectional study investigated the relationship between types of occupation and symptomatic dry eye. METHODS 40,501 employed people working ≥8 h a week were included from the population-based Lifelines cohort in the Netherlands. Logistic regression was used to determine the association between symptomatic dry eye (assessed by the WHS questionnaire) and occupation (using the ISCO-08 classification system). RESULTS After correction for age and sex, the professionals (e.g. legal, health, and business and administration professionals) (OR = 1.14, 95%CI = 1.08-1.19, P < 0.001) and clerical support workers (OR = 1.14, 95%CI = 1.07-1.22, P < 0.001) had the highest risk of dry eye of all 10 major occupation groups. Skilled agricultural workers (OR = 0.57, 95%CI = 0.49-0.67, P < 0.001) and elementary occupations (OR = 0.77, 95%CI = 0.69-0.85, P < 0.001), such as cleaners and carers, carried the lowest risk of dry eye. After additional correction for 45 dry eye associated comorbidities, professionals and clerical support workers showed no increased risk anymore, while craft and related trades workers, e.g. building workers and metal and machinery workers, showed the highest risk of dry eye (OR = 1.12, 95%CI = 1.02-1.24, P = 0.01). CONCLUSIONS This study underlines the importance of asking about type of occupation in dry eye patients. Screening for symptomatic dry eye in high risk occupations such as in building workers and in indoor occupations with high screen use is relevant from an occupational health and work productivity perspective. The lower risk of dry eye in outdoor and active occupation is intriguing and justifies future studies to investigate potential protective and treatment effects.
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Pena-Verdeal H, García-Resúa C, Vazquez-Sanchez C, Garcia-Queiruga J, Yebra-Pimentel E, Giráldez MJ. Reproducibility in measuring tear samples using a freezing point depression osmometer. Clin Exp Optom 2019; 102:571-575. [PMID: 30818419 DOI: 10.1111/cxo.12886] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2018] [Revised: 01/06/2019] [Accepted: 01/21/2019] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Hyperosmolarity of tear fluid has been recognised as a common feature of all types of dry eye disease. This study was designed to assess the inter-session reproducibility of a freezing point depression osmometer (Fiske 110) as the most common and precise way of measuring osmolality, by using two different volumes of tear samples on healthy subjects, and to determine the possible applications of this device in tear film research and clinical practice. METHODS Measurements were made by using the Fiske 110 osmometer under two different tear sample volumes (4 μl and 2 μl). In both cases, samples were diluted in purified water to obtain the 20 μl required by the device to perform the measurement (1:4 and 1:9 dilutions, respectively). Inter-session reproducibility was determined in two groups of 40 healthy subjects, in two sessions, one week apart. In each group, one of the two different tear sample volumes was used to determine the reproducibility of each technique. RESULTS No significant differences were detected between the measurements obtained in the two sessions using the 4 μl (paired t-test, p = 0.772; mean difference ± SD = -0.85 ± 18.77 mOsm/L; 95 per cent limits of agreement [LoAs] = -37.64/+35.94) or the 2 μl volume sample (paired t-test, p = 0.054; mean difference ± SD = 9.27 ± 29.44 mOsm/L; 95 per cent LoAs = -48.43/+66.97). CONCLUSIONS Whereas both techniques show an acceptable inter-session reproducibility, the bias range with the present protocol was higher using the 2 μl tear sample volume than the 4 μl one. Therefore, it seems that the diluted 4 μl sample was the only dilution that could be acceptable for use in routine clinical practice for tear film analysis.
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Affiliation(s)
- Hugo Pena-Verdeal
- Departamento de Física Aplicada (Area de Optometría), Universidade de Santiago de Compostela, Santiago de Compostela, Galicia, Spain.,Facultad de Óptica y Optometría, Universidad de Santiago de Compostela, Santiago de Compostela, Galicia, Spain
| | - Carlos García-Resúa
- Departamento de Física Aplicada (Area de Optometría), Universidade de Santiago de Compostela, Santiago de Compostela, Galicia, Spain
| | - Covadonga Vazquez-Sanchez
- Departamento de Física Aplicada (Area de Optometría), Universidade de Santiago de Compostela, Santiago de Compostela, Galicia, Spain
| | - Jacobo Garcia-Queiruga
- Departamento de Física Aplicada (Area de Optometría), Universidade de Santiago de Compostela, Santiago de Compostela, Galicia, Spain
| | - Eva Yebra-Pimentel
- Departamento de Física Aplicada (Area de Optometría), Universidade de Santiago de Compostela, Santiago de Compostela, Galicia, Spain
| | - María J Giráldez
- Departamento de Física Aplicada (Area de Optometría), Universidade de Santiago de Compostela, Santiago de Compostela, Galicia, Spain
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Bradley JL, Özer Stillman I, Pivneva I, Guerin A, Evans AM, Dana R. Dry eye disease ranking among common reasons for seeking eye care in a large US claims database. Clin Ophthalmol 2019; 13:225-232. [PMID: 30774303 PMCID: PMC6362914 DOI: 10.2147/opth.s188314] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES Dry eye disease (DED) is a complex multifactorial condition of the ocular surface characterized by symptoms of ocular discomfort, irritation, and visual disturbance. Data previously reported from this study showed an increase in prevalence and incidence of DED with age and over time. The objective of this study was to compare the ranking of DED prevalence among other ocular conditions that led patients to seek eye care. METHODS In this population-based study using the US Department of Defense Military Health System claims database of >9.7 million beneficiaries, indicators of DED and other ocular conditions were analyzed over time. The overall prevalence (2003-2015) and annual incidence (2008-2012) of DED and other ocular conditions were estimated using an algorithm based on two independent indicators derived from selected diagnostic and procedure codes and prescriptions for cyclosporine ophthalmic emulsion for DED and diagnostic codes for the indicators of other common ocular conditions. RESULTS In 2003-2015, the most common ocular conditions were disorders of refraction and accommodation (25.84%), cataracts (17.14%), glaucoma (7.27%), disorders of the conjunctiva (6.76%), other retinal disorders (5.94%), and DED (5.28%). DED was the fifth most prevalent ocular condition in women (7.78%) and ninth most prevalent in men (2.96%). In 2012, DED had the third highest annual incidence (0.87%), behind disorders of refraction/accommodation (1.87%) and cataracts (1.50%). CONCLUSION This study provided further epidemiologic evidence for DED as a commonly occurring condition that drives patients to seek treatment.
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Affiliation(s)
- John L Bradley
- Naval Medical Research Unit Dayton, Vision Science Lab, Wright Patterson AFB, OH, USA
- University of Pikeville, Kentucky College of Optometry, Pikeville, KY, USA
| | | | | | | | | | - Reza Dana
- Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
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Ooi KGJ, Rao A, Goh JSK, Gracie G, Cherepanoff S, Madigan MC, Watson SL. HMG-CoA reductase expression in human eyelid tissue and in a human meibomian gland epithelial cell line. Graefes Arch Clin Exp Ophthalmol 2019; 257:785-790. [DOI: 10.1007/s00417-019-04247-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 12/26/2018] [Accepted: 01/11/2019] [Indexed: 12/20/2022] Open
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Ahn Y, Jee D. Socioeconomic Costs of Age-related Macular Degeneration in Korea. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2019. [DOI: 10.3341/jkos.2019.60.8.765] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Yongsun Ahn
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Suncheon Public Health Center, Suncheon, Korea
| | - Donghyun Jee
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Gomes JAP, Santo RM. The impact of dry eye disease treatment on patient satisfaction and quality of life: A review. Ocul Surf 2018; 17:9-19. [PMID: 30419303 DOI: 10.1016/j.jtos.2018.11.003] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 11/02/2018] [Accepted: 11/07/2018] [Indexed: 12/23/2022]
Abstract
Several aspects of the quality of life (QoL) and treatment satisfaction of patients with dry eye disease (DED) may be underestimated. Ocular symptoms, which are assessed by validated patient-reported questionnaires and may include stinging, burning, itchiness, grittiness, dryness and discomfort, reduce QoL by affecting daily activities and work productivity. Self-reported symptoms do not always correlate with post-treatment improvements in clinical measures such as tear film break-up time, inflammation and osmolarity. Thus, treatments may improve clinical ocular features without improving symptoms that affect daily life. This review explores 1500 abstracts from congress presentations and peer-reviewed journals for QoL and treatment satisfaction data on the use of active lubricants, osmoprotectants, secretagogues, and immunomodulators present in topical formulations for DED treatment, and validated symptom questionnaires. Patient-reported symptoms of DED are generally improved after treatment with topical formulations for tear replacement, tear stimulation or anti-inflammatory therapy compared with baseline or a control treatment. However, more data are required to compare the performance of active ingredients. It is fundamental to diagnose patients with DED accurately, recognising the major cause behind their dry eyes. Studies are also necessary to identify how patient satisfaction and QoL may be improved through long-term use of topical preparations. We conclude that careful and thorough consideration of patient-reported symptoms should be integrated into DED management to help tailor treatment to patient needs.
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Affiliation(s)
- José A P Gomes
- Department of Ophthalmology and Visual Sciences, Federal University of Sao Paulo (UNIFESP/EPM), Brazil.
| | - Ruth M Santo
- Department of Ophthalmology, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil.
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Shinomiya K, Ueta M, Kinoshita S. A new dry eye mouse model produced by exorbital and intraorbital lacrimal gland excision. Sci Rep 2018; 8:1483. [PMID: 29367638 PMCID: PMC5784089 DOI: 10.1038/s41598-018-19578-6] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 01/04/2018] [Indexed: 12/22/2022] Open
Abstract
Chronic dry eye is an increasingly prevalent condition worldwide, with resulting loss of visual function and quality of life. Relevant, repeatable, and stable animal models of dry eye are still needed. We have developed an improved surgical mouse model for dry eye based on severe aqueous fluid deficiency, by excising both the exorbital and intraorbital lacrimal glands (ELG and ILG, respectively) of mice. After ELG plus ILG excision, dry eye symptoms were evaluated using fluorescein infiltration observation, tear production measurement, and histological evaluation of ocular surface. Tear production in the model mice was significantly decreased compared with the controls. The corneal fluorescein infiltration score of the model mice was also significantly increased compared with the controls. Histological examination revealed significant severe inflammatory changes in the cornea, conjunctiva or meibomian glands of the model mice after surgery. In the observation of LysM-eGFP(+/−) mice tissues, postsurgical infiltration of green fluorescent neutrophils was observed in the ocular surface tissues. We theorize that the inflammatory changes on the ocular surface of this model were induced secondarily by persistent severe tear reduction. The mouse model will be useful for investigations of both pathophysiology as well as new therapies for tear-volume-reduction type dry eye.
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Affiliation(s)
- Katsuhiko Shinomiya
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan.,Pharmacology Group, Non-Clinical Research, Global R&D Division, Santen Pharmaceutical Co., Ltd., Ikoma, Japan
| | - Mayumi Ueta
- Department of Frontier Medical Science and Technology for Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
| | - Shigeru Kinoshita
- Department of Frontier Medical Science and Technology for Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
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Abstract
PURPOSE Modern offices and the use of electronic devices are increasing factors in work-related eye symptoms. However, symptoms of eye fatigue or dry eye sensation can be mixed and confusing. This study surveys the eye symptoms reported during a working day at modern offices to investigate the possible inhibition on daily work activities. METHODS Two online digital surveys were sent to three different work locations, by direct e-mail. Survey A consisted of 14 questions that investigated eye symptoms experienced during daily activities at work and the impact on daily activities. Survey B consisted of four general questions, the Dutch Ocular Surface Disease Index, the Work Productivity and Activity Index, and the Illness Perception Questionnaire. RESULTS A total of 505 participants completed survey A, and 213 completed survey B. The participants reported that a high proportion of their day was spent working on a computer (60%). The majority experienced an air draft (79.1%) and had no adjustable light (81.5%) at their workspace. Dry eye-related symptoms were reported at a significantly higher frequency at work than at home (P < .001). Up to 70% experienced some inhibition of daily activity at work due to eye symptoms, with more than 5% experiencing symptoms most or all of the time. Indoor environment, work environment, and general health were perceived as the main reasons for developing dry eye. Compared with males, females showed a statistically significant higher Ocular Surface Disease Index score (P < .001) and experienced more inhibition and adverse effects on daily life and work productivity. CONCLUSIONS This investigation shows that dry eye symptoms have a negative impact on daily activities at work. These findings suggest that multidisciplinary understanding of the negative impact of dry eye by a range of specialists will be of help in managing work-related dry eye.
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Abstract
The subcommittee reviewed the prevalence, incidence, risk factors, natural history, morbidity and questionnaires reported in epidemiological studies of dry eye disease (DED). A meta-analysis of published prevalence data estimated the impact of age and sex. Global mapping of prevalence was undertaken. The prevalence of DED ranged from 5 to 50%. The prevalence of signs was higher and more variable than symptoms. There were limited prevalence studies in youth and in populations south of the equator. The meta-analysis confirmed that prevalence increases with age, however signs showed a greater increase per decade than symptoms. Women have a higher prevalence of DED than men, although differences become significant only with age. Risk factors were categorized as modifiable/non-modifiable, and as consistent, probable or inconclusive. Asian ethnicity was a mostly consistent risk factor. The economic burden and impact of DED on vision, quality of life, work productivity, psychological and physical impact of pain, are considerable, particularly costs due to reduced work productivity. Questionnaires used to evaluate DED vary in their utility. Future research should establish the prevalence of disease of varying severity, the incidence in different populations and potential risk factors such as youth and digital device usage. Geospatial mapping might elucidate the impact of climate, environment and socioeconomic factors. Given the limited study of the natural history of treated and untreated DED, this remains an important area for future research.
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