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Terpos E, Gavriatopoulou M, Ntanasis-Stathopoulos I, Malandrakis P, Fotiou D, Migkou M, Theodorakakou F, Spiliopoulou V, Kostopoulos IV, Syrigou RE, Eleutherakis-Papaiakovou E, Gkolfinopoulos S, Tsitsilonis OE, Kastritis E, Dimopoulos MA. Belantamab mafodotin, lenalidomide and dexamethasone in transplant-ineligible patients with newly diagnosed multiple myeloma: part 1 results of a phase I/II study. Haematologica 2024; 109:2594-2605. [PMID: 38356458 PMCID: PMC11290537 DOI: 10.3324/haematol.2023.284347] [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: 09/25/2023] [Accepted: 02/06/2024] [Indexed: 02/16/2024] Open
Abstract
Preclinical and clinical data demonstrate synergy between belantamab mafodotin (belamaf) and immunomodulatory drugs with limited overlapping toxicities. We investigated the safety and efficacy of belamaf with lenalidomide 25 mg on days 1-21 every 28 days and dexamethasone 40 mg weekly (belamaf-Rd) in transplant-ineligible patients with newly diagnosed multiple myeloma. Thirty-six patients (median age, 72.5 years) were randomized to receive belamaf at three different doses (2.5, 1.9, or 1.4 mg/kg) every 8 weeks. The dosing schedule was extended to every 12 weeks to mitigate ocular toxicity. Most common grade ≥3 adverse events were fatigue (n=21, 58.3%), rash (n=6, 16.7%), diarrhea (n=8, 22.2%) and COVID-19 (n=5, 13.9%). Grade 3-4 ocular adverse events, comprising visual acuity decline from baseline and/or keratopathy, were reported in 39/216 (18.1%), 33/244 (13.5%), and 26/207 (12.6%) ophthalmological assessments in the 2.5, 1.9, and 1.4 mg/kg cohorts, respectively. Importantly, grade 3-4 keratopathy was identified in 9/216 (4.2%), 1/244 (0.4%) and 1/207(0.5%) assessments. Most patients (32/36, 88.9%) were treated with the extended, every-12-week schedule, during which 40, 33 and 16 doses were withheld due to ocular adverse events in the 2.5, 1.9, and 1.4 mg/kg cohorts, respectively. Overall, the rates of very good partial response and better and complete response and better were 83.3% and 52.8%, respectively, without significant differences among cohorts. Over a median follow-up of 20.3 months no disease progression was reported; six patients discontinued treatment due to infection-related death (4 cases of COVID-19, 2 cases of pneumonia) and one patient withdrew consent. Based on the toxicity/efficacy balance, the recommended phase II dose was 1.9 mg/kg every 8 weeks, extended to every 12 weeks because of toxicity. In conclusion, Belamaf-Rd, with the extended schedule for belamaf, showed important clinical activity and a significant improvement of ocular adverse events with minimal impact on vision-related functioning in an elderly, non-transplant eligible population.
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Affiliation(s)
- Evangelos Terpos
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, School of Medicine, Athens.
| | - Maria Gavriatopoulou
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, School of Medicine, Athens
| | | | - Panagiotis Malandrakis
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, School of Medicine, Athens
| | - Despina Fotiou
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, School of Medicine, Athens
| | - Magdalini Migkou
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, School of Medicine, Athens
| | - Foteini Theodorakakou
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, School of Medicine, Athens
| | - Vasiliki Spiliopoulou
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, School of Medicine, Athens
| | - Ioannis V Kostopoulos
- Department of Biology, School of Science, National and Kapodistrian University of Athens, Athens
| | - Rodanthi-Eleni Syrigou
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, School of Medicine, Athens
| | | | | | - Ourania E Tsitsilonis
- Department of Biology, School of Science, National and Kapodistrian University of Athens, Athens
| | - Efstathios Kastritis
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, School of Medicine, Athens
| | - Meletios A Dimopoulos
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, School of Medicine, Athens
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Sun CC, Hsu SL, Liang CM, Tsai YY, Lin PY. Bridging the gap in managing dry eye disease: a consensus report by the Taiwan society of cataract and refractive surgeons. BMC Ophthalmol 2024; 24:314. [PMID: 39075430 PMCID: PMC11285138 DOI: 10.1186/s12886-024-03565-9] [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: 03/16/2024] [Accepted: 07/08/2024] [Indexed: 07/31/2024] Open
Abstract
BACKGROUND An impaired ocular surface presents substantial challenges in terms of planning for cataract surgery. As a multifactorial ocular disorder, dry eye disease (DED) is common in the general population and prevalent in patients scheduled for lens replacement surgery. Cataract surgery can exacerbate DED and worsen several ocular parameters. Timely diagnosis and appropriate treatment of DED are vital to ensuring positive ophthalmic surgical outcomes. This consensus report of the Taiwan Society of Cataract and Refractive Surgeons (TSCRS) regarding the management of DED before, during, and after cataract surgery highlights the gaps between clinical guidelines and several aspects of DED, including diagnostic testing, diagnostic criteria, and clinical practice treatment. METHODS An expert panel of five specialists in the field of ophthalmology was recruited to develop consensus statements regarding the management of DED in both the general population and in patients undergoing cataract surgery in Taiwan. Two separate meetings of the five specialists, who were endorsed by the TSCRS, were convened for this purpose. A survey questionnaire consisting of binary or multiple-choice questions was developed through a consensus-driven formulation process. A percentage value was calculated for each statement, and a minimum of 60% agreement (equivalent to three out of five members) was required to achieve consensus. The second discussion meeting involved the presentation of the finalized consensus statements and concluded the consensus development process. Lastly, the finalized consensus statements were approved by all the experts, and the formulated recommendations for DED in the general population and prospective cataract surgery patients were accordingly presented. RESULTS The optimal algorithm for managing DED in the general population and in patients scheduled for cataract surgery was developed to address the unmet needs of this cohort in Taiwan. CONCLUSION This report provides recommendations for managing dry eye disease. It is essential to screen and confirm DED through endorsed questionnaires and tests and then diagnose it. Treatment and management of DED should follow a stepwise approach. Screening and diagnosing DED is also recommended before cataract surgery. After cataract surgery, relatively aggressive treatment strategies are recommended to manage DED effectively.
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Affiliation(s)
- Chi-Chin Sun
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Shiuh-Liang Hsu
- Department of Ophthalmology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | | | - Yi-Yu Tsai
- Department of Ophthalmology, China Medical University Hospital, Taichung, Taiwan.
| | - Pei-Yu Lin
- Department of Ophthalmology, School of Medicine, National Yang-Ming Chiao Tung University, Taipei, Taiwan.
- Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan.
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Ouyang XW, Fang S, Yi YM, Zou SP, Hu QY, Huang ZX, Li QX, Luo JY. Different concentrations of hyaluronic acid eye drops for dry eye syndrome: a systematic review and Meta-analysis. Int J Ophthalmol 2024; 17:1110-1119. [PMID: 38895674 PMCID: PMC11144765 DOI: 10.18240/ijo.2024.06.17] [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: 09/23/2023] [Accepted: 02/02/2024] [Indexed: 06/21/2024] Open
Abstract
AIM To compare high or low concentration of hyaluronic acid eye drops (HY) for dry eye syndromes (DES). METHODS Randomized controlled trials (RCTs) comparing various concentrations of HY were searched in PubMed, Embase, Web of Science, Cochrane, SinoMed, CNKI, Wanfang Database, CQVIP, and Chinese journals databases between inception and July 2023. Pooled standardized mean differences (SMD) or weighted mean difference (WMD) with 95% confidence intervals (CI) from RCTs evaluating Schirmer's I test (SIT), corneal fluorescein staining score (CFS), tear breakup time (TBUT), DES score (DESS), and Ocular Surface Disease Index (OSDI) were calculated. Sensitivity analysis, Egger's test and Meta-regression analysis were performed for all indicators. RESULTS We conducted a Meta-analysis of 10 RCTs that met the inclusion criteria, involving 1796 cases. High-concentrations group significantly improved the outcome of CFS according to random effects modelling (SMD, -3.37; 95%CI, -5.25 to -1.48; P=0.0005). The rest of the results were not statistically significant, including indicators such as SIT, TBUT, DESS and OSDI. CONCLUSION For dry eyes with positive corneal staining, a high concentration of HY is recommended, whereas in other cases, a high concentration of HY does not offer a more pronounced advantage over a low concentration of HY in the treatment of dry eyes.
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Affiliation(s)
- Xiao-Wei Ouyang
- Department of Ophthalmology, Nanchang Hongdu Hospital of Traditional Chinese Medicine, Nanchang 330000, Jiangxi Province, China
| | - Sheng Fang
- Department of Ophthalmology, Jiangxi Hospital of Integrated Traditional Chinese and Western Medicine, Nanchang 330000, Jiangxi Province, China
| | - Yun-Min Yi
- Department of Cataract, Nanchang University Affiliated Eye Hospital, Nanchang 330000, Jiangxi Province, China
| | - Shi-Peng Zou
- Department of Neuro-ophthalmology, Nanchang University Affiliated Eye Hospital, Nanchang 330000, Jiangxi Province, China
| | - Qi-Yu Hu
- Department of Ophthalmology, Nanchang Hongdu Hospital of Traditional Chinese Medicine, Nanchang 330000, Jiangxi Province, China
| | - Zi-Xuan Huang
- Department of Ophthalmology, Nanchang Hongdu Hospital of Traditional Chinese Medicine, Nanchang 330000, Jiangxi Province, China
| | - Qing-Xia Li
- Department of Ophthalmology, Nanchang Hongdu Hospital of Traditional Chinese Medicine, Nanchang 330000, Jiangxi Province, China
| | - Jin-Yan Luo
- Department of Ophthalmology, Nanchang Hongdu Hospital of Traditional Chinese Medicine, Nanchang 330000, Jiangxi Province, China
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Wolffsohn JS, Travé-Huarte S, Craig JP, Muntz A, Stapleton FJ. Appropriateness of Questionnaires for the Diagnosis and Monitoring Treatment of Dry Eye Disease. J Clin Med 2024; 13:3146. [PMID: 38892857 PMCID: PMC11172740 DOI: 10.3390/jcm13113146] [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: 03/04/2024] [Revised: 04/23/2024] [Accepted: 05/23/2024] [Indexed: 06/21/2024] Open
Abstract
Objectives: If questionnaires contributing to the diagnosis of dry eye disease are to be recommended as alternatives to existing questionnaires, they must be comparable, with similar repeatability and treatment sensitivity. Comparability was thus examined for three common dry eye questionnaires along with identifying the individual questions that most strongly predicted overall scores. Methods: Anonymised data (n = 329) collected via the Ocular Surface Disease Index (OSDI), 5-item Dry Eye Questionnaire (DEQ-5) and Symptom Assessment in Dry Eye (SANDE) questionnaires (including responses to individual questions) from consenting patients were drawn from real-world dry eye clinics/registries in the United Kingdom, Australia and New Zealand; at follow-up, normalised changes were evaluated in 54 of these patients. Treatment data were also analysed from a 6-month, randomised controlled trial assessing artificial tear supplement treatments with 43 responders and 13 non-responders to treatment identified. The questions extracted from the OSDI which form the abbreviated 6-item OSDI were also analysed. Results: The agreement between the questionnaires ranged from r = 0.577 to 0.754 (all p < 0.001). For the OSDI, three questions accounted for 89.1% of the variability in the total score. The correlation between the OSDI and OSDI-6 was r = 0.939, p < 0.001. For the DEQ-5, two questions accounted for 88.5% of the variance in the total score. Normalised treatment changes were also only moderately correlated between the questionnaires (r = 0.441 to 0.595, p < 0.01). For non-responders, variability was 7.4% with both OSDI and OSDI-6, 9.7% with DEQ-5, 12.1% with SANDE-frequency and 11.9% with SANDE-severity scale. For responders, improvement with drops was detected with a 19.1% change in OSDI, 20.2% in OSDI-6, 20.9% in DEQ-5, and 27.5%/23.6% in SANDE-frequency/severity scales. Conclusions: Existing commonly used dry eye questionnaire scores do not show high levels of correlation. The OSDI was the least variable of the questionnaires and while displaying a slightly lower treatment effect than either the DEQ or SANDE, it was more sensitive to detection of a treatment effect. The quicker-to-complete OSDI-6 exhibited essentially the same outcome as the OSDI, with similar variability and treatment sensitivity.
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Affiliation(s)
- James S. Wolffsohn
- School of Optometry, College of Health & Life Sciences, Aston University, Birmingham B4 7ET, UK;
| | - Sònia Travé-Huarte
- School of Optometry, College of Health & Life Sciences, Aston University, Birmingham B4 7ET, UK;
| | - Jennifer P. Craig
- School of Optometry, College of Health & Life Sciences, Aston University, Birmingham B4 7ET, UK;
- Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland 1010, New Zealand;
| | - Alex Muntz
- Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland 1010, New Zealand;
- Institute of Optometry, University of Applied Sciences and Arts Northwestern Switzerland, 4600 Olten, Switzerland
| | - Fiona J. Stapleton
- School of Optometry and Vision Science, UNSW, Sydney, NSW 2052, Australia;
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Bhattacharya P, Edwards K, Schmid KL. Regional Variations in Corneal Epithelial Cell Density and Morphology Assessed Using In Vivo Confocal Microscopy. Eye Contact Lens 2024; 50:163-170. [PMID: 38350097 DOI: 10.1097/icl.0000000000001067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2023] [Indexed: 02/15/2024]
Abstract
AIM To characterize the regional variations in corneal epithelial cell density and morphology using in vivo confocal microscopy (IVCM). METHODS Corneal imaging (IVCM) at 10 locations was performed; corneal apex (i.e., the center), immediately anterior to the corneal nerve whorl (i.e., slightly inferior to the apex), and four quadrants (superior, nasal, inferior, and temporal) both at 1.5 mm and 4.5 mm from the corneal apex (corresponding to 3 mm central and 9 mm peripheral diameter rings). The data of 21 young adults, aged 18 to 35 years, were analyzed. Cell morphometric parameters, including cell density, area, perimeter, Feret diameter, and circularity, were measured for basal and wing cells using Image J software. RESULTS There was a significant difference in basal cell density (BCD) ( P <0.001) and wing cell density (WCD) ( P <0.001) for different corneal locations. The BCD (mean±SD: 8,839±416 cells/mm 2 ) and WCD (mean±SD: 5,932±310 cells/mm 2 ) were highest at the corneal nerve whorl compared with all other corneal locations. There were significant differences in wing cell area ( P <0.001), perimeter ( P <0.001), Feret diameter ( P <0.001), and circularity ( P <0.001) at varying corneal locations. CONCLUSION There are significant regional variations in corneal epithelial cell density and morphology. The BCD and WCD was highest anterior to the corneal nerve whorl.
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Affiliation(s)
- Pradipta Bhattacharya
- Centre for Vision and Eye Research, Faculty of Health, Queensland University of Technology, Kelvin Grove, Australia
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Singer M, O'Brien P, Mein L, Olvera A. Corneal Sensitivity Is Inversely Correlated With Severity of Diabetic Retinopathy in a Predominantly Underrepresented Population. Am J Ophthalmol 2024; 259:53-61. [PMID: 37643714 DOI: 10.1016/j.ajo.2023.08.010] [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: 12/19/2022] [Revised: 04/18/2023] [Accepted: 08/16/2023] [Indexed: 08/31/2023]
Abstract
PURPOSE To assess the relationship between diabetic retinopathy (DR) and corneal sensitivity. METHODS In this prospective study, 100 eyes of 50 patients from primarily underrepresented racial and ethnic backgrounds with DR underwent assessment of corneal sensitivity using a Cochet-Bonnet esthesiometer. Severity of DR was graded by a masked reading center. Corneal sensitivity was compared in eyes with current or regressed proliferative DR (PDR) (n=35) and eyes with nonproliferative DR (NPDR) with no history of PDR (n=65). Corneal sensitivity in eyes that regressed from PDR to NPDR with anti-vascular endothelial growth factor (anti-VEGF) therapy (n=7) was compared to treatment-naïve eyes with no current or prior PDR (n=55) and to eyes with newly diagnosed, treatment-naïve PDR (n=12). RESULTS In eyes with current or prior PDR, the median corneal sensitivity (average of 4 quadrants) was 0.5 cm (interquartile range [IQR] 0-3.375), whereas in eyes with no current or prior PDR, the median corneal sensitivity was 4.75 cm (IQR 2.0-6.0, P < .0001). The median corneal sensitivity in eyes with regressed PDR was 0 cm (IQR 0-0.875), significantly lower than eyes with no current or prior PDR (4.5 cm, IQR 4.0, P = .0076) and no different than eyes with untreated PDR (0 cm, IQR 1.25). The odds of eyes with DR severity scale score ≥60 having complete corneal sensitivity loss was 3.6 times that of eyes with NPDR. CONCLUSIONS Corneal sensitivity is impaired in eyes with PDR compared to NPDR and is not rescued by anti-VEGF therapy. Assessment of corneal sensitivity in eyes with DR may identify patients at risk for additional complications, including neurotrophic keratopathy. NOTE: Publication of this article is sponsored by the American Ophthalmological Society.
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Affiliation(s)
- Michael Singer
- From the University Medical Center Ophthalmology Associates (M.S., L.M.), San Antonio, Texas.
| | - Preston O'Brien
- University of the Incarnate Word School of Osteopathic Medicine (P.O.), San Antonio, Texas
| | - Luke Mein
- From the University Medical Center Ophthalmology Associates (M.S., L.M.), San Antonio, Texas
| | - Andrea Olvera
- University Medical Center Ophthalmology Associates, 9157 Huebner Road, San Antonio TX, 78240, USA
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Zou X, Nagino K, Okumura Y, Midorikawa-Inomata A, Eguchi A, Yee A, Fujimoto K, Miura M, Sung J, Huang T, Fujio K, Akasaki Y, Nakao S, Kobayashi H, Inomata T. Optimal cutoff value of the dry eye-related quality-of-life score for diagnosing dry eye disease. Sci Rep 2024; 14:4623. [PMID: 38409465 PMCID: PMC10897401 DOI: 10.1038/s41598-024-55358-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 02/22/2024] [Indexed: 02/28/2024] Open
Abstract
This retrospective study aimed to determine the optimal cutoff values of the Dry Eye-Related Quality-of-Life Score (DEQS) questionnaire for diagnosing dry eye disease (DED) and classifying DED severities. Participants completed the DEQS questionnaire, the Japanese version of the Ocular Surface Disease Index (J-OSDI) questionnaire, and DED examinations. DED was diagnosed according to the 2016 Asia Dry Eye Society diagnostic criteria based on DED symptoms (J-OSDI ≥ 13 points) and tear film breakup time ≤ 5 s. Receiver operating characteristic (ROC) analysis was used to calculate the optimal cutoff values of the DEQS summary score for detecting DED and grading its severity. Among 427 patients, 296 (69.3%) and 131 (30.7%) were diagnosed with DED and non-DED, respectively. ROC analysis determined an optimal cutoff value of 15.0 points for DED diagnosis, with 83.5% sensitivity, 87.0% specificity, and an area under the curve of 0.915. The positive and negative predictive values for DEQS ≥ 15.0 points were 93.6% and 69.9%, respectively. DEQS cutoff values of 15.0, 20.0, and 26.8 points could be accepted for severity classification of DED subjective symptoms in clinical use and represent mild, moderate, and severe DED, respectively. Conclusively, the optimal cutoff values of DEQS enable DED detection and subjective symptom severity classification.
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Affiliation(s)
- Xinrong Zou
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
- Department of Ophthalmology, Fengcheng Hospital, Fengxian District, Shanghai, China
| | - Ken Nagino
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
- Department of Hospital Administration, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yuichi Okumura
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, 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
| | - Atsuko Eguchi
- Department of Hospital Administration, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Alan Yee
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Keiichi Fujimoto
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Maria Miura
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Jaemyoung Sung
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Tianxiang Huang
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kenta Fujio
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yasutsugu Akasaki
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Shintaro Nakao
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Hiroyuki Kobayashi
- Department of Hospital Administration, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Takenori Inomata
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
- Department of Hospital Administration, Juntendo University Graduate School of Medicine, Tokyo, Japan.
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.
- AI Incubation Farm, Juntendo University Graduate School of Medicine, Tokyo, Japan.
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Shahraki T, Baradaran-Rafii A, Ayyala R, Arabi A, Jarstad J, Memar F. New advances in medical management of dry eye: optimizing treatment strategies for enhanced relief. Int Ophthalmol 2024; 44:49. [PMID: 38337030 DOI: 10.1007/s10792-024-02978-1] [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: 05/13/2023] [Accepted: 10/29/2023] [Indexed: 02/12/2024]
Abstract
PURPOSE Dry eye disease (DED) is a prevalent ocular surface disease that is conventionally characterized by tear film hyperosmolarity and instability. This review presents a summarized classification of DED, followed by a comprehensive discussion of the most recent topical and systemic medications and clinical recommendations for selecting the most appropriate option for each patient. METHODS An extensive literature search was conducted on electronic databases, such as PubMed, Scopus, and Web of Science, using keywords including "dry eye syndrome," "ocular surface disease," "medical management," "artificial tears," "topical immunomodulators," and "meibomian gland dysfunction." RESULTS The underlying reasons for DED can range from insufficient aqueous tear production to increased tear evaporation. Recent literature has provided a more in-depth understanding of the pathophysiology of DED by examining the tear film's lipid, aqueous, and mucin layers. However, despite these advancements, medical management of patients with symptomatic DED has not fully reflected this modernized knowledge of its pathophysiology. CONCLUSION To develop a rationalized strategy for treating DED, it is crucial to have updated knowledge of therapeutic options, their mechanisms of actions, and indications based on the DED type and underlying causes.
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Affiliation(s)
- Toktam Shahraki
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, No. 23, Paidarfard St., Boostan 9 St., Pasdaran Ave, Tehran, Iran.
| | - Alireza Baradaran-Rafii
- Department of Ophthalmology, University of South Florida, Morsani College of Medicine, Tampa, FL, USA
| | - Ramesh Ayyala
- Department of Ophthalmology, University of South Florida, Morsani College of Medicine, Tampa, FL, USA
| | - Amir Arabi
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, No. 23, Paidarfard St., Boostan 9 St., Pasdaran Ave, Tehran, Iran
| | - John Jarstad
- Department of Ophthalmology, University of South Florida, Morsani College of Medicine, Tampa, FL, USA
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Pratomo TG, Zaifar A, Wibowo NP, Suryono AN, Aziza Y. Current application of intense pulsed light for the management of dry eye disease: A systematic review and meta-analysis. Indian J Ophthalmol 2024; 72:S183-S190. [PMID: 38146980 DOI: 10.4103/ijo.ijo_671_23] [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: 03/08/2023] [Accepted: 10/03/2023] [Indexed: 12/27/2023] Open
Abstract
This review explored intense pulsed light (IPL) as an alternative treatment for dry eye disease (DED) symptom relief by correcting tear-film homeostasis. A systematic search was performed in March 2022 on five databases (Medline, Embase, SCOPUS, ProQuest, and EBSCO). Studies were extracted for the following outcomes of interest: standard patient evaluation of eye dryness questionnaire (SPEED), ocular surface disease index (OSDI), tear break-up time (TBUT), and corneal fluorescein staining (CFS). All studies published up to March 2022 were reviewed. Cochrane risk of bias tool (RoB 2) was used to screen studies for risk of bias where appropriate. A meta-analysis was done to quantify any reported quantitative data. Thirteen studies were included in this study. A total of 931 individuals and 1454 numbers of eyes were reviewed in this meta-analysis. Among studies that explored and reported the effect of IPL in individuals with DED, TBUT and OSDI improved significantly post intervention, with a standardized mean difference (SMD) of 1.02 [95% CI 0.41-1.64] and 0.28 [95% CI 0.04-0.52], respectively. CFS and SPEED scores, however, showed no statistically significant difference, with an SMD of 0.22 [95% CI -0.19 to 0.64] and 0.28 [95% CI -0.11 to 0.66], respectively. In conclusion, current evidence indicates IPL as a possible adjunctive treatment in individuals with DED in an otherwise limited treatment option. Further studies through more extensive trials are needed to validate this finding and elucidate its mechanism.
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Affiliation(s)
- Tiara G Pratomo
- Department of Ophthalmology Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Kirana Eye Hospital, Jakarta, Indonesia
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Zhao DX, Quintero M, Mihailovic A, Akpek E, Karakus S, Guo L, Ramulu PY. Utilizing visual symptoms to distinguish dry eye from glaucoma, cataract, and suspect glaucoma patients: a cross-sectional study. BMC Ophthalmol 2024; 24:16. [PMID: 38195490 PMCID: PMC10775660 DOI: 10.1186/s12886-023-03219-2] [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: 07/16/2023] [Accepted: 11/13/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND The diagnosis of dry eye and other common ophthalmological conditions can be supported using patient reported symptoms, which is increasingly useful in contexts such as telemedicine. We aim to ascertain visual symptoms that differentiate dry eye from cataract, glaucoma, or glaucoma suspects. METHODS Adults with dry eye, glaucoma, cataract, and suspected glaucoma (controls) completed a questionnaire to rate the frequency and severity of 28 visual symptoms. Univariate, followed by multivariable logistic regression with backward stepwise selection (p < 0.05), determined the individual symptoms and set of symptoms best distinguishing dry eye from each of the other conditions. RESULTS Mean age of 353 patients (94 glaucoma suspect controls, 79 glaucoma, 84 cataract, and 96 dry eye) was 64.1 years (SD = 14.1); 67% were female and 68% White. Dry eye patients reported more frequent light sensitivity (OR = 15.0, 95% CI = 6.3-35.7) and spots in vision (OR = 2.8, 95% CI = 1.2-6.3) compared to glaucoma suspect controls. Compared to glaucoma patients, dry eye patients experienced more frequent light sensitivity (OR = 9.2, 95% CI = 2.0-41.7), but less frequent poor peripheral vision (OR = 0.2, 95% CI = 0.06-0.7), difference in vision between eyes (OR = 0.09, 95% CI = 0.01-0.7), and missing patches of vision (OR = 0.06, 95% CI = 0.009-0.3). Compared to cataract patients, dry eye patients reported more frequent spots in vision (OR = 4.5, 95% CI = 1.5-13.4) and vision variability across the week (OR = 4.7, 95% CI = 1.2-17.7) and were less likely to report worsening vision (OR = 0.1, 95% CI = 0.03-0.4) and blindness (OR = 0.1, 95% CI = 0.02-0.8). CONCLUSION Visual symptoms may serve as a complementary tool to distinguish dry eye from various ocular conditions, though the symptoms that best distinguish dry eye differ across comparisons. Differentiating how patients visually perceive common eye diseases may be used in a variety of clinical settings to rule out specific conditions.
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Affiliation(s)
- David X Zhao
- Johns Hopkins Wilmer Eye Institute, Baltimore, MD, USA
| | | | | | - Esen Akpek
- Johns Hopkins Wilmer Eye Institute, Baltimore, MD, USA
| | - Sezen Karakus
- Johns Hopkins Wilmer Eye Institute, Baltimore, MD, USA
| | - Lee Guo
- Johns Hopkins Wilmer Eye Institute, Baltimore, MD, USA
| | - Pradeep Y Ramulu
- Johns Hopkins Wilmer Eye Institute, Baltimore, MD, USA.
- Wilmer Eye Institute, Johns Hopkins Medical Institutions, 600 N. Wolfe St., Wilmer 129, Baltimore, MD, 21287, USA.
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Ajouz L, Hallak J, Naik R, Nguyen A, Zhao C, Robinson MR, Nichols KK. Evaluation of the Impact of Meibomian Gland Dysfunction Using a Novel Patient-Reported Outcome Instrument. J Ocul Pharmacol Ther 2024; 40:48-56. [PMID: 37910805 PMCID: PMC10890943 DOI: 10.1089/jop.2023.0080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 09/25/2023] [Indexed: 11/03/2023] Open
Abstract
Purpose: This study was intended to characterize the impact of meibomian gland dysfunction (MGD) on patients' quality of life. Methods: In this prospective, multicenter, noninterventional clinical study (NCT01979887), eligible individuals (age ≥40 years; absence of uncontrolled ocular/systemic disease) were categorized, based on composite grading of ocular symptoms, Schirmer score, and meibum quality, into (1) non-MGD, (2) mild/moderate MGD, or (3) severe MGD cohorts. The MGD Impact Questionnaire (MGD IQ), a 10-item patient-reported outcome measure, was self-administered at clinic visit on day 1, and readministered on day 22 to assess intervisit agreement regarding MGD IQ responses. Results: In total, 75 subjects were assigned to the study cohorts (25 per cohort). Across cohorts, MGD IQ item scores rose incrementally with increasing MGD severity. The severe MGD cohort experienced greater difficulty with reading and performance of leisure activities, greater time on eye care, and greater bother with eye care and eye appearance than the mild/moderate MGD cohort (all P < 0.05). Compared with the non-MGD cohort, the mild/moderate MGD cohort had greater difficulty working on computer, whereas the severe MGD cohort had greater difficulty reading, driving, and performing leisure activities, more frequent difficulty with outdoor activities, more time on eye care, and greater bother with eye care (all P < 0.05). Intervisit agreement between MGD IQ responses was fair to moderate (weighted kappa statistic 0.33‒0.58). Conclusions: Vision-related activities are negatively impacted by increasing severity of MGD. The MGD IQ instrument can help characterize disease severity and amplify the patient's voice in patient-centric clinical research. ClinicalTrials.gov NCT01979887.
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Affiliation(s)
- Layla Ajouz
- Allergan (an AbbVie company), Irvine, California, USA
| | - Joelle Hallak
- Allergan (an AbbVie company), Irvine, California, USA
| | - Rupali Naik
- Noesis Healthcare Technologies, Redwood City, California, USA
| | - Ashley Nguyen
- Allergan (an AbbVie company), Irvine, California, USA
| | - Cathy Zhao
- Allergan (an AbbVie company), Irvine, California, USA
| | | | - Kelly K. Nichols
- School of Optometry, University of Alabama at Birmingham, Birmingham, Alabama, USA
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12
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Wolffsohn JS. 2022 Glenn A. Fry Award lecture: Enhancing clinical assessment for improved ophthalmic management. Optom Vis Sci 2024; 101:12-24. [PMID: 38350054 DOI: 10.1097/opx.0000000000002102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024] Open
Abstract
ABSTRACT Detailed clinical assessment is critical to allow sensitive evaluation of the eye and its management. As technology advances, these assessment techniques can be adapted and refined to improve the detection of pathological changes of ocular tissue and their impact on visual function. Enhancements in optical medical devices including spectacle, contact, and intraocular lenses have allowed for a better understanding of the mechanism and amelioration of presbyopia and myopia control. Advancements in imaging technology have enabled improved quantification of the tear film and ocular surface, informing diagnosis and treatment strategies. Miniaturized electronics, large processing power, and in-built sensors in smartphones and tablets capacitate more portable assessment tools for clinicians, facilitate self-monitoring and treatment compliance, and aid communication with patients. This article gives an overview of how technology has been used in many areas of eye care to improve assessments and treatment and provides a snapshot of some of my studies validating and using technology to inform better evidence-based patient management.
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Lee G, Kardon RH, Nellis JK, Pham CM, Sales CS, Carter KD, Shriver EM. Quantitative Assessment of Subjective Symptoms and Corneal Sensitivity in Chronic Orbital Pain Patients. Ophthalmic Plast Reconstr Surg 2024; 40:88-92. [PMID: 38241621 DOI: 10.1097/iop.0000000000002515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2024]
Abstract
PURPOSE To objectively evaluate the subjective symptoms and characteristics of chronic orbital pain as well as to quantify sensitization of peripheral trigeminal nerves. METHODS In this prospective cohort study, patients who previously showed a response to peripheral trigeminal nerve blocks for unilateral, idiopathic chronic orbital pain and healthy subjects completed validated questionnaires assessing headaches, neuropathic signs and symptoms, photophobia, and pain qualities. Corneal sensitivity was measured in both eyes for all subjects with a Cochet-Bonnet aesthesiometer. For pain patients, the full assessment protocol was repeated 2-4 weeks after the study injection, and corneal sensitivity was also measured 30 minutes postinjection. Outcomes assessed were headache, neuropathic pain, and photophobia scores; pain qualities; and corneal sensitivity. RESULTS Six female chronic orbital pain patients (mean age 48.2 years) and 11 female controls (mean age 47.5) were included. The mean headache, neuropathic pain, and photophobia questionnaire scores were significantly higher for pain patients than for controls (p < 0.001). On sensory testing, 5 pain patients (83.3%) endorsed allodynia, and all 6 (100%) had hyperalgesia in the ipsilateral frontal nerve dermatome. No controls had allodynia or hyperalgesia. Corneal sensitivity was similar between eyes in pain patients and between groups. Questionnaire scores and corneal sensitivity did not change significantly after the injection. CONCLUSIONS Chronic orbital pain patients have a measurable reduction in quality of life due to headaches and photophobia. The supraorbital and supratrochlear nerves are sensitized, resulting in cutaneous hypersensitivity in the corresponding dermatome, but corneal nerves have normal sensitivity.
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Affiliation(s)
- Grace Lee
- Carver College of Medicine, University of Iowa, Iowa City, Iowa, U.S.A
| | - Randy H Kardon
- Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, Iowa, U.S.A
- Veteran's Affairs Center for the Prevention and Treatment of Visual Loss, Iowa City, Iowa, U.S.A
| | - Julie K Nellis
- Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, Iowa, U.S.A
- Veteran's Affairs Center for the Prevention and Treatment of Visual Loss, Iowa City, Iowa, U.S.A
| | - Chau M Pham
- Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, Iowa, U.S.A
| | - Christopher S Sales
- Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, Iowa, U.S.A
| | - Keith D Carter
- Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, Iowa, U.S.A
| | - Erin M Shriver
- Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, Iowa, U.S.A
- Veteran's Affairs Center for the Prevention and Treatment of Visual Loss, Iowa City, Iowa, U.S.A
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14
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Ji H, Yang Y, Lu Y, Kong X, Yang G, Liu J, Yang Y, Wang X, Ma X. Prevalence of dry eye during the COVID-19 pandemic: A systematic review and meta-analysis. PLoS One 2023; 18:e0288523. [PMID: 38091282 PMCID: PMC10718424 DOI: 10.1371/journal.pone.0288523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 06/28/2023] [Indexed: 12/18/2023] Open
Abstract
OBJECTIVE During the COVID-19 pandemic, many people devoted longer time to screen viewing due to the need for study, work, and online social activities, instead of outdoor activities, which may have led to an increase in dry eye symptoms. This study aimed to evaluate the prevalence of dry eye during the COVID-19 pandemic. METHODS PubMed, Cochrane Library, Embase, and Web of Science were searched from January 1, 2020 to October 20, 2022. Cross-sectional surveys on dry eye prevalence conducted after January 1, 2020 were included. Two review authors independently performed data extraction and assessed study quality. The random-effects model was used to analyze the prevalence of dry eye, and the odds ratio was used to assess the strength of the association between variables. Subgroup analysis was performed to detect heterogeneity, the leave-one-out method for sensitivity analysis, and the Egger test for publication bias. RESULTS A total of eleven studies with 15692 individuals met the eligibility criteria. The prevalence of dry eye during the COVID-19 pandemic was 61.0% (95%CI: 51.8%-70.2%) globally and 56.7% (95%CI: 45.3%-68.1%) in Asia. The prevalence of dry eye had significant differences in sex and visual display time, with higher prevalence among females and visual display time of more than 4 hours per day. Subgroup analysis was performed based on diagnostic tools, study population, and average age. A significant difference was found in diagnostic tools, but no significant change in heterogeneity (P<0.05). The leave-one-out method showed stable results, and the Egger test identified no significant publication bias. CONCLUSION The prevalence of dry eye during the COVID-19 pandemic is significantly higher than before, and a higher prevalence is found among females and those having a visual display time of more than 4 hours per day.
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Affiliation(s)
- Haiyang Ji
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yun Yang
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yunqiong Lu
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiehe Kong
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai, China
| | - Guang Yang
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai, China
| | - Jie Liu
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai, China
| | - Yanting Yang
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai, China
| | - Xuejun Wang
- Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Xiaopeng Ma
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai, China
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Nagino K, Inomata T, Nakamura M, Sung J, Midorikawa-Inomata A, Iwagami M, Fujio K, Akasaki Y, Okumura Y, Huang T, Fujimoto K, Eguchi A, Miura M, Hurramhon S, Zhu J, Ohno M, Hirosawa K, Morooka Y, Dana R, Murakami A, Kobayashi H. Symptom-based stratification algorithm for heterogeneous symptoms of dry eye disease: a feasibility study. Eye (Lond) 2023; 37:3484-3491. [PMID: 37061620 PMCID: PMC10630441 DOI: 10.1038/s41433-023-02538-4] [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: 01/10/2023] [Revised: 03/31/2023] [Accepted: 04/06/2023] [Indexed: 04/17/2023] Open
Abstract
BACKGROUND/OBJECTIVE To test the feasibility of a dry eye disease (DED) symptom stratification algorithm previously established for the general population among patients visiting ophthalmologists. SUBJECT/METHODS This retrospective cross-sectional study was conducted between December 2015 and October 2021 at a university hospital in Japan; participants who underwent a comprehensive DED examination and completed the Japanese version of the Ocular Surface Disease Index (J-OSDI) were included. Patients diagnosed with DED were stratified into seven clusters using a previously established symptom-based stratification algorithm for DED. Characteristics of the patients in stratified clusters were compared. RESULTS In total, 426 participants were included (median age [interquartile range]; 63 [48-72] years; 357 (83.8%) women). Among them, 291 (68.3%) participants were diagnosed with DED and successfully stratified into seven clusters. The J-OSDI total score was highest in cluster 1 (61.4 [52.2-75.0]), followed by cluster 5 (44.1 [38.8-47.9]). The tear film breakup time was the shortest in cluster 1 (1.5 [1.1-2.1]), followed by cluster 3 (1.6 [1.0-2.5]). The J-OSDI total scores from the stratified clusters in this study and those from the clusters identified in the previous study showed a significant correlation (r = 0.991, P < 0.001). CONCLUSIONS The patients with DED who visited ophthalmologists were successfully stratified by the previously established algorithm for the general population, uncovering patterns for their seemingly heterogeneous and variable clinical characteristics of DED. The results have important implications for promoting treatment interventions tailored to individual patients and implementing smartphone-based clinical data collection in the future.
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Affiliation(s)
- Ken Nagino
- Department of Hospital Administration, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Takenori Inomata
- Department of Hospital Administration, Juntendo University Graduate School of Medicine, Tokyo, Japan.
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.
- Juntendo University Graduate School of Medicine, AI Incubation Farm, 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 Engineering, Graduate School of Bioengineering, The University of Tokyo, Tokyo, Japan
| | - Jaemyoung Sung
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
- University of South Florida, Morsani College of Medicine, Tampa, FL, USA
| | - Akie Midorikawa-Inomata
- Department of Hospital Administration, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Masao Iwagami
- Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Ibaraki, 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
| | - 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
| | - 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
| | - 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
| | - 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
| | - Atsuko Eguchi
- Department of Hospital Administration, 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
| | - Shokirova Hurramhon
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Jun Zhu
- Department of Ophthalmology, 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
| | - 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
| | - 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
| | - Reza Dana
- Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - 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
| | - Hiroyuki Kobayashi
- Department of Hospital Administration, Juntendo University Graduate School of Medicine, Tokyo, Japan
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Zanutigh V, Galetto L, Valvecchia F, Logioco C. Ocular Surface Evaluation after Switch from Latanoprost 0.005% to Latanoprostene Bunod 0.024. J Curr Glaucoma Pract 2023; 17:205-209. [PMID: 38269264 PMCID: PMC10803279 DOI: 10.5005/jp-journals-10078-1422] [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: 08/18/2023] [Accepted: 09/15/2023] [Indexed: 01/26/2024] Open
Abstract
Aim and background To evaluate the ocular surface of patients treated with latanoprost (LT) 0.005% who switched to latanoprostene bunod (LBN) 0.024%. Materials and methods A prospective and nonrandomized clinical study of a case series was performed, including patients with chronic open-angle glaucoma who were on previous LT-only treatment and, after a washout period, switched to LBN, with a 3-month follow-up. The main parameter to be evaluated was the ocular surface disease index (OSDI) test. In addition, best-corrected visual acuity (BCVA), intraocular pressure (IOP), biomicroscopic aspect of the ocular surface, measuring tear breakup time, fluorescein staining (grading performed on Oxford scale) and Schirmer I test were evaluated. Results A total of 36 patients (72 eyes) were included, 21 women (58.3%) and 15 men (41.7%, with a mean age of 65.6 ± 10.9 years (37-86). The initial OSDI score was 17.8 ± 12.1 and improved to 11.1 ± 10.5 (p < 0.01). From the data evaluated at biomicroscopy, an improvement was observed in the Oxford scale from 0.6 ± 0.7 to 0.2 ± 0.8 (p: 0.01), but no statistically significant changes were observed in the break-up time (BUT) and Schirmer. BCVA remained stable, as did IOP, which was initially 13.4 ± 2.1 mm Hg and, after performing the LBN treatment change, went to 13.1 ± 1.7 mm Hg. Conclusion After the change of treatment from LT 0.005% to LBN 0.024%, the patients had an improvement in the ocular surface, maintaining control of their IOP. The need to investigate possible beneficial mechanisms on the ocular surface in glaucoma patients treated with LBN, potentially related to nitric oxide, is raised. Clinical significance Patients treated with LT 0.005% who switched to LBN 0.024% had an improvement in ocular surface symptoms and signs, keeping IOP under control.Latanoprostene bunod (LBN) 0.024% may have beneficial effects on the ocular surface, which should be further studied. How to cite this article Zanutigh V, Galetto L, Valvecchia F, et al. Ocular Surface Evaluation after Switch from Latanoprost 0.005% to Latanoprostene Bunod 0.024%. J Curr Glaucoma Pract 2023;17(4):205-209.
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Affiliation(s)
- Virginia Zanutigh
- Department of Glaucoma, Centro de Ojos Quilmes, Quilmes, Buenos Aires, Argentina
| | - Leila Galetto
- Department of Glaucoma, Centro de Ojos Quilmes, Quilmes, Buenos Aires, Argentina
| | - Florencia Valvecchia
- Department of Ocular Surface, Centro de Ojos Quilmes, Quilmes, Buenos Aires, Argentina
| | - Celina Logioco
- Department of Glaucoma, Centro de Ojos Quilmes, Quilmes, Buenos Aires, Argentina
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Le DTM, Kandel H, Watson SL. Evaluation of ocular neuropathic pain. Ocul Surf 2023; 30:213-235. [PMID: 37748645 DOI: 10.1016/j.jtos.2023.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 09/21/2023] [Accepted: 09/22/2023] [Indexed: 09/27/2023]
Abstract
AIM To identify and assess the quality of current validated questionnaires that could be used to evaluate ocular neuropathic pain and its associated aetiologies. METHODS A literature search was performed on MEDLINE, PubMed, EMBASE, PsycINFO and The Cochrane Library. Articles evaluating questionnaires for ocular neuropathic pain and its associated aetiologies were included. Data on psychometric properties, validity, and reliability of the questionnaires was extracted and analysed using a set of quality criteria. Clinical and demographical associations with ocular neuropathic pain were also reviewed. RESULTS The search generated 1738 results with 61 publications meeting the inclusion criteria. The 61 publications covered 28 questionnaires including 3 ocular pain, 12 dry eye disease, 2 blepharitis, 2 refractive surgery, 3 contact lens wear, 3 Sjogren's Syndrome, and 3 that were non-disease-specific. Only 57 publications provided enough data on psychometric properties and validity of the questionnaire to be included for quality assessment. The Contact Lens Discomfort Index (CLDI) had the highest rated psychometric properties, whereas the English version of the Ocular Comfort Index (OCI) provided the most data on psychometric properties (9 out of 10 criteria). Most ocular pain and disease-specific questionnaires contained appropriate items to assess ocular pain in specific populations. However, non-disease-specific ophthalmic questionnaires demonstrated poor reliability and validity when evaluating ocular pain. CONCLUSION Ocular pain questionnaires can potentially diagnose ocular neuropathic pain. Disease-specific questionnaires were limited to their target populations, and non-disease-specific ophthalmic questionnaires were unreliable. Further studies are required to determine the most appropriate questionnaire to evaluate ocular neuropathic pain.
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Affiliation(s)
- Damien Tuan-Man Le
- The University of Sydney, Save Sight Institute, Sydney, NSW, 2000, Australia; Sydney Eye Hospital, Sydney, NSW, 2000, Australia.
| | - Himal Kandel
- The University of Sydney, Save Sight Institute, Sydney, NSW, 2000, Australia; Sydney Eye Hospital, Sydney, NSW, 2000, Australia
| | - Stephanie L Watson
- The University of Sydney, Save Sight Institute, Sydney, NSW, 2000, Australia; Sydney Eye Hospital, Sydney, NSW, 2000, Australia
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18
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Nagino K, Okumura Y, Akasaki Y, Fujio K, Huang T, Sung J, Midorikawa-Inomata A, Fujimoto K, Eguchi A, Hurramhon S, Yee A, Miura M, Ohno M, Hirosawa K, Morooka Y, Murakami A, Kobayashi H, Inomata T. Smartphone App-Based and Paper-Based Patient-Reported Outcomes Using a Disease-Specific Questionnaire for Dry Eye Disease: Randomized Crossover Equivalence Study. J Med Internet Res 2023; 25:e42638. [PMID: 37535409 PMCID: PMC10436120 DOI: 10.2196/42638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 03/22/2023] [Accepted: 07/12/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND Using traditional patient-reported outcomes (PROs), such as paper-based questionnaires, is cumbersome in the era of web-based medical consultation and telemedicine. Electronic PROs may reduce the burden on patients if implemented widely. Considering promising reports of DryEyeRhythm, our in-house mHealth smartphone app for investigating dry eye disease (DED) and the electronic and paper-based Ocular Surface Disease Index (OSDI) should be evaluated and compared to determine their equivalency. OBJECTIVE The purpose of this study is to assess the equivalence between smartphone app-based and paper-based questionnaires for DED. METHODS This prospective, nonblinded, randomized crossover study enrolled 34 participants between April 2022 and June 2022 at a university hospital in Japan. The participants were allocated randomly into 2 groups in a 1:1 ratio. The paper-app group initially responded to the paper-based Japanese version of the OSDI (J-OSDI), followed by the app-based J-OSDI. The app-paper group responded to similar questionnaires but in reverse order. We performed an equivalence test based on minimal clinically important differences to assess the equivalence of the J-OSDI total scores between the 2 platforms (paper-based vs app-based). A 95% CI of the mean difference between the J-OSDI total scores within the ±7.0 range between the 2 platforms indicated equivalence. The internal consistency and agreement of the app-based J-OSDI were assessed with Cronbach α coefficients and intraclass correlation coefficient values. RESULTS A total of 33 participants were included in this study. The total scores for the app- and paper-based J-OSDI indicated satisfactory equivalence per our study definition (mean difference 1.8, 95% CI -1.4 to 5.0). Moreover, the app-based J-OSDI total score demonstrated good internal consistency and agreement (Cronbach α=.958; intraclass correlation=0.919; 95% CI 0.842 to 0.959) and was significantly correlated with its paper-based counterpart (Pearson correlation=0.932, P<.001). CONCLUSIONS This study demonstrated the equivalence of PROs between the app- and paper-based J-OSDI. Implementing the app-based J-OSDI in various scenarios, including telehealth, may have implications for the early diagnosis of DED and longitudinal monitoring of PROs.
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Affiliation(s)
- Ken Nagino
- Department of Hospital Administration, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Digital Medicine, 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
| | - 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
- AI Incubation Farm, 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
| | - 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
| | - Jaemyoung Sung
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Akie Midorikawa-Inomata
- 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
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Atsuko Eguchi
- Department of Hospital Administration, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Shokirova Hurramhon
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Alan Yee
- 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
| | - 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
| | - 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
| | - 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
| | - Hiroyuki Kobayashi
- Department of Hospital Administration, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Takenori Inomata
- Department of Hospital Administration, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
- AI Incubation Farm, Juntendo University Graduate School of Medicine, Tokyo, Japan
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19
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Liu B, Zhou D, Li Z, Wang Y, Chen Z. A survey on the degree of eye discomfort caused by video terminal use among college students in different altitudes. BMC Public Health 2023; 23:1209. [PMID: 37349685 PMCID: PMC10286401 DOI: 10.1186/s12889-023-16004-z] [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: 09/03/2022] [Accepted: 05/27/2023] [Indexed: 06/24/2023] Open
Abstract
OBJECTIVE To analyze the risk factors associated with different levels of eye discomfort due to video terminal use among college students at different altitudes. METHODS This cross-sectional study was conducted to assess the prevalence and extent of eye discomfort by distributing an questionnaire to university students via the Internet. To analyze the causes and risk factors of eye discomfort among college students at different altitudes after using video terminals. RESULTS A total of 647 participants who met the criteria were included in this survey, of whom 292 (45.1%) were males and 355 (54.9%) were females. The results of the survey showed 194 (30.0%) participants without eye discomfort and 453 (70.0%) participants with eye discomfort. The results of the univariate comparison of the degree of eye discomfort in the study subjects with different characteristics showed that the differences in the degree of eye discomfort were statistically significant (P < 0.05) for the 7 groups of indicators: gender, region, wearing corneal contact lenses for more than 2 h per day, frequent use of eye drops, sleep time, total time of VDT use per day, and total time per VDT use, while the remaining indicators, including age, profession, and whether refractive surgery or other eye surgery was performed, whether frame glasses were worn for a long time, and duration of daily mask wear were not statistically significant. The results of multi-factor logistic analysis of the degree of eye discomfort in the study subjects with different characteristics showed that gender, region, frequent use of eye drops, sleep time, and total time of VDT use per day were the risk factors affecting the degree of eye discomfort. CONCLUSIONS Female, high altitude, frequent use of eye drops, shorter daily sleep duration and longer daily VDT use were associated risk factors for the development of severe eye discomfort, where the severity of eye discomfort was significantly negatively correlated with increased sleep duration and significantly positively correlated with increased total time of VDT use.
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Affiliation(s)
- Bingjie Liu
- The Affiliated Hospital of Kunming University of Science and Technology, Kunming, 650500, P.R. China
- Department of Ophthalmology, The First People's Hospital of Yunnan Province, Kunming, 650500, P.R. China
- Medical School, Kunming University of Science and Technology, Kunming, 650500, P.R. China
| | - Daijiao Zhou
- Department of Ophthalmology, The First People's Hospital of Yunnan Province, Kunming, 650500, P.R. China
| | - Zuyou Li
- The Affiliated Hospital of Kunming University of Science and Technology, Kunming, 650500, P.R. China
- Department of Ophthalmology, The First People's Hospital of Yunnan Province, Kunming, 650500, P.R. China
- Medical School, Kunming University of Science and Technology, Kunming, 650500, P.R. China
| | - Yao Wang
- The Affiliated Hospital of Kunming University of Science and Technology, Kunming, 650500, P.R. China
- Department of Ophthalmology, The First People's Hospital of Yunnan Province, Kunming, 650500, P.R. China
- Medical School, Kunming University of Science and Technology, Kunming, 650500, P.R. China
| | - Zhen Chen
- The Affiliated Hospital of Kunming University of Science and Technology, Kunming, 650500, P.R. China.
- Department of Ophthalmology, The First People's Hospital of Yunnan Province, Kunming, 650500, P.R. China.
- Medical School, Kunming University of Science and Technology, Kunming, 650500, P.R. China.
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20
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Nagino K, Sung J, Midorikawa-Inomata A, Eguchi A, Fujimoto K, Okumura Y, Yee A, Fujio K, Akasaki Y, Huang T, Miura M, Hurramhon S, Hirosawa K, Ohno M, Morooka Y, Kobayashi H, Inomata T. The minimal clinically important difference of app-based electronic patient-reported outcomes for hay fever. Clin Transl Allergy 2023; 13:e12244. [PMID: 37227421 DOI: 10.1002/clt2.12244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 03/06/2023] [Accepted: 04/03/2023] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND Hay fever is a common allergic disease, with an estimated worldwide prevalence of 14.4% and a variety of symptoms. This study assessed the minimal clinically important difference (MCID) of nasal symptom score (NSS), non-nasal symptom score (NNSS), and total symptoms score (TSS) for app-based hay-fever monitoring. METHODS MCIDs were calculated based on the data from a previous large-scale, crowdsourced, cross-sectional study using AllerSearch, an in-house smartphone application. MCIDs were determined with anchor-based and distribution-based methods. The face scale score of the Japanese Allergic Conjunctival Disease Standard Quality of Life Questionnaire Domain III and the daily stress level due to hay fever were used as anchors for determining MCIDs. The MCID estimates were summarized as MCID ranges. RESULTS A total of 7590 participants were included in the analysis (mean age: 35.3 years, 57.1% women). The anchor-based method produced a range of MCID values (median, interquartile range) for NSS (2.0, 1.5-2.1), NNSS (1.0, 0.9-1.2), and TSS (2.9, 2.4-3.3). The distribution-based method produced two MCIDs (based on half a standard deviation, based on a standard error of measurement) for NSS (2.0, 1.8), NNSS (1.3, 1.2), and TSS (3.0, 2.3). The final suggested MCID ranges for NSS, NNSS, and TSS were 1.8-2.1, 1.2-1.3, and 2.4-3.3, respectively. CONCLUSIONS MCID ranges for app-based hay-fever symptom assessment were obtained from the data collected through a smartphone application, AllerSearch. These estimates may be useful for monitoring the subjective symptoms of Japanese patients with hay fever through mobile platforms.
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Affiliation(s)
- Ken Nagino
- Department of Hospital Administration, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Jaemyoung Sung
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
- University of South Florida, Morsani College of Medicine, Tampa, Florida, USA
| | - Akie Midorikawa-Inomata
- Department of Hospital Administration, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Atsuko Eguchi
- 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
| | - 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
| | - Alan Yee
- 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
| | - 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
| | - 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
| | - 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
| | - Shokirova Hurramhon
- Department of Ophthalmology, 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
| | - 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
| | - Hiroyuki Kobayashi
- Department of Hospital Administration, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Takenori Inomata
- Department of Hospital Administration, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Juntendo University Graduate School of Medicine, AI Incubation Farm, Tokyo, Japan
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21
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Alkhaldi SA, Allam KH, Radwan MA, Sweeney LE, Alshammeri S. Estimates of dry eye disease in Saudi Arabia based on a short questionnaire of prevalence, symptoms, and risk factors: The Twaiq Mountain Eye Study I. Cont Lens Anterior Eye 2023; 46:101770. [PMID: 36210288 DOI: 10.1016/j.clae.2022.101770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 09/01/2022] [Accepted: 09/26/2022] [Indexed: 11/17/2022]
Abstract
PURPOSE To estimate the prevalence and associated risk factors of dry eye disease (DED) among the citizens of Saudi Arabia. METHODS A cross-sectional prevalence survey was administered to 4066 healthy adults from the five main regions of Saudi Arabia. Initial estimates of the prevalence and associated risk factors of DED were calculated for the general population and then stratified by demographic characteristics such as age, sex, and location. DED was assessed by a short, validated dry-eye questionnaire. RESULTS The overall prevalence of DED was 49.5 % (n = 2016), including 33.1 % (n = 1347) of participants who reported a previous DED diagnosis and 16.4 % (n = 669) who reported severe symptoms; 14.7 % reported severe symptoms and a previous DED diagnosis (n = 598). The DED prevalence among men was 49.8 % (n = 1005) compared with 50.2 % (n = 1011) for women. The multivariate model analysis confirmed the increased prevalence of DED in women (OR 1.48; 95 % CI 1.30-1.88), those ≥60 years of age (OR 1.99; 95 % CI 1.60-2.81), those who had undergone refractive surgery (OR 1.79; 95 % CI 1.50-2.59), those having undergone acne treatment (OR 1.51; 95 % CI 1.34-1.97), contact lens wearers (OR 1.77; 95 % CI 1.40-2.48), those having taken antiallergy drugs (OR 2.23; 95 % CI 1.55-2.78) or antidepressants (OR 1.60; 95 % CI 1.14-2.44), and those who reported computer use of >6 h per day (OR 1.66; 95 % CI 1.41-2.52). CONCLUSION Dry eye is a common disease among the Saudi Arabian population. Prevalence is found to be high and vary significantly across the country. DED could be attributed to dry weather, low annual rainfall, low humidity, widespread use of air conditioners, air pollution, high temperature, and exposure to sunlight.
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Affiliation(s)
- Saleh A Alkhaldi
- Department of Ophthalmology, King Saud Medical City, Riyadh, Saudi Arabia
| | - Khalid H Allam
- Department of Ophthalmology, King Saud Medical City, Riyadh, Saudi Arabia
| | - Mohammed A Radwan
- Department of Ophthalmology, King Saud Medical City, Riyadh, Saudi Arabia; College of Medicine, Cairo University, Cairo, Egypt
| | - Laura E Sweeney
- Department of Vision Sciences, Glasgow Caledonian University, Glasgow, United Kingdom
| | - Saleh Alshammeri
- Department of Optometry, College of Applied Medical Sciences, Qassim University, Saudi Arabia.
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22
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Nagino K, Okumura Y, Yamaguchi M, Sung J, Nagao M, Fujio K, Akasaki Y, Huang T, Hirosawa K, Iwagami M, Midorikawa-Inomata A, Fujimoto K, Eguchi A, Okajima Y, Kakisu K, Tei Y, Yamaguchi T, Tomida D, Fukui M, Yagi-Yaguchi Y, Hori Y, Shimazaki J, Nojiri S, Morooka Y, Yee A, Miura M, Ohno M, Inomata T. Diagnostic Ability of a Smartphone App for Dry Eye Disease: Protocol for a Multicenter, Open-Label, Prospective, and Cross-sectional Study. JMIR Res Protoc 2023; 12:e45218. [PMID: 36912872 PMCID: PMC10131757 DOI: 10.2196/45218] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/31/2023] [Accepted: 01/31/2023] [Indexed: 03/14/2023] Open
Abstract
BACKGROUND Dry eye disease (DED) is one of the most common ocular surface diseases. Numerous patients with DED remain undiagnosed and inadequately treated, experiencing various subjective symptoms and a decrease in quality of life and work productivity. A mobile health smartphone app, namely, the DEA01, has been developed as a noninvasive, noncontact, and remote screening device, in the context of an ongoing paradigm shift in the health care system, to facilitate a diagnosis of DED. OBJECTIVE This study aimed to evaluate the capabilities of the DEA01 smartphone app to facilitate a DED diagnosis. METHODS In this multicenter, open-label, prospective, and cross-sectional study, the test method will involve using the DEA01 smartphone app to collect and evaluate DED symptoms, based on the Japanese version of the Ocular Surface Disease Index (J-OSDI), and to measure the maximum blink interval (MBI). The standard method will then involve a paper-based J-OSDI evaluation of subjective symptoms of DED and tear film breakup time (TFBUT) measurement in an in-person encounter. We will allocate 220 patients to DED and non-DED groups, based on the standard method. The primary outcome will be the sensitivity and specificity of the DED diagnosis according to the test method. Secondary outcomes will be the validity and reliability of the test method. The concordance rate, positive and negative predictive values, and the likelihood ratio between the test and standard methods will be assessed. The area under the curve of the test method will be evaluated using a receiver operating characteristic curve. The internal consistency of the app-based J-OSDI and the correlation between the app-based J-OSDI and paper-based J-OSDI will be assessed. A DED diagnosis cutoff value for the app-based MBI will be determined using a receiver operating characteristic curve. The app-based MBI will be assessed to determine a correlation between a slit lamp-based MBI and TFBUT. Adverse events and DEA01 failure data will be collected. Operability and usability will be assessed using a 5-point Likert scale questionnaire. RESULTS Patient enrollment will start in February 2023 and end in July 2023. The findings will be analyzed in August 2023, and the results will be reported from March 2024 onward. CONCLUSIONS This study may have implications in identifying a noninvasive, noncontact route to facilitate a diagnosis of DED. The DEA01 may enable a comprehensive diagnostic evaluation within a telemedicine setting and facilitate early intervention for undiagnosed patients with DED confronting health care access barriers. TRIAL REGISTRATION Japan Registry of Clinical Trials jRCTs032220524; https://jrct.niph.go.jp/latest-detail/jRCTs032220524. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/45218.
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Affiliation(s)
- Ken Nagino
- Department of Hospital Administration, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Department of Digital Medicine, 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
| | - Masahiro Yamaguchi
- Department of Ophthalmology, 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, United States
| | - Masashi Nagao
- Department of Orthopedics, Juntendo University Faculty of Medicine, Tokyo, Japan.,Medical Technology Innovation Center, Juntendo University, Tokyo, Japan.,Graduate School of Health and Sports Science, Juntendo University, 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
| | - 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
| | - 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
| | - 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
| | - 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
| | - Atsuko Eguchi
- Department of Hospital Administration, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yukinobu Okajima
- Department of Ophthalmology, Toho University Omori Medical Center, Tokyo, Japan
| | - Koji Kakisu
- Department of Ophthalmology, Toho University Omori Medical Center, Tokyo, Japan
| | - Yuto Tei
- Department of Ophthalmology, Toho University Omori Medical Center, Tokyo, Japan
| | - Takefumi Yamaguchi
- Department of Ophthalmology, Tokyo Dental College Ichikawa General Hospital, Chiba, Japan
| | - Daisuke Tomida
- Department of Ophthalmology, Tokyo Dental College Ichikawa General Hospital, Chiba, Japan
| | - Masaki Fukui
- Department of Ophthalmology, Tokyo Dental College Ichikawa General Hospital, Chiba, Japan
| | - Yukari Yagi-Yaguchi
- Department of Ophthalmology, Tokyo Dental College Ichikawa General Hospital, Chiba, Japan
| | - Yuichi Hori
- Department of Ophthalmology, Toho University Omori Medical Center, Tokyo, Japan
| | - Jun Shimazaki
- Department of Ophthalmology, Tokyo Dental College Ichikawa General Hospital, Chiba, Japan
| | - Shuko Nojiri
- Medical Technology Innovation Center, Juntendo University, 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
| | - Alan Yee
- 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
| | - Takenori Inomata
- Department of Hospital Administration, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.,AI Incubation Farm, Juntendo University Graduate School of Medicine, Tokyo, Japan
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23
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Sánchez-Brau M, Seguí-Crespo M, Cantó-Sancho N, Tauste A, Ramada JM. What Are the Dry Eye Questionnaires Available in the Scientific Literature Used for? A Scoping Review. Am J Ophthalmol 2023; 246:174-191. [PMID: 36336073 DOI: 10.1016/j.ajo.2022.10.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 10/21/2022] [Accepted: 10/24/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE Dry eye disease (DED) is a frequent chronic ophthalmic condition. Its diagnosis includes tests and patient reported outcomes (PRO) questionnaires. Although many PRO dry eye questionnaires (PRO-DEQs) are available, they differ greatly from each other and not all have been validated. The purpose of this study was to retrieve the PRO-DEQs present in the scientific literature by performing a descriptive analysis of them and identifying those with known validity and reliability characteristics and to perform a descriptive analysis of the geographic area, year of publication, and characteristics of the target population of the clinical studies that have used validated PRO-DEQs. DESIGN Scoping review of the literature. METHODS Searches were conducted in PubMed to retrieve PRO-DEQs published up to July 2018 and written in English, French, Italian or Spanish. RESULTS One thousand six hundred two records were identified and 973 were included in the final analysis. Of these, 56 provided information on the design and validation of PRO-DEQs and 49 PRO-DEQs were identified. Twenty-two PRO-DEQs were validated (17 original and 5 modified) and 27 had no associated design, validity, and reliability studies. Most of the validated PRO-DEQs were designed in English, the number of items varies from 1 to 57, the dimensions are generally not specified, and they are self-administered. The greatest use of validated PRO-DEQs in clinical studies has been in Asia since 2010, with the Ocular Surface Disease Index being the most used. These questionnaires have been used mostly in adults, retired professionals, and people with visual diseases to diagnose DED. CONCLUSIONS This study aims to encourage the use of validated PRO-DEQs to guarantee the quality of the results obtained and the comparability and replicability among studies.
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Affiliation(s)
- Mar Sánchez-Brau
- Doctoral Programme in Health Sciences (M.S-B., N.C-S.), University of Alicante, San Vicente del Raspeig, Spain
| | - Mar Seguí-Crespo
- Department of Optics, Pharmacology and Anatomy (M.S-C., N.C-S.), University of Alicante, San Vicente del Raspeig, Spain; Public Health Research Group (M.S-C.), University of Alicante, San Vicente del Raspeig, Spain.
| | - Natalia Cantó-Sancho
- Doctoral Programme in Health Sciences (M.S-B., N.C-S.), University of Alicante, San Vicente del Raspeig, Spain; Department of Optics, Pharmacology and Anatomy (M.S-C., N.C-S.), University of Alicante, San Vicente del Raspeig, Spain
| | - Ana Tauste
- Department of Optics, Optometry and Vision Sciences (A.T.), University of Valencia, Valencia, Spain
| | - José María Ramada
- Institut Hospital del Mar d'Investigacions Mèdiques (J.M.R.), Barcelona, Spain; CIBER of Epidemiology and Public Health (J.M.R.), Madrid, Spain
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24
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INOMATA TAKENORI, SUNG JAEMYOUNG, YEE ALAN, MURAKAMI AKIRA, OKUMURA YUICHI, NAGINO KEN, FUJIO KENTA, AKASAKI YASUTSUGU, MIDORIKAWA-INOMATA AKIE, EGUCHI ATSUKO, FUJIMOTO KEIICHI, HUANG TIANXIANG, MOROOKA YUKI, MIURA MARIA, SHOKIROVA HURRAMHON, HIROSAWA KUNIHIKO, OHNO MIZU, KOBAYASHI HIROYUKI. P4 Medicine for Heterogeneity of Dry Eye: A Mobile Health-based Digital Cohort Study. JUNTENDO IJI ZASSHI = JUNTENDO MEDICAL JOURNAL 2023; 69:2-13. [PMID: 38854846 PMCID: PMC11153075 DOI: 10.14789/jmj.jmj22-0032-r] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 10/11/2022] [Indexed: 06/11/2024]
Abstract
During the 5th Science, Technology, and Innovation Basic Plan, the Japanese government proposed a novel societal concept -Society 5.0- that promoted a healthcare system characterized by its capability to provide unintrusive, predictive, longitudinal care through the integration of cyber and physical space. The role of Society 5.0 in managing our quality of vision will become more important in the modern digitalized and aging society, both of which are known risk factors for developing dry eye. Dry eye is the most common ocular surface disease encountered in Japan with symptoms including increased dryness, eye discomfort, and decreased visual acuity. Owing to its complexity, implementation of P4 (predictive, preventive, personalized, participatory) medicine in managing dry eye requires a comprehensive understanding of its pathology, as well as a strategy to visualize and stratify its risk factors. Using DryEyeRhythm®, a mobile health (mHealth) smartphone software (app), we established a route to collect holistic medical big data on dry eye, such as the subjective symptoms and lifestyle data for each individual. The studies to date aided in determining the risk factors for severe dry eye, the association between major depressive disorder and dry eye exacerbation, eye drop treatment adherence, app-based stratification algorithms based on symptomology, blink detection biosensoring as a dry eye-related digital phenotype, and effectiveness of app-based dry eye diagnosis support compared to traditional methods. These results contribute to elucidating disease pathophysiology and promoting preventive and effective measures to counteract dry eye through mHealth.
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Affiliation(s)
- TAKENORI INOMATA
- Corresponding author: Takenori Inomata, Juntendo University Graduate School of Medicine, Department of Ophthalmology, 2-1-1 Hongo, Bunkyo-ku, Tokyo. 113-8431, Japan, TEL: +81-3-5802-1228 FAX: +81-3-5689-0394 E-mail:
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25
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Tappeiner C, Heiligenhaus A, Halter JP, Miserocchi E, Bandello F, Goldblum D. Challenges and concepts in the diagnosis and management of ocular graft-versus-host disease. Front Med (Lausanne) 2023; 10:1133381. [PMID: 36891189 PMCID: PMC9987249 DOI: 10.3389/fmed.2023.1133381] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 01/18/2023] [Indexed: 02/19/2023] Open
Abstract
Graft-versus-host disease (GVHD) is characterized by tissue inflammation in the host following an allogeneic hematopoietic cell transplantation (HCT). The pathophysiology is complex and only incompletely understood yet. Donor lymphocyte interaction with the histocompatibility antigens of the host plays a crucial role in the pathogenesis of the disease. Inflammation may affect multiple organs and tissues, e.g., the gastrointestinal tract, liver, lung, fasciae, vaginal mucosa, and the eye. Subsequently, alloreactive donor-derived T and B lymphocytes may lead to severe inflammation of the ocular surface (i.e., cornea and conjunctiva) and the eyelids. Furthermore, fibrosis of the lacrimal gland may lead to severe dry eye. This review focuses on ocular GVHD (oGVHD) and provides an overview of current challenges and concepts in the diagnosis and management of oGVHD. Ophthalmic manifestations, diagnostic procedures, grading of severity and recommendations for ophthalmic examination intervals are provided. Management of ocular surface disease with lubricants, autologous serum eye drops, topical anti-inflammatory agents and systemic treatment options are described based on the current evidence. Ocular surface scarring and corneal perforation are severe complications of oGVHD. Therefore, ophthalmic screening and interdisciplinary treatment approaches are highly relevant to improve the quality of life of patients and to prevent potentially irreversible visual loss.
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Affiliation(s)
- Christoph Tappeiner
- Department of Ophthalmology, Pallas Klinik, Olten, Switzerland.,Department of Ophthalmology, University Hospital Essen, University Duisburg-Essen, Essen, Germany.,Department of Ophthalmology, San Raffaele Scientific Institute, University Vita-Salute, Milan, Italy.,Faculty of Medicine, University of Bern, Bern, Switzerland
| | - Arnd Heiligenhaus
- Department of Ophthalmology at St. Franziskus Hospital, Muenster, Germany
| | - Joerg P Halter
- Department of Hematology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Elisabetta Miserocchi
- Department of Ophthalmology, San Raffaele Scientific Institute, University Vita-Salute, Milan, Italy
| | - Francesco Bandello
- Department of Ophthalmology, San Raffaele Scientific Institute, University Vita-Salute, Milan, Italy
| | - David Goldblum
- Department of Ophthalmology, Pallas Klinik, Olten, Switzerland.,Faculty of Medicine, University of Basel, Basel, Switzerland
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Zhmud T, Malachkova N, Redjak R, Costagliola C, Concilio M, Drozhzhyna G, Toro Mario D, Veretelnyk S. Dry eye disease severity and impact on quality of life in type II diabetes mellitus. Front Med (Lausanne) 2023; 10:1103400. [PMID: 36923012 PMCID: PMC10009182 DOI: 10.3389/fmed.2023.1103400] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 02/07/2023] [Indexed: 03/03/2023] Open
Abstract
Aim To assess the severity of dry eye disease (DED) in humans, its impact on quality of life (QoL) and to grade the damage incurred by the anterior ocular surface in patients diagnosed with type 2 diabetes mellitus (T2DM). Patients and methods Forty-six patients (mean age ± SD = 63.8 ± 6.7 years) diagnosed with T2DM were enrolled in the experimental group and 26 healthy individuals constituted the control group (67.9 ± 8.9 years). The diagnosis and gradation of DED were conducted in accordance with the International Task Force severity grading scheme. Disease-specific questionnaires were used to obtain the Ocular Surface Disease Index (OSDI) and assess the negative effects of the disease on the patient's QoL. The severity of conjunctival redness and corneal/conjunctival staining was assessed by Efron and Oxford scales, respectively. Results According to OSDI scores, the entire experimental group presented symptoms of DED: 54.4% were diagnosed with mild DED and 46.6% with moderately severe DED. No cases of severe DED were diagnosed in either the experimental or control group. In the control group, 57.7% of individuals did not have the disease. A significant difference between the experimental and control groups was recorded for both OSDI scores (p < 0.01) and health-related QoL (p < 0.01). It was observed that keratopathy influenced the mean OSDI values of patients. The mean OSDI value was 25.14 ± 3 in the experimental group diagnosed with keratopathy, 19.3 ± 3.5 in the subgroup with no indications of corneal injury (p = 0.000002), and 13.0 ± 3.0 in the control group (p < 0.000002). Based on the DEWS scheme, a grade I severity level was observed in 46% of control subjects and 33% of patients diagnosed with T2DM (p = 0.4915); grades II and III were detected in the bulk of the experimental group (p = 0.0051; p = 0.1707). None of the subjects in the control or experimental groups manifested grade IV severity of DED. Conclusion In comparison to healthy adults, DED adversely impacts the QoL of type 2 DM patients, regardless of the disease's association with keratopathy.
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Affiliation(s)
- Tetiana Zhmud
- Department of Ophthalmology, National Pirogov Memorial Medical University, Vinnytsia, Ukraine
| | - Natalia Malachkova
- Department of Ophthalmology, National Pirogov Memorial Medical University, Vinnytsia, Ukraine
| | - Robert Redjak
- Department of General and Pediatric Ophthalmology, Medical University of Lublin, Lublin, Poland
| | - Ciro Costagliola
- Eye Clinic, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy
| | - Marina Concilio
- Department of Medicine and Health Sciences "V. Tiberio", University of Molise, Campobasso, Italy
| | - Galyna Drozhzhyna
- Department of Corneal Pathology, SI "Filatov Institute of Eye Diseases and Tissue Therapy of the NAMS of Ukraine", Odesa, Ukraine
| | - Damiano Toro Mario
- Department of General and Pediatric Ophthalmology, Medical University of Lublin, Lublin, Poland.,Eye Clinic, Public Health Department, University of Naples Federico II, Naples, Italy
| | - Svitlana Veretelnyk
- Department of Ophthalmology, National Pirogov Memorial Medical University, Vinnytsia, Ukraine
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Muacevic A, Adler JR, Ganji V, Mali KR, Yadav K, Patnaik N, Morya AK. Face Mask in COVID-19 and Its Association With Dry Eye Disease: A Cross-Sectional Study. Cureus 2022; 14:e32937. [PMID: 36712728 PMCID: PMC9873484 DOI: 10.7759/cureus.32937] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/25/2022] [Indexed: 12/27/2022] Open
Abstract
AIM To determine whether wearing a face mask for more than three to six hours/day leads to the new onset of symptoms or worsening of pre-existing dry eye disease (DED) in healthcare workers (HCWs) of our institute. METHODOLOGY An observational cross-sectional study, where 114 HCWs using face masks regularly participated voluntarily in the study. A survey with a modified Ocular Surface Disease Index (OSDI) questionnaire was completed by participants. They were divided into groups based on their sex, age, how long they had been wearing face masks, and whether they had a history of DED. RESULTS We found that for HCWs who had previously experienced DED and who were under the age of 40, wearing a face mask for more than three to six hours/day could contribute to or worsen symptoms of DED. Also, we observed that the N-95 mask has a higher chance of causing DED than surgical masks. CONCLUSION Medical professionals need to be aware of any potential dry eye symptoms related to the prolonged use of a face mask. Additional consideration should be given to patients who already have DED. The possible concerns that incorrectly fitted facemasks may cause to the health of their ocular surface should be discussed with patients by ophthalmologists. Future research involving larger populations will shed light on the prevalence and scope of the mask-associated dry eye problem.
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Barrio AR, González-Pérez M, Heredia-Pastor C, Enríquez-Fuentes J, Antona B. Spanish Cross-Cultural Adaptation, Rasch Analysis and Validation of the Ocular Comfort Index (OCI) Questionnaire. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15142. [PMID: 36429862 PMCID: PMC9690133 DOI: 10.3390/ijerph192215142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 11/14/2022] [Accepted: 11/15/2022] [Indexed: 06/16/2023]
Abstract
The Ocular Comfort Index (OCI) assesses ocular surface irritation and grades the severity of dry eye disease. This study sought to adapt the OCI questionnaire into Spanish, and then to assess the psychometric performance and validity of the new adapted version (OCI-versión española, OCIVE). The questionnaire was translated, back translated, and then cross-culturally adapted for use with Spanish-speaking individuals. The OCIVE was completed by 450 participants, including 53 subjects that were diagnosed with dry eye disease. Through a Rasch analysis, the psychometric properties of item fit, targeting, person separation, reliability, and differential item functioning (DIF) were assessed. To test the convergent validity, we examined the correlation between the OCIVE and the Computer Vision Symptom Scale (CVSS17). Validity was tested in a subgroup of participants with and without dry eye, and test-retest repeatability was determined in a subset of 151 individuals. We also compared, via DIF, the performance of the OCIVE with that of the original OCI. Our Rasch analysis revealed a good model fit, high accuracy, good targeting, unidimensionality, and no DIF according to gender. The validity and repeatability were good. The OCIVE shows comparable psychometric properties to the original English version, making it a valid tool for measuring dry eye symptoms in Spanish adults.
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Affiliation(s)
- Ana Rosa Barrio
- Optics and Optometry Department, Faculty of Optics and Optometry, Complutense University of Madrid, 28037 Madrid, Spain
- Applied Vision Research Group, Faculty of Optics and Optometry, Complutense University of Madrid, 28037 Madrid, Spain
| | - Mariano González-Pérez
- Optics and Optometry Department, Faculty of Optics and Optometry, Complutense University of Madrid, 28037 Madrid, Spain
| | | | | | - Beatriz Antona
- Optics and Optometry Department, Faculty of Optics and Optometry, Complutense University of Madrid, 28037 Madrid, Spain
- Applied Vision Research Group, Faculty of Optics and Optometry, Complutense University of Madrid, 28037 Madrid, Spain
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Tatti F, Mangoni L, Pirodda S, Demarinis G, Iovino C, Siotto Pintor E, Orrù G, Lecca LI, Campagna M, Denotti G, Peiretti E. Ocular Surface Changes Associated with Face Masks in Healthcare Personnel during COVID-19 Pandemic. Life (Basel) 2022; 12:1491. [PMID: 36294925 PMCID: PMC9604707 DOI: 10.3390/life12101491] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/20/2022] [Accepted: 09/21/2022] [Indexed: 02/23/2024] Open
Abstract
The aim of this study was to investigate ocular surface changes associated with face mask (FMs) use of healthcare personnel during the COVID-19 pandemic. We prospectively evaluated 200 eyes of 100 individuals during working hours and 40 eyes of 20 individuals during their rest days as a control group. Dry eye symptoms were assessed with the Ocular Surface Disease Index (OSDI) and McMonnies questionnaire. The clinical investigation included the best corrected visual acuity (BCVA), corneal fluorescein staining (FS), break-up time (BUT), and Schirmer test I before and after a 7-h work shift with a continuative use of surgical or N95 masks. The control group was evaluated similarly twice a day, at 8:00 a.m. and at 3:00 p.m.. In the study group, BCVA, FS, BUT, and Schirmer test were investigated and there was a significant negative variation at the end of the shift. On the contrary, the control group did not show significant variations of any clinical feature. Furthermore, no significant changes in clinical parameters were observed during the use of surgical or N95 masks. In conclusion, FMs continuative use resulted in daily ocular surface modifications specifically in healthcare personnel.
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Affiliation(s)
- Filippo Tatti
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, 09124 Cagliari, Italy
| | - Lorenzo Mangoni
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, 09124 Cagliari, Italy
| | - Simone Pirodda
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, 09124 Cagliari, Italy
| | - Giuseppe Demarinis
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, 09124 Cagliari, Italy
| | - Claudio Iovino
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, 09124 Cagliari, Italy
- Multidisciplinary Department of Medical, Surgical and Dental Sciences, Eye Clinic, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
| | - Emanuele Siotto Pintor
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, 09124 Cagliari, Italy
| | - Germano Orrù
- Molecular Biology Service Lab, Department of Surgical Science, University of Cagliari, 09124 Cagliari, Italy
| | - Luigi Isaia Lecca
- Division of Occupational Medicine, Department of Medical Sciences and Public Health, University of Cagliari, 09042 Monserrato, Italy
| | - Marcello Campagna
- Division of Occupational Medicine, Department of Medical Sciences and Public Health, University of Cagliari, 09042 Monserrato, Italy
| | - Gloria Denotti
- Department of Surgical Science, Institute of Dentistry, University of Cagliari, 09124 Cagliari, Italy
| | - Enrico Peiretti
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, 09124 Cagliari, Italy
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Aljarousha M, Badarudin NE, Che Azemin MZ, Aljeesh Y, Amer A, Abdul Rahim MAS. The validity and reliability of the Arabic version of the ocular surface disease index (OSDI) questionnaire in a sample of the Gazan population: a study from Palestine. Int Ophthalmol 2022; 43:1303-1316. [PMID: 36156181 DOI: 10.1007/s10792-022-02528-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 09/11/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE To develop an Arabic version of OSDI for the Gazan population. METHODS A cross-sectional observational study was conducted using a convenience sample technique. The translation procedure included five stages: forward translation, revision of translation, backward translation, refinement of translation, and a final test of the pre-final version. The final sets of questionnaires were constructed using an online JotForm platform. The online platform was chosen to automatically calculate the questionnaire's final overall score. Overall, 260 participants were instructed to fill out the English and the Arab-OSDI version twice to conduct the reliability of the translated version and repeatability evaluation. RESULTS The mean age of the participants was 33.45 ± 11.74 years old. Cronbach's alpha for all items was greater than 0.80, except for the "blurred vision" and "deteriorating vision" items (0.77 and 0.74, respectively). The mean overall score difference between the English-OSDI and Arab-OSDI was 0.86 based on the Bland-Altman chart. For repeatability, no significant difference in the overall scores between the two repeats of the Arab-OSDI (p = 0.632). The Arab-OSDI overall score (sessions 1 and 2) has a clinical difference (bias) of 0.21. Using the varimax rotation method, only three factors (ocular symptoms, vision-related function, and environmental triggers) had eigenvalues greater than one in the structure of the Arab-OSDI. CONCLUSION The Arab-OSDI is an appropriate, reliable, and repeatable tool for the determination of dry eye symptoms, ocular discomfort, and quality of life in the Gazan population. This version could remove the language barrier in answering OSDI items more easily.
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Affiliation(s)
- Mohammed Aljarousha
- Department of Optometry and Visual Science, Kulliyyah of Allied Health Sciences, International Islamic University Malaysia, Bandar Indera Mahkota, 25200, Kuantan, Pahang, Malaysia
- Department of Optometry, Faculty of Health Science, Islamic University-Gaza, Gaza, Palestine
- Department of Optometry, European Gaza Hospital, Gaza, Palestine
| | - Noor Ezailina Badarudin
- Department of Optometry and Visual Science, Kulliyyah of Allied Health Sciences, International Islamic University Malaysia, Bandar Indera Mahkota, 25200, Kuantan, Pahang, Malaysia
| | - Mohd Zulfaezal Che Azemin
- Department of Optometry and Visual Science, Kulliyyah of Allied Health Sciences, International Islamic University Malaysia, Bandar Indera Mahkota, 25200, Kuantan, Pahang, Malaysia.
| | - Yousef Aljeesh
- College of Nursing, Islamic University-Gaza, Gaza, Palestine
| | - Abuimara Amer
- Department of Optometry, Faculty of Health Science, Islamic University-Gaza, Gaza, Palestine
| | - Muhammad Afzam Shah Abdul Rahim
- Department of Optometry and Visual Science, Kulliyyah of Allied Health Sciences, International Islamic University Malaysia, Bandar Indera Mahkota, 25200, Kuantan, Pahang, Malaysia
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31
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Akasaki Y, Inomata T, Sung J, Okumura Y, Fujio K, Miura M, Hirosawa K, Iwagami M, Nakamura M, Ebihara N, Nakamura M, Ide T, Nagino K, Murakami A. Reliability and Validity of Electronic Patient-Reported Outcomes Using the Smartphone App AllerSearch for Hay Fever: Prospective Observational Study. JMIR Form Res 2022; 6:e38475. [PMID: 35998022 PMCID: PMC9449823 DOI: 10.2196/38475] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 08/08/2022] [Accepted: 08/10/2022] [Indexed: 01/20/2023] Open
Abstract
Background Hay fever is a highly prevalent, heterogenous, and multifactorial disease. Patients may benefit from longitudinal assessments using mobile health (mHealth) principles. We have previously attempted to establish an effective mHealth platform for patients with hay fever through AllerSearch, our in-house smartphone app that assesses electronic patient-reported outcomes through a questionnaire on hay fever and provides evidence-based advice. To be used by the public, an investigation on its reliability and validity is necessary. Objective The aim of this paper is to assess the reliability and validity of subjective symptom data on hay fever collected through our app, AllerSearch. Methods This study used a prospective observational design. The participants were patients aged ≥20 years recruited from a single university hospital between June 2, 2021, and January 26, 2022. We excluded patients who could not use smartphones as well as those with incomplete data records and outlier data. All participants answered the Japanese Allergic Conjunctival Disease Standard Quality of Life Questionnaire (JACQLQ), first in the paper-and-pencil format and subsequently on AllerSearch on the same day. The JACQLQ comprises the following three domains: Domain I, with 9 items on ocular or nasal symptoms; Domain II, with 17 items on daily activity and psychological well-being; and Domain III, with 3 items on overall condition by face score. The concordance rate of each domain between the 2 platforms was calculated. The internal consistency of Domains I and II of the 2 platforms was assessed using Cronbach alpha coefficients, the concurrent validity of Domains I and II was assessed by calculating Pearson correlation coefficients, and the mean differences between the 2 platforms were assessed using Bland-Altman analysis. Results In total, 22 participants were recruited; the data of 20 (91%) participants were analyzed. The average age was 65.4 (SD 12.8) years, and 80% (16/20) of the participants were women. The concordance rate of Domains I, II, and III between the paper-based and app-based JACQLQ was 0.78, 0.85, and 0.90, respectively. The internal consistency of Domains I and II between the 2 platforms was satisfactory (Cronbach alpha of .964 and .919, respectively). Pearson correlation analysis yielded a significant positive correlation between Domains I and II across the 2 platforms (r=0.920 and r=0.968, respectively). The mean difference in Domains I and II between the 2 platforms was 3.35 units (95% limits of agreement: –6.51 to 13.2). Conclusions Our findings indicate that AllerSearch is a valid and reliable tool for the collection of electronic patient-reported outcomes to assess hay fever, contributing to the advantages of the mHealth platform.
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Affiliation(s)
- 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
| | - 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
| | - 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
| | - 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
| | - 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
| | - 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
| | - Masao Iwagami
- Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Masahiro Nakamura
- Precision Health, Department of Bioengineering, Graduate School of Engineering, The University of Tokyo, Tokyo, Japan
| | - Nobuyuki Ebihara
- Department of Ophthalmology, Urayasu Hospital, Juntendo University, Chiba, Japan
| | - Masahiro Nakamura
- Department of Otorhinolaryngology, Head and Neck Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Takuma Ide
- Department of Otorhinolaryngology, Head and Neck Surgery, Juntendo University Faculty 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
| | - 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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The Effects of Lycium chinense, Cuscuta chinensis, Senna tora, Ophiopogon japonicus, and Dendrobium nobile Decoction on a Dry Eye Mouse Model. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58081134. [PMID: 36013601 PMCID: PMC9414943 DOI: 10.3390/medicina58081134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 08/06/2022] [Accepted: 08/17/2022] [Indexed: 11/22/2022]
Abstract
Background and objective: Dry eye disease (DED) is a relatively common disorder associated with abnormal tear film and the ocular surface that causes ocular irritation, dryness, visual impairment, and damage to the cornea. DED is not a life-threatening disease but causes discomfort and multifactorial disorders in vision that affect daily life. It has been reported that all traditional medicinal plants exhibit anti-inflammatory effects on several diseases. We hypothesized that the decoction ameliorated ocular irritation and decreased cytokine expression in the cornea. This study aimed to investigate the molecular mechanisms of DED and discover a therapeutic strategy to reduce corneal inflammation. Material and Methods: We used a DED mouse model with extraorbital lacrimal gland (ELG) excision and treated the mice with a decoction of five traditional medicines: Lycium chinense, Cuscuta chinensis, Senna tora, Ophiopogon japonicus, and Dendrobium nobile for 3 months. The tear osmolarity and the ocular surface staining were evaluated as indicators of DED. Immunohistochemistry was used to detect the level of inflammation on the cornea. Results: After treatment with the decoction for three months, epithelial erosions and desquamation were reduced, the intact of corneal endothelium was maintained, and tear osmolarity was restored in the eyes. The IL-1β-associated inflammatory response was reduced in the cornea in the DED model. Conclusions: These data suggested that a mixture of traditional medicines might be a novel therapy to treat DED.
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Assessment of the Effect of Wearing a Surgical Face Mask on Tear Film in Normal Eye Subjects. J Ophthalmol 2022; 2022:2484997. [PMID: 36017483 PMCID: PMC9398824 DOI: 10.1155/2022/2484997] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 07/28/2022] [Indexed: 11/17/2022] Open
Abstract
Purpose. To assess the effect of wearing a face mask for a short time on the tear film parameters in normal eye subjects. Methods. Fifty-four normal eye subjects (14 female and 40 male) aged 18–40 years (23.8 ± 4.4 years) were recruited. A standardized patient evaluation of eye dryness was completed first, followed by noninvasive tear break-up time, phenol red thread, and tear ferning tests. A 5-minute gap was allowed between the tests. The subjects were asked to wear a surgical mask for one hour. The measurements were taken both before wearing a face mask and immediately after its removal. Results. Significant (Wilcoxon test) differences were found between the standardized patient evaluation of eye dryness (
) and the noninvasive tear break-up time scores (
) before and after wearing face masks. No significant differences (Wilcoxon test,
) were found between the phenol red thread scores and tear ferning grades before and after wearing face masks. Strong correlations (Spearman’s rank correlation coefficient, r) were found among the standardized patient evaluation of eye dryness score (r = 0.590;
), noninvasive tear break-up time measurements (r = 0.631;
), and the tear ferning grades (r = 0.517;
) before and after wearing the mask. A medium correlation (r = 0.377;
) was found between the noninvasive tear break-up time scores and tear ferning grades before wearing the mask. Conclusions. Wearing a surgical face mask for a short duration of one hour has an effect on ocular tear film in normal eye subjects. Dry eye symptoms and tear break-up increased after wearing a face mask compared with those experienced before wearing one.
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Kucnerowicz K, Pietrzak A, Cholewiński W, Martenka P, Marszałek A, Burchardt E, Strzesak E. The quality-adjusted life-years in the oncological patients' health-related quality of life. Sci Rep 2022; 12:13562. [PMID: 35945241 PMCID: PMC9363419 DOI: 10.1038/s41598-022-17942-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 08/03/2022] [Indexed: 11/16/2022] Open
Abstract
The oncological treatment can significantly affect patients’ health-related quality of life (HRQoL), which should be monitored to ensure our patients’ well-being. The often-used HRQoL measurer is the quality-adjusted life-year (QALY) indicator of the disease burden, describing both quality and quantity of life lived. The main aim of the study was to discuss the methodology and usefulness of evaluating QALYs using the HRQoL questionnaires: EuroQoL (EQ)-5 dimensions-3 levels (EQ-5D-3L) and EQ visual analogue scale (EQ-VAS) in 32 cervical cancer patients. We obtained the questionnaire and calculated QALYs based on the Gross Domestic Product (GDP) method. In our study, the total scoring of the EQ-Index, EQ-VAS evaluation was 2620 and 2409 points, respectively, which corresponds with the QALYs value of 26.2 and 24.9, respectively. We expressed the QALYs outcome into the economic equivalent of nearly 900,000 US dollars (USD) as the total health profit for both the patients and the healthcare system. Obtaining the QALY factor can help establish the medical management’s influence on the patients’ HRQoL and improve the healthcare services to ensure the best health outcomes.
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Affiliation(s)
- Karolina Kucnerowicz
- Medical Services Records Department, Greater Poland Cancer Centre, Garbary 15, 61-866, Poznan, Poland
| | - Agata Pietrzak
- Electroradiology Department, Poznan University of Medical Sciences, Garbary 15, 61-866, Poznan, Poland. .,Nuclear Medicine Department, Greater Poland Cancer Centre, Garbary 15, 61-866, Poznan, Poland.
| | - Witold Cholewiński
- Electroradiology Department, Poznan University of Medical Sciences, Garbary 15, 61-866, Poznan, Poland
| | - Piotr Martenka
- Radiotherapy Department, Greater Poland Cancer Centre, Garbary 15, 61-866, Poznan, Poland
| | - Andrzej Marszałek
- Oncologic Pathology and Prophylaxis, Greater Poland Cancer Centre, Poznan University of Medical Sciences, Garbary 15, 61-866, Poznan, Poland
| | - Ewa Burchardt
- Electroradiology Department, Poznan University of Medical Sciences, Garbary 15, 61-866, Poznan, Poland
| | - Erwin Strzesak
- Electroradiology Department, Poznan University of Medical Sciences, Garbary 15, 61-866, Poznan, Poland
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Changes in the tear film and meibomian gland morphology between preclinical dry eye and normal subjects represented by ocular surface disease index scores. Exp Eye Res 2022; 222:109188. [PMID: 35841949 DOI: 10.1016/j.exer.2022.109188] [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: 03/16/2022] [Revised: 06/15/2022] [Accepted: 07/05/2022] [Indexed: 11/22/2022]
Abstract
Tear film and MG morphology play an essential role in detecting dry eyes and Meibomian Gland Dysfunction (MGD). Previous studies have reported these changes in cases diagnosed with dry eyes. However, it is important to study these changes among subjects with symptoms of dry eyes without signs. Hence, this study evaluated the changes in the tear film and meibomian gland (MG) morphology among subjects with pre-clinical dry eye and compared it with the normals defined by the Ocular Surface Disease Index score. One hundred and fifty subjects were enrolled in this prospective cross-sectional study. All the subjects completed the Ocular Surface Disease Index (OSDI) questionnaire and the Computer Vision Syndrome Questionnaire (CVS-Q). Tear film tests such as non-invasive break-up time (NIBUT), tear meniscus height (TMH), lipid layer pattern, Schirmer's test, and corneal staining were performed. Images were captured from both the upper and the lower eyelids to study the MG morphology. TMH, MG length, thickness, loss, and tortuosity were measured using ImageJ software. Subjects were differentiated into two groups based on an OSDI threshold score of ≥13 as preclinical dry eye and normals. Among all the subjects, 43.6% of them were categorized as pre-clinical dry eye, and 56.4% as normals. In the pre-clinical dry eye group, a significant reduction in NIBUT (Z = -2.13, p = 0.03) and MG length of the lower lid (Z = -2.58, p = 0.01) was found when compared to normals. TMH, Schirmer's test, and MG width did not vary among both groups (p > 0.05). Similarly, MG loss and tortuosity score was higher in the pre-clinical dry eye group, but did not show any statistical significance (p > 0.05). The majority of the young individuals presenting for the regular eye examination may have pre-clinical dry eye based on their OSDI scores. Hence, it is important to administer the OSDI questionnaire and perform non-invasive tests such as NIBUT and IR imaging of MG as a part of the routine eye examination.
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Preclinical study of a new matrix to help the ocular surface in dry eye disease. Exp Eye Res 2022; 222:109168. [PMID: 35777472 DOI: 10.1016/j.exer.2022.109168] [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: 04/22/2022] [Revised: 06/05/2022] [Accepted: 06/25/2022] [Indexed: 11/23/2022]
Abstract
Dry eye disease (DED), a multifactorial disease of the tears and ocular system, causes loss of tear film homeostasis with damage to the ocular surface. This study aimed to assess whether a peculiar matrix based on sodium hyaluronate (HA), xanthan gum (XNT), glycine (GLY) and betaine (BET) as osmoprotectants, could be involved in biological responses. Wound healing assay on human corneal epithelial (HCE) cells in monolayer showed a synergistic effect of the combination of HA + XNT (**p ≤ 0.01) together with an efficient extracellular matrix remodeling of the formulation in SkinEthic™ HCE 3D-model sought by integrin beta-1 (ITGβ1) expression and morphological analysis by hematoxylin and eosin (H&E), compared to a reference marketed product. The synergistic effect of HA + XNT + GLY + BET showed an antioxidant effect on HCE cells (***p ≤ 0.001). Real-time PCR analysis showed that the combination of GLY + BET seemed to ameliorate the effect exhibited by the single osmoprotectants in reducing tumor necrosis factor-alpha (TNFα, #p ≤ 0.05), interleukin-1 beta (IL1β, ####p ≤ 0.0001) and cyclooxygenases-2 (COX2, ####p ≤ 0.0001) genes in SIRC cells under hyperosmotic stress. Furthermore, pretreatment with XNT, alone and in combination (##p ≤ 0.01), reduced COX2 expression in human non-small cell lung cancer cells (A549). Finally, the formulation was well-tolerated following q.i.d. ocular administration in rabbits during a 28-day study. Due to the synergistic effect of its components, the matrix proved able to repair the ocular surface restoring cell homeostasis and to protect the ocular surface from pro-inflammatory pathways activation and oxidative damage, thus behaving as a reactive oxygen species (ROS) scavenger.
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Changing Medical Paradigm on Inflammatory Eye Disease: Technology and Its Implications for P4 Medicine. J Clin Med 2022; 11:jcm11112964. [PMID: 35683352 PMCID: PMC9181649 DOI: 10.3390/jcm11112964] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 05/23/2022] [Indexed: 12/10/2022] Open
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38
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Thein AS, Hedengran A, Azuara-Blanco A, Arita R, Cvenkel B, Gazzard G, Heegaard S, de Paiva CS, Petrovski G, Prokosch-Willing V, Utheim TP, Virgili G, Kolko M. Adverse effects and Safety in Glaucoma Patients - Agreement on Clinical Trial Outcomes for Reports on Eye Drops (ASGARD) - A Delphi Consensus Statement. Am J Ophthalmol 2022; 241:190-197. [PMID: 35594917 DOI: 10.1016/j.ajo.2022.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 05/08/2022] [Accepted: 05/09/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE The purpose of this study is to establish consensus among experts on outcomes and methods to be used in clinical trials to assess adverse effects of anti-glaucomatous eye drops. DESIGN Modified Delphi method. METHODS Clinical experts from Europe, North America, South America, the Middle East, and Asia were invited to participate in two sequential web-based surveys administered from June 27 to August 29, 2021. A total of 91 clinical experts were invited to participate. Of these, 71 (78%) experts from 23 different countries accepted the invitation and answered the first questionnaire. The importance of items was ranked using a 10-point scale (1 as not important, 10 as very important). RESULTS A total of 84 items were rated in round one by 71 participants. Of these, 68 (81%) reached consensus. In round two, 19 items, including three additional items, were rated by 53 (75%) participants. Consensus was reached in 98% of investigated items. Eight outcomes were agreed as important to assess when conducting future trials: ocular surface, dryness, epithelial damage, local adverse effects related to eye drops as reported by patients, periocular surroundings and eyelids, quality of life questionnaires, hyperemia, visual acuity, tear film, and anterior chamber inflammation. CONCLUSION We propose a consensus-based series of outcomes and assessment methods to be used in clinical trials assessing adverse effects of anti-glaucomatous eye drops. This will hopefully improve the comparability of results from future trials and thus facilitate meta-analyses and progress in this field.
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Prevalence and Characteristics of Dry Eye Disease After Cataract Surgery: A Systematic Review and Meta-Analysis. Ophthalmol Ther 2022; 11:1309-1332. [PMID: 35534685 PMCID: PMC9253209 DOI: 10.1007/s40123-022-00513-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 04/04/2022] [Indexed: 12/15/2022] Open
Abstract
Dry eye disease (DED) after cataract surgery is associated with various risk factors, while causing a wide range of heterogeneous symptoms including decreased quality of vision. This systematic review and meta-analysis aimed to determine the prevalence and characteristics of DED after cataract surgery. We searched PubMed and EMBASE and included studies on patients with DED after cataract surgery, between January 2011 and June 2020. Study-specific estimates (DED prevalence rates after cataract surgery in patients without preexisting DED) were combined using one-group meta-analysis in a random-effects model. We included 36 studies published between 2013 and 2020. We included nine of these in the meta-analysis of DED prevalence after cataract surgery. Overall 37.4% (95% CI 22.6-52.3; 206/775) of patients without preexisting DED developed DED after cataract surgery. The risk factors for DED after cataract surgery included age, female sex, systemic diseases, systemic medications, psychiatric conditions, preexisting DED, meibomian gland dysfunction, preservatives in eye drops, surgery techniques, and lifestyle. DED severity peak occurred 1 day postoperatively and persisted for at least 1-12 months following cataract surgery; therefore, consistent follow-up for DED is warranted for at least 1 month after cataract surgery. Topical administration of preservative-free diquafosol tetrasodium solution and preoperative meibomian gland treatment were effective in preventing and treating DED following cataract surgery. As more than one-third of patients develop DED after cataract surgery, careful DED management and treatment is needed after cataract surgery to improve satisfaction and vision quality.
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OSDI Questions on Daily Life Activities Allow to Detect Subclinical Dry Eye in Young Contact Lens Users. J Clin Med 2022; 11:jcm11092626. [PMID: 35566752 PMCID: PMC9101005 DOI: 10.3390/jcm11092626] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/29/2022] [Accepted: 05/02/2022] [Indexed: 02/05/2023] Open
Abstract
Dry eye disease (DED) is difficult to detect in young contact lens (CL) wearers, who usually have no signs, mild symptoms and an ocular surface disease index (OSDI) below the DED diagnosis values (OSDI ≥ 13). We investigate if some of the 12 OSDI questions (OSDI A—ocular symptoms; OSDI B—vision-related functionality; OSDI C—environmental triggers) contribute the most to classify young CL as symptomatic. TBUT and tear volume are also measured. Age, gender and refraction error-matched eye glasses (EG) wearers participated as the control. CL and EG data were compared with t-test and z-test. Confusion matrices and logistic correlation analyses were performed to define the contribution of each OSDI question to classify symptomatic subjects. OSDI classified symptomatic CL better than the tear volume or TBUT values. In CL, only OSDI B and C values were significantly higher in symptomatic vs. asymptomatic subjects (p < 0.001), while values of all twelve OSDI questions were significantly higher in symptomatic vs. asymptomatic EG (p < 0.05−0.001). All OSDI questions contribute equally to identify symptomatic EG, while only OSDI B questions on daily life visual functions are significant to classify symptomatic CL wearers at risk to develop DED or at a subclinical stage. CL wearers scoring ≥ 2 on the OSDI B questions should be considered for preventive treatments, even if their clinical sings are scarce or absent.
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41
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Rolando M, Merayo-Lloves J. Management Strategies for Evaporative Dry Eye Disease and Future Perspective. Curr Eye Res 2022; 47:813-823. [PMID: 35521685 DOI: 10.1080/02713683.2022.2039205] [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: 11/03/2022]
Abstract
Dry eye disease (DED) is a common disorder that remains challenging from a clinical perspective. Unstable or deficient tear film is a major factor contributing to DED and the inability to resolve the loss of tear film homeostasis that accompanies DED can result in a vicious circle of inflammation and treatment-refractory disease. Recently recognized as a multifactorial disease, the main etiological subtypes of DED are aqueous-deficient and evaporative which exist on a continuum, although evaporative dry eye (EDE) is the more frequent classification. Although attaining greater recognition in recent years, there is currently no consensus and no clear recommendation on how to manage EDE. Clarity on the early diagnosis and treatment of EDE may facilitate the avoidance of progression to chronic inflammation, permanent damage to the ocular surface, and treatment-refractory disease. The purpose of this review was to identify current best practice for management of EDE in order to help clinicians in providing accurate diagnosis and optimized treatment. We summarize recent literature considering the role of the lipid layer on tear film stability, the importance of its composition and of its dynamic behavior, and the link between its malfunction and the insurgence and maintenance of tear film-related diseases. We have provided an assessment of the best management of lipid-deficient EDE based upon an understanding of disease pathophysiology, while indicating the flow of current treatments and possible future evolution of treatment approaches. Lipid containing eye drops may be considered as a step closer to natural tears from artificial aqueous tears because they more closely mimic the aqueous and lipid layers and may be used in combination with other management approaches. As a next step, we recommend working with a wider expert group to develop full guidelines to enable patient-centered management of EDE. Key pointsDry eye is a multifactorial disease of variable presentation with the tendency to become a chronic disease for which it is essential to identify and treat the main pathogenic mechanisms involved and tailor the treatment to the individual patient.Early intervention is needed to prevent the vicious cycle of DED and may require a multi-faceted management approach.EDE is not just a problem of MGD but can be the result of anything affecting blinking, mucin spreading, aqueous layer volume and content.Lipid-containing eye drops may provide significant relief of symptoms by improving the lipid layer and its spreading ability and, as such, are an appropriate component of the overall management of lipid-deficient EDE; natural lipid-containing eye drops should be the preferred treatment.
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Affiliation(s)
| | - Jesús Merayo-Lloves
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica & Universidad de Oviedo, Oviedo, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain
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42
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Okumura Y, Inomata T, Midorikawa-Inomata A, Sung J, Fujio K, Akasaki Y, Nakamura M, Iwagami M, Fujimoto K, Eguchi A, Miura M, Nagino K, Hirosawa K, Huang T, Kuwahara M, Dana R, Murakami A. DryEyeRhythm: A reliable and valid smartphone application for the diagnosis assistance of dry eye. Ocul Surf 2022; 25:19-25. [PMID: 35483601 DOI: 10.1016/j.jtos.2022.04.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 04/14/2022] [Accepted: 04/19/2022] [Indexed: 12/22/2022]
Abstract
PURPOSE Undiagnosed or inadequately treated dry eye disease (DED) decreases the quality of life. We aimed to investigate the reliability, validity, and feasibility of the DryEyeRhythm smartphone application (app) for the diagnosis assistance of DED. METHODS This prospective, cross-sectional, observational, single-center study recruited 82 participants (42 with DED) aged ≥20 years (July 2020-May 2021). Patients with a history of eyelid disorder, ptosis, mental disease, Parkinson's disease, or any other disease affecting blinking were excluded. Participants underwent DED examinations, including the Japanese version of the Ocular Surface Disease Index (J-OSDI) and maximum blink interval (MBI). We analyzed their app-based J-OSDI and MBI results. Internal consistency reliability and concurrent validity were evaluated using Cronbach's alpha coefficients and Pearson's test, respectively. The discriminant validity of the app-based DED diagnosis was assessed by comparing the results of the clinical-based J-OSDI and MBI. The app feasibility and screening performance were evaluated using the precision rate and receiver operating characteristic curve analysis. RESULTS The app-based J-OSDI showed good internal consistency (Cronbach's α = 0.874). The app-based J-OSDI and MBI were positively correlated with their clinical-based counterparts (r = 0.891 and r = 0.329, respectively). Discriminant validity of the app-based J-OSDI and MBI yielded significantly higher total scores for the DED cohort (8.6 ± 9.3 vs. 28.4 ± 14.9, P < 0.001; 19.0 ± 11.1 vs. 13.2 ± 9.3, P < 0.001). The app's positive and negative predictive values were 91.3% and 69.1%, respectively. The area under the curve (95% confidence interval) was 0.910 (0.846-0.973) with concurrent use of the app-based J-OSDI and MBI. CONCLUSIONS DryEyeRhythm app is a novel, non-invasive, reliable, and valid instrument for assessing DED.
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Affiliation(s)
- Yuichi Okumura
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Strategic Operating Room Management and Improvement, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Takenori Inomata
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Strategic Operating Room Management and Improvement, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Hospital Administration, Juntendo University Graduate School of Medicine, Tokyo, Japan.
| | - Akie Midorikawa-Inomata
- Department of Hospital Administration, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Jaemyoung Sung
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kenta Fujio
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yasutsugu Akasaki
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Masahiro Nakamura
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan; Precision Health, Department of Bioengineering, 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
| | - Keiichi Fujimoto
- Department of Digital Medicine, Juntendo University Graduate School 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
| | - Maria Miura
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan; 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
| | - Kunihiko Hirosawa
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Tianxiang Huang
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Mizu Kuwahara
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Reza Dana
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - Akira Murakami
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
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Inomata T, Nakamura M, Sung J, Midorikawa-Inomata A, Iwagami M, Fujio K, Akasaki Y, Okumura Y, Fujimoto K, Eguchi A, Miura M, Nagino K, Shokirova H, Zhu J, Kuwahara M, Hirosawa K, Dana R, Murakami A. Smartphone-based digital phenotyping for dry eye toward P4 medicine: a crowdsourced cross-sectional study. NPJ Digit Med 2021; 4:171. [PMID: 34931013 PMCID: PMC8688467 DOI: 10.1038/s41746-021-00540-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 11/28/2021] [Indexed: 01/01/2023] Open
Abstract
Multidimensional integrative data analysis of digital phenotyping is crucial for elucidating the pathologies of multifactorial and heterogeneous diseases, such as the dry eye (DE). This crowdsourced cross-sectional study explored a novel smartphone-based digital phenotyping strategy to stratify and visualize the heterogenous DE symptoms into distinct subgroups. Multidimensional integrative data were collected from 3,593 participants between November 2016 and September 2019. Dimension reduction via Uniform Manifold Approximation and Projection stratified the collected data into seven clusters of symptomatic DE. Symptom profiles and risk factors in each cluster were identified by hierarchical heatmaps and multivariate logistic regressions. Stratified DE subgroups were visualized by chord diagrams, co-occurrence networks, and Circos plot analyses to improve interpretability. Maximum blink interval was reduced in clusters 1, 2, and 5 compared to non-symptomatic DE. Clusters 1 and 5 had severe DE symptoms. A data-driven multidimensional analysis with digital phenotyping may establish predictive, preventive, personalized, and participatory medicine.
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Affiliation(s)
- Takenori Inomata
- Juntendo University Graduate School of Medicine, Department of Ophthalmology, Tokyo, Japan. .,Juntendo University Graduate School of Medicine, Department of Strategic Operating Room Management and Improvement, Tokyo, Japan. .,Juntendo University Graduate School of Medicine, Department of Hospital Administration, Tokyo, Japan. .,Juntendo University Graduate School of Medicine, Department of Digital Medicine, Tokyo, Japan.
| | - Masahiro Nakamura
- Juntendo University Graduate School of Medicine, Department of Digital Medicine, Tokyo, Japan.,Precision Health, Department of Engineering, Graduate School of Bioengineering, The University of Tokyo, Tokyo, Japan
| | - Jaemyoung Sung
- Juntendo University Graduate School of Medicine, Department of Ophthalmology, Tokyo, Japan.,University of South Florida, Morsani College of Medicine, Tampa, FL, USA
| | - Akie Midorikawa-Inomata
- Juntendo University Graduate School of Medicine, Department of Hospital Administration, Tokyo, Japan
| | - Masao Iwagami
- Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Kenta Fujio
- Juntendo University Graduate School of Medicine, Department of Ophthalmology, Tokyo, Japan.,Juntendo University Graduate School of Medicine, Department of Digital Medicine, Tokyo, Japan
| | - Yasutsugu Akasaki
- Juntendo University Graduate School of Medicine, Department of Ophthalmology, Tokyo, Japan.,Juntendo University Graduate School of Medicine, Department of Digital Medicine, Tokyo, Japan
| | - Yuichi Okumura
- Juntendo University Graduate School of Medicine, Department of Ophthalmology, Tokyo, Japan.,Juntendo University Graduate School of Medicine, Department of Strategic Operating Room Management and Improvement, Tokyo, Japan.,Juntendo University Graduate School of Medicine, Department of Digital Medicine, Tokyo, Japan
| | - Keiichi Fujimoto
- Juntendo University Graduate School of Medicine, Department of Ophthalmology, Tokyo, Japan
| | - Atsuko Eguchi
- Juntendo University Graduate School of Medicine, Department of Hospital Administration, Tokyo, Japan
| | - Maria Miura
- Juntendo University Graduate School of Medicine, Department of Ophthalmology, Tokyo, Japan.,Juntendo University Graduate School of Medicine, Department of Digital Medicine, Tokyo, Japan
| | - Ken Nagino
- Juntendo University Graduate School of Medicine, Department of Hospital Administration, Tokyo, Japan
| | - Hurramhon Shokirova
- Juntendo University Graduate School of Medicine, Department of Ophthalmology, Tokyo, Japan
| | - Jun Zhu
- Juntendo University Graduate School of Medicine, Department of Ophthalmology, Tokyo, Japan
| | - Mizu Kuwahara
- Juntendo University Graduate School of Medicine, Department of Ophthalmology, Tokyo, Japan.,Juntendo University Graduate School of Medicine, Department of Digital Medicine, Tokyo, Japan
| | - Kunihiko Hirosawa
- Juntendo University Graduate School of Medicine, Department of Ophthalmology, Tokyo, Japan.,Juntendo University Graduate School of Medicine, Department of Digital Medicine, Tokyo, Japan
| | - Reza Dana
- Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Akira Murakami
- Juntendo University Graduate School of Medicine, Department of Ophthalmology, Tokyo, Japan.,Juntendo University Graduate School of Medicine, Department of Digital Medicine, Tokyo, Japan
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Wu J, Wu X, Zhang H, Zhang X, Zhang J, Liu Y, Liu J, Lu L, Zhang S, Zhang G, Liu L. Dry Eye Disease Among Mongolian and Han Older Adults in Grasslands of Northern China: Prevalence, Associated Factors, and Vision-Related Quality of Life. Front Med (Lausanne) 2021; 8:788545. [PMID: 34901096 PMCID: PMC8655125 DOI: 10.3389/fmed.2021.788545] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 11/01/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose: Dry eye disease (DED) is projected to have increasing public health burden in China with the aging population. No published studies on the epidemiology of DED have been found in grasslands. We estimated DED prevalence among older adults living in grasslands of northern China and investigated its associated factors and impact on vision-related quality of life (VR-QoL). Methods: A multistage cluster random sampling technique was used to select Mongolian and Han participants aged over 40 from November 2020 to May 2021 in this area. An assessment of DED was performed with Ocular Surface Disease Index (OSDI) questionnaire, Schirmer's I test (ST), and Tear film break up time (TBUT). All the participants completed the Chinese version of National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) assessing VR-QoL. Results: Of the 1,400 enumerated residents, 1,287 were examined. The overall age and gender standardized prevalence of DED was 34.5%, of which, 32.6% of Mongolian and 35.4% of Han had DED. In a multivariate model, statistically significant associations were found with advancing age [odds ratio (OR) 1.03, 95% confidence interval (CI) 1.02-1.04], female gender (OR 1.32, 95% CI 1.04-1.68), smoking (OR 0.7, 95% CI 0.5-0.98), anti-fatigue eye-drop use (OR 0.56, 95% CI 0.41-0.77), milk product intake (OR 0.55, 95% CI 0.39-0.77), number of household members (OR 0.8, 95% CI 0.72-0.88). DED was associated with lower scores on VR-QoL (β= -0.14, P < 0.01). Similar results were observed when analyses were stratified by ethnicity. Conclusions: The novelty-associated factors for DED in the grasslands area were anti-fatigue eye drop use, milk product intake, and number of household members. DED and its components were associated with VR-QoL. Further prospective studies are needed to confirm these findings.
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Affiliation(s)
- Jianhua Wu
- Inner Mongolia Chaoju Eye Hospital, Inner Mongolia Chaoju Institute of Eye Disease Control, Hohhot, China
| | - Xiaomei Wu
- Department of Clinical Epidemiology and Center of Evidence-Based Medicine, The First Hospital of China Medical University, Shenyang, China
| | - Han Zhang
- Inner Mongolia Chaoju Eye Hospital, Inner Mongolia Chaoju Institute of Eye Disease Control, Hohhot, China
| | - Xiaoguang Zhang
- Inner Mongolia Chaoju Eye Hospital, Inner Mongolia Chaoju Institute of Eye Disease Control, Hohhot, China
| | - Jie Zhang
- School of Public Health, Weifang Medical University, Weifang, China.,Tobacco Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yanqiu Liu
- Department of Ophthalmology, Anshan Central Hospital, Anshan, China
| | - Jun Liu
- Department of Ophthalmology, Changzhi People's Hospital, Changzhi, China
| | - Lu Lu
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Song Zhang
- The First Hospital of China Medical University, Shenyang, China
| | - Guisen Zhang
- Inner Mongolia Chaoju Eye Hospital, Inner Mongolia Chaoju Institute of Eye Disease Control, Hohhot, China
| | - Lei Liu
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.,School of Medicine, South China University of Technology, Guangzhou, China.,Department of Ophthalmology, The First Affiliated Hospital of China Medical University, Shenyang, China
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45
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Bakkar MM, El-Sharif AK, Al Qadire M. Validation of the Arabic version of the Ocular Surface Disease Index Questionnaire. Int J Ophthalmol 2021; 14:1595-1601. [PMID: 34667738 DOI: 10.18240/ijo.2021.10.18] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 05/17/2021] [Indexed: 11/23/2022] Open
Abstract
AIM To develop an Arabic version of the ocular surface disease index (OSDI) and to assess its reliability and validity. METHODS A cross sectional study was carried out to validate the Arabic version of the OSDI questionnaire. Initially, forward-backward translation was used to translate the English version of OSDI into Arabic. The translated questionnaire was tested for equivalence and cultural adaptability. Totally 200 subjects were then recruited from a non-clinical population and asked to complete the Arabic version of the OSDI (ARB-OSDI). The reliability of the questionnaire was assessed using Cronbach's-α. A subgroup of 30 participants was asked to complete the questionnaire on two occasions to test the test-retest reliability. RESULTS A total of 200 participants were enrolled in the study. The average age of the study participants was 31.21±13.2y and 57% were male. An acceptable internal consistency level for the ARB-OSDI questionnaire measured by Cronbach's-α was revealed. All questions showed good internal consistency. Test-retest reliability analysis revealed good stability (interclass correlation coefficient, r=0.832, P<0.001). The construct validity for the questionnaire was also high. CONCLUSION The ARB-OSDI questionnaire shows very good psychometric properties (acceptable internal consistency and test-retest reliability). That makes the questionnaire a valid potential tool to use in Arabic-speaking countries to monitor symptoms of dry eye disease in a larger population.
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Affiliation(s)
- May M Bakkar
- Department of Allied Medical Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Ahmad K El-Sharif
- Department of English Language and Literature, Faculty of Arts and Humanities, Al Al-Bayt University, Mafraq 25113, Jordan
| | - Mohammad Al Qadire
- Department of Adult Health, Faculty of Nursing, Al Al-Bayt University, Mafraq 25113, Jordan.,College of Nursing, Sultan Qaboos University, Muscat 123, Oman
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Tansanguan S, Tananuvat N, Wongpakaran N, Wongpakaran T, Ausayakhun S. Thai version of the dry eye-related quality-of-life score questionnaire: preliminary assessment for psychometric properties. BMC Ophthalmol 2021; 21:310. [PMID: 34454466 PMCID: PMC8400753 DOI: 10.1186/s12886-021-02077-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 08/13/2021] [Indexed: 01/02/2023] Open
Abstract
Background This study aimed to develop a Thai version of the Dry Eye–Related Quality-of-Life Score (DEQS-Th) questionnaire and evaluate its validity, reliability, and feasibility among Thai participants. Methods The DEQS-Th, a 15-item self-report measuring dry eye and its impact on quality of life (QOL) was developed based on the DEQS. The questionnaire was divided into two subscales: Bothersome Ocular Symptoms (six questions), and Impact on Daily Life (nine questions). It employed a 5-point Likert scale, addressing on both the frequency and the degree of symptoms. Backward and forward and cultural adaptation process translation methods were employed. Thirty healthy participants were enrolled to evaluate the feasibility of the DEQS-Th in terms of difficulty and convenience. Reliability was assessed using internal consistency determined by Cronbach’s alpha, with values > 0.7 considered acceptable. Convergent validity was determined by the correlation between DEQS-Th and overall health status. Confirmatory factor analysis was conducted for its factor structure. Results The participants’ mean age was 38.6 ± 12.9 years, and 23 (76.7%) were females. The mean time to complete the questionnaire was 9.3 ± 2.7 min. The Cronbach’s alpha of the ocular symptoms subscale, impact on QOL subscale, and summary score on frequency and degree were 0.80 and 0.70, 0.89 and 0.89, and 0.90 and 0.89, respectively. The overall health status significantly correlated with the summary score (r = 0.564, p = .001), subscale ocular symptoms (r = 0.594, p = .001), and impact on QOL scores (r = 0.626, p < .001) of the DEQS-Th, respectively. A one-factor model fitted the data the best for both the ocular symptoms subscale (CFI = 1.000, TLI = 1.000, RMSEA = 0.000) and the impact on QOL subscale (CFI = 0.998, TLI = 0.997, RMSEA = 0.053). Conclusion When tested among normal participants, the DEQS-Th is a valid and reliable measurement for dry eye symptoms and impact on QOL. Supplementary Information The online version contains supplementary material available at 10.1186/s12886-021-02077-0.
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Affiliation(s)
- Sasiwimon Tansanguan
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Napaporn Tananuvat
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.
| | - Nahathai Wongpakaran
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Tinakon Wongpakaran
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Somsanguan Ausayakhun
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
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García-Ayuso D, Di Pierdomenico J, Moya-Rodríguez E, Valiente-Soriano FJ, Galindo-Romero C, Sobrado-Calvo P. Assessment of dry eye symptoms among university students during the COVID-19 pandemic. Clin Exp Optom 2021; 105:507-513. [PMID: 34279190 DOI: 10.1080/08164622.2021.1945411] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
CLINICAL RELEVANCE The synchronous hybrid learning environment is associated with increased time spent by students working with VDT and increased prevalence of dry eye symptoms in a university-based population. BACKGROUND To assess the prevalence of dry eye symptoms using the ocular surface disease index (OSDI) questionnaire in university students and to identify whether factors such as the synchronous hybrid learning environment as a preventive measure of COVID-19, video display terminal use, gender or contact lens wear influence dry eye symptomatology. METHODS This study was performed using a web-based questionnaire that was distributed to university students to assess questions related to class attendance, to the use of video display terminals, the need for optical correction and, finally, the OSDI questionnaire. RESULTS A total of 676 university students with an average age of 20.7 ± 2.9 years completed the questionnaire, of which 72.6% (491) were females and 27.4% (185) were males. Only 10.2% of the participants attended face to face classes. Of the participants, 35.5% were contact lens wearers. The mean OSDI score of the study population was 27.68 ± 20.09 and the prevalence of symptomatic dry eye disease (OSDI score above 22) was 51.8%. Female gender (X2(3) = 38.605, p < 0.001), online class attendance (X2(1) = 20.31; p < 0.001), increased hours of online class attendance (X2(2) = 26.84, p < 0.001) and contact lens wear (X2(2) = 15.264, p < 0.05) were associated with a higher incidence of symptomatic dry eye disease. CONCLUSION The synchronous hybrid learning environment increases the time students spend working with video display terminals and the prevalence of dry eye symptoms. Female gender and contact lens wear were also associated with a higher prevalence of dry eye symptoms. It should not be ignored that dry eye could also affect academic performance.
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Affiliation(s)
- Diego García-Ayuso
- Departamento de Oftalmología, Facultad de Medicina, Universidad de Murcia and Instituto Murciano de Investigación Biosanitaria Hospital Virgen de la Arrixaca (IMIB-virgen de la Arrixaca), Murcia, Spain.,Facultad de Óptica y Optometría, Universidad de Murcia, Murcia, Spain
| | - Johnny Di Pierdomenico
- Departamento de Oftalmología, Facultad de Medicina, Universidad de Murcia and Instituto Murciano de Investigación Biosanitaria Hospital Virgen de la Arrixaca (IMIB-virgen de la Arrixaca), Murcia, Spain.,Facultad de Óptica y Optometría, Universidad de Murcia, Murcia, Spain
| | | | - Francisco J Valiente-Soriano
- Departamento de Oftalmología, Facultad de Medicina, Universidad de Murcia and Instituto Murciano de Investigación Biosanitaria Hospital Virgen de la Arrixaca (IMIB-virgen de la Arrixaca), Murcia, Spain.,Facultad de Óptica y Optometría, Universidad de Murcia, Murcia, Spain
| | - Caridad Galindo-Romero
- Departamento de Oftalmología, Facultad de Medicina, Universidad de Murcia and Instituto Murciano de Investigación Biosanitaria Hospital Virgen de la Arrixaca (IMIB-virgen de la Arrixaca), Murcia, Spain.,Facultad de Óptica y Optometría, Universidad de Murcia, Murcia, Spain
| | - Paloma Sobrado-Calvo
- Departamento de Oftalmología, Facultad de Medicina, Universidad de Murcia and Instituto Murciano de Investigación Biosanitaria Hospital Virgen de la Arrixaca (IMIB-virgen de la Arrixaca), Murcia, Spain.,Facultad de Óptica y Optometría, Universidad de Murcia, Murcia, Spain
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Carreno-Galeano JT, Dohlman TH, Kim S, Yin J, Dana R. A Review of Ocular Graft-versus-Host Disease: Pathophysiology, Clinical Presentation and Management. Ocul Immunol Inflamm 2021; 29:1190-1199. [PMID: 34228599 DOI: 10.1080/09273948.2021.1939390] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Graft-versus-host disease is a common complication following allogeneic hematopoetic stem cell transplantation that can affect multiple organ systems, including the eyes. Ocular GVHD (oGVHD) is characterized by a T cell-mediated immune response that leads to immune cell infiltration and inflammation of ocular structures, including the lacrimal glands, eyelids, cornea and conjunctiva. oGVHD has a significant negative impact on visual function and quality of life and successful management requires a multi-disciplinary approach with frequent monitoring. Here, we review the pathophysiology and clinical presentation of oGVHD, along with current therapeutic strategies based on our clinical experience and the reported literature.
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Affiliation(s)
| | - Thomas H Dohlman
- Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA
| | - Stella Kim
- Department of Ophthalmology, University of Texas McGovern Medical School, Houston, Texas, USA
| | - Jia Yin
- Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA
| | - Reza Dana
- Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA
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Chang YA, Wu YY, Lin CT, Kawasumi M, Wu CH, Kao SY, Yang YP, Hsu CC, Hung KF, Sun YC. Animal models of dry eye: Their strengths and limitations for studying human dry eye disease. J Chin Med Assoc 2021; 84:459-464. [PMID: 33871392 DOI: 10.1097/jcma.0000000000000529] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Dry eye disease (DED), also called the keratoconjunctivitis sicca, is one of the most common diseases in the ophthalmology clinics. While DED is not a life-threatening disease, life quality may be substantially affected by the discomfort and the complications of poor vision. As such, a large number of studies have made contributions to the investigation of the DED pathogenesis and novel treatments. DED is a multifactorial disease featured with various phenotypic consequences; therefore, animal models are valuable tools suitable for the related studies. Accordingly, selection of the animal model to recapitulate the clinical presentation of interest is important for appropriately addressing the research objective. To this end, we systemically reviewed different murine and rabbit models of DED, which are categorized into the quantitative (aqueous-deficient) type and the qualitative (evaporative) type, based on the schemes to establish. The clinical manifestations of dry eye on animal models can be induced by mechanical or surgical approaches, iatrogenic immune response, topical eye drops, blockage of neural pathway, or others. Although these models have shown promising results, each has its own limitation and cannot fully reproduce the pathophysiological mechanisms that occur in patients. Nonetheless, the animal models remain the best approximation of human DED and represent the valuable tool for the DED studies.
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Affiliation(s)
- Yu-An Chang
- Institute of Veterinary Clinical Science, School of Veterinary Medicine, National Taiwan University, Taipei, Taiwan, ROC
| | - Yi-Ying Wu
- Institute of Veterinary Clinical Science, School of Veterinary Medicine, National Taiwan University, Taipei, Taiwan, ROC
| | - Chung-Tien Lin
- Institute of Veterinary Clinical Science, School of Veterinary Medicine, National Taiwan University, Taipei, Taiwan, ROC
| | - Masaoki Kawasumi
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Cheng-Hsien Wu
- Department of Stomatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Shou-Yen Kao
- Department of Stomatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Yi-Ping Yang
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Chih-Chien Hsu
- Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Kai-Feng Hung
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Dentistry, School of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Yi-Chen Sun
- Department of Ophthalmology, Taipei Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation, Taiwan, ROC; and College of Medicine, Tzu-Chi University, Hualien, Taiwan
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Akowuah PK, Adjei-Anang J, Nkansah EK, Fummey J, Osei-Poku K, Boadi P, Frimpong AA. Comparison of the performance of the dry eye questionnaire (DEQ-5) to the ocular surface disease index in a non-clinical population. Cont Lens Anterior Eye 2021; 45:101441. [PMID: 33836971 DOI: 10.1016/j.clae.2021.101441] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 03/22/2021] [Accepted: 03/24/2021] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To compare the performance of the dry eye questionnaire (DEQ-5) with the Ocular Surface Disease Index (OSDI) and further validate the DEQ-5 questionnaire. METHODS A population-based cross-sectional study conducted in Ghana. OSDI and DEQ-5 questionnaires were administered to participants. Cronbach's alpha was used to evaluate the reliability of the OSDI and DEQ-5 questionnaires. Analysis of variance was used to evaluate the discriminant validity of DEQ-5. Concurrent validity was evaluated using the Spearman correlation analysis. A receiver operating characteristic (ROC) curve was generated to describe the sensitivity and specificity of the DEQ-5 questionnaire for diagnosis of dry eye symptoms. Cohen Kappa was used to evaluate agreement between the two questionnaires. RESULTS The reliability of the overall OSDI and DEQ-5 scores were 0.919 and 0.819 respectively. The mean (SD) DEQ-5 scores for asymptomatic, mild, moderate and severe dry eye symptoms as defined by the OSDI grading were 3.05 (2.73), 5.13 (3.69), 7.65 (3.30) and 9.77 (4.16) respectively. There was a statistically significant correlation between total OSDI and total DEQ-5 scores (rs = 0.649, p < 0.0001). The area under the curve (AUC) of the ROC curve for DEQ-5 was 0.835 (95 % CI: 0.796 - 0.875). A DEQ-5 threshold of 5.5 yielded maximum sensitivity (0.712) and specificity (0.827). The Cohen kappa using a the DEQ-5 total score threshold of 5.5 was K = 0.539 (p < 0.0001). CONCLUSION In conclusion, performance of the DEQ-5 questionnaire in discriminating symptoms of dry eye is comparable to the OSDI questionnaire. The DEQ-5 questionnaire is a valid measure of dry eye symptoms and can be used as a dry eye symptoms assessment tool in both clinical and epidemiological studies.
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Affiliation(s)
- Prince Kwaku Akowuah
- Department of Optometry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana; College of Optometry, University of Houston, Houston, TX, USA.
| | - Joseph Adjei-Anang
- Department of Optometry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Ernest Kyei Nkansah
- Department of Optometry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Jeremiah Fummey
- Department of Optometry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Kofi Osei-Poku
- Department of Optometry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Prince Boadi
- Department of Optometry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Asafo Agyei Frimpong
- Department of Optometry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
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