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Tawfik A, Pistilli M, Maguire MG, Chen Y, Yu Y, Greiner JV, Asbell PA, Ying GS. Association of Dry Eye Symptoms and Signs in Patients with Dry Eye Disease. Ophthalmic Epidemiol 2024; 31:274-282. [PMID: 37592829 PMCID: PMC10873469 DOI: 10.1080/09286586.2023.2248629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 06/07/2023] [Accepted: 08/11/2023] [Indexed: 08/19/2023]
Abstract
PURPOSE To determine the correlations among symptoms and signs of dry eye disease (DED) in the Dry Eye Assessment and Management (DREAM) study. METHODS A total of 535 patients with moderate-to-severe DED were assessed for symptoms using the Ocular Surface Disease Index (OSDI) and four DED signs in both eyes (conjunctival lissamine green staining, corneal fluorescein staining, Schirmer's testing, and tear break-up time (TBUT)) following standardized protocols at baseline and follow-up visits (months 3, 6, and 12). Spearman correlation coefficients (rho) were calculated for correlations among symptoms and signs of DED at baseline and among changes in symptoms and signs from baseline at 12 months. The confidence intervals and p-values for correlation coefficients were calculated using a cluster bootstrapping to account for inter-eye correlation. RESULTS At baseline, OSDI total score was not correlated with signs; however, OSDI subscale score of ocular symptoms was weakly correlated with corneal staining score (rho = 0.14, p = .002) and Schirmer test score (rho = 0.11, p = .01). There were statistically significant correlations among the four signs (p < .001), with absolute correlation coefficient ranging from 0.14 (conjunctival staining score vs. TBUT) to 0.33 (conjunctival staining score vs. cornea staining score). The correlations among changes in symptoms and signs were weaker, with the highest correlation between change in conjunctival staining and corneal staining (rho = 0.21, p < .001). CONCLUSIONS Consistent with previous studies, among DREAM participants with moderate-to-severe DED at baseline, correlations of DED symptoms with signs were low and correlations among four objective signs were low to moderate. The correlations among changes in symptoms and signs were even weaker.
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Affiliation(s)
- Andrew Tawfik
- Drexel University College of Medicine, Philadelphia, PA, USA
| | - Maxwell Pistilli
- Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Maureen G Maguire
- Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Yineng Chen
- Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Yinxi Yu
- Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jack V Greiner
- Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Penny A Asbell
- Department of Bioengineering, University of Memphis, Memphis, Tennessee
| | - Gui-shuang Ying
- Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Ayaki M, Negishi K. Seasonality of Tear Meniscus Volume and Dry Eye-Related Symptoms - A Cross-Sectional Retrospective Cohort Study. Clin Ophthalmol 2023; 17:3809-3816. [PMID: 38105909 PMCID: PMC10725749 DOI: 10.2147/opth.s442567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 12/05/2023] [Indexed: 12/19/2023] Open
Abstract
Purpose We aimed to determine the seasonal variation in the tear meniscus level on strip meniscometry and its association with ocular parameters and symptoms. In Japan, there are four distinct seasons characterized by marked differences in temperature and humidity, which may contribute to an observed seasonality of ocular surface symptoms. Methods We conducted a cross-sectional study in two Japanese clinics and recruited first-visit patients for 3 years. Tear strip meniscometry, tear break-up time (BUT), Schirmer test, and corneal staining were examined, and major ocular symptoms (dryness, irritation, pain, fatigue, blurred vision, and photophobia) were determined through interviews. Results The 1196 participants had a mean age of 58.9±15.2 years; 37.1% were of male sex. Strip meniscometry values and BUT revealed significant seasonality with one-way analysis of variance. The mean strip meniscometry value (mm) was 2.15±2.59 in spring (p=0.025 vs winter), 2.37±2.79 in summer (p<0.001), 2.38±2.80 in fall (p<0.001), and 1.64±2.29 in winter. Regression analysis indicated that strip meniscometry levels were correlated with BUT (p<0.001), Schirmer test values (p<0.001), corneal staining scores (p=0.022), and presence of dryness (p<0.001). Conclusion Strip meniscometry values exhibited distinct seasonality, being lowest in winter when the ambient condition is dry and cool, and were correlated with BUT, Schirmer test values, corneal staining scores, and the presence of subjective dryness.
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Affiliation(s)
- Masahiko Ayaki
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
- Otake Eye Clinic, Kanagawa, Japan
| | - Kazuno Negishi
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
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Gui SY, Wang F, Qiao JC, Wang XC, Huang ZH, Yang F, Hu CY, Tao FB, Tao LM, Liu DW, Yi XL, Jiang ZX. Short-term effect of meteorological factors and extreme weather events on daily outpatient visits for dry eye disease between 2013 and 2020: a time-series study in Urumqi, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:111967-111981. [PMID: 37821738 DOI: 10.1007/s11356-023-29651-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 08/29/2023] [Indexed: 10/13/2023]
Abstract
Dry eye disease (DED) is a common disorder of tear secretion on the ocular surface caused by multiple factors with dry eyes as the main symptom, but until now studies focusing on relationship between local meteorological factors and ocular surface diseases in Urumqi are very limited. Besides, the effects of long-term and extreme meteorological factors on DED and the lag effect have not been fully evaluated. Electronic case information of 9970 DED outpatients from the Ophthalmology Department of the First Affiliated Hospital of Xinjiang Medical University (Urumqi, Xinjiang, China) between January 1, 2013, and December 31, 2020, was screened and analyzed. We used a time-series analysis design and a quasi-Poisson generalized linear regression model combined with a distributed lagged nonlinear model (DLNM) to fit the effects of exposure to different meteorological factors and extreme weather on DED outpatient visits. Subgroup analyses were further performed for gender, age, and season. The results showed that exposure to extremely low mean temperature (P1:RR = 1.18), atmospheric pressure (P1:RR = 1.11), and extremely high relative humidity (P99:RR = 1.35) were the risk factors, while extremely high atmospheric pressure (P90:RR = 0.883) and extremely low humidity (P10:RR = 0.856) appeared to have a positive effect on reduced risk of DED. Relative humidity exhibited a 1-day lag effect (RR = 1.06). Increased mean temperature positively affected female DED patients (RR = 0.761) with similar effects in the cold season (RR = 0.926). However, elevated relative humidity had a negative effect on female patients (RR = 1.14). We conducted the first large sample size time-series analysis study in this major city at the farthest distance from the ocean in the world and in northwest China, confirming the association of DED outpatient visits with the remaining three meteorological factors except wind speed in Urumqi, and a larger sample size multi-center epidemiological study with a longer duration is still needed.
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Affiliation(s)
- Si-Yu Gui
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, China
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Fei Wang
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, China
| | - Jian-Chao Qiao
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Xin-Chen Wang
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, China
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Zhi-Hao Huang
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Fan Yang
- Department of Clinical Medicine, The First School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Cheng-Yang Hu
- Department of Humanistic Medicine, School of Humanistic Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Fang-Biao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Li-Ming Tao
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, China
| | - Dong-Wei Liu
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, China
| | - Xiang-Long Yi
- Department of Ophthalmology, The First Affiliated Hospital of Xinjiang Medical University, 137 Liyu Shan Road, Urumqi, 830011, China
| | - Zheng-Xuan Jiang
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, China.
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Inomata T, Sung J, Nakamura M, Iwagami M, Akasaki Y, Fujio K, Nakamura M, Ebihara N, Ide T, Nagao M, Okumura Y, Nagino K, Fujimoto K, Eguchi A, Hirosawa K, Midorikawa-Inomata A, Muto K, Fujisawa K, Kikuchi Y, Nojiri S, Murakami A. Using the AllerSearch Smartphone App to Assess the Association Between Dry Eye and Hay Fever: mHealth-Based Cross-Sectional Study. J Med Internet Res 2023; 25:e38481. [PMID: 37698897 PMCID: PMC10523221 DOI: 10.2196/38481] [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: 04/04/2022] [Revised: 09/21/2022] [Accepted: 08/17/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND Dry eye (DE) and hay fever (HF) show synergistic exacerbation of each other's pathology through inflammatory pathways. OBJECTIVE This study aimed to investigate the association between DE and HF comorbidity and the related risk factors. METHODS A cross-sectional observational study was conducted using crowdsourced multidimensional data from individuals who downloaded the AllerSearch smartphone app in Japan between February 2018 and May 2020. AllerSearch collected the demographics, medical history, lifestyle and residential information, HF status, DE symptoms, and HF-related quality of life. HF symptoms were evaluated using the nasal symptom score (0-15 points) and nonnasal symptom score (0-12 points). HF was defined by the participants' responses to the questionnaire as HF, non-HF, or unknown. Symptomatic DE was defined as an Ocular Surface Disease Index total score (0-100 points), with a threshold score of 13 points. HF-related quality of life was assessed using the Japanese Allergic Conjunctival Disease Standard Quality of Life Questionnaire (0-68 points). We conducted a multivariable linear regression analysis to examine the association between the severity of DE and HF symptoms. We subsequently conducted a multivariable logistic regression analysis to identify the factors associated with symptomatic DE (vs nonsymptomatic DE) among individuals with HF. Dimension reduction via Uniform Manifold Approximation and Projection stratified the comorbid DE and HF symptoms. The symptom profiles in each cluster were identified using hierarchical heat maps. RESULTS This study included 11,284 participants, classified into experiencing HF (9041 participants), non-HF (720 participants), and unknown (1523 participants) groups. The prevalence of symptomatic DE among individuals with HF was 49.99% (4429/9041). Severe DE symptoms were significantly associated with severe HF symptoms: coefficient 1.33 (95% CI 1.10-1.57; P<.001) for mild DE, coefficient 2.16 (95% CI 1.84-2.48; P<.001) for moderate DE, and coefficient 3.80 (95% CI 3.50-4.11; P<.001) for severe DE. The risk factors for comorbid symptomatic DE among individuals with HF were identified as female sex; lower BMI; medicated hypertension; history of hematologic, collagen, heart, liver, respiratory, or atopic disease; tomato allergy; current and previous mental illness; pet ownership; living room and bedrooms furnished with materials other than hardwood, carpet, tatami, and vinyl; discontinuation of contact lens use during the HF season; current contact lens use; smoking habits; and sleep duration of <6 hours per day. Uniform Manifold Approximation and Projection stratified the heterogeneous comorbid DE and HF symptoms into 14 clusters. In the hierarchical heat map, cluster 9 was comorbid with the most severe HF and DE symptoms, and cluster 1 showed severe HF symptoms with minimal DE-related symptoms. CONCLUSIONS This crowdsourced study suggested a significant association between severe DE and HF symptoms. Detecting DE among individuals with HF could allow effective prevention and interventions through concurrent treatment for ocular surface management along with HF treatment.
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Affiliation(s)
- Takenori Inomata
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Hospital Administration, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Jaemyoung Sung
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Masahiro Nakamura
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Bioengineering, Graduate School of Bioengineering, Precision Health, The University of Tokyo, Tokyo, Japan
| | - Masao Iwagami
- Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Yasutsugu Akasaki
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kenta Fujio
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Masahiro Nakamura
- Department of Otorhinolaryngology, Head and Neck Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Nobuyuki Ebihara
- Department of Ophthalmology, Urayasu Hospital, Juntendo University, Chiba, Japan
| | - Takuma Ide
- Department of Otorhinolaryngology, Head and Neck Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Masashi Nagao
- Medical Technology Innovation Center, Juntendo University, Tokyo, Japan
- Department of Orthopedic Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan
- Graduate School of Health and Sports Science, Juntendo University, Tokyo, Japan
| | - Yuichi Okumura
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Ken Nagino
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Hospital Administration, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Keiichi Fujimoto
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Atsuko Eguchi
- Department of Hospital Administration, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kunihiko Hirosawa
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Akie Midorikawa-Inomata
- Department of Hospital Administration, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kaori Muto
- Department of Public Policy, The Institute of Medical Science, Human Genome Center, The University of Tokyo, Tokyo, Japan
| | - Kumiko Fujisawa
- Department of Public Policy, The Institute of Medical Science, Human Genome Center, The University of Tokyo, Tokyo, Japan
| | - Yota Kikuchi
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Shuko Nojiri
- Medical Technology Innovation Center, Juntendo University, Tokyo, Japan
| | - Akira Murakami
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
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Inomata T, Sung J, Fujio K, Nakamura M, Akasaki Y, Nagino K, Okumura Y, Iwagami M, Fujimoto K, Ebihara N, Nakamura M, Midorikawa-Inomata A, Shokirova H, Huang T, Hirosawa K, Miura M, Ohno M, Morooka Y, Iwata N, Iwasaki Y, Murakami A. Individual multidisciplinary clinical phenotypes of nasal and ocular symptoms in hay fever: Crowdsourced cross-sectional study using AllerSearch. Allergol Int 2023:S1323-8930(23)00001-1. [PMID: 36740498 DOI: 10.1016/j.alit.2023.01.001] [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: 08/28/2022] [Revised: 10/08/2022] [Accepted: 12/15/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Multidisciplinary efforts to prospectively collect and analyze symptoms of hay fever are limited. We aimed to identify the characteristics of nasal and ocular symptoms of hay fever, using the AllerSearch smartphone application. METHODS This mobile health-based prospective observational study using the AllerSearch smartphone application was conducted between February 1, 2018, and May 1, 2020. Individuals who downloaded AllerSearch from Japan and provided comprehensive self-assessments (including 17 items related to quality of life [QoL]-related items) were included. The characteristics and risk factors for allergic rhinitis (AR) and allergic conjunctivitis (AC) were identified using hierarchical heat maps and multivariate logistic regression. RESULTS Of the 9041 participants with hay fever, 58.8% had AR and AC, 22.2% had AR, and 5.7% had AC. The AR-AC comorbid cohort showed worse symptoms of hay fever and QoL scores than the other cohorts. Factors (odds ratio, 95% confidence interval) associated with AR-AC included a lower age (0.98, 0.97-0.98), female sex (1.31, 1.19-1.45), liver disease (1.58, 1.26-2.35), dry eye disease (1.45, 1.30-1.63), unknown dry eye disease status (1.46, 1.31-1.62), contact lens use discontinuation during the hay fever season (1.69, 1.28-2.23), and bedroom flooring material other than hardwood, carpet, tatami, or vinyl (1.91, 1.16-3.14). CONCLUSIONS Analysis of medical big data for hay fever performed using a mobile health app helped identify risk factors and characteristics of AC, AR, and AR-AC. Phenotyping of highly variable symptoms of hay fever, such as nasal and ocular symptoms, can facilitate better-quality clinical care.
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Affiliation(s)
- Takenori Inomata
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Hospital Administration, Juntendo University Graduate School of Medicine, Tokyo, Japan; AI Incubation Farm, Juntendo University Graduate School of Medicine, Tokyo, Japan.
| | - Jaemyoung Sung
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan; Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Kenta Fujio
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Masahiro Nakamura
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan; Precision Health, Department of Bioengineering, Graduate School of Bioengineering, The University of Tokyo, Tokyo, Japan
| | - Yasutsugu Akasaki
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Ken Nagino
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Hospital Administration, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yuichi Okumura
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Masao Iwagami
- Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Keiichi Fujimoto
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Nobuyuki Ebihara
- Department of Ophthalmology, Urayasu Hospital, Juntendo University, Chiba, Japan
| | - Masahiro Nakamura
- Department of Otorhinolaryngology and Head and Neck Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Akie Midorikawa-Inomata
- Department of Hospital Administration, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Hurramhon Shokirova
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Tianxiang Huang
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kunihiko Hirosawa
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Maria Miura
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Mizu Ohno
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yuki Morooka
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Nanami Iwata
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yuma Iwasaki
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Akira Murakami
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
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Yu H, Zeng W, Zhang M, Zhao G, Wu W, Feng Y. Utilizing Baidu Index to Investigate Seasonality, Spatial Distribution and Public Attention of Dry Eye Diseases in Chinese Mainland. Front Public Health 2022; 10:834926. [PMID: 35875014 PMCID: PMC9298962 DOI: 10.3389/fpubh.2022.834926] [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: 01/11/2022] [Accepted: 06/15/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose To explore the characteristics of spatial-temporal prevalence and public attention of dry eye diseases (DED) through Baidu Index (BI) based on infodemiology method. Methods The data about BI of DED were collected from Baidu search engine using "Dry eye diseases" as keyword. The spatial and temporal distribution of DED were analyzed through timeseries data decomposition as well as spatial autocorrelation and hotspot detection of BI about DED. The most popular related words and demographic characteristics were recorded to determine the public attention of DED. Results The trends of BI about DED in Chinese mainland had gradually increased over time with a rapid increase from 2012 to 2014 and in 2018. The results of timeseries decomposition indicated that there was seasonality in the distribution of BI about DED with the peak in winter, especially in northern regions. The geographic distribution demonstrated the search activities of DED was highest in the east of Chinese mainland while lowest in the west. The vast majority of people searching for DED were teenagers (20-29 years), with a predominance of females. Glaucoma, keratitis and conjunctivitis were the diseases most often confused with DED, and the artificial tears were the most common treatment for DED in Chinese mainland according to the BI about DED. Conclusions The analysis revealed the seasonality, geographic hotspots and public concern of DED through BI in Chinese mainland, which provided new insights into the epidemiology of DED.
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Affiliation(s)
- Haozhe Yu
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - Weizhen Zeng
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - Mengyao Zhang
- Department of Ophthalmology, Peking University Third Hospital Yanqing Hospital, Beijing, China
| | - Gezheng Zhao
- School of Nursing, Peking University, Beijing, China
| | - Wenyu Wu
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - Yun Feng
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
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Prevalence of Comorbidity between Dry Eye and Allergic Conjunctivitis: A Systematic Review and Meta-Analysis. J Clin Med 2022; 11:jcm11133643. [PMID: 35806928 PMCID: PMC9267454 DOI: 10.3390/jcm11133643] [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] [Received: 05/07/2022] [Revised: 06/16/2022] [Accepted: 06/21/2022] [Indexed: 12/07/2022] Open
Abstract
This systematic review aimed to determine the comorbid dry eye (DE) and allergic conjunctivitis (AC) prevalence. We searched PubMed and EMBASE for articles published until 22 March 2022, combining the terms “(dry eye OR keratoconjunctivitis sicca) AND allergic conjunctivitis.” Study-specific estimates (DE and AC incidence rates among patients with AC and DE, respectively) were combined using the one-group meta-analysis in a random-effects model. The initial search yielded 700 studies. Five articles reporting AC incidence among individuals with DE and six articles reporting DE incidence among individuals with AC were included in the qualitative synthesis. In these nine articles, the total sample size was 7254 patients. The DE incidence among individuals with AC was 0.9–97.5%; the AC incidence among individuals with DE was 6.2–38.0%. One-group meta-analysis using a random-effects model showed that 47.2% (95% confidence interval: 0.165–0.779; 320/1932 cases) of patients with AC had comorbid DE and 17.8% (95% confidence interval: 0.120–0.236; 793/4855 cases) of patients with DE had comorbid AC, as defined by each article. Complimentary screening and treatment for patients with DE and AC may improve long-term outcomes and prevent chronic ocular damage in highly susceptible populations.
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Ayaki M, Negishi K. Decrease of tear break-up time at Japanese eye clinics during five consecutive years. Sci Rep 2022; 12:6848. [PMID: 35477771 PMCID: PMC9043507 DOI: 10.1038/s41598-022-11035-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 04/07/2022] [Indexed: 01/03/2023] Open
Abstract
The aim of this retrospective chart review study was to evaluate the 5-year trend of ocular surface examination results in participants who visited the eye clinic from 2015 to 2019, underwent corneal and lacrimal examinations, refraction, and intra-ocular pressure measurements, and reported six dry eye-related symptoms. A total of 1468 patients were analyzed. Tear break-up time (BUT) decreased continuously for five consecutive years: 4.76 ± 1.84 s in 2015, 4.57 ± 1.70 s in 2016 (p = 0.999, vs 2015), 4.35 ± 2.06 s in 2017 (p = 0.662), 3.83 ± 2.18 s in 2018 (p < 0.001), and 3.63 ± 2.10 s in 2019 (p < 0.001). The decrease of BUT was more prominent in women than men (p < 0.001) and the correlation coefficient between calendar year and BUT was greater in women than men (p = 0.002). Schirmer test value, strip tear meniscometry value, and corneal staining score did not exhibit significant changes. Prevalence of blurring, photophobia, and pain increased toward 2019 among symptoms surveyed (eye fatigue, blurring, photophobia, dryness, irritation, and pain) and regression analysis indicated blurring (p < 0.001), photophobia (p < 0.001), and pain (p < 0.001) were correlated with BUT. In conclusion, BUT decreased continuously for five consecutive years from 2015 to 2019 and was associated with dry-eye related symptoms.
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Affiliation(s)
- Masahiko Ayaki
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan. .,Otake Clinic Moon View Eye Center, Kanagawa, Japan.
| | - Kazuno Negishi
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
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Inomata T, Nakamura M, Iwagami M, Sung J, Nakamura M, Ebihara N, Fujisawa K, Muto K, Nojiri S, Ide T, Okano M, Okumura Y, Fujio K, Fujimoto K, Nagao M, Hirosawa K, Akasaki Y, Murakami A. Individual characteristics and associated factors of hay fever: A large-scale mHealth study using AllerSearch. Allergol Int 2022; 71:325-334. [PMID: 35105520 DOI: 10.1016/j.alit.2021.12.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 11/26/2021] [Accepted: 12/13/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The prevalence of hay fever, a multifactorial allergic disease, is increasing. Identifying individual characteristics and associated factors of hay fever is essential for predictive, preventive, personalized, and participatory (P4) medicine. This study aimed to identify individual characteristics and associated factors of hay fever using an iPhone application AllerSearch. METHODS This large-scale mobile health-based cross-sectional study was conducted between February 2018 and May 2020. Individuals who downloaded AllerSearch in Japan and provided a comprehensive self-assessment (general characteristics, medical history, lifestyle habits, and hay fever symptoms [score range 0-36]) were included. Associated factors of hay fever (vs. non-hay fever) and severe hay fever symptoms were identified using multivariate logistic and linear regression analyses, respectively. RESULTS Of the included 11,284 individuals, 9041 had hay fever. Factors associated with hay fever (odds ratio) included age (0.98), female sex (1.33), atopic dermatitis (1.40), history of dry eye diagnosis (1.36), discontinuation of contact lens use during hay fever season (3.34), frequent bowel movements (1.03), and less sleep duration (0.91). The factors associated with severe hay fever symptoms among individuals with hay fever (coefficient) included age (-0.104), female sex (1.329), history of respiratory disease (1.539), history of dry eye diagnosis (0.824), tomato allergy (1.346), discontinuation of contact lens use during hay fever season (1.479), smoking habit (0.614), and having a pet (0.303). CONCLUSIONS Our large-scale mobile health-based study using AllerSearch elucidated distinct hay fever presentation patterns, characteristics, and factors associated with hay fever. Our study establishes the groundwork for effective individualized interventions for P4 medicine.
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10
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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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11
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Negishi K, Ayaki M, Uchino M, Takei K, Tsubota K. Strip Meniscometry Correlates With Ocular Surface Tests and Symptoms. Transl Vis Sci Technol 2020; 9:31. [PMID: 33262905 PMCID: PMC7691796 DOI: 10.1167/tvst.9.12.31] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 10/26/2020] [Indexed: 12/22/2022] Open
Abstract
Purpose The aim of this study was to investigate the association of dry eye disease (DED)-related signs and symptoms with two tear function tests. Methods This was a clinic-based, cross-sectional study with recruitment of consecutive participants. Schirmer test (ST), tear strip meniscometry (SM), and fluorescein tear breakup time were measured and corneal staining score was examined in outpatients at three clinics. Seven subjective symptoms were assessed by interview, including dryness, irritation, pain, lacrimation, fatigue, blurring, and photophobia. Statistical analyses included regression analysis and comparison tests. Results The mean age of the 210 participants was 61.2 ± 15.2 years (range, 12-91 years), with 135 women (64.3%) in the cohort. The mean ST value was 12.9 ± 9.3 (0-35) mm, and SM was 2.5 ± 1.6 (0-10) mm, with no difference between women and men. SM values were lower in the presence of irritation (P = 0.046) and photophobia (P = 0.011). Regression analysis revealed ST and SM values were strongly correlated (β = 0.255, P < 0.001). SM was significantly correlated with breakup time (β = 0.149, P = 0.032), whereas there was no correlation between ST and DED-related signs and symptoms. Conclusions SM was correlated with DED-related symptoms and breakup time, whereas ST was not. A low SM value could be an alternative clinical parameter to determine tear film-oriented therapy. Translational Relevance Tear strip meniscometry could be a useful tear function examination on a routine clinical basis since it is a 5-second noninvasive procedure and associated with subjective symptoms and the value of the conventional Schirmer test.
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Affiliation(s)
- Kazuno Negishi
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Masahiko Ayaki
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
- Otake Clinic Moon View Eye Center, Kanagawa, Japan
| | - Miki Uchino
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | | | - Kazuo Tsubota
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
- Tsubota Laboratory, Inc., Tokyo, Japan
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12
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Inomata T, Nakamura M, Iwagami M, Midorikawa-Inomata A, Sung J, Fujimoto K, Okumura Y, Eguchi A, Iwata N, Miura M, Fujio K, Nagino K, Hori S, Tsubota K, Dana R, Murakami A. Stratification of Individual Symptoms of Contact Lens-Associated Dry Eye Using the iPhone App DryEyeRhythm: Crowdsourced Cross-Sectional Study. J Med Internet Res 2020; 22:e18996. [PMID: 32589162 PMCID: PMC7381048 DOI: 10.2196/18996] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 04/23/2020] [Accepted: 04/27/2020] [Indexed: 12/13/2022] Open
Abstract
Background Discontinuation of contact lens use is mainly caused by contact lens–associated dry eye. It is crucial to delineate contact lens–associated dry eye's multifaceted nature to tailor treatment to each patient’s individual needs for future personalized medicine. Objective This paper aims to quantify and stratify individual subjective symptoms of contact lens–associated dry eye and clarify its risk factors for future personalized medicine using the smartphone app DryEyeRhythm (Juntendo University). Methods This cross-sectional study included iPhone (Apple Inc) users in Japan who downloaded DryEyeRhythm. DryEyeRhythm was used to collect medical big data related to contact lens–associated dry eye between November 2016 and January 2018. The main outcome measure was the incidence of contact lens–associated dry eye. Univariate and multivariate adjusted odds ratios of risk factors for contact lens–associated dry eye were determined by logistic regression analyses. The t-distributed Stochastic Neighbor Embedding algorithm was used to depict the stratification of subjective symptoms of contact lens–associated dry eye. Results The records of 4454 individuals (median age 27.9 years, SD 12.6), including 2972 female participants (66.73%), who completed all surveys were included in this study. Among the included participants, 1844 (41.40%) were using contact lenses, and among those who used contact lenses, 1447 (78.47%) had contact lens–associated dry eye. Multivariate adjusted odds ratios of risk factors for contact lens–associated dry eye were as follows: younger age, 0.98 (95% CI 0.96-0.99); female sex, 1.53 (95% CI 1.05-2.24); hay fever, 1.38 (95% CI 1.10-1.74); mental illness other than depression or schizophrenia, 2.51 (95% CI 1.13-5.57); past diagnosis of dry eye, 2.21 (95% CI 1.63-2.99); extended screen exposure time >8 hours, 1.61 (95% CI 1.13-2.28); and smoking, 2.07 (95% CI 1.49-2.88). The t-distributed Stochastic Neighbor Embedding analysis visualized and stratified 14 groups based on the subjective symptoms of contact lens–associated dry eye. Conclusions This study identified and stratified individuals with contact lens–associated dry eye and its risk factors. Data on subjective symptoms of contact lens–associated dry eye could be used for prospective prevention of contact lens–associated dry eye progression.
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Affiliation(s)
- Takenori Inomata
- Department of Ophthalmology, Juntendo University Faculty of Medicine, Tokyo, Japan.,Department of Strategic Department of Operating Room Management and Improvement, Juntendo University Faculty of Medicine, Tokyo, Japan.,Department of Hospital Administration, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Masahiro Nakamura
- Department of Bioengineering, Precision Health, Graduate School of Engineering, The University of Tokyo, Tokyo, Japan
| | - Masao Iwagami
- Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Akie Midorikawa-Inomata
- Department of Hospital Administration, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Jaemyoung Sung
- Department of Ophthalmology, Juntendo University Faculty of Medicine, Tokyo, Japan.,Morsani College of Medicine, University of South Florida, Tampa, FL, United States
| | - Keiichi Fujimoto
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yuichi Okumura
- Department of Strategic Department of Operating Room Management and Improvement, Juntendo University Faculty of Medicine, Tokyo, Japan.,Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Atsuko Eguchi
- Department of Hospital Administration, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Nanami Iwata
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Maria Miura
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kenta Fujio
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Ken Nagino
- Department of Hospital Administration, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Satoshi Hori
- Department of Electric Medical Intelligence Management, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Kazuo Tsubota
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Reza Dana
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, United States
| | - Akira Murakami
- Department of Ophthalmology, Juntendo University Faculty of Medicine, Tokyo, Japan
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Abstract
PURPOSE To define the factors that affect patient's self-assessed postoperative pain after photorefractive keratectomy (PRK). METHODS Patients who underwent PRK in 2016 were evaluated. Anonymized data collected included patient gender, age, and season at the time of surgery, ablation depth, surgeon status (attending vs. resident), topical tetracaine use, and subjective pain scores at postoperative days (PODs) 1 and 7. Average pain scores and amount of pain medication taken were analyzed for each of the previously mentioned variables. RESULTS Overall, 231 patients who underwent PRK were analyzed. The mean pain score and SD were 0.78 ± 1.87 on POD 1 and 0.03 ± 0.37 by POD 7. Patients who used topical tetracaine reported significantly higher pain on POD 1 and 7 compared with patients who did not use tetracaine (P < 0.001 and P = 0.038, respectively). No significant differences in pain scores were seen based on surgeon status, ablation depth, gender, and season. Patients who used topical tetracaine took a higher amount of oral pain medication (9.44 ± 6.01) compared with those who did not (7.02 ± 4.71) (P = 0.022). CONCLUSIONS Postoperative pain was significantly elevated in patients who used tetracaine on POD 1 and POD 7. These patients were also more likely to take oral pain medication than those who did not use topical tetracaine. Surgeon status, season, gender, and ablation depth showed no significant differences in subjective pain scores. Oral pain medication should be evaluated to assess efficacy and safety in inhibiting ocular pain after PRK.
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Age Is a Determining Factor of Dry Eye-Related Signs and Symptoms. Diagnostics (Basel) 2020; 10:diagnostics10040193. [PMID: 32244289 PMCID: PMC7235903 DOI: 10.3390/diagnostics10040193] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 03/28/2020] [Accepted: 03/29/2020] [Indexed: 11/16/2022] Open
Abstract
PURPOSE The reported signs and symptoms of dry eye (DE) have been discordant. This study evaluated risk factors of DE-related symptoms and signs to explore their association with patient demographics, focusing on the age factor. METHODS The study enrolled 704 consecutive patients visiting general eye clinics who complained of ocular discomfort, but had normal vision. The patients were asked about the presence of six common symptoms related to DE and, tear break-up time (TBUT). The severity of patients' keratopathy was also examined, and patients underwent Schirmer's test. RESULTS Logistic regression analysis demonstrated that younger age (≤29 years) was associated with non-visual symptoms and keratopathy, while older age (≥60 years) was associated with short TBUT and low values on Schirmer's test. Middle age was associated with both severe symptoms and signs. CONCLUSIONS Discrepancies in the signs and symptoms of DE may depend, in part, on age, with younger subjects showing severe non-visual symptoms with apparently normal tear function and severe keratopathy, and older subjects showing fewer symptoms and less severe keratopathy despite worse tear function.
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15
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Ayaki M, Negishi K, Yuki K, Kawashima M, Uchino M, Tsubota K. Tear Break-Up Time and Seasonal Variation in Intraocular Pressure in a Japanese Population. Diagnostics (Basel) 2020; 10:E124. [PMID: 32102457 PMCID: PMC7167993 DOI: 10.3390/diagnostics10020124] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 02/17/2020] [Accepted: 02/22/2020] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To evaluate seasonal variation in intraocular pressure (IOP) with and without short tear break-up time (SBUT, BUT ≤5 s) since dry eye and IOP are known to have seasonal variation. METHODS This study enrolled 176 patients who visited one of six eye clinics, in Japan, four times for IOP measurement, in every season. The mean patient age was 67.9 years, including 79 males. Participants were divided into four groups based on the presence of glaucoma and/or SBUT and we compared the seasonal variation in IOP (winter and summer) among the four groups. RESULTS The IOP (mmHg) in winter and summer, respectively, was 12.8 ± 3.7 and 12.8 ± 3.1 for non-glaucoma patients without SBUT (n = 47, p = 0.964), 14.8 ± 3.4 and 13.3 ± 3.4 for non-glaucoma patients with SBUT (n = 57, p < 0.001), 14.3 ± 3.2 and 14.1 ± 3.4 for glaucoma patients without SBUT (n = 36, p = 0.489), and 13.3 ± 3.0 and 11.6 ± 2.9 for glaucoma with SBUT (n = 36, p < 0.001). Seasonal variation was largest across the seasons in the glaucoma with the SBUT group, and the magnitude of seasonal variation correlated with BUT (β = 0.228, p = 0.003). CONCLUSIONS Seasonal variation tended to be larger in patients with SBUT than those without SBUT.
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Affiliation(s)
- Masahiko Ayaki
- Otake Clinic Moon View Eye Center, Yamato 2420001, Japan
- Department of Ophthalmology, Keio University School of Medicine, Tokyo 1608582, Japan; (K.Y.); (M.K.); (M.U.); (K.T.)
| | - Kazuno Negishi
- Department of Ophthalmology, Keio University School of Medicine, Tokyo 1608582, Japan; (K.Y.); (M.K.); (M.U.); (K.T.)
| | - Kenya Yuki
- Department of Ophthalmology, Keio University School of Medicine, Tokyo 1608582, Japan; (K.Y.); (M.K.); (M.U.); (K.T.)
| | - Motoko Kawashima
- Department of Ophthalmology, Keio University School of Medicine, Tokyo 1608582, Japan; (K.Y.); (M.K.); (M.U.); (K.T.)
| | - Miki Uchino
- Department of Ophthalmology, Keio University School of Medicine, Tokyo 1608582, Japan; (K.Y.); (M.K.); (M.U.); (K.T.)
| | - Kazuo Tsubota
- Department of Ophthalmology, Keio University School of Medicine, Tokyo 1608582, Japan; (K.Y.); (M.K.); (M.U.); (K.T.)
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Tauber J, Owen J, Bloomenstein M, Hovanesian J, Bullimore MA. Comparison of the iLUX and the LipiFlow for the Treatment of Meibomian Gland Dysfunction and Symptoms: A Randomized Clinical Trial. Clin Ophthalmol 2020; 14:405-418. [PMID: 32103887 PMCID: PMC7024784 DOI: 10.2147/opth.s234008] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 01/10/2020] [Indexed: 12/15/2022] Open
Abstract
Purpose To compare the effects of eyelid treatment with the iLUX MGD Treatment System and the LipiFlow Thermal Pulsation System on objective and subjective parameters of meibomian gland function and symptoms. Patients and Methods In this randomized, open-label, controlled, multicenter clinical trial, both eyes of 142 patients aged ≥18 years with Ocular Surface Disease Index (OSDI) scores ≥23, total meibomian gland scores (MGS) ≤12 in the lower eyelid of each eye, and tear break-up time (TBUT) <10 s were randomized 1:1 to iLUX or LipiFlow treatment, with stratification by test center. The primary effectiveness endpoints were changes in total MGS (masked) and TBUT from baseline to 4 weeks. The secondary effectiveness endpoint was changed in OSDI score from baseline to 4 weeks. Results Both devices significantly improved effectiveness outcomes, with no differences between the two devices. At the 4-week visit, mean MGS, TBUT, and OSDI scores improved at least 16.9 ± 11.5, 2.6 ± 3.2 s, and 28.0 ± 22.8, respectively, across treatment groups and treated eyes. Four device/procedure-related events occurred in the iLUX group, compared with none in the LipiFlow group, but there were no device-related adverse events that involved changes in lid margins, eyelids, or lash integrity. Corneal staining, intraocular pressure, and visual acuity did not differ in the two groups. Conclusion Both treatments produced significant improvements in meibomian gland function and symptoms. For all effectiveness measures, there were no statistically significant differences between the two treatments.
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Affiliation(s)
| | - James Owen
- TLC Laser Eye Centers-La Jolla, La Jolla, CA 92122, USA
| | | | | | - Mark A Bullimore
- University of Houston, College of Optometry, Houston, TX 77204, USA
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Prospective, Multicenter, Cross-Sectional Survey on Dry Eye Disease in Japan. Adv Ther 2020; 37:316-328. [PMID: 31728824 DOI: 10.1007/s12325-019-01143-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Dry eye disease (DED) is commonly encountered in eye clinics and hospitals, and it is therefore very important to understand DED prevalence in outpatients. METHODS A multicenter, hospital-based cross-sectional study was conducted among outpatients in Japan to ascertain DED prevalence and relationships between DED and patient profiles, including eye disease, DED diagnosis history, and surgical history. DED was diagnosed according to diagnostic criteria of the Asia Dry Eye Society. Patient self-assessment of DED-related subjective symptoms was conducted using the 5-Item Dry Eye Questionnaire (DEQ-5). Tear break-up time was evaluated in subjective symptom-positive patients. RESULTS The prevalence of DED was 55.7% in 990 patients (mean age 69.1 ± 13.4 years), DED was commonly experienced in combination with other ocular diseases. In revisiting patients, 15.2% had not previously been diagnosed as DED, and their total DEQ-5 scores were higher than those of patients who had undergone DED treatment. CONCLUSION This study revealed that more than half of the outpatients had DED. Among revisiting patients, there were many "hidden" DED patients who had not been diagnosed with DED in the past. There is a high likelihood of finding DED comorbidity in patients with other eye diseases in eye clinics and hospitals. FUNDING Santen Pharmaceutical Co., Ltd. TRIAL REGISTRATION UMIN Clinical Trials Registry Identifier, UMIN000035506.
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Friehmann A, Mimouni M, Assad N, Rabina G, Spierer O, Nemet A, Kaiserman I. Risk factors for early flap misalignment following microkeratome-assisted laser in situ keratomileusis: A retrospective large database analysis. Eur J Ophthalmol 2019; 31:385-389. [PMID: 31813266 DOI: 10.1177/1120672119892431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To determine factors associated with early flap misalignment following microkeratome-assisted laser in situ keratomileusis. MATERIALS AND METHODS This retrospective study included the right eyes of consecutive patients who underwent laser in situ keratomileusis procedure between 2005 and 2016 at Care-Vision Laser Centers, Tel-Aviv, Israel. Patients were divided into two groups according to whether or not they subsequently developed early flap misalignment. RESULTS A total of 14,582 eyes (mean age of patients: 32.4 ± 10.3 years) were included. Post-laser in situ keratomileusis early flap misalignment developed in 158 eyes (1.1%). Misalignment was more frequent during the spring (32.3% vs 22.8%, p = 0.003) and in a higher operating room temperature (23.34 ± 1.06 vs 22.98 ± 1.26, p < 0.001). In addition, in the misalignment group, there was a higher rate with the of use of the a Moria M2 microkeratome (rather than sub-Bowman's keratomileusis microkeratome) head (55.2% vs 40.5%, respectively, p < 0.001). In a multivariable analysis adjusted for surgeon and year of surgery, high operating room temperature (odds ratio = 1.22, p = 0.006), treatment zone of 9.0 mm (as opposed to smaller treatment zones, odds ratio = 1.54, p = 0.04), and springtime (odds ratio = 1.58, p = 0.02) were associated with flap misalignment. There was a significant difference in misalignment rates between surgeons (p = 0.02). CONCLUSION This study found that larger treatment zones, higher operating room temperature, operating during the spring, and the use of Moria M2 microkeratome were associated with increased flap misalignment rates. The association with operating room temperature and seasonal variation is of interest and merits further research.
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Affiliation(s)
- Asaf Friehmann
- Department of Ophthalmology, Meir Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michael Mimouni
- Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Negme Assad
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Gilad Rabina
- Division of Ophthalmology, Sourasky Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Oriel Spierer
- Department of Ophthalmology, Wolfson Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Achia Nemet
- Department of Ophthalmology, Wolfson Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Igor Kaiserman
- Care-Vision Laser Centers, Tel Aviv, Israel
- Department of Ophthalmology, Barzilai Medical Center, and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba, Israel
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Dedousi A, Karatzia MA, Katsoulos PD. Reference values of Schirmer tear test in sheep and the effect of season on the test results. Acta Vet Hung 2019; 67:553-560. [PMID: 31842602 DOI: 10.1556/004.2019.054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The aim of this study was to determine the reference range of Schirmer tear test (STT) values in sheep using Greek indigenous and mixed breeds and to investigate the potential effect of breed and season on these values. Ninety (30 Chios, 30 Florina and 30 Lacaune mixed breed) ewes aged 2 years or more were used for the study. The aqueous portion of the tear film was measured using Schirmer tear test (STT) commercial strips bilaterally by the same investigator with the animal in standing position. The average STT value recorded was 18.45 ± 3.93 mm/min and the range 10.8-26.2 mm/min. STT was significantly affected by the season and the recorded values were significantly higher in summer compared to winter. The breed had no significant effect on tear secretion. The results of the present study provide a reference range of STT values in sheep and indicate that tear secretion is significantly affected by the season.
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Affiliation(s)
- Anna Dedousi
- 1 Veterinary Research Institute, Hellenic Agricultural Organization, Demeter, Thessaloniki, Greece
| | - Maria A. Karatzia
- 2 Research Institute of Animal Science, Hellenic Agricultural Organization, Demeter, Paralimni Giannitsa, Greece
| | - Panagiotis D. Katsoulos
- 3Clinic of Farm Animals, School of Veterinary Medicine, Aristotle University of Thessaloniki, St. Voutyra 11, 54627 Thessaloniki, Greece
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Abstract
PURPOSE Our eyes are chronically exposed to airborne particulate matter shown to adversely affect the ocular surface. This research examines size, type (organic vs. inorganic), and elemental composition of particles recovered from the ocular surface in 2 environments and their associations with dry eye (DE) metrics. METHODS Particles were recovered from the right eye using Schirmer strips obtained both in the clinic and home environments 9 ± 8 days apart. Particle size and elemental composition were assessed using scanning electron microscopy and energy dispersive spectroscopy. The paired t test was used to evaluate the differences in the size and types of ocular surface particles recovered from the clinic and home settings. Associations of particle size and type with home environmental conditions and DE measures were evaluated using correlation analyses. RESULTS The mean age of the 15 patients was 56 years, standard deviation (±) 12 years; 93% were men and 53% self-identified as white. Size, type, and elemental composition did not vary significantly between clinic and home. Particle surface area was marginally associated with home indoor temperature (25 °C ± 2, ρ=-0.53, P = 0.06) and significantly associated with the select DE signs: tear osmolality (304 mOsm/L ± 14, ρ= -0.60, P = 0.02), inflammation (0.7 ± 0.8, ρ = 0.53, P = 0.04), and tear breakup time (7 seconds ± 3, ρ = 0.56, P = 0.03). CONCLUSIONS Ocular surface particles were consistently detected across 2 different environments. Greater particle area detected on Schirmer strips correlated with some DE measures, suggesting that particles detected on the ocular surface may affect eye health.
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Kawashima M, Tsuno S, Matsumoto M, Tsubota K. Hydrogen-producing milk to prevent reduction in tear stability in persons using visual display terminals. Ocul Surf 2019; 17:714-721. [PMID: 31352083 DOI: 10.1016/j.jtos.2019.07.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 07/19/2019] [Accepted: 07/24/2019] [Indexed: 12/23/2022]
Abstract
PURPOSE To examine the effect of hydrogen (H2)-producing milk, which induces H2 production by intestinal microbiota, on the prevention of dry eye disease. METHODS A randomized, double-blind, placebo-controlled, parallel-group comparative study was conducted in humans. Of 118 candidates aged 20-60 years who were using visual display terminals daily, 54 subjects (mean age, 42.4 years) with mild-to-moderate dry eye symptoms, who were not dry eye patients based on the 2006 Japanese Diagnostic Criteria for Dry Eye, were included in the study. Subjects were assigned to the H2-producing milk group or the placebo group. They were instructed to ingest the assigned test beverage once per day for three consecutive weeks. Breath H2 concentration, fluorescein tear film breakup time (fTBUT), Schirmer's test, 8-OHdG concentration in tears, reported ocular symptoms using the dry eye-related QOL score questionnaire, and the visual analogue scale were assessed at weeks 0 and 3. RESULTS Change in fTBUT in the H2-producing milk group was significantly greater than that in the placebo group. A significant decline in fTBUT was observed in the placebo group (p = 0.04), but not the H2-producing group (p = 0.26). This phenomenon was strongly observed in females. We found a positive correlation between the change in fTBUT and net H2 production, and a negative correlation between the change in 8-OHdG concentration and net H2 production in young females. CONCLUSIONS H2-producing milk appeared to retard the decline in tear stability and may prevent short fTBUT-type dry eye by decreasing oxidative stress in the lacrimal functional unit.
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Affiliation(s)
- Motoko Kawashima
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, 160-8582, Japan.
| | - Saki Tsuno
- Dairy Science and Technology Institute, Kyodo Milk Industry Co. Ltd., Hinode-machi, Nishitama-gun, Tokyo, 190-0182, Japan
| | - Mitsuharu Matsumoto
- Dairy Science and Technology Institute, Kyodo Milk Industry Co. Ltd., Hinode-machi, Nishitama-gun, Tokyo, 190-0182, Japan.
| | - Kazuo Tsubota
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, 160-8582, Japan
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22
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Abstract
Measurement of tear film breakup time (TBUT) has become a standard diagnostic procedure in the dry eye clinic. Short TBUT-type dry eye is characterized by TBUT of less than 5 seconds and dry eye symptoms such as ocular fatigue or dryness; the importance of this type has recently been gaining prominence. Patients with this condition show no reduction in tear production and no staining of the ocular surface. The severity of symptoms is almost the same as in dry eye in which the ocular surface is stained with rose bengal or fluorescein. In addition to discomfort, patients suffer from decreased vision due to the unstable tear film, which can be attributed to the relative abnormality of the lipid layer, aqueous layer, and/or mucin layer. The diagnosis should be performed carefully on the basis of the patient's symptoms and the TBUT test, because the ocular surface appears normal and remains unstained.
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Affiliation(s)
- Kazuo Tsubota
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
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23
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Association between Retinal Nerve Fiber Layer Thickness and Eye Fatigue. BIOMED RESEARCH INTERNATIONAL 2019; 2019:3014567. [PMID: 30809534 PMCID: PMC6364103 DOI: 10.1155/2019/3014567] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 12/10/2018] [Accepted: 12/30/2018] [Indexed: 12/11/2022]
Abstract
Eye fatigue is a common health problem across all age groups. Herein, we explored the correlation between eye fatigue and thickness of the retinal nerve fiber layer (NFL). Included in the NFL are intrinsically photosensitive retinal ganglion cells (ipRGCs), which are associated with trigeminal pain. This retrospective cross-sectional study included outpatients with best-corrected visual acuity above 20/30 in both eyes and without dry eye, glaucoma, or retinal disease. A total of 1981 patients were initially enrolled and 377 patients were declared as eligible for the study analysis. We tested subjects for the presence of major ocular symptoms and measured thickness of ganglion cell complex (GCC) using optical coherence tomography. A total of 377 outpatients (46.4% men, mean age of 57.1 years) were enrolled for analysis, based on the interview-reported prevalence of six eye symptom, as follows: 31.5% for eye fatigue, 19.2% for blurring, 18.6% for dryness, 15.7% for photophobia, 13.5% for irritation, and 4.6% for pain. The macular GCC was significantly thicker in subjects with eye fatigue compared to the group not reporting eye fatigue (103.8 μm versus 100.3 μm, P = 0.014). Regression analysis identified eye fatigue (P = 0.026, β=0.122, adjusted for age and sex) and dryness (P =0.024, β=0.130) as significantly correlated with the macular GCC thickness, while the full macular thickness showed no significant correlation. In conclusions, eye fatigue and dryness were positively associated with thickness of the macular GCC. Nonvisual symptoms might therefore play a role in the development of eye fatigue.
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Dermer H, Galor A, Hackam AS, Mirsaeidi M, Kumar N. Impact of seasonal variation in meteorological conditions on dry eye severity. Clin Ophthalmol 2018; 12:2471-2481. [PMID: 30555221 PMCID: PMC6278710 DOI: 10.2147/opth.s181637] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Purpose To compare dry eye (DE) diagnosis patterns by season in Miami vis-a-vis the US and examine differences in DE symptoms and signs by season in Miami. Patients and methods US veteran affairs (VA) patient visits with ICD-9 codes for DE (375.15) and routine medical examination (V70.0) from 2010 to 2013 were retrospectively analyzed to evaluate the seasonal pattern of DE diagnosis. A total of 365 patients with normal ocular anatomy were prospectively recruited from the Miami VA eye clinic from 2014 to 2016 for the assessment of symptoms and signs. Results While DE visit prevalence in Miami was about 10% lower than that of the rest of the country (22.5% vs 33.7%), Miami had roughly four times higher variability in DE visit prevalence throughout the year than the US. Peak values for DE symptoms in the Miami cohort aligned with peak DE prevalence seen in the retrospective sample, occurring in spring and fall. A similar, but less dramatic, pattern was noted with DE signs. The seasonal pattern in DE symptoms remained even after controlling for confounders including demographics and medication use. Conclusion DE symptoms, and to a lesser degree signs, varied by month, with the highest severity of symptoms occurring in spring and fall, which corresponded with peak allergy season and weather fluctuations, respectively. These findings have important implications for season-specific diagnosis, treatment, and management of DE.
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Affiliation(s)
- Harrison Dermer
- Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Anat Galor
- Eye Care (Ophthalmology), Miami Veterans Affairs (VA) Medical Center, Miami, FL, USA.,Ophthalmology Department, Bascom Palmer Eye Institute, Miami, FL, USA
| | - Abigail S Hackam
- Ophthalmology Department, Bascom Palmer Eye Institute, Miami, FL, USA
| | - Mehdi Mirsaeidi
- Eye Care (Ophthalmology), Miami Veterans Affairs (VA) Medical Center, Miami, FL, USA.,Ophthalmology Department, Bascom Palmer Eye Institute, Miami, FL, USA.,Divison of Pulmonary, Critical Care, Sleep and Allergy, Department of Medicine, University of Miami, Miami, FL, USA
| | - Naresh Kumar
- Public Health Sciences, Environmental Health Division, University of Miami, Miami, FL, USA,
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25
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Affiliation(s)
- Akihiro Higuchi
- Institute for Research Promotion, Oita University, Oita, Japan
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26
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Inomata T, Iwagami M, Hiratsuka Y, Fujimoto K, Okumura Y, Shiang T, Murakami A. Maximum blink interval is associated with tear film breakup time: A new simple, screening test for dry eye disease. Sci Rep 2018; 8:13443. [PMID: 30194447 PMCID: PMC6128834 DOI: 10.1038/s41598-018-31814-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 08/28/2018] [Indexed: 11/16/2022] Open
Abstract
The prevalence of dry eye disease (DED) is increasing worldwide, and its diagnosis often needs dedicated reagents and machines. We investigated the usefulness of maximum blink interval (MBI) (the length of time that participants could keep their eyes open) in screening for DED. This cross-sectional study included 292 patients (194 with DED and 98 without DED) recruited between September 2016 and September 2017. We compared the MBI between patients with and without DED; examined correlations between MBI and other clinical features of DED, including subjective symptoms (Dry Eye-Related Quality-of-Life Score), tear film breakup time (TFBUT), cornea fluorescence score (CFS), and Schirmer test I value; and determined the optimal cutoff value of MBI to suspect DED using a receiver operating characteristic (ROC) analysis. The MBI was significantly shortened in DED group compared to the non-DED group (10.0 ± 9.1 vs. 24.3 ± 38.2 seconds, p < 0.001). TFBUT was strongly positively correlated with MBI (r = 0.464), whereas CFS was negatively correlated with MBI (r = −0.273). The area under the ROC curve was 0.677, and the optimal MBI cutoff value was 12.4 seconds, providing a sensitivity of 82.5% and specificity of 51.0% to suspect DED. In conclusion, MBI may be a simple, useful test for screening DED.
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Affiliation(s)
- Takenori Inomata
- Juntendo University Faculty of Medicine, Department of Ophthalmology, Tokyo, Japan. .,Juntendo University Faculty of Medicine, Department of Strategic Operating Room Management and Improvement, Tokyo, Japan.
| | - Masao Iwagami
- London School of Hygiene and Tropical Medicine, Department of Non-Communicable Disease Epidemiology, London, UK
| | - Yoshimune Hiratsuka
- Juntendo University Faculty of Medicine, Department of Ophthalmology, Tokyo, Japan
| | - Keiichi Fujimoto
- Juntendo University Faculty of Medicine, Department of Ophthalmology, Tokyo, Japan
| | - Yuichi Okumura
- Juntendo University Faculty of Medicine, Department of Ophthalmology, Tokyo, Japan
| | - Tina Shiang
- University of Massachusetts Medical School, Worcester, MA, USA
| | - Akira Murakami
- Juntendo University Faculty of Medicine, Department of Ophthalmology, Tokyo, Japan
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