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Guntermann A, Fatoba O, Kronenberg M, Reinehr S, Grotegut P, Schargus M, Tsai T, Ivanova S, Serschnitzki B, Kumowski N, Maier C, Marcus K, Dick HB, Joachim SC, May C. Investigation of Inter- and Intra-Day Variability of Tear Fluid Regarding Flow Rate, Protein Concentration as well as Protein Composition. Invest Ophthalmol Vis Sci 2023; 64:13. [PMID: 37815507 PMCID: PMC10573576 DOI: 10.1167/iovs.64.13.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 07/21/2023] [Indexed: 10/11/2023] Open
Abstract
Purpose The purpose of this study was to present the determination of inter- and intra-day variations in tear flow rate, and tear fluid protein concentration, as well as protein composition regarding their impact for future biomarker studies. Methods Tear fluid was collected noninvasively from 18 healthy subjects by performing Schirmer tests at 4 different time points repetitive in a period of 2 days. The tear flow rate on the Schirmer test strips was measured. Proteins were extracted from strips and quantified using amino acid analysis. Protein composition was analyzed by the strips data-independent (DIA) based mass spectrometry. To exclude any impairments to health, volunteers underwent a detailed neurological as well as an ophthalmological examination. Results Whether tear fluid was collected from oculus sinister or oculus dexter did not affect the tear flow rate (P ≈ 0.63) or protein concentration (P ≈ 0.97) of individual subjects. Moreover, protein concentration was independent from the tear volume, so that a change in volume may only influence the total protein amount. When the examination days were compared, investigation of tear flow rate (P ≈ 0.001) and protein concentration (P ≈ 0.0003) indicated significant differences. Further, mass spectrometric analysis of tear fluid revealed 11 differentially regulated proteins when comparing both examination days. Conclusions Our findings provide evidence of inter-day variation in tear flow rate, tear proteome concentration, and composition in healthy subjects, suggesting that inter-day variation needs to be taken into consideration in biomarker research of tear fluid. Identified proteins were assigned to functions in the immune response, oxidative and reducing processes, as well as mannose metabolism.
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Affiliation(s)
- Annika Guntermann
- Ruhr-University Bochum, Center for Protein Diagnostics (ProDi), Medical Proteome Analysis, Bochum, Germany
- Ruhr-University Bochum, Medical Faculty, Medizinisches Proteom-Center, Bochum, Germany
| | - Oluwaseun Fatoba
- Ruhr-University Bochum, Center for Protein Diagnostics (ProDi), Medical Proteome Analysis, Bochum, Germany
- Ruhr-University Bochum, Medical Faculty, Medizinisches Proteom-Center, Bochum, Germany
| | - Marc Kronenberg
- Ruhr-University Bochum, Center for Protein Diagnostics (ProDi), Medical Proteome Analysis, Bochum, Germany
- Ruhr-University Bochum, Medical Faculty, Medizinisches Proteom-Center, Bochum, Germany
| | - Sabrina Reinehr
- Experimental Eye Research Institute, University Eye Hospital, Ruhr-University Bochum, Bochum, Germany
| | - Pia Grotegut
- Experimental Eye Research Institute, University Eye Hospital, Ruhr-University Bochum, Bochum, Germany
| | - Marc Schargus
- Experimental Eye Research Institute, University Eye Hospital, Ruhr-University Bochum, Bochum, Germany
- Department of Ophthalmology, University Hospital Duesseldorf, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany
- Asklepios Eye Hospital Nord-Heidberg, Hamburg, Germany
| | - Teresa Tsai
- Experimental Eye Research Institute, University Eye Hospital, Ruhr-University Bochum, Bochum, Germany
| | - Svetlana Ivanova
- Experimental Eye Research Institute, University Eye Hospital, Ruhr-University Bochum, Bochum, Germany
| | - Bettina Serschnitzki
- Ruhr-University Bochum, Center for Protein Diagnostics (ProDi), Medical Proteome Analysis, Bochum, Germany
- Ruhr-University Bochum, Medical Faculty, Medizinisches Proteom-Center, Bochum, Germany
| | - Nina Kumowski
- Department of Pain Medicine, BG University Hospital Bergmannsheil GmbH, Ruhr-University Bochum, Bochum, Germany
- Medical Clinic I - Cardiology, Angiology and Internal Intensive Care Medicine, RWTH Aachen University Hospital, Aachen, Germany
| | - Christoph Maier
- University Children's Hospital, Ruhr-University Bochum, Bochum, Germany
| | - Katrin Marcus
- Ruhr-University Bochum, Center for Protein Diagnostics (ProDi), Medical Proteome Analysis, Bochum, Germany
- Ruhr-University Bochum, Medical Faculty, Medizinisches Proteom-Center, Bochum, Germany
| | - H Burkhard Dick
- Experimental Eye Research Institute, University Eye Hospital, Ruhr-University Bochum, Bochum, Germany
| | - Stephanie C Joachim
- Experimental Eye Research Institute, University Eye Hospital, Ruhr-University Bochum, Bochum, Germany
| | - Caroline May
- Ruhr-University Bochum, Center for Protein Diagnostics (ProDi), Medical Proteome Analysis, Bochum, Germany
- Ruhr-University Bochum, Medical Faculty, Medizinisches Proteom-Center, Bochum, Germany
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Wang C, Yuan K, Mou Y, Wu Y, Wang X, Hu R, Min J, Huang X, Jin X. High-Intensity Use of Smartphone Can Significantly Increase the Diagnostic Rate and Severity of Dry Eye. Front Med (Lausanne) 2022; 9:829271. [PMID: 35559345 PMCID: PMC9086534 DOI: 10.3389/fmed.2022.829271] [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: 12/05/2021] [Accepted: 04/04/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose To investigate the effects of high-intensity use of smartphones on ocular surface homeostasis and to explore whether high-intensity use of handheld digital devices can cause false increase of dry eye diagnostic rate. Methods In this prospective self-control study, 60 subjects (120 eyes) were recruited and asked to read on smartphones provided by the same manufacturer for two consecutive hours. This study was conducted during 8:00 – 10:00 AM to eliminate the influence of digital equipment used the previous day. Ophthalmological examinations [non-invasive tear breakup time (NIBUT), fluorescein breakup time (FBUT), Schirmer I test, corneal fluorescein staining (CFS), bulbar conjunctival redness and meibomian gland (MG) assessment] and a questionnaire survey were conducted before and after the reading test. Based on the collected data, the changes in ocular surface damage and subjective symptoms of the subjects were evaluated, and the differences in the diagnostic rate of dry eye before and after high-intensity use of smartphones were compared. Results The diagnostic rate of dry eye was sharply increased (61.7% vs. 74.2%). The severity of dry eye also changed significantly, and the moderate and severe degree increased after reading (10% vs. 15%; 5% vs. 10.8%). The aggravated severity subjects had lower MG expressibility and more evident bulbar conjunctival redness compared to the non-aggravated severity subjects. After 2 h of continuous reading, NIBUT-First, NIBUT-Average and FBUT-Average were significantly decreased, while the proportion of BUT ≤ 5 s increased significantly. Non-invasive keratograph tear meniscus height(NIKTMH) decreased significantly compared to the baseline level, while the proportion of NIKTMH<0.20 mm increased significantly. No significant difference was observed in the Schirmer I test and CFS score between the two groups. Compared to the baseline, evident aggravation was observed in bulbar conjunctival redness. The Ocular Surface Disease Index (OSDI) was significantly higher than the baseline after the reading test. Conclusion Diagnostic indicators related to dry eye are rapidly deteriorating after high-intensity smartphone use, especially those with lower MG expressibility and ocular redness. High-intensity smartphone use can increase the false positive rate of dry eye diagnosis by disturbing ocular surface homeostasis.
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Pena-Verdeal H, Garcia-Resua C, Garcia-Queiruga J, Sabucedo-Villamarin B, Yebra-Pimentel E, Giraldez MJ. Diurnal variations of tear film osmolarity on the ocular surface. Clin Exp Optom 2022; 106:351-361. [PMID: 35410571 DOI: 10.1080/08164622.2022.2051697] [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: 10/18/2022] Open
Abstract
The measurement of tear film osmolarity has been suggested as a gold standard in the diagnosis of dry eye. Many tear film physiological variables oscillate during the day. This review summarises current clinical knowledge regarding diurnal osmolarity variation in the tear film. A critical analysis is presented in respect of of sample size and characteristics, differences in the diurnal osmolarity variation on healthy versus altered tear film conditions or environment, and time of day and number of measurements undertaken. A comparison of 21 studies was made for studies in which one of the main objectives was to analyse the variance of tear film osmolarity at different time-points in a day on human cohorts. Tear film osmolarity appeard to be somewhat influenced by the time of day in healthy subjects and patients with ocular surface disease, or altered by environmental conditions. Both healthy and non-physiological tear film cohorts showed variations in results depending on the study: no variations during the day or statistically different values at some point in the day. These differences could be in the middle of the day or between the beginning and the end of the day, with higher values in the morning than in the afternoon, or even the opposite situation. The possibility of diurnal variations in tear film osmolarity should be considered by the clinician since the time of day when the tear film measurements are made can be critical in making the right diagnosis. Future studies in the diurnal variation field may have to use a well-established range of measurement time-points and a larger group of healthy subjects and and subjects who have a tear film altered by pathological or environmental conditions.
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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
| | - Carlos Garcia-Resua
- 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
| | - Belen Sabucedo-Villamarin
- 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
| | - Maria Jesus Giraldez
- Departamento de Física Aplicada (Area de Optometría), Universidade de Santiago de Compostela, Santiago de Compostela, Galicia, Spain
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Vu CHV, Kawashima M, Nakamura W, Nakamura TJ, Tsubota K. Circadian clock regulates tear secretion in the lacrimal gland. Exp Eye Res 2021; 206:108524. [PMID: 33662354 DOI: 10.1016/j.exer.2021.108524] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 01/12/2021] [Accepted: 02/23/2021] [Indexed: 11/28/2022]
Abstract
Although diurnal variations have been observed in tear film parameters in various species, the molecular mechanisms that control circadian tear secretion remain unclear. The aim of our study was to evaluate the role of clock genes in the lacrimal gland (LG) in regulation of tear secretion. Tear volume was measured by cotton thread test in core clock genes deficient (Cry1-/-Cry2-/--) mice which are behaviorally arrhythmic. Real-time quantitative RT-PCR was used to examine expression profiles of core clock genes in the LG including Per1, Per2, Per3, Clock, Bmal1. All experiments were performed under a 12 h of light and 12 h of darkness (LD) and constant dark (DD) conditions. Under both LD and DD conditions, diurnal and circadian rhythms were observed in tear secretion of wild-type mice with tear volume increased in the objective and subjective night while disruption in diurnal and circadian variations of tear secretion were found in Cry1-/-Cry2-/--mice. In wild-type mice, the expression level of major clock genes in the LG showed oscillatory patterns under both LD and DD conditions. In contrast, expression clock genes in the lacrimal gland of Cry1-/-Cry2-/-- mice showed complete loss of oscillation regardless of environmental light conditions. These findings confirmed the presence of diurnal and circadian rhythms of tear secretion and provided evidences supporting a critical role for the clock in the control of tear secretion.
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Affiliation(s)
- Chi Hoang Viet Vu
- Department of Ophthalmology, Keio University, School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Motoko Kawashima
- Department of Ophthalmology, Keio University, School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Wataru Nakamura
- Department of Oral Chrono-Physiology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, 852-8588, Japan
| | - Takahiro J Nakamura
- Laboratory of Animal Physiology, School of Agriculture, Meiji University, Kawasaki, 214-8571, Japan.
| | - Kazuo Tsubota
- Department of Ophthalmology, Keio University, School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan; Tsubota Laboratory, Inc., 304 Toshin-ekimae Bldg., 34 Shinanomachi, Shinjuku-ku, Tokyo, 160-0016, Japan.
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Barna S, Garai I, Gesztelyi R, Kemeny-Beke A. Evaluation of the tear clearance rate by dacryoscintigraphy in patients with obstructive meibomian gland dysfunction. Cont Lens Anterior Eye 2019; 42:359-365. [PMID: 31103453 DOI: 10.1016/j.clae.2019.04.017] [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: 05/26/2018] [Revised: 04/19/2019] [Accepted: 04/30/2019] [Indexed: 11/18/2022]
Abstract
PURPOSE To measure tear clearance values in patients with meibomian gland dysfunction (MGD) with a dynamic nuclear medicine method, namely, dacryoscintigraphy (DSCI). METHODS Twenty-four MGD patients and 24 healthy volunteers were examined. During DSCI one drop of a solution with 100 MBq/mL99mTc sodium pertechnetate was instilled with a micropipette into the lacrimal lake of both eyes. Measurements were performed according to a dynamic data acquisition protocol, which resulted in summed DSCI images. Data were also evaluated separately in special regions of interest (ROI), and consecutive time activity curves were created. Tear clearance (T½) values were calculated based on the activity curves. In addition, tear osmolarity measurements, tear breakup time (tBUT), and Schirmer I (STI) tests were performed prior to DSCI examination. RESULTS The T½ values were 29.91 ± 11.61 min in MGD patients and 6.26 ± 1.5 min in healthy controls. Tear osmolarity parameters were 308 ± 9.41 mOsm/L and 288.9 ± 6.4 mOsm/L, tBUT values were 5.54 ± 2.73 s and 11.4 ± 2.7 s, while the STI test values were 6.17 ± 2.78 mm and 13.58 ± 3.8 mm, respectively. The differences were significant (p < 0.01) in all cases. CONCLUSIONS Although the MGD patients' lacrimal drainage systems were patent their tear clearance values were significantly higher than those of healthy volunteers, which may be caused by decreased drainage of tears from the eyes towards the nasal cavity. The understanding of new features regarding the altered physico-chemical characteristics of MGD tears has been augmented by the results of this study.
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Affiliation(s)
- Sandor Barna
- Scanomed Ltd, Nagyerdei krt. 98, 4032 Debrecen, Hungary
| | - Ildiko Garai
- Scanomed Ltd, Nagyerdei krt. 98, 4032 Debrecen, Hungary
| | - Rudolf Gesztelyi
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Debrecen, Nagyerdei krt. 98, 4032 Debrecen, Hungary
| | - Adam Kemeny-Beke
- Department of Ophthalmology, Faculty of Medicine, University of Debrecen, Nagyerdei krt. 98, 4032 Debrecen, Hungary.
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Response to "Variability of Tear Osmolarity Measurements With a Point-of-Care System in Healthy Subjects-Systematic Review". Cornea 2019; 38:e21-e23. [PMID: 30950898 PMCID: PMC6511426 DOI: 10.1097/ico.0000000000001944] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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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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Variability of Tear Osmolarity Measurements With a Point-of-Care System in Healthy Subjects-Systematic Review. Cornea 2018; 37:938-945. [PMID: 29620566 DOI: 10.1097/ico.0000000000001562] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE To assess the variability of osmolarity measured by the point-of-care TearLab system in healthy eyes. METHODS A systematic review was performed by searching MEDLINE, Scopus, and the Web of Science Databases until November 2016 and checking reference lists of included articles and reviews. The requirements for inclusion were the availability of TearLab results in healthy subjects and a minimum study sample of 20 eyes. Two reviewers assessed articles against the inclusion criteria, extracted relevant data, and examined the methodological quality. We computed the weighted mean osmolarity using the study size as the weighting factor and calculated the rate of subjects with osmolarity values >308 mOsm/L, the Dry Eye Workshop Report 2017 (DEWS) cut-off value for dry eye disease (DED). We repeated the analysis after excluding reports with a possible conflict of interest or missing description of subject selection. RESULTS Searches retrieved 105 nonduplicate articles, and we included 33 studies investigating 1362 eyes of healthy participants who were asymptomatic and showed no clinical signs of DED. Sixty-three percent were female, and mean age was 37.3 years (range: 21.5-69.0 yr). Weighted mean osmolarity was 298 mOsm/L (95% confidence interval, 282-321 mOsm/L). The result of the subgroup analysis was similar. Overall, 386 of 1362 eyes (28.3%) fulfilled the DEWS's definition of DED (>308 mOsm/L). CONCLUSIONS There is a high variability of osmolarity measurements with the TearLab system. A substantial number of healthy subjects fulfill the DEWS's definition of DED. We propose interpreting the TearLab osmolarity results cautiously and in the context of other established methods.
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Garaszczuk IK, Montes Mico R, Iskander DR, Expósito AC. The tear turnover and tear clearance tests – a review. Expert Rev Med Devices 2018; 15:219-229. [DOI: 10.1080/17434440.2018.1435271] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Izabela K. Garaszczuk
- Department of Optics, Optometry and Vision Sciences, University of Valencia, Valencia, Spain
| | - Robert Montes Mico
- Department of Optics, Optometry and Vision Sciences, University of Valencia, Valencia, Spain
| | - D. Robert Iskander
- Department of Biomedical Engineering, Wroclaw University of Science and Technology, Wroclaw, Poland
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Abstract
The members of the Tear Film Subcommittee reviewed the role of the tear film in dry eye disease (DED). The Subcommittee reviewed biophysical and biochemical aspects of tears and how these change in DED. Clinically, DED is characterized by loss of tear volume, more rapid breakup of the tear film and increased evaporation of tears from the ocular surface. The tear film is composed of many substances including lipids, proteins, mucins and electrolytes. All of these contribute to the integrity of the tear film but exactly how they interact is still an area of active research. Tear film osmolarity increases in DED. Changes to other components such as proteins and mucins can be used as biomarkers for DED. The Subcommittee recommended areas for future research to advance our understanding of the tear film and how this changes with DED. The final report was written after review by all Subcommittee members and the entire TFOS DEWS II membership.
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Pekel E, Pekel G. Clinical Characteristics of Dry Eye Patients With Chronic Pain Syndromes. Am J Ophthalmol 2016; 166:203. [PMID: 27103576 DOI: 10.1016/j.ajo.2016.03.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2016] [Revised: 03/12/2016] [Accepted: 03/14/2016] [Indexed: 11/30/2022]
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Börger M, Funke S, Bähr M, Grus F, Lingor P. Biomarker sources for Parkinson's disease: Time to shed tears? ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.baga.2015.05.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Abstract
Dry eye is one of the most commonly encountered problems in ophthalmology. Signs can include punctate epithelial erosions, hyperemia, low tear lakes, rapid tear break-up time, and meibomian gland disease. Current methods of diagnosis include a slit-lamp examination with and without different stains, including fluorescein, rose bengal, and lissamine green. Other methods are the Schirmer test, tear function index, tear break-up time, and functional visual acuity. Emerging technologies include meniscometry, optical coherence tomography, tear film stability analysis, interferometry, tear osmolarity, the tear film normalization test, ocular surface thermography, and tear biomarkers. Patient-specific considerations involve relevant history of autoimmune disease, refractive surgery or use of oral medications, and allergies or rosacea. Other patient considerations include clinical examination for lid margin disease and presence of lagophthalmos or blink abnormalities. Given a complex presentation and a variety of signs and symptoms, it would be beneficial if there was an inexpensive, readily available, and reproducible diagnostic test for dry eye.
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Affiliation(s)
| | - Darby Douglas Miller
- New York Eye and Ear Infirmary, New York, NY, USA ; Laser and Corneal Surgery Associates, New York, NY, USA
| | - Robert Latkany
- The Dry Eye Center at Physician Eyecare of New York, New York, NY, USA ; New York Eye and Ear Infirmary, New York, NY, USA
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