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Zhou HZ, Liu X, Zhou D, Shao F, Li Q, Li D, He T, Ren Y, Lu CW. Effects of Air Pollution and Meteorological Conditions on DED: Associated Manifestations and Underlying Mechanisms. Klin Monbl Augenheilkd 2024; 241:1062-1070. [PMID: 38688324 DOI: 10.1055/a-2316-6808] [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: 05/02/2024]
Abstract
This study aims to explore the associations and the underlying mechanism among dry eye disease (DED), air pollution, and meteorological conditions. DED is positively correlated with air pollutants (i.e., PM2.5, PM10, O3, NO2, CO, and SO2) and meteorological conditions (i.e., high altitude and wind speed), while negatively associated with relative humidity. Both low and high air temperatures effect DED. Atmospheric pollutants affect DED mainly through necroptosis or autophagy, inflammatory responses, and oxidative stress. Meteorological factors affect DED not only by their own affects but also by dispersing the concentration of air pollutants, and then reducing the negative exposure. In summary, this review may expand the understanding of the effects of air pollution and meteorological factors on DED and emphasize the importance of air environmental protection.
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Affiliation(s)
- Hui-Zhong Zhou
- Department of Ophthalmology, The First Hospital of Jilin University, Changchun, China
| | - Xiufen Liu
- Department of Ophthalmology, The First Hospital of Jilin University, Changchun, China
| | - Dandan Zhou
- Department of Radiology, The First Hospital of Jilin University, Changchun, China
| | - Fei Shao
- Department of Ophthalmology, The First Hospital of Jilin University, Changchun, China
| | - Qian Li
- Department of Ophthalmology, The First Hospital of Jilin University, Changchun, China
| | - Dan Li
- Department of Ophthalmology, The First Hospital of Jilin University, Changchun, China
| | - Tianlong He
- Department of Ophthalmology, The First Hospital of Jilin University, Changchun, China
| | - Yu Ren
- Department of Ophthalmology, The First Hospital of Jilin University, Changchun, China
| | - Cheng-Wei Lu
- Department of Ophthalmology, The First Hospital of Jilin University, Changchun, China
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Choi YH, Song MS, Lee Y, Paik HJ, Song JS, Choi YH, Kim DH. Adverse effects of meteorological factors and air pollutants on dry eye disease: a hospital-based retrospective cohort study. Sci Rep 2024; 14:17776. [PMID: 39090167 PMCID: PMC11294595 DOI: 10.1038/s41598-024-68070-x] [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: 05/04/2024] [Accepted: 07/19/2024] [Indexed: 08/04/2024] Open
Abstract
Although previous studies have suggested that meteorological factors and air pollutants can cause dry eye disease (DED), few clinical cohort studies have determined the individual and combined effects of these factors on DED. We investigated the effects of meteorological factors (humidity and temperature) and air pollutants [particles with a diameter ≤ 2.5 μ m (PM2.5), ozone (O3), nitrogen dioxide (NO2), and carbon monoxide (CO)] on DED. A retrospective cohort study was conducted on 53 DED patients. DED was evaluated by Symptom Assessment in Dry Eye (SANDE), tear secretion, tear film break-up time (TBUT), ocular staining score (OSS), and tear osmolarity. To explore the individual, non-linear, and joint associations between meteorological factors, air pollutants, and DED parameters, we used generalized linear mixed model (GLMM) and Bayesian kernel machine regression (BKMR). After adjusting for all covariates, lower relative humidity or temperature was associated with a higher SANDE (p < 0.05). Higher PM2.5, O3, and NO2 levels were associated with higher SANDE and tear osmolarity (p < 0.05). Higher O3 levels were associated with lower tear secretion and TBUT, whereas higher NO2 levels were associated with higher OSS (p < 0.05). BKMR analyses indicated that a mixture of meteorological factors and air pollutants was significantly associated with increased SANDE, OSS, tear osmolarity, and decreased tear secretion.
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Affiliation(s)
- Yun-Hee Choi
- Department of Ophthalmology, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841, South Korea
- School of Health and Environmental Science, Korea University, Seoul, South Korea
| | - Myung-Sun Song
- Department of Ophthalmology, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841, South Korea
| | - Yunjin Lee
- Department of Ophthalmology, Gachon University College of Medicine, Gil Medical Center, Incheon, South Korea
| | - Hae Jung Paik
- Department of Ophthalmology, Gachon University College of Medicine, Gil Medical Center, Incheon, South Korea
| | - Jong Suk Song
- Department of Ophthalmology, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841, South Korea
| | - Yoon-Hyeong Choi
- School of Health and Environmental Science, Korea University, Seoul, South Korea.
- Institute of Health Science, Korea University, Seoul, South Korea.
| | - Dong Hyun Kim
- Department of Ophthalmology, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841, South Korea.
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Erdinest N, Noyman DBE, London N, Lavy I, Levinger N, Landau D, Solomon A, Morad Y, Naroo SA. Applications of topical immunomodulators enhance clinical signs of vernal keratoconjunctivitis (VKC) and atopic keratoconjunctivitis (AKC): a meta-analysis. Int Ophthalmol 2024; 44:157. [PMID: 38522059 DOI: 10.1007/s10792-024-03097-7] [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: 06/30/2023] [Accepted: 03/05/2024] [Indexed: 03/25/2024]
Abstract
PURPOSE This meta-analysis aimed to review the safety and efficacy of topical cyclosporine A (CsA) and topical tacrolimus in allergic eye disease. METHODS A systematic search identified thirteen studies and a total of 445 patients for inclusion, making this the largest meta-analysis published on the subject. The current review was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). RESULTS Thirteen randomized control trials were included in the meta-analysis. Eleven studies used CsA as the treatment, and two used Tacrolimus. In total, 445 participants were included, of whom 76.6% were male. The mean age of participants across the included studies was 14 years. All studies reported clinical signs as evaluated by an examining clinician. Signs were usually assessed by anatomical region, with the most common regions being the conjunctiva and the cornea, and the most common signs assessed were hyperemia and papillae. Three studies accounted for more than 50% of the meta-analysis's weight. Effect size (d) ranged from - 2.37 to - 0.03, negative values favoring immunomodulators. Fixed Effect Meta-Analysis returned an SMD of - 0.81 (95% CI [- 0.98, - 0.65]). However, there was significant heterogeneity (I2 = 61%, Qw = 30.76) in the outcome measure (P = 0.0021); therefore, a random-effect meta-analysis was also completed in which the pooled SMD was - 0.98 (95% CI [- 1.26, - 0.69], τ2 = 0.16). CONCLUSIONS This study affirms the current scientific community's stance that immunomodulators effectively treat clinical signs, including blepharitis, conjunctival hyperemia, edema, papillae, and corneal damage in severe ocular allergic disease.
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Affiliation(s)
- Nir Erdinest
- Department of Ophthalmology, Faculty of Medicine, Hadassah-Hebrew University Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | | | | | - Itay Lavy
- Department of Ophthalmology, Faculty of Medicine, Hadassah-Hebrew University Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Nadav Levinger
- Department of Ophthalmology, Faculty of Medicine, Hadassah-Hebrew University Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
- Department of Ophthalmology, Enaim Refractive Surgery Center, Jerusalem, Israel
| | - David Landau
- Department of Ophthalmology, Faculty of Medicine, Hadassah-Hebrew University Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Abraham Solomon
- Department of Ophthalmology, Faculty of Medicine, Hadassah-Hebrew University Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Yair Morad
- Department of Ophthalmology, Asaf Harofeh Medical Center, Béer Yáakov, Israel
| | - Shehzad A Naroo
- College of Health and Life Sciences, Aston University, Birmingham, UK
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Upaphong P, Thonusin C, Wanichthanaolan O, Chattipakorn N, Chattipakorn SC. Consequences of exposure to particulate matter on the ocular surface: Mechanistic insights from cellular mechanisms to epidemiological findings. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 345:123488. [PMID: 38311159 DOI: 10.1016/j.envpol.2024.123488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 01/28/2024] [Accepted: 01/31/2024] [Indexed: 02/10/2024]
Abstract
Exposure to air pollutants, especially in the case of particulate matter (PM), poses significant health risks throughout the body. The ocular surface is directly exposed to atmospheric PM making it challenging to avoid. This constant exposure makes the ocular surface a valuable model for investigating the impact of air pollutants on the eyes. This comprehensive review assembles evidence from across the spectrum, from in vitro and in vivo investigations to clinical studies and epidemiological studies, offering a thorough understanding of how PM10 and PM2.5 affect the health of the ocular surface. PM has been primarily found to induce inflammatory responses, allergic reactions, oxidative stress, DNA damage, mitochondrial impairment, and inhibit the proliferation and migration of ocular surface cells. In toto these effects ultimately lead to impaired wound healing and ocular surface damage. In addition, PM can alter tear composition. These events contribute to ocular diseases such as dry eye disease, blepharitis, conjunctivitis, keratitis, limbal stem cell deficiency and pterygium. Importantly, preexisting ocular conditions such as dry eye, allergic conjunctivitis, and infectious keratitis can be worsened by PM exposure. Adaptive responses may partially alleviate the mentioned insults, resulting in morphological and physiological changes that could be different between periods of short-term and long-term exposure. Particle size is not the only determinant of the ocular effect of PM, the composition and solubility of PM also play critical roles. Increasing awareness of how PM affects the ocular surface is crucial in the field of public health, and mechanistic insights of these adverse effects may provide guidelines for preventive and therapeutic strategies in dealing with a polluted environment.
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Affiliation(s)
- Phit Upaphong
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Chanisa Thonusin
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Cardiac Electrophysiology Unit, Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, Thailand
| | | | - Nipon Chattipakorn
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Cardiac Electrophysiology Unit, Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, Thailand
| | - Siriporn C Chattipakorn
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, Thailand; Department of Oral Biology and Diagnostic Sciences, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand.
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Xia M, Yang Y, Sun J, Huang R, Huang Y, Zhang M, Yao X. Time-series analysis of the association between air pollution exposure and outpatient visits for dry eye disease: a case study in Zhengzhou, China. Front Public Health 2024; 12:1352057. [PMID: 38550319 PMCID: PMC10973159 DOI: 10.3389/fpubh.2024.1352057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 03/04/2024] [Indexed: 04/02/2024] Open
Abstract
Background Dry eye disease (DED) is a prevalent ocular surface disease that significantly impacts patients' quality of life. The association between air pollution and the risk of dry eye disease remains uncertain. Methods Data on outdoor air pollutants, meteorological information, and outpatient visits for DED were collected from July 1, 2014, to December 31, 2019. The relationship between ambient air pollutants and DED outpatient visits was analyzed using a generalized additive model with a Poisson distribution. Results Among the 5,204 DED patients included in the study, 63.76% were female and 36.24% were male. The single-pollutant model revealed a significant association between a 10 μg/m3 increase in concentrations of fine-particulate matter with a median aerometric diameter of less than 10 μm (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), and carbon monoxide (CO) and outpatient visits for DED. Fine-particulate matter with a median aerometric diameter of less than 2.5 μm (PM2.5) showed a significant association with DED outpatient visits in males and the 19-59 years age group. The strongest associations between air pollutants and outpatient visits were observed in male patients and during the cold season. Conclusion The noteworthy correlation between air pollutants and DED outpatient visits can offer evidence for policy makers and underscore the significance of reinforcing environmental protection.
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Affiliation(s)
- Mengting Xia
- Henan Eye Institute & Henan Eye Hospital, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Yingrui Yang
- Henan Eye Institute & Henan Eye Hospital, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Jiali Sun
- Henan Eye Institute & Henan Eye Hospital, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Ranran Huang
- Henan Eye Institute & Henan Eye Hospital, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Yonghui Huang
- Henan Eye Institute & Henan Eye Hospital, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Mengqi Zhang
- Hospital-Acquired Infection Control Department, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Xi Yao
- Henan Eye Institute & Henan Eye Hospital, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
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Di Zazzo A, Barabino S, Fasciani R, Aragona P, Giannaccare G, Villani E, Rolando M. One Soul and Several Faces of Evaporative Dry Eye Disease. J Clin Med 2024; 13:1220. [PMID: 38592038 PMCID: PMC10932174 DOI: 10.3390/jcm13051220] [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: 11/20/2023] [Revised: 02/02/2024] [Accepted: 02/04/2024] [Indexed: 04/10/2024] Open
Abstract
The ocular surface system interacts with, reacts with, and adapts to the daily continuous insults, trauma, and stimuli caused by direct exposure to the atmosphere and environment. Several tissue and para-inflammatory mechanisms interact to guarantee such an ultimate function, hence maintaining its healthy homeostatic equilibrium. Evaporation seriously affects the homeostasis of the system, thereby becoming a critical trigger in the pathogenesis of the vicious cycle of dry eye disease (DED). Tear film lipid composition, distribution, spreading, and efficiency are crucial factors in controlling water evaporation, and are involved in the onset of the hyperosmolar and inflammatory cascades of DED. The structure of tear film lipids, and subsequently the tear film, have a considerable impact on tears' properties and main functions, leading to a peculiar clinical picture and specific management.
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Affiliation(s)
- Antonio Di Zazzo
- Ophthalmology Complex Operative Unit, Foundation Campus Bio-Medico University Hospital, 00128 Rome, Italy
- Ophthalmology Unit, Campus Bio-Medico University, 00128 Rome, Italy
| | - Stefano Barabino
- Ocular Surface & Dry Eye Center, ASST Fatebenefratelli SACCO, Kilan Univeristy, 20123 Milan, Italy;
| | - Romina Fasciani
- Ophthalmology Unit, “Fondazione Policlinico Universitario A. Gemelli IRCCS”, 00128 Rome, Italy;
- Ophtalmology Unit, Catholic University of “Sacro Cuore”, 00128 Rome, Italy
| | - Pasquale Aragona
- Ophthalmology Clinic, Department of Biomedical Sciences, University Hospital of Messina, 98122 Messina, Italy;
| | - Giuseppe Giannaccare
- Eye Clinic, Department of Surgical Sciences, University of Cagliari, 09124 Cagliari, Italy;
| | - Edoardo Villani
- Eye Clinic, San Giuseppe Hospital, IRCCS Multimedica, University of Milan, 20123 Milan, Italy;
| | - Maurizio Rolando
- Ocular Surface and Dry Eye Center, ISPRE Ophthalmics, 16129 Genoa, Italy;
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Millen AE, Dighe S, Kordas K, Aminigo BZ, Zafron ML, Mu L. Air Pollution and Chronic Eye Disease in Adults: A Scoping Review. Ophthalmic Epidemiol 2024; 31:1-10. [PMID: 36864662 DOI: 10.1080/09286586.2023.2183513] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 02/18/2023] [Indexed: 03/04/2023]
Abstract
PURPOSE We conducted a scoping review of studies examining ambient air pollution as a risk factor for chronic eye disease influencing the lens, retina, and intraocular pressure in adults. METHODS Terms related to air pollution and eye disease outcomes were used to search for publications on Embase, Web of Science Core Collection, Global Health, PubMed, and the Cochrane Central Register of Controlled Trials from January 1, 2010, through April 11, 2022. RESULTS We identified 27 articles, focusing on the following non-mutually exclusive outcomes: cataract (n = 9), presbyopia (n = 1), retinal vein occlusion or central retinal arteriolar and venular equivalents (n = 5), intraocular pressure (IOP) (n = 3), glaucoma (n = 5), age-related macular degeneration (AMD) (n = 5), diabetic retinopathy (n = 2), and measures of retinal morphology (n = 3). Study designs included cross-sectional (n = 16), case-control (n = 4), and longitudinal (n = 7). Air pollutants were measured in 50% and 95% of the studies on lens and retina or IOP, respectively, and these exposures were assigned to geographic locations. Most research was conducted in global regions with high exposure to air pollution. Consistent associations suggested a possibly increased risk of cataract and retina-associated chronic eye disease with increasing exposure to particulate matter (PM2.5-PM10), NO2, NOx, and SO2. Associations with O3 were less consistent. CONCLUSIONS Accumulating research suggests air pollution may be a modifiable risk factor for chronic eye diseases of the lens and retina. The number of studies on each specific lens- or retina-related outcome is limited. Guidelines regarding the role of air pollution in chronic eye disease do not exist.
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Affiliation(s)
- Amy E Millen
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York, USA
| | - Shruti Dighe
- Department of Family Medicine, Allegheny Health Network Saint Vincent, Erie, PA, USA
| | - Katarzyna Kordas
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York, USA
| | - Boma Zelma Aminigo
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York, USA
| | - Michelle L Zafron
- Health Sciences at Abbott Library, University Libraries, University at Buffalo, Buffalo, New York, USA
| | - Lina Mu
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York, USA
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Ayaki M, Negishi K. Seasonality of Tear Meniscus Volume and Dry Eye-Related Symptoms - A Cross-Sectional Retrospective Cohort Study. Clin Ophthalmol 2023; 17:3809-3816. [PMID: 38105909 PMCID: PMC10725749 DOI: 10.2147/opth.s442567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 12/05/2023] [Indexed: 12/19/2023] Open
Abstract
Purpose We aimed to determine the seasonal variation in the tear meniscus level on strip meniscometry and its association with ocular parameters and symptoms. In Japan, there are four distinct seasons characterized by marked differences in temperature and humidity, which may contribute to an observed seasonality of ocular surface symptoms. Methods We conducted a cross-sectional study in two Japanese clinics and recruited first-visit patients for 3 years. Tear strip meniscometry, tear break-up time (BUT), Schirmer test, and corneal staining were examined, and major ocular symptoms (dryness, irritation, pain, fatigue, blurred vision, and photophobia) were determined through interviews. Results The 1196 participants had a mean age of 58.9±15.2 years; 37.1% were of male sex. Strip meniscometry values and BUT revealed significant seasonality with one-way analysis of variance. The mean strip meniscometry value (mm) was 2.15±2.59 in spring (p=0.025 vs winter), 2.37±2.79 in summer (p<0.001), 2.38±2.80 in fall (p<0.001), and 1.64±2.29 in winter. Regression analysis indicated that strip meniscometry levels were correlated with BUT (p<0.001), Schirmer test values (p<0.001), corneal staining scores (p=0.022), and presence of dryness (p<0.001). Conclusion Strip meniscometry values exhibited distinct seasonality, being lowest in winter when the ambient condition is dry and cool, and were correlated with BUT, Schirmer test values, corneal staining scores, and the presence of subjective dryness.
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Affiliation(s)
- Masahiko Ayaki
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
- Otake Eye Clinic, Kanagawa, Japan
| | - Kazuno Negishi
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
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Song MS, Lee Y, Paik HJ, Kim DH. A Comprehensive Analysis of the Influence of Temperature and Humidity on Dry Eye Disease. KOREAN JOURNAL OF OPHTHALMOLOGY 2023; 37:501-509. [PMID: 37899282 PMCID: PMC10721396 DOI: 10.3341/kjo.2023.0077] [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: 08/01/2023] [Revised: 09/03/2023] [Accepted: 10/06/2023] [Indexed: 10/31/2023] Open
Abstract
PURPOSE To investigate the effects of humidity and temperature on dry eye disease (DED). METHODS A retrospective, clinic-based study was conducted on DED patients undergoing dry eye treatment. Patients were followed up at least twice, and symptoms and signs were evaluated using the Symptoms Assessment Questionnaire in Dry Eye (SANDE) score, tear secretion, tear film breakup time (TBUT), ocular staining score, and tear osmolarity. Mean humidity and temperature values for 1 week before ocular examinations were used as the environmental exposure level. The relationship between humidity and temperature, with DED clinical parameters was analyzed in single- and multi-environmental factor models. RESULTS The study included 33 patients with a mean age of 53.9 ± 12.2 years. The low humidity group showed significantly higher SANDE scores (p = 0.023) and tear osmolarity (p = 0.008), and the low temperature group had higher SANDE scores (p = 0.004), ocular staining scores (p = 0.036), and tear osmolarity (p < 0.001). In the linear mixed model, single factor analysis showed that an increase in humidity resulted in decreased SANDE scores (p = 0.043), and an increase in temperature led to a decrease in SANDE score (p = 0.007), ocular staining score (p = 0.007), and tear osmolarity (p = 0.012). In the multifactor analysis, changes in humidity had no significant effect on dry eye parameters, but an increase in temperature was significantly correlated with decreased SANDE score (p = 0.026), ocular staining score (p = 0.024), and tear osmolarity (p = 0.002). CONCLUSIONS Lower temperature led to aggravated symptoms and signs of DED and the effect of temperature on DED was more pronounced than humidity. Tear osmolarity was the most sensitive clinical parameter to be affected by climate factors in DED patients.
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Affiliation(s)
- Myung-Sun Song
- Department of Ophthalmology, Korea University College of Medicine, Seoul,
Korea
| | - Yunjin Lee
- Department of Ophthalmology, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon,
Korea
| | - Hae Jung Paik
- Department of Ophthalmology, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon,
Korea
| | - Dong Hyun Kim
- Department of Ophthalmology, Korea University College of Medicine, Seoul,
Korea
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Gui SY, Wang F, Qiao JC, Wang XC, Huang ZH, Yang F, Hu CY, Tao FB, Tao LM, Liu DW, Yi XL, Jiang ZX. Short-term effect of meteorological factors and extreme weather events on daily outpatient visits for dry eye disease between 2013 and 2020: a time-series study in Urumqi, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:111967-111981. [PMID: 37821738 DOI: 10.1007/s11356-023-29651-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 08/29/2023] [Indexed: 10/13/2023]
Abstract
Dry eye disease (DED) is a common disorder of tear secretion on the ocular surface caused by multiple factors with dry eyes as the main symptom, but until now studies focusing on relationship between local meteorological factors and ocular surface diseases in Urumqi are very limited. Besides, the effects of long-term and extreme meteorological factors on DED and the lag effect have not been fully evaluated. Electronic case information of 9970 DED outpatients from the Ophthalmology Department of the First Affiliated Hospital of Xinjiang Medical University (Urumqi, Xinjiang, China) between January 1, 2013, and December 31, 2020, was screened and analyzed. We used a time-series analysis design and a quasi-Poisson generalized linear regression model combined with a distributed lagged nonlinear model (DLNM) to fit the effects of exposure to different meteorological factors and extreme weather on DED outpatient visits. Subgroup analyses were further performed for gender, age, and season. The results showed that exposure to extremely low mean temperature (P1:RR = 1.18), atmospheric pressure (P1:RR = 1.11), and extremely high relative humidity (P99:RR = 1.35) were the risk factors, while extremely high atmospheric pressure (P90:RR = 0.883) and extremely low humidity (P10:RR = 0.856) appeared to have a positive effect on reduced risk of DED. Relative humidity exhibited a 1-day lag effect (RR = 1.06). Increased mean temperature positively affected female DED patients (RR = 0.761) with similar effects in the cold season (RR = 0.926). However, elevated relative humidity had a negative effect on female patients (RR = 1.14). We conducted the first large sample size time-series analysis study in this major city at the farthest distance from the ocean in the world and in northwest China, confirming the association of DED outpatient visits with the remaining three meteorological factors except wind speed in Urumqi, and a larger sample size multi-center epidemiological study with a longer duration is still needed.
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Affiliation(s)
- Si-Yu Gui
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, China
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Fei Wang
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, China
| | - Jian-Chao Qiao
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Xin-Chen Wang
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, China
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Zhi-Hao Huang
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Fan Yang
- Department of Clinical Medicine, The First School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Cheng-Yang Hu
- Department of Humanistic Medicine, School of Humanistic Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Fang-Biao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Li-Ming Tao
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, China
| | - Dong-Wei Liu
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, China
| | - Xiang-Long Yi
- Department of Ophthalmology, The First Affiliated Hospital of Xinjiang Medical University, 137 Liyu Shan Road, Urumqi, 830011, China
| | - Zheng-Xuan Jiang
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, China.
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11
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Abdolalizadeh P, Falavarjani KG. The Correlation of Global Burden of Vision Impairment and Ambient Atmospheric Fine Particulate Matter. J Curr Ophthalmol 2023; 35:387-394. [PMID: 39281396 PMCID: PMC11392291 DOI: 10.4103/joco.joco_125_23] [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: 06/30/2023] [Revised: 09/16/2023] [Accepted: 11/10/2023] [Indexed: 09/18/2024] Open
Abstract
Purpose To assess the correlation between the worldwide burden of vision impairment (VI) and fine particulate matter (PM) 2.5. Methods In this retrospective cross-sectional study, global and national prevalence and disability-adjusted lost year (DALY) numbers and rates of total VI, glaucoma, cataract, and age-related macular degeneration (AMD) were obtained from the Global Burden of Disease database. The global and national levels of PM2.5 levels were also extracted. The main outcome measures were the correlation of PM2.5 levels with total VI and three ocular diseases in different age, sex, and socioeconomic subgroups. Results In 2019, the worldwide prevalence of total VI and exposure level of PM2.5 was 9.6% (95% uncertainty interval: 8.0-11.3) and 42.5 μg/m3, respectively. The national age-standardized prevalence rates of total VI (r p = 0.52, P < 0.001), glaucoma (r p = 0.65, P < 0.001), AMD (r p = 0.67, P < 0.001), and cataract (r p = 0.44, P < 0.001) have a positive correlation with PM2.5 levels. In addition, the national age-standardized DALY rates of total VI (r p = 0.62, P < 0.001), glaucoma (r p = 0.62, P < 0.001), AMD (r p = 0.54, P < 0.001), and cataract (r p = 0.45, P < 0.001) significantly correlated with PM2.5 levels. The correlations remained significant in different age, sex, and sociodemographic subgroups. Conclusion National prevalence rates of VI and three major ocular diseases correlate significantly with PM2.5 exposure levels, worldwide.
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Affiliation(s)
- Parya Abdolalizadeh
- Department of Ophthalmology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Khalil Ghasemi Falavarjani
- Eye Research Center, The Five Senses Health Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
- Stem Cell and Regenerative Medicine Research Center, Iran University of Medical Sciences, Tehran, Iran
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12
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Patel S, Mittal R, Kumar N, Galor A. The environment and dry eye-manifestations, mechanisms, and more. FRONTIERS IN TOXICOLOGY 2023; 5:1173683. [PMID: 37681211 PMCID: PMC10482047 DOI: 10.3389/ftox.2023.1173683] [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: 05/17/2023] [Accepted: 08/07/2023] [Indexed: 09/09/2023] Open
Abstract
Dry eye disease (DED) is a multifactorial condition that often presents with chronic symptoms of pain (that can be characterized as "dryness," "burning," and "irritation," to name a few) and/or fluctuating or poor-quality vision. Given its multifactorial nature, several pathophysiologic mechanisms have been identified that can underlie symptoms, including tear film, ocular surface, and/or corneal somatosensory nerve abnormalities. Research has focused on understanding how environmental exposures can increase the risk for DED flares and negatively impact the tear film, the ocular surface, and/or nerve health. Given that DED is a common condition that negatively impacts physical and mental functioning, managing DED requires multiple strategies. These can include both medical approaches and modulating adverse environmental conditions, the latter of which may be a cost-effective way to avoid DED flares. Thus, an understanding of how environmental exposures relate to disease is important. This Review summarizes research on the relationships between environmental exposures and DED, in the hope that this information will engage healthcare professionals and patients to consider environmental manipulations in their management of DED.
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Affiliation(s)
- Sneh Patel
- Division of Physical Medicine and Rehabilitation, Veterans Affairs (VA) Greater Los Angeles Healthcare System, Los Angeles, CA, United States
- University of California Los Angeles (UCLA), Los Angeles, CA, United States
| | - Rhiya Mittal
- University of Miami Leonard M. Miller School of Medicine, Miami, FL, United States
- Bascom Palmer Eye Institute, University of Miami, Miami, FL, United States
| | - Naresh Kumar
- Department of Public Health Sciences, University of Miami, Miami, FL, United States
| | - Anat Galor
- Bascom Palmer Eye Institute, University of Miami, Miami, FL, United States
- Ophthalmology and Research Services, Miami VA Medical Center, Miami, FL, United States
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13
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Martin R. Symptoms of dry eye related to the relative humidity of living places. Cont Lens Anterior Eye 2023; 46:101865. [PMID: 37208284 DOI: 10.1016/j.clae.2023.101865] [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: 09/01/2022] [Revised: 05/09/2023] [Accepted: 05/11/2023] [Indexed: 05/21/2023]
Abstract
PURPOSE To investigate the impact of relative humidity (RH) and climate variables of the place of residence on symptoms of dry eye disease (DED) in primary eye care practice. METHODS A cross-sectional analysis of the Ocular Surface Disease Index (OSDI) dry eye classification of 1.033 patients [classified as non-DED (OSDI ≤22) and DED (OSDI >22)] was conducted in a multicentre study in Spain. Participants were classified according to the 5-year RH value (data from the Spanish Climate Agency -www.aemet.es) into two groups: those who lived in low RH (<70%) places and those who lived in high RH (≥70%) places. Additionally, differences in daily climate records (EU Copernicus Climate Change Service) were assessed. RESULTS The prevalence of DED symptoms was 15.5% (95% CI 13.2%-17.6%). Participants who lived in places with <70% RH showed a higher prevalence of DED (17.7%; 95% CI 14.5%-21.1%; P < 0.01 adjusted for age and sex) than those who lived in places with ≥70% RH (13.6%; 95% CI 11.1%-16.7%) and a closer, but not statistically significant, risk for DED (OR = 1.34, 95% CI 0.96 to 1.89; P = 0.09) than previously described DED risk factors [age older than 50 years (OR = 1.51, 95% CI 1.06 to 2.16; P = 0.02) and female sex (OR = 1.99, 95% CI 1.36 to 2.90; P < 0.01)]. Some climate data showed statistically significant differences (P < 0.05) between participants with DED and non-DED (mean wind gusts; atmospheric pressure; mean and minimum relative humidity); these variables did not significantly increase DED risk (OR close to 1.0 and P > 0.05). CONCLUSION This study is the first to describe the impact of climate data on dryness symptomatology in Spain, confirming that participants who live in locations with RH <70% have a higher prevalence (corrected for age and sex) of DED. These findings support the use of climate databases in DED research.
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Affiliation(s)
- R Martin
- Universidad de Valladolid, Instituto Universitario de Oftalmobiología Aplicada (IOBA), Paseo de Belén, 17 - Campus Miguel Delibes, Valladolid 47011, España; Universidad de Valladolid, Departamento de Física Teórica, Atómica y Óptica, Paseo de Belén, 7 - Campus Miguel Delibes, Valladolid 47011, España; Optometry Research Group, IOBA Eye Institute, School of Optometry, University of Valladolid, Valladolid, Spain.
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14
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Heilenbach N, Hu G, Lamrani R, Prasad J, Ogunsola T, Iskander M, Elgin CY, McGowan R, Vieira D, Al-Aswad LA. Environmental influences on ophthalmic conditions: A scoping review. Clin Exp Ophthalmol 2023; 51:516-545. [PMID: 37309709 DOI: 10.1111/ceo.14262] [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: 01/07/2023] [Revised: 05/05/2023] [Accepted: 05/18/2023] [Indexed: 06/14/2023]
Abstract
BACKGROUND Environmental factors have been implicated in various eye pathologies. The purpose of this review is to synthesise the published research on environmental effects on eye disease. METHODS Four databases were searched for terms relating to environmental exposures and ophthalmic disease. Titles and abstracts were screened followed by full-text review. Data was extracted from 118 included studies. Quality assessment was conducted for each study. RESULTS Air pollutants, including nitrogen dioxide, nitrites, sulphur dioxide, particulate matter, carbon monoxide, ozone and hydrocarbons are associated with ocular conditions ranging from corneal damage to various retinopathies, including central retinal artery occlusion. Certain chemicals and metals, such as cadmium, are associated with increased risk of age-related macular degeneration. Climate factors, such as sun exposure, have been associated with the development of cataracts. Living in rural areas was associated with various age-related eye diseases whereas people living in urban settings had higher risk for dry eye disease and uveitis. CONCLUSION Environmental exposures in every domain are associated with various ophthalmic conditions. These findings underscore the importance of continued research on the interplay between the environment and eye health.
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Affiliation(s)
- Noah Heilenbach
- Grossman School of Medicine, Department of Ophthalmology, New York University, New York, New York, USA
| | - Galen Hu
- Grossman School of Medicine, Department of Ophthalmology, New York University, New York, New York, USA
| | - Ryan Lamrani
- Department of Ophthalmology, Eastern Virginia Medical School, Norfolk, Virginia, USA
| | - Jaideep Prasad
- Grossman School of Medicine, Department of Ophthalmology, New York University, New York, New York, USA
| | - Titilola Ogunsola
- Department of Ophthalmology, Howard University College of Medicine, Washington, District of Columbia, USA
| | - Mina Iskander
- Miller School of Medicine, Department of Medicine, University of Miami, Miami, Florida, USA
| | - Cansu Yuksel Elgin
- Department of Ophthalmology, Istanbul Universitesi-Cerrahpaşa, Istanbul, Turkey
| | - Richard McGowan
- Health Sciences Library, New York University, New York, New York, USA
| | - Dorice Vieira
- Health Sciences Library, New York University, New York, New York, USA
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15
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Alves M, Asbell P, Dogru M, Giannaccare G, Grau A, Gregory D, Kim DH, Marini MC, Ngo W, Nowinska A, Saldanha IJ, Villani E, Wakamatsu TH, Yu M, Stapleton F. TFOS Lifestyle Report: Impact of environmental conditions on the ocular surface. Ocul Surf 2023; 29:1-52. [PMID: 37062427 DOI: 10.1016/j.jtos.2023.04.007] [Citation(s) in RCA: 28] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 04/06/2023] [Indexed: 04/18/2023]
Abstract
Environmental risk factors that have an impact on the ocular surface were reviewed and associations with age and sex, race/ethnicity, geographical area, seasonality, prevalence and possible interactions between risk factors are reviewed. Environmental factors can be (a) climate-related: temperature, humidity, wind speed, altitude, dew point, ultraviolet light, and allergen or (b) outdoor and indoor pollution: gases, particulate matter, and other sources of airborne pollutants. Temperature affects ocular surface homeostasis directly and indirectly, precipitating ocular surface diseases and/or symptoms, including trachoma. Humidity is negatively associated with dry eye disease. There is little data on wind speed and dewpoint. High altitude and ultraviolet light exposure are associated with pterygium, ocular surface degenerations and neoplastic disease. Pollution is associated with dry eye disease and conjunctivitis. Primary Sjögren syndrome is associated with exposure to chemical solvents. Living within a potential zone of active volcanic eruption is associated with eye irritation. Indoor pollution, "sick" building or house can also be associated with eye irritation. Most ocular surface conditions are multifactorial, and several environmental factors may contribute to specific diseases. A systematic review was conducted to answer the following research question: "What are the associations between outdoor environment pollution and signs or symptoms of dry eye disease in humans?" Dry eye disease is associated with air pollution (from NO2) and soil pollution (from chromium), but not from air pollution from CO or PM10. Future research should adequately account for confounders, follow up over time, and report results separately for ocular surface findings, including signs and symptoms.
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Affiliation(s)
- Monica Alves
- Department of Ophthalmology and Otorhinolaryngology, University of Campinas Campinas, Brazil.
| | - Penny Asbell
- Department of Bioengineering, University of Memphis, Memphis, USA
| | - Murat Dogru
- School of Optometry and Vision Science, UNSW, Sydney, NSW, Australia
| | - Giuseppe Giannaccare
- Department of Ophthalmology, University Magna Graecia of Catanzaro, Cantanzaro, Italy
| | - Arturo Grau
- Department of Ophthalmology, Pontifical Catholic University of Chile, Santiago, Chile
| | - Darren Gregory
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, USA
| | - Dong Hyun Kim
- Department of Ophthalmology, Korea University College of Medicine, Seoul, South Korea
| | | | - William Ngo
- School of Optometry & Vision Science, University of Waterloo, Waterloo, Canada
| | - Anna Nowinska
- Clinical Department of Ophthalmology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Ian J Saldanha
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Edoardo Villani
- Department of Clinical Sciences and Community Health, University of Milan, Eye Clinic, San Giuseppe Hospital, IRCCS Multimedica, Milan, Italy
| | - Tais Hitomi Wakamatsu
- Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, São Paulo Hospital, Federal University of São Paulo, Brazil
| | - Mitasha Yu
- Sensory Functions, Disability and Rehabilitation Unit, World Health Organization, Geneva, Switzerland
| | - Fiona Stapleton
- School of Optometry and Vision Science, UNSW, Sydney, NSW, Australia
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16
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Muruganandam N, Mahalingam S, Narayanan R, Rajadurai E. Meandered and muddled: a systematic review on the impact of air pollution on ocular health. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:64872-64890. [PMID: 37097565 DOI: 10.1007/s11356-023-27079-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 04/13/2023] [Indexed: 05/17/2023]
Abstract
From the years 1970-2023, a systematic overview of the diverse consequences of particulate matter on eye health and a disease classification according to acute, chronic, and genetic are presented using the PubMed, Research Gate, Google Scholar, and Science Direct databases. Various studies on medical aspects correlate with the eye and health. However, from an application perspective, there is limited research on the ocular surface and air pollution. The main objective of the study is to uncover the relationship between eye health and air pollution, particularly particulate matter, along with other external factors acting as aggravators. The secondary goal of the work is to examine the existing models for mimicking human eyes. The study is followed by a questionnaire survey in a workshop, in which the exposure-based investigation was tagged based on their activity. This paper establishes a relationship between particulate matter and its influence on human health, leading to numerous eye diseases like dry eyes, conjunctivitis, myopia, glaucoma, and trachoma. The results of the questionnaire survey indicate that about 68% of the people working in the workshop are symptomatic with tears, blurred vision, and mood swings, while 32% of the people were asymptomatic. Although there are approaches for conducting experiments, the evaluation is not well defined; empirical and numerical solutions for particle deposition on the eye are needed. There prevails a broad gap in the arena of ocular deposition modeling.
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Affiliation(s)
- Niveditha Muruganandam
- Department of Civil Engineering, Kumaraguru College of Technology, Anna University, Coimbatore, Tamil Nadu, India
- Department of Civil Engineering, Kumaraguru College of Technology, Coimbatore, Tamil Nadu, India
| | - Sneha Mahalingam
- Department of Civil Engineering, Kumaraguru College of Technology, Anna University, Coimbatore, Tamil Nadu, India
- Department of Civil Engineering, Kumaraguru College of Technology, Coimbatore, Tamil Nadu, India
| | - Ramsundram Narayanan
- Department of Civil Engineering, Kumaraguru College of Technology, Coimbatore, Tamil Nadu, India.
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17
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Monfared N, Murphy PJ. Features and influences on the normal tear evaporation rate. Cont Lens Anterior Eye 2023; 46:101809. [PMID: 36621341 DOI: 10.1016/j.clae.2022.101809] [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: 05/13/2022] [Revised: 12/23/2022] [Accepted: 12/28/2022] [Indexed: 01/09/2023]
Abstract
Tear evaporation is a normal physiological phenomenon that has an important role in regulating blink activity and tear production. An altered tear evaporation rate (TER) is a defining characteristic of evaporative dry eye disease (DED), and the measurement of tear evaporation is a useful clinical test for diagnosis. Reported values for a normal TER cover a broad range, which may be due to the influence of ocular, environmental, and systemic factors. For improved disease diagnosis, a fuller understanding of the normal TER range is essential. This paper reports on a literature review of the current knowledge of these normal influences on TER.
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Affiliation(s)
- Naeimeh Monfared
- School of Optometry and Vision Science, University of Waterloo, Waterloo, Canada.
| | - Paul J Murphy
- School of Optometry and Vision Science, University of Waterloo, Waterloo, Canada
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18
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Zhao H, Lin T, Yang Y, Feng C, Wang W, Gong L. The effect of short-term air pollutants exposure on outpatient admission for blepharitis in Shanghai, China: a hospital-based study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:47655-47669. [PMID: 36745352 DOI: 10.1007/s11356-023-25605-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 01/24/2023] [Indexed: 02/07/2023]
Abstract
Blepharitis is a very common ophthalmologic disease, and few studies have examined if air pollutants contribute to the risk of blepharitis. We investigated the presence of any potential correlation between exposure to air pollution and outpatient admission for blepharitis in Shanghai, China. Data on daily outpatient admission for blepharitis were collected from January 2017 to July 2022. Air pollution and meteorological data were acquired from the Shanghai Environmental Protection Agency. Using the distributed lag non-linear model (DLNM) we investigated the relationship between air pollutants and blepharitis. Seasonal stratified analysis was carried out. In total, 10,681 blepharitis patients were recruited. In the single-pollutant model, a 10 μg/m3 increase in particulate matter with < 2.5 μm PM2.5 and 10 μm PM10 along with sulfur dioxide (SO2) and 100 μg/m3 increase in carbon monoxide (CO) was significantly associated with outpatient visits for blepharitis. In the multi-pollutant model, a 10 μg/m3 increase in ozone (O3) and nitrogen dioxide (NO2) and a 100 μg/m3 increase in carbon monoxide (CO) was significantly associated with outpatient visits for blepharitis. Moreover, there was an obvious relationship between blepharitis and PM2.5 and O3 in the summers and blepharitis and PM10, NO2, and SO2 during the winters. Exposure to short-term air pollution increases the risk of blepharitis outpatient visits in Shanghai, China.
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Affiliation(s)
- Han Zhao
- Department of Ophthalmology, Eye, Ear, Nose, and Throat Hospital of Fudan University, No.83, Fenyang Road, Xuhui District, Shanghai, 200000, China
- Laboratory of Myopia, NHC Key Laboratory of Myopia (Fudan University), Chinese Academy of Medical Sciences, Shanghai, 200000, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, 200000, China
| | - Tong Lin
- Department of Ophthalmology, Eye, Ear, Nose, and Throat Hospital of Fudan University, No.83, Fenyang Road, Xuhui District, Shanghai, 200000, China
- Laboratory of Myopia, NHC Key Laboratory of Myopia (Fudan University), Chinese Academy of Medical Sciences, Shanghai, 200000, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, 200000, China
| | - Yun Yang
- Department of Ophthalmology, Eye, Ear, Nose, and Throat Hospital of Fudan University, No.83, Fenyang Road, Xuhui District, Shanghai, 200000, China
- Laboratory of Myopia, NHC Key Laboratory of Myopia (Fudan University), Chinese Academy of Medical Sciences, Shanghai, 200000, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, 200000, China
| | - Changming Feng
- Department of Ophthalmology, Eye, Ear, Nose, and Throat Hospital of Fudan University, No.83, Fenyang Road, Xuhui District, Shanghai, 200000, China
- Laboratory of Myopia, NHC Key Laboratory of Myopia (Fudan University), Chinese Academy of Medical Sciences, Shanghai, 200000, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, 200000, China
| | - Wushuang Wang
- Department of Ophthalmology, Eye, Ear, Nose, and Throat Hospital of Fudan University, No.83, Fenyang Road, Xuhui District, Shanghai, 200000, China
- Laboratory of Myopia, NHC Key Laboratory of Myopia (Fudan University), Chinese Academy of Medical Sciences, Shanghai, 200000, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, 200000, China
| | - Lan Gong
- Department of Ophthalmology, Eye, Ear, Nose, and Throat Hospital of Fudan University, No.83, Fenyang Road, Xuhui District, Shanghai, 200000, China.
- Laboratory of Myopia, NHC Key Laboratory of Myopia (Fudan University), Chinese Academy of Medical Sciences, Shanghai, 200000, China.
- Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, 200000, China.
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19
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Jaiswal S, Jalbert I, Schmid K, Tein N, Wang S, Golebiowski B. Smoke and the eyes: A review of the harmful effects of wildfire smoke and air pollution on the ocular surface. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 309:119732. [PMID: 35839974 DOI: 10.1016/j.envpol.2022.119732] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 06/16/2022] [Accepted: 07/04/2022] [Indexed: 06/15/2023]
Abstract
Wildfires are occurring worldwide with greater frequency and intensity. Wildfires, as well as other sources of air pollution including environmental tobacco smoke, household biomass combustion, agricultural burning, and vehicular emissions, release large amounts of toxic substances into the atmosphere. The ocular surface is constantly exposed to the ambient air and is hence vulnerable to damage from air pollutants. This review describes the detrimental effects of wildfire smoke and air pollution on the ocular surface and resultant signs and symptoms. The latest relevant evidence is synthesised and critically evaluated. A mechanism for the pathophysiology of ocular surface damage will be proposed considering the existing literature on respiratory effects of air pollution. Current strategies to reduce human exposure to air pollutants are discussed and specific possible approaches to protect the ocular surface and manage air pollution induced ocular surface damage are suggested. Further avenues of research are suggested to understand how acute and chronic air pollution exposure affects the ocular surface including the short and long-term implications.
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Affiliation(s)
- Sukanya Jaiswal
- School of Optometry and Vision Science, UNSW Sydney, Australia.
| | | | - Katrina Schmid
- School of Optometry and Vision Science, Queensland University of Technology, Australia
| | - Natasha Tein
- School of Optometry and Vision Science, UNSW Sydney, Australia
| | - Sarah Wang
- School of Optometry and Vision Science, UNSW Sydney, Australia
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20
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Yu H, Zeng W, Zhang M, Zhao G, Wu W, Feng Y. Utilizing Baidu Index to Investigate Seasonality, Spatial Distribution and Public Attention of Dry Eye Diseases in Chinese Mainland. Front Public Health 2022; 10:834926. [PMID: 35875014 PMCID: PMC9298962 DOI: 10.3389/fpubh.2022.834926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 06/15/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose To explore the characteristics of spatial-temporal prevalence and public attention of dry eye diseases (DED) through Baidu Index (BI) based on infodemiology method. Methods The data about BI of DED were collected from Baidu search engine using "Dry eye diseases" as keyword. The spatial and temporal distribution of DED were analyzed through timeseries data decomposition as well as spatial autocorrelation and hotspot detection of BI about DED. The most popular related words and demographic characteristics were recorded to determine the public attention of DED. Results The trends of BI about DED in Chinese mainland had gradually increased over time with a rapid increase from 2012 to 2014 and in 2018. The results of timeseries decomposition indicated that there was seasonality in the distribution of BI about DED with the peak in winter, especially in northern regions. The geographic distribution demonstrated the search activities of DED was highest in the east of Chinese mainland while lowest in the west. The vast majority of people searching for DED were teenagers (20-29 years), with a predominance of females. Glaucoma, keratitis and conjunctivitis were the diseases most often confused with DED, and the artificial tears were the most common treatment for DED in Chinese mainland according to the BI about DED. Conclusions The analysis revealed the seasonality, geographic hotspots and public concern of DED through BI in Chinese mainland, which provided new insights into the epidemiology of DED.
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Affiliation(s)
- Haozhe Yu
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - Weizhen Zeng
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - Mengyao Zhang
- Department of Ophthalmology, Peking University Third Hospital Yanqing Hospital, Beijing, China
| | - Gezheng Zhao
- School of Nursing, Peking University, Beijing, China
| | - Wenyu Wu
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - Yun Feng
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
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21
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Hao R, Zhang M, Zhao L, Liu Y, Sun M, Dong J, Xu Y, Wu F, Wei J, Xin X, Luo Z, Lv S, Li X. Impact of Air Pollution on the Ocular Surface and Tear Cytokine Levels: A Multicenter Prospective Cohort Study. Front Med (Lausanne) 2022; 9:909330. [PMID: 35872759 PMCID: PMC9301315 DOI: 10.3389/fmed.2022.909330] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 06/14/2022] [Indexed: 11/30/2022] Open
Abstract
Purpose To assess air pollution-induced changes on ocular surface and tear cytokine levels. Methods As a prospective multicenter cohort study, 387 dry eye disease (DED) participants were recruited from five provinces in China and underwent measurements of ocular surface disease index (OSDI), Schirmer’s I test (ST), tear meniscus height (TMH), tear film break-up time (TBUT), corneal fluorescein staining (CFS), meibomian gland (MG) function, and tear cytokines. The associations between ocular surface parameters and exposure to particulate matter (PM), ozone (O3), nitrogen dioxide (NO2), and sulfur dioxide (SO2) for 1 day, 1 week, and 1 month before the examination were analyzed in single- and multi-pollutant models adjusted for confounding factors. Results In the multi-pollutant model, the OSDI score was positively correlated with PM with diameter ≤2.5 μm (PM2.5), O3, and SO2 exposure [PM2.5: β (1 week/month) = 0.229 (95% confidence interval (CI): 0.035–0.424)/0.211 (95% CI: 0.160–0.583); O3: β (1 day/week/month) = 0.403 (95% CI: 0.229–0.523)/0.471 (95% CI: 0.252–0.693)/0.468 (95% CI: 0.215–0.732); SO2: β (1 day/week) = 0.437 (95% CI: 0.193–0.680)/0.470 (95% CI: 0.040–0.901)]. Tear secretion was negatively correlated with O3 and NO2 exposures but positively correlated with PM2.5 levels. Air pollutants were negatively correlated with TBUT and positively related with CFS score. Besides SO2, all other pollutants were associated with aggravated MG dysfunction (MG expression, secretion, and loss) and tear cytokines increasement, such as PM2.5 and interleukin-8 (IL-8) [β (1 day) = 0.016 (95% CI: 0.003–0.029)], PM with diameter ≤10 μm (PM10) and IL-6 [β (1 day) = 0.019 (95% CI: 0.006–0.033)], NO2 and IL-6 [β (1 month) = 0.045 (95% CI: 0.018–0.072)], among others. The effects of air pollutants on DED symptoms/signs, MG functions and tear cytokines peaked within 1 week, 1 month, and 1 day, respectively. Conclusion Increased PM2.5, O3, and SO2 exposures caused ocular discomfort and damage with tear film instability. PM10 exposure led to tear film instability and ocular injury. PM, O3, and NO2 exposures aggravated MG dysfunction and upregulated tear cytokine levels. Therefore, each air pollutant may influence DED via different mechanisms within different time windows.
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Affiliation(s)
- Ran Hao
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Mingzhou Zhang
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Liming Zhao
- Department of Ophthalmology, Beijing Fengtai Hospital, Beijing, China
| | - Yang Liu
- Department of Ophthalmology, Daqing Oilfield General Hospital, Daqing, China
| | - Min Sun
- Department of Ophthalmology, Huabei Petroleum General Hospital, Cangzhou, China
| | - Jing Dong
- Department of Ophthalmology, The First Affiliated Hospital of Baotou Medical College, Inner Mongolia, China
| | - Yanhui Xu
- Department of Ophthalmology, Hebei Provincial Eye Hospital, Shijiazhuang, China
| | - Feng Wu
- Department of Ophthalmology, Fuyang Hospital Affiliated to Anhui Medical University, Fuyang, China
| | - Jinwen Wei
- Department of Ophthalmology, Inner Mongolia Autonomous Region Xilingol League Hospital, Inner Mongolia, China
| | - Xiangyang Xin
- Department of Ophthalmology, Inner Mongolia Baogang Hospital, Inner Mongolia, China
| | - Zhongping Luo
- Department of Ophthalmology, Tongliao City Ke’erqin Zuoyi Zhongqi People’s Hospital, Inner Mongolia, China
| | - Shuxuan Lv
- Department of Ophthalmology, Yongqing People’s Hospital, Langfang, China
| | - Xuemin Li
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
- *Correspondence: Xuemin Li, , orcid.org/0000-0001-7822-4694
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22
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Huang R, Su C, Fang L, Lu J, Chen J, Ding Y. Dry eye syndrome: comprehensive etiologies and recent clinical trials. Int Ophthalmol 2022; 42:3253-3272. [PMID: 35678897 PMCID: PMC9178318 DOI: 10.1007/s10792-022-02320-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 04/18/2022] [Indexed: 12/07/2023]
Abstract
Dry eye syndrome (DES) is multifactorial and likely to be a cause of concern more so than ever given the rapid pace of modernization, which is directly associated with many of the extrinsic causative factors. Additionally, recent studies have also postulated novel etiologies that may provide the basis for alternative treatment methods clinically. Such insights are especially important given that current approaches to tackle DES remains suboptimal. This review will primarily cover a comprehensive list of causes that lead to DES, summarize all the upcoming and ongoing clinical trials that focuses on treating this disease as well as discuss future potential treatments that can improve inclusivity.
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Affiliation(s)
- Ruojing Huang
- Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Huangpu Avenue West 613, Tianhe District, Guangzhou, 510630, China
| | - Caiying Su
- Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Huangpu Avenue West 613, Tianhe District, Guangzhou, 510630, China
| | - Lvjie Fang
- Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Huangpu Avenue West 613, Tianhe District, Guangzhou, 510630, China
| | - Jiaqi Lu
- Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Huangpu Avenue West 613, Tianhe District, Guangzhou, 510630, China
| | - Jiansu Chen
- Institute of Ophthalmology, Medical College, Jinan University, Huangpu Avenue West 601, Tianhe District, Guangzhou, 510632, China.
| | - Yong Ding
- Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Huangpu Avenue West 613, Tianhe District, Guangzhou, 510630, China.
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23
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Biochemistry of human tear film: A review. Exp Eye Res 2022; 220:109101. [DOI: 10.1016/j.exer.2022.109101] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 04/18/2022] [Accepted: 04/26/2022] [Indexed: 12/13/2022]
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24
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Ayaki M, Negishi K. Decrease of tear break-up time at Japanese eye clinics during five consecutive years. Sci Rep 2022; 12:6848. [PMID: 35477771 PMCID: PMC9043507 DOI: 10.1038/s41598-022-11035-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 04/07/2022] [Indexed: 01/03/2023] Open
Abstract
The aim of this retrospective chart review study was to evaluate the 5-year trend of ocular surface examination results in participants who visited the eye clinic from 2015 to 2019, underwent corneal and lacrimal examinations, refraction, and intra-ocular pressure measurements, and reported six dry eye-related symptoms. A total of 1468 patients were analyzed. Tear break-up time (BUT) decreased continuously for five consecutive years: 4.76 ± 1.84 s in 2015, 4.57 ± 1.70 s in 2016 (p = 0.999, vs 2015), 4.35 ± 2.06 s in 2017 (p = 0.662), 3.83 ± 2.18 s in 2018 (p < 0.001), and 3.63 ± 2.10 s in 2019 (p < 0.001). The decrease of BUT was more prominent in women than men (p < 0.001) and the correlation coefficient between calendar year and BUT was greater in women than men (p = 0.002). Schirmer test value, strip tear meniscometry value, and corneal staining score did not exhibit significant changes. Prevalence of blurring, photophobia, and pain increased toward 2019 among symptoms surveyed (eye fatigue, blurring, photophobia, dryness, irritation, and pain) and regression analysis indicated blurring (p < 0.001), photophobia (p < 0.001), and pain (p < 0.001) were correlated with BUT. In conclusion, BUT decreased continuously for five consecutive years from 2015 to 2019 and was associated with dry-eye related symptoms.
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Affiliation(s)
- Masahiko Ayaki
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan. .,Otake Clinic Moon View Eye Center, Kanagawa, Japan.
| | - Kazuno Negishi
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
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25
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The effects of short-term and long-term air pollution exposure on meibomian gland dysfunction. Sci Rep 2022; 12:6710. [PMID: 35468976 PMCID: PMC9038913 DOI: 10.1038/s41598-022-10527-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 04/08/2022] [Indexed: 01/23/2023] Open
Abstract
We aim to assess the effects of different air pollutants on meibomian gland dysfunction (MGD). As a prospective multicenter study, 864 patients were recruited from four different regions (i.e., coal, oil, steel, and living). The oil region had a significantly lower temperature and higher O3 and SO2 concentrations than other regions. Notably, participants in oil region presented with more frequent and serious MGD signs and higher cytokine levels (median interleukin 6 [IL-6] in oil: 2.66, steel: 0.96, coal: 0.38, living: 0.56; IL-8 in oil: 117.52, steel: 46.94, coal: 26.89, living: 33; vascular endothelial growth factor [VEGF] in oil: 25.09, steel: 14.02, coal: 14.02, living: 28.47). The short-term fluctuations of cytokine levels were associated with the changes in gas levels (PM2.5 and IL-8: β = 0.016 [0.004–0.029]; O3 and IL-6: β = 0.576 [0.386–0.702]; O3 and IL-8: β = 0.479 [0.369–0.890]; SO2 and VEGF: β = 0.021 [0.001–0.047]). After long-term exposure, lid margin neovascularization (r = 0.402), meibomian gland (MG) expression (r = 0.377), MG secretion (r = 0.303), MG loss (r = 0.404), and tear meniscus height (r = − 0.345) were moderately correlated with air quality index (AQI). Individuals in oil region had more serious MGD signs and higher cytokine levels. MGD is susceptible to long-term exposure to high AQI.
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26
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Mu J, Zeng D, Zeng H. Effects of nitrogen dioxide exposure on the risk of eye and adnexa diseases among children in Shenzhen, China: an assessment using the generalized additive modeling approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2022; 32:840-849. [PMID: 32746628 DOI: 10.1080/09603123.2020.1801603] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 07/20/2020] [Indexed: 06/11/2023]
Abstract
This study aimed to assess the relationship between nitrogen dioxide (NO2) exposure and the risk of eye and adnexa diseases (EADs) among children in Shenzhen, China. Information about the daily number of outpatients with EADs and the concentration of air pollutants and meteorological data were collected. A generalized additive model was used to assess the effect of NO2 exposure on the risk of EADs during outpatient visits. An increase in NO2 level by 10 μg/m3 was related to an increase in the daily number of outpatients by 5.43% (95% confidence interval [CI]: 2.25%, 8.70%) at lag0, by 4.35% (95% CI: 1.15%, 7.66%) at lag1, and by 3.21% (95% CI: 0.05%, 6.47%) at lag3. In addition, the relationship between NO2 exposure and the risk of dacryoadenitis was the strongest, with an estimated value of 15.0% (95% CI: 7.99%, 22.5%) at lag0. Moreover, the association between NO2 exposure and the risk of EADs among children in Shenzhen was confirmed in this study. Therefore, the government should introduce stringent environmental policies to control air pollution and protect human health, particularly that of the vulnerable population.
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Affiliation(s)
- Jingfeng Mu
- Shenzhen Key Laboratory of Ophthalmology, Shenzhen Eye Hospital, Shenzhen University Health Science Center, Shenzhen, China
| | - Dan Zeng
- Department of Pharmacy, Shenzhen Maternal and Child Health Care Hospital, Shenzhen, China
| | - Hongwu Zeng
- Department of medical imaging, Shenzhen Children's Hospital, Shenzhen, China
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27
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Lv X, Gao X, Hu K, Yao Y, Zeng Y, Chen H. Associations of Humidity and Temperature With Cataracts Among Older Adults in China. Front Public Health 2022; 10:872030. [PMID: 35433602 PMCID: PMC9008244 DOI: 10.3389/fpubh.2022.872030] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 03/03/2022] [Indexed: 11/22/2022] Open
Abstract
Background The burden of cataracts was substantial in the current aging world. However, few epidemiological studies have examined the associations between climate and weather conditions and cataract in older populations. We aimed to investigate the associations of air relative humidity and temperature with cataracts in older adults in China. Methods We used the cohort data from 2002, 2005, 2008, 2011, 2014, and 2018 waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). A total of 62,595 Chinese older adults aged between 65 and 105 years were included in the analyses. City-level annual average air humidity and temperature during 2001 and 2017 (before the survey year) was used to measure population exposure. A cataract was self-reports based on the medical record or the doctor's diagnosis and 8,071 older adults had cataract. Covariates included socio-demographic, health status, lifestyles, and chronic conditions. We adopted the Generalized estimation equation (GEE) model to analyze the associations of relative humidity and temperature with cataracts. Results We found that the average relative humidity (OR: 0.99; 95% CI: 0.98–0.99) in the past year was inversely associated with cataract likelihoods in older adults and a positive association between temperature (OR: 1.04; 95%CI: 1.03,1.05) in the past year and cataract likelihoods in older adults. The associations were robust in stratified analyses by sex, urban/rural residence, and education level. Furthermore, we found a nonlinear J-shaped relationship between temperature and cataract prevalence. Conclusion Our findings provide the evidence that higher temperature and low relative humidity may be associated with cataracts in older adults.
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Affiliation(s)
- Xiaoyang Lv
- School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xiangyang Gao
- The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Health Management Institute, Chinese PLA General Hospital, Beijing, China
- Xiangyang Gao
| | - Kejia Hu
- School of Public Health, Institute of Big Data in Health Science, Zhejiang University, Hangzhou, China
| | - Yao Yao
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Yi Zeng
- Center for Healthy Aging and Development Studies, National School of Development, Peking University, Beijing, China
| | - Huashuai Chen
- Business School of Xiangtan University, Xiangtan, China
- *Correspondence: Huashuai Chen
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28
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Roth M, Herrmann ME, Geerling G, Guthoff R. [Current and future effects of climate change on ophthalmology]. Ophthalmologe 2022; 119:552-560. [PMID: 35294593 DOI: 10.1007/s00347-022-01594-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND OBJECTIVES Climate change is also an increasingly important issue in the healthcare system. Due to its anatomical and physiological nature, the eye is directly exposed to environmental influences and changes in a special way. METHODS The current literature is used to illustrate the effects of climate-induced changes and the respective influences on the eye. A PubMed search (cut-off date 3 October 2021) using the search terms "climate change" or "planetary health" or "global health" and in each case "ophthalmology" or "eye" or "ocular" was used to determine the development of the number of publications between 2011 and 2021. RESULTS Measurable effects of climate change are already evident in a wide variety of ophthalmological fields. The significance of this topic, for instance, is reflected in a relatively constant increase in the number of publications and an almost tenfold increase in the number of publications per year from 2011 to 2021. CONCLUSION The impact of climate change on eye diseases and on the field of ophthalmology is multifaceted and could be expected to intensify in the coming years. Therefore, the interrelationships need to be further investigated in future studies, preferably on a large scale.
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Affiliation(s)
- M Roth
- Universitätsaugenklinik Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland.
| | - M E Herrmann
- Universitätsaugenklinik Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland
| | - G Geerling
- Universitätsaugenklinik Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland
| | - R Guthoff
- Universitätsaugenklinik Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland
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29
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The Adverse Effects of Air Pollution on the Eye: A Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031186. [PMID: 35162209 PMCID: PMC8834466 DOI: 10.3390/ijerph19031186] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 01/14/2022] [Accepted: 01/15/2022] [Indexed: 12/11/2022]
Abstract
Air pollution is inevitably the result of human civilization, industrialization, and globalization. It is composed of a mixture of gases and particles at harmful levels. Particulate matter (PM), nitrogen oxides (NOx), and carbon dioxides (CO2) are mainly generated from vehicle emissions and fuel consumption and are the main materials causing outdoor air pollution. Exposure to polluted outdoor air has been proven to be harmful to human eyes. On the other hand, indoor air pollution from environmental tobacco smoking, heating, cooking, or poor indoor ventilation is also related to several eye diseases, including conjunctivitis, glaucoma, cataracts, and age-related macular degeneration (AMD). In the past 30 years, no updated review has provided an overview of the impact of air pollution on the eye. We reviewed reports on air pollution and eye diseases in the last three decades in the PubMed database, Medline databases, and Google Scholar and discussed the effect of various outdoor and indoor pollutants on human eyes.
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30
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Mu N, Wang H, Chen D, Wang F, Ji L, Zhang C, Li M, Lu P. A Novel Rat Model of Dry Eye Induced by Aerosol Exposure of Particulate Matter. Invest Ophthalmol Vis Sci 2022; 63:39. [PMID: 35089331 PMCID: PMC8802024 DOI: 10.1167/iovs.63.1.39] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Purpose The purpose of this study was to introduce a novel dry eye rat model induced by aerosol exposure of particulate matter (PM). Methods A total of 30 female Sprague Dawley (SD) rats divided into 3 groups: the control group, the low-level exposed group, and the high-level exposed group. The rats in the experience groups were directly exposed to PM samples in the exposure chamber over 14 days. The clinical observation, including tear volume, corneal fluorescein staining, breakup time (BUT), inflammation index, corneal irregularity score, and corneal confocal microscopy. Eyeballs were collected on day 14 for hematoxylin and eosin (H&E) staining and PAS staining. TUNEL assay, CD45, and Ki67 immunostaining was performed and corneal ultrastructural changes were detected by electron microscopy. IL-1β, TNF-α, IFN-γ, and NF-κB Western blot analysis were used to observe the possible pathogenesis. Results In the PM-treated groups, the number of layers in the corneal epithelium and corneal nerve fiber length were significantly decreased compared with that of the control group. The number of corneal epithelial microvilli and chondriosome/desmosomes were drastically reduced in PM-treated groups. Confocal microscopy and CD45 immunohistochemistry showed inflammatory cell infiltration in the PM-treated groups. PM caused apoptosis of corneal and conjunctival epithelial cells while leading to abnormal epithelial cell proliferation, meanwhile, conjunctival goblet cells in the PM-treated group were also significantly reduced. PM significantly increased the levels of IL-1β, TNF-α, IFN-γ, and p-NF-κB-p65 in the cornea. Conclusions Aerosol exposure of PM can reduce the stability of tear film and cause the change of ocular surface, which is similar to the performance of human dry eye, suggesting a novel animal model of dry eye.
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Affiliation(s)
- Ning Mu
- Department of Ophthalmology, the First Affiliated Hospital of Soochow University, Suzhou, , Jiangsu Province, P.R. China.,Department of Ophthalmology, the Affiliated Hospital of XuZhou Medical University, Xuzhou, Jiangsu Province, P.R. China
| | - He Wang
- Department of Ophthalmology, the Affiliated Hospital of XuZhou Medical University, Xuzhou, Jiangsu Province, P.R. China
| | - Dongyan Chen
- Department of Ophthalmology, the Affiliated Hospital of XuZhou Medical University, Xuzhou, Jiangsu Province, P.R. China
| | - Fan Wang
- Department of Ophthalmology, the Affiliated Hospital of XuZhou Medical University, Xuzhou, Jiangsu Province, P.R. China
| | - Ling Ji
- Department of Ophthalmology, the Affiliated Hospital of XuZhou Medical University, Xuzhou, Jiangsu Province, P.R. China
| | - Can Zhang
- Department of Ophthalmology, the Affiliated Hospital of XuZhou Medical University, Xuzhou, Jiangsu Province, P.R. China
| | - Mingxin Li
- Department of Ophthalmology, the Affiliated Hospital of XuZhou Medical University, Xuzhou, Jiangsu Province, P.R. China
| | - Peirong Lu
- Department of Ophthalmology, the First Affiliated Hospital of Soochow University, Suzhou, , Jiangsu Province, P.R. China
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31
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Chang SW, Ho WT, Chiu CY. Low ambient temperature correlates with the severity of dry eye symptoms. Taiwan J Ophthalmol 2022; 12:191-197. [PMID: 35813789 PMCID: PMC9262028 DOI: 10.4103/tjo.tjo_25_21] [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: 04/11/2021] [Accepted: 05/28/2021] [Indexed: 11/10/2022] Open
Abstract
PURPOSE: The symptoms of dry eye disease (DED) are influenced by environmental factors, but the effect of ambient temperature is less certain. Our purpose was to investigate the relationship between the severity of DED symptoms and the ambient temperature. MATERIALS AND METHODS: This retrospective study reviewed the symptom scores, including ocular surface disease index (OSDI) and standardized patient evaluation of eye dryness (SPEED), as well as tear film parameters of first-time DED patients between June 2018 and June 2019. The contribution of tear film parameters and environmental factors, including ambient temperature, humidity, wind speed, and the concentration of air pollutants, to the severity of dry eye symptoms was evaluated by univariate and multivariate linear regression analyses. RESULTS: There were 351 patients included aged 52.8 ± 13.6 years, and 257 (73.2%) were female. The average tear film break-up time, Schirmer test value, and lipid layer thickness were 2.6 ± 0.7 s, 5.5 ± 4.3 mm, and 64.1 ± 6.0 μm, respectively. The average OSDI and SPEED were 41.8 ± 19.8 and 12.1 ± 5.1, respectively. In winter, the patients reported higher OSDI and SPEED. Both scores were significantly correlated with low ambient temperature. Regression analysis showed that low ambient temperature and Schirmer test value contributed to higher OSDI, while low ambient temperature and younger age contributed to higher SPEED. CONCLUSION: Low ambient temperature plays a significant role in DED symptom severity.
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32
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Su SH, Ho TJ, Yang CC. Retrospective evaluation of the curative effect of traditional Chinese medicine on dry eye disease. Tzu Chi Med J 2021; 33:365-369. [PMID: 34760632 PMCID: PMC8532587 DOI: 10.4103/tcmj.tcmj_281_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 12/24/2020] [Accepted: 01/05/2021] [Indexed: 01/11/2023] Open
Abstract
Dry eye disease (DED) is a multifactorial illness with an increasingly high global prevalence and multiple risk factors that widely influences patients’ daily lives. It is essential to identify treatments with few or no side effects for patients with DED. We have reviewed studies published from 2001 to 2020 that investigated traditional Chinese medicine (TCM) and integrated Chinese and Western medicine for DED treatment. Current Chinese medicines used in DED therapy were categorized into four types, namely anti-oxidants, anti-inflammatory agents, hormone-like agents, and cell-repairing agents. Compound herbs, including Chi-Ju-Di-Huang-Wan and Qiming granule, can effectively alleviate dry eye symptoms. Moreover, patients with DED who were treated with Western medicine combined with TCM experienced significantly magnified therapeutic effects and reasonable costs of treatment. In conclusion, TCM can be a promising approach for treating DED, and combined treatment with TCM and Western drugs may represent a new strategy for improving the curative effect.
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Affiliation(s)
- San-Hua Su
- Department of Chinese Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Tsung-Jung Ho
- Department of Chinese Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Cheng-Chan Yang
- Department of Chinese Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.,School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan
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Protective effects of low-molecular-weight components of adipose stem cell-derived conditioned medium on dry eye syndrome in mice. Sci Rep 2021; 11:21874. [PMID: 34750552 PMCID: PMC8575953 DOI: 10.1038/s41598-021-01503-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 10/29/2021] [Indexed: 11/08/2022] Open
Abstract
The present study demonstrated the protective effects of low-molecular-weight adipose-derived stem cell-conditioned medium (LADSC-CM) in a mouse model of dry eye syndrome. Mice subjected to desiccating stress and benzalkonium chloride had decreased tear secretion, impaired corneal epithelial tight junction with microvilli, and decreased conjunctival goblet cells. Topical application of adipose-derived stem cell-conditioned medium (ADSC-CM) stimulated lacrimal tear secretion, preserved tight junction and microvilli of the corneal epithelium, and increased the density of goblet cells and MUC16 expression in the conjunctiva. The low-molecular-weight fractions (< 10 kDa and < 3 kDa) of ADSC-CM (LADSC-CM) provided better protections than the > 10 kDa or > 3 kDa fractions of ADSC-CM. In the in vitro study, desiccation for 10 min or hyperosmolarity (490 osmols) for 24 h caused decreased viability of human corneal epithelial cells, which were reversed by LADSC-CM. The active ingredients in the LADSC-CM were lipophobic and stable after heating and lyophilization. Our study demonstrated that LADSC-CM had beneficial effects on experimental dry eye. It is worthy of further exploration for the active ingredient(s) and the mechanism.
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Mu J, Zeng D, Fan J, Liu M, Yu S, Ding W, Zhang S. Associations Between Air Pollution Exposure and Daily Pediatric Outpatient Visits for Dry Eye Disease: A Time-Series Study in Shenzhen, China. Int J Public Health 2021; 66:1604235. [PMID: 34483811 PMCID: PMC8415162 DOI: 10.3389/ijph.2021.1604235] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 08/02/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: This study aimed to investigate the associations between air pollution exposure and pediatric outpatient visits for dry eye disease (DED) in Shenzhen, China. Methods: Generalized additive models were utilized to explore the acute effects of air pollution exposure on pediatric outpatient visits for DED. Results: Single-day lag exposures to NO2, O3, PM2.5, and PM10 were associated with DED outpatient visits at lag days 0, 6, 4 and 2. Relative risks (RRs) for DED given a 10-μg/m3 increase in NO2, O3, PM2.5, and PM10 concentrations were 1.062[95% confidence interval (CI) 1.003, 1.123], 1.015(95% CI 1.001, 1.031), 1.052(95% CI 1.001, 1.115), and 1.038 (95% CI 1.002, 1.076), respectively. RR for DED given a 10-μg/m3 increase in NO2 over cumulative lag days 0–1 was 1.075 (95% CI 1.009, 1.147), and RR for DED given a 10-μg/m3 increase in PM10 over cumulative lag days 0–4 was 1.051 (95% CI 1.003, 1.102). Conclusion: The observed associations between air pollution and outpatient visits for DED may provide evidence for policy makers to consider implementing measures to reduce the risk of DED owing to air pollution in China.
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Affiliation(s)
- Jingfeng Mu
- Shenzhen Eye Institute, Shenzhen Eye Hospital, Jinan University, Shenzhen, China.,School of Ophthalmology, Optometry, Shenzhen Eye Hospital, Shenzhen University, Shenzhen, China
| | - Dan Zeng
- Shenzhen Maternal and Child Health Care Hospital, Shenzhen, China
| | - Jingjie Fan
- Shenzhen Maternal and Child Health Care Hospital, Shenzhen, China
| | - Meizhou Liu
- Shenzhen Eye Institute, Shenzhen Eye Hospital, Jinan University, Shenzhen, China.,School of Ophthalmology, Optometry, Shenzhen Eye Hospital, Shenzhen University, Shenzhen, China
| | - Shuyuan Yu
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Wanfu Ding
- Shenzhen Eye Institute, Shenzhen Eye Hospital, Jinan University, Shenzhen, China.,School of Ophthalmology, Optometry, Shenzhen Eye Hospital, Shenzhen University, Shenzhen, China
| | - Shaochong Zhang
- Shenzhen Eye Institute, Shenzhen Eye Hospital, Jinan University, Shenzhen, China.,School of Ophthalmology, Optometry, Shenzhen Eye Hospital, Shenzhen University, Shenzhen, China
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Echevarría-Lucas L, Senciales-González JM, Medialdea-Hurtado ME, Rodrigo-Comino J. Impact of Climate Change on Eye Diseases and Associated Economical Costs. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7197. [PMID: 34281132 PMCID: PMC8297364 DOI: 10.3390/ijerph18137197] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 06/25/2021] [Accepted: 07/02/2021] [Indexed: 01/22/2023]
Abstract
Climate change generates negative impacts on human health. However, little is known about specific impacts on eye diseases, especially in arid and semi-arid areas where increases in air temperatures are expected. Therefore, the main goals of this research are: (i) to highlight the association between common eye diseases and environmental factors; and (ii) to analyze, through the available literature, the health expenditure involved in combating these diseases and the savings from mitigating the environmental factors that aggravate them. Mixed methods were used to assess the cross-variables (environmental factors, eye diseases, health costs). Considering Southern Spain as an example, our results showed that areas with similar climatic conditions could increase eye diseases due to a sustained increase in temperatures and torrential rains, among other factors. We highlight that an increase in eye diseases in Southern Spain is conditioned by the effects of climate change by up to 36.5%; the economic burden of the main eye diseases, extrapolated to the rest of the country, would represent an annual burden of 0.7% of Spain's Gross Domestic Product. In conclusion, the increase in eye diseases has a strong economic and social impact that could be reduced with proper management of the effects of climate change. We propose a new concept: disease sink, defined as any climate change mitigation action which reduces the incidence or morbidity of disease.
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Affiliation(s)
- Lucía Echevarría-Lucas
- Ophthalmology Service of Axarquía Hospital, 29700 Vélez-Málaga, Spain; (L.E.-L.); (M.E.M.-H.)
| | | | | | - Jesús Rodrigo-Comino
- Department of Regional Geographical Analysis and Physical Geography, University of Granada, 18010 Granada, Spain
- Department of Physical Geography, University of Trier, 54296 Trier, Germany
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Exposure to Ambient NO 2 Increases the Risk of Dry Eye Syndrome in Females: An 11-Year Population-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18136860. [PMID: 34206755 PMCID: PMC8296916 DOI: 10.3390/ijerph18136860] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/22/2021] [Accepted: 06/24/2021] [Indexed: 01/02/2023]
Abstract
Previous studies have indicated that women suffer from dry eye syndrome (DES) more significantly than men. Therefore, we specifically explore the associations between air pollutant levels and the risks of DES for women. The study obtained 27,605 participants from the 29 recruitment centers of the Taiwan Biobank, which was established in October 2012. A large scale cross-sectional study involving DES sufferers and age- and education-matched control groups without DES was designed. Based on the municipality of residence, the predicted concentration levels of various air pollutants, including PM2.5, sulfur dioxide (SO2), ozone (O3), and nitrogen dioxide (NO2) were estimated by using hybrid kriging/LUR model. Multiple logistic regressions were applied to estimate the prevalence ratios (PR) of DES and 95% confidence interval. Hormone supplementations, DBP, allergies, and arthritis were considered as important comorbidities for increased PR risk of DES. In addition, with each standard deviation (SD) increment of PM2.5 and temperature, women had significant increases in PRs of DES of 1.09- and 1.07-fold, respectively; conversely, each SD increment of relative humidity (RH) had a protective effect against the risk of DES. After considering hormone supplementation, arthritis, and allergy, the SD increment of NO2 and temperature were associated with the PRs of DES. In conclusion, significant associations of ambient NO2 concentration, RH and temperature with DES indicated the importance of increased environmental protection in the female population. Female exposure to high levels of NO2 when receiving hormone supplementation, or suffering with allergies or arthritis, had significantly increased risk of DES.
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Chatterjee S, Agrawal D, Sanowar G, Kandoi R. Prevalence of symptoms of dry eye disease in an urban Indian population. Indian J Ophthalmol 2021; 69:1061-1066. [PMID: 33913832 PMCID: PMC8186626 DOI: 10.4103/ijo.ijo_1796_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Purpose: The aim of this study was to estimate the prevalence of symptoms of dry eye disease (DED) in an urban population in India. Methods: In this cross-sectional study, a two-stage cluster sampling procedure was conducted across 50 municipal wards in the city of Raipur, India, between December 2019 and February 2020, to include 2500 households. Interviewers collected demographic and lifestyle data from participants aged ≥20 years. DED symptoms were assessed using a standard six-item validated questionnaire. The presence of one or more of the six dry eye symptoms often or all the time was considered positive for DED symptoms. Results: In this study, 2378 people completed the survey of whom 1397 (58.7%) were males and 981 (41.3%) were females. The crude and overall age-adjusted prevalence for any positive symptom was 6.5% and 6.8% (95% CI: 5.8–7.8%), respectively. The commonest symptom was red eyes (2.8%) followed by burning sensation (1.8%), foreign body sensation (1.7%), dry eyes (1.2%), gummy eyes (1.2%), and crusts on eyelashes (0.8%). The associated risk factors were female sex, use of digital display, smoking and stay in an air-conditioned environment. Conclusion: The prevalence of DED symptoms in this urban Indian population was less than the prevalence reported in most other population-based studies from outside India, and lower than other hospital-based studies from India. Hence, DED prevalence in India is either lower than current estimates or is non-uniform in distribution.
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Affiliation(s)
- Samrat Chatterjee
- Cornea and Anterior Segment Services, MGM Eye Institute, Raipur, Chhattisgarh, India
| | - Deepshikha Agrawal
- Cornea and Anterior Segment Services, MGM Eye Institute, Raipur, Chhattisgarh, India
| | - Gul Sanowar
- Cornea and Anterior Segment Services, MGM Eye Institute, Raipur, Chhattisgarh, India
| | - Rushi Kandoi
- Cornea and Anterior Segment Services, MGM Eye Institute, Raipur, Chhattisgarh, India
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Trend Analysis of Air Quality Index (AQI) and Greenhouse Gas (GHG) Emissions in Taiwan and Their Regulatory Countermeasures. ENVIRONMENTS 2021. [DOI: 10.3390/environments8040029] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A reduction in the energy-related emissions of air pollutants would not only mitigate climate change but would also improve local air quality and public health. This paper aimed to analyze the trends of air quality index (AQI) and greenhouse gas (GHG) emissions in Taiwan by using the latest official statistics. In addition, this study also summarized regulatory measures for controlling air pollution from the energy sector with relevance to sustainable development goals (SDGs). With the joint efforts by the public and private sectors, the change in the total GHG emissions did not vary much with the exception of 2009, ranging from 250 to 272 million metric tons of CO2 equivalent from 2005 through 2019. Based on the data on AQI, the percentage of AQI by station-day with AQI > 100 has decreased from 18.1% in 2017 to 10.1% in 2020, indicating a decreasing trend for all criteria air pollutants. On the other hand, the coronavirus disease (COVID-19) lockdown, in 2019, has positively impacted Taiwan’s urban air quality, which was consistent with those observed in other countries. This consistent situation could be attributed to the climate change mitigation policies and promotional actions under the revised Air Pollution Control Act and the Greenhouse Gas Reduction and Management Act of 2015. In response to the SDGs launched by the Taiwan government in 2018, achieving the relevant targets by 2030 can be prospective.
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Bai YC, Wang CY, Lin CL, Lai JN, Wei JCC. Association Between Air Pollution and the Risk of Uveitis: A Nationwide, Population-Based Cohort Study. Front Immunol 2021; 12:613893. [PMID: 33815370 PMCID: PMC8013994 DOI: 10.3389/fimmu.2021.613893] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Accepted: 03/01/2021] [Indexed: 11/22/2022] Open
Abstract
Previous studies have revealed an association between ocular surface disorders and air pollution, few studies have focused on the risk of uveitis. We aimed to investigate whether air pollution increases the risk of uveitis. We used the Taiwan Longitudinal Health Insurance Database (LHID) and the Taiwan Air Quality Monitoring Database (TAQMD) to conduct a retrospective cohort study. Air pollutant concentrations, including those of carbon dioxide (CO2), were grouped into four levels according to quartiles. The outcome was the incidence of uveitis, as defined in the International Classification of Diseases, Ninth Revision. We used univariable and multivariable Cox proportional hazard regression models to calculate the adjusted hazard ratios (aHRs) and determine the potential risk factors of uveitis. Overall, 175,489 subjects were linked to their nearby air quality monitoring stations. We found that for carbon monoxide, the aHRs of uveitis risk for the Q3 and Q4 levels were 1.41 (95% confidence interval (CI) = 1.23–1.61) and 2.19 (95% CI = 1.93–2.47), respectively, in comparison with those for the Q1 level. For nitric oxide, the aHRs for the Q3 and Q4 levels were 1.46 (95% CI = 1.27–1.67) and 2.05 (95% CI = 1.81–2.32), respectively. For nitrogen oxide (NOx), the aHRs for the Q2, Q3, and Q4 levels were 1.27 (95% CI = 1.11–1.44), 1.34 (95% CI = 1.16–1.53), and 1.85 (95% CI = 1.63–2.09), respectively. For total hydrocarbon (THC), the aHRs for the Q2, Q3, and Q4 levels were 1.42 (95% CI = 1.15–1.75), 3.80 (95% CI = 3.16–4.57), and 5.02 (95% CI = 4.19–6.02), respectively. For methane (CH4), the aHRs for the Q3 and Q4 levels were 1.94 (95% CI = 1.60–2.34) and 7.14 (95% CI = 6.01–8.48), respectively. In conclusion, air pollution was significantly associated with incidental uveitis, especially at high THC and CH4 levels. Furthermore, the uveitis risk appeared to increase with increasing NOx and THC levels.
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Affiliation(s)
- Yi-Chiao Bai
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Department of Optometry, Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan
| | - Cheng-You Wang
- College of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Institute of Medicine, E-DA Hospital, Kaohsiung, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Jung-Nien Lai
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan.,Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan
| | - James Cheng-Chung Wei
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan.,Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
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Wolkoff P, Azuma K, Carrer P. Health, work performance, and risk of infection in office-like environments: The role of indoor temperature, air humidity, and ventilation. Int J Hyg Environ Health 2021; 233:113709. [PMID: 33601136 DOI: 10.1016/j.ijheh.2021.113709] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 02/02/2021] [Accepted: 02/03/2021] [Indexed: 12/12/2022]
Abstract
Epidemiological and experimental studies have revealed the effects of the room temperature, indoor air humidity, and ventilation on human health, work and cognitive performance, and risk of infection. In this overview, we integrate the influence of these important microclimatic parameters and assess their influence in offices based on literature searches. The dose-effect curves of the temperature describe a concave shape. Low temperature increases the risk of cardiovascular and respiratory diseases and elevated temperature increases the risk of acute non-specific symptoms, e.g., dry eyes, and respiratory symptoms. Cognitive and work performance is optimal between 22 °C and 24 °C for regions with temperate or cold climate, but both higher and lower temperatures may deteriorate the performances and learning efficiency. Low temperature may favor virus viability, however, depending on the status of the physiological tissue in the airways. Low indoor air humidity causes vulnerable eyes and airways from desiccation and less efficient mucociliary clearance. This causes elevation of the most common mucous membrane-related symptoms, like dry and tired eyes, which deteriorates the work performance. Epidemiological, experimental, and clinical studies support that intervention of dry indoor air conditions by humidification alleviates symptoms of dry eyes and airways, fatigue symptoms, less complaints about perceived dry air, and less compromised work performance. Intervention of dry air conditions by elevation of the indoor air humidity may be a non-pharmaceutical treatment of the risk of infection by reduced viability and transport of influenza virus. Relative humidity between 40 and 60% appears optimal for health, work performance, and lower risk of infection. Ventilation can reduce both acute and chronic health outcomes and improve work performance, because the exposure is reduced by the dilution of the indoor air pollutants (including pathogens, e.g., as virus droplets), and in addition to general emission source control strategies. Personal control of ventilation appears an important factor that influences the satisfaction of the thermal comfort due to its physical and positive psychological impact. However, natural ventilation or mechanical ventilation can become sources of air pollutants, allergens, and pathogens of outdoor or indoor origin and cause an increase in exposure. The "health-based ventilation rate" in a building should meet WHO's air quality guidelines and dilute human bio-effluent emissions to reach an acceptable perceived indoor air quality. Ventilation is a modifying factor that should be integrated with both the indoor air humidity and the room temperature in a strategic joint control to satisfy the perceived indoor air quality, health, working performance, and minimize the risk of infection.
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Affiliation(s)
- Peder Wolkoff
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen Ø, Denmark.
| | - Kenichi Azuma
- Dept Environmental Medicine and Behavioral Science, Kindai University, Faculty of Medicine, Osakasayama, Osaka, Japan.
| | - Paolo Carrer
- Dept Biomedical and Clinical Sciences "L. Sacco", University of Milan, 20157, Milan, Italy.
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Alhusuny A, Cook M, Khalil A, Johnston V. Visual symptoms, Neck/shoulder problems and associated factors among surgeons performing Minimally Invasive Surgeries (MIS): A comprehensive survey. Int Arch Occup Environ Health 2021; 94:959-979. [PMID: 33515063 DOI: 10.1007/s00420-020-01642-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 12/24/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE Minimally Invasive Surgery (MIS) is demanding on the musculoskeletal and visual systems. Prevalence, severity and association of neck/shoulder problems and visual symptoms were examined among MIS surgeons. The associations of workplace and individual factors with these symptoms independently and combined were also examined. METHODS MIS surgeons completed a comprehensive online survey inclusive of 52 questions about individual and workplace physical factors, neck/shoulder problems and visual symptoms. Binary logistic regression models were conducted to determine the associations of the neck/shoulder problems, visual symptoms and combined symptoms with workplace and individual factors. RESULTS 290 surgeons completed the survey. Neck/shoulder problems and visual symptoms were reported by 31.0% and 29.0%, respectively, 15.5% reported both problems. The prevalence and severity of neck/shoulder problems and visual symptoms were significantly associated (p < 0.001). Several workplace and individual factors were associated with these symptoms (p ≤ 0.05). CONCLUSIONS Several factors in the workplace environment (temperature, asymmetrical weight bearing and forward head movement) and individual (being female and wearing vision correction glasses) were significantly associated with neck/shoulder problems and visual symptoms. Evaluation of different strategies to minimise the strain on the neck/shoulder region and the visual system is required.
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Affiliation(s)
- Ameer Alhusuny
- School of Health and Rehabilitation Sciences, The University of Queensland, Level 3, Therapies Annexe Building 84, Brisbane, St Lucia, QLD, 4068, Australia.
| | - Margaret Cook
- School of Earth and Environmental Sciences, Faculty of Science, The University of Queensland, Brisbane, Australia
| | - Akram Khalil
- Faculty of Medicine, The University of Queensland, Brisbane, Australia.,Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Venerina Johnston
- RECOVER Injury Research Centre, The University of Queensland, Brisbane, Australia
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Shin J, Lee H, Kim H. Association between Exposure to Ambient Air Pollution and Age-Related Cataract: A Nationwide Population-Based Retrospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E9231. [PMID: 33321894 PMCID: PMC7763970 DOI: 10.3390/ijerph17249231] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 12/08/2020] [Accepted: 12/09/2020] [Indexed: 12/11/2022]
Abstract
This study aimed to investigate the association between ambient air pollutants and cataracts in the general population aged 50 years or older using data from the Korean National Insurance Service-National Sample Cohort. Cataract patients were defined as those diagnosed by a physician and having undergone cataract surgery. After matching the average concentrations of PM2.5, PM10, NO2, CO, SO2, and O3 in residential areas, the association between quartile level of air pollutants and incidence of cataract was analyzed using a multivariate Cox-proportional hazard risk model. Among the 115,728 participants, 16,814 (14.5%) were newly diagnosed with cataract and underwent related surgery between 1 January 2004, and 31 December 2015. Exposure to PM10, NO2, and SO2 was positively associated with cataract incidence, while O3 was negatively associated. The adjusted hazard ratio (HR) with 95% confidence interval was 1.069 (1.025-1.115) in PM10 and 1.080 (1.030-1.133) in NO2. However, the association between cataract and the quartile of PM2.5 measured during one year in 2015 was not clear. The HR of female participants aged 65 or older was significantly increased according to quartile of air pollutants. We identified exposure to PM10, NO2, SO2, and O3 associated with cataract development in Korean adults aged ≥ 50 years. This information may be helpful for policymaking to control air pollution as a risk factor for eye health.
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Affiliation(s)
- Jinyoung Shin
- Department of Family Medicine, Konkuk University Medical Center, Seoul 05030, Korea;
| | - Hyungwoo Lee
- Department of Ophthalmology, Konkuk University Medical Center, Seoul 05030, Korea;
| | - Hyeongsu Kim
- Department of Preventive Medicine, Konkuk University School of Medicine, Seoul 05030, Korea
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Impact of Air Pollution and Weather on Dry Eye. J Clin Med 2020; 9:jcm9113740. [PMID: 33233863 PMCID: PMC7699870 DOI: 10.3390/jcm9113740] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 11/16/2020] [Accepted: 11/19/2020] [Indexed: 01/05/2023] Open
Abstract
Air pollution has broad effects on human health involving many organ systems. The ocular surface is an excellent model with which to study the effects of air pollution on human health as it is in constant contact with the environment, and it is directly accessible, facilitating disease monitoring. Effects of air pollutants on the ocular surface typically manifest as dry eye (DE) symptoms and signs. In this review, we break down air pollution into particulate matter (organic and inorganic) and gaseous compounds and summarize the literature regarding effects of various exposures on DE. Additionally, we examine the effects of weather (relative humidity, temperature) on DE symptoms and signs. To do so, we conducted a PubMed search using key terms to summarize the existing literature on the effects of air pollution and weather on DE. While we tried to focus on the effect of specific exposures on specific aspects of DE, environmental conditions are often studied concomitantly, and thus, there are unavoidable interactions between our variables of interest. Overall, we found that air pollution and weather conditions have differential adverse effects on DE symptoms and signs. We discuss these findings and potential mitigation strategies, such as air purifiers, air humidifiers, and plants, that may be instituted as treatments at an individual level to address environmental contributors to DE.
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44
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Wang W, Du X, Ye L, Wang X, Zhang G. Distribution of serum specific IgE in children with allergic conjunctivitis and analysis of its concomitant allergic diseases. Transl Pediatr 2020; 9:636-644. [PMID: 33209726 PMCID: PMC7658764 DOI: 10.21037/tp-20-216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Allergic conjunctivitis (AC) is predominantly caused by serum specific-IgE (sIgE)-mediated type I allergy. This study aims to analyze the distribution of sIgE in children with AC, and the concomitant allergic diseases. METHODS The clinical data from 310 children, diagnosed with AC and admitted to our hospital from January 2017 to January 2019 were retrospectively collected. The children were divided into three groups: infant group (2 months to 1 year old, 91 cases), child group (1 to 3 years old, 112 cases), and preschool group (3 to 6 years old, 107 cases). Children in every group were analyzed for positive rates, the number of positive sIgE types, the distribution of positive inhaling and ingesting allergens and concomitant allergic diseases. RESULTS The sIgE positive rate of infant was significantly lower than that of the other two groups, and the number of 18.75% sIgE positive species was 1. The number of sIgE positive species in the child group and preschool group was more than 2 (78.30%, 71.15%). The positive rate of sIgE to dust mites, house dust, animal dander, eggs, beef, mutton and mango in the preschool group was significantly higher than the other groups (P<0.05). The positive rate of sIgE to milk in infant group was significantly higher than the other two groups (P<0.05). Children in the preschool group showed the highest incidence of AC, AC + allergic rhinitis, AC + allergic rhinitis + wheezing, while those in the infant group displayed the lowest incidence (P<0.05). AC + gastrointestinal allergy, AC + atopic dermatitis, AC + gastrointestinal allergy + atopic dermatitis in infant group was significantly higher than the other two groups (P<0.05). Patients in the child group displayed a significantly higher incidence of AC + infant wheezing than the other two groups (P<0.05). CONCLUSIONS We correlated children's age with the positive rate and gradual increase in types of AC allergens. Concomitant allergic diseases of children with AC at different ages conform to the natural course of allergic diseases. In clinic, improving the diagnostic efficiency of AC in children, and early interventional treatment will positively contribute to their prognosis, and reduce the risk of other allergic diseases.
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Affiliation(s)
- Wenjun Wang
- Department of Optometry Center, Xi'an People's Hospital (Xi'an Fourth Hospital), Xi'an, China
| | - Xiumei Du
- Department of Optometry Center, Xi'an People's Hospital (Xi'an Fourth Hospital), Xi'an, China
| | - Lu Ye
- Department of Optometry Center, Xi'an People's Hospital (Xi'an Fourth Hospital), Xi'an, China
| | - Xiaoli Wang
- Department of Optometry Center, Xi'an People's Hospital (Xi'an Fourth Hospital), Xi'an, China
| | - Guoyun Zhang
- Department of Optometry Center, Xi'an People's Hospital (Xi'an Fourth Hospital), Xi'an, China
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Tandon R, Vashist P, Gupta N, Gupta V, Sahay P, Deka D, Singh S, Vishwanath K, Murthy GVS. Association of dry eye disease and sun exposure in geographically diverse adult (≥40 years) populations of India: The SEED (sun exposure, environment and dry eye disease) study - Second report of the ICMR-EYE SEE study group. Ocul Surf 2020; 18:718-730. [PMID: 32783926 DOI: 10.1016/j.jtos.2020.07.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 07/12/2020] [Accepted: 07/25/2020] [Indexed: 12/29/2022]
Abstract
PURPOSE To estimate the prevalence and determine risk factors for dry eye disease (DED) in geographically diverse regions of India. METHOD A population based cross-sectional study was conducted on people aged ≥40 years in plain, hilly and coastal areas. Dry eye assessment by objective [tear film break-up time (TBUT), Schirmer I, corneal staining] and subjective [Ocular Surface Disease Index (OSDI)] parameters was performed with questionnaire-based assessment of exposure to sunlight, cigarette smoke, indoor smoke. The prevalence of DED with age, sex, occupation, location, smoking, exposure to sunlight, indoor smoke, diabetes, hypertension, was subjected to logistic regression analysis. RESULTS 9,735 people (age 54.5 ± 0.1 years; range 40-99, males 45.5%) were included. The prevalence of DED was 26.2%, was higher in plains (41.3%) compared to hilly (24.0%) and coastal area (9.9%) (p < 0.001) and increased with age (p < 0.001), female gender (p < 0.001), smoking (p < 0.001), indoor smoke (p < 0.001), diabetes (p-0.02), hypertension (0.001), occupations with predominant outdoor activity (p-0.013) and increasing exposure to sunlight (trend). Multi-logistic regression showed a positive association with female sex (OR-1.2, CI-1.01, 1.4), exposure to indoor smoke (OR-1.3, CI-1.1, 1.5), smoking (OR-1.2; CI-1.03, 1.3), prolonged exposure to sunlight (OR-1.8, CI-1.5, 2.2), hypertension (OR 1.3, CI-1.2, 1.4), diabetes (OR-1.2, CI-1, 1.5) and negative association with region - hilly (OR-0.5, CI-0.4, 0.6) and coastal (OR-0.2; CI-0.1, 0.2), and BMI (OR-0.8, CI-0.7, 0.9). CONCLUSION DED is common in population ≥40 years of age. Its prevalence is affected by extrinsic (geographic location, exposure to sunlight, smoking, indoor smoke) and intrinsic (age, sex, hypertension, diabetes, BMI) factors.
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Affiliation(s)
- Radhika Tandon
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India.
| | - Praveen Vashist
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Noopur Gupta
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Vivek Gupta
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Pranita Sahay
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Dipali Deka
- Regional Institute of Ophthalmology, Guwahati, India
| | | | - K Vishwanath
- Pushpagiri Vitreo Retina Institute, Secunderabad, Telangana, India
| | - G V S Murthy
- Indian Institute of Public Health, Hyderabad, India
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Prediction Model for Dry Eye Syndrome Incidence Rate Using Air Pollutants and Meteorological Factors in South Korea: Analysis of Sub-Region Deviations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17144969. [PMID: 32664192 PMCID: PMC7399894 DOI: 10.3390/ijerph17144969] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 06/22/2020] [Accepted: 07/02/2020] [Indexed: 11/16/2022]
Abstract
Here, we develop a dry eye syndrome (DES) incidence rate prediction model using air pollutants (PM10, NO2, SO2, O3, and CO), meteorological factors (temperature, humidity, and wind speed), population rate, and clinical data for South Korea. The prediction model is well fitted to the incidence rate (R2 = 0.9443 and 0.9388, p < 2.2 × 10−16). To analyze regional deviations, we classify outpatient data, air pollutant, and meteorological factors in 16 administrative districts (seven metropolitan areas and nine states). Our results confirm NO2 and relative humidity are the factors impacting regional deviations in the prediction model.
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Idarraga MA, Guerrero JS, Mosle SG, Miralles F, Galor A, Kumar N. Relationships Between Short-Term Exposure to an Indoor Environment and Dry Eye (DE) Symptoms. J Clin Med 2020; 9:E1316. [PMID: 32370240 PMCID: PMC7290742 DOI: 10.3390/jcm9051316] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 04/21/2020] [Accepted: 04/26/2020] [Indexed: 01/05/2023] Open
Abstract
Air composition influences Dry Eye (DE) symptoms as demonstrated by studies that have linked the outdoor environment to DE. However, there is insufficient data on the effect of short-term exposure to indoor environments on DE symptoms. We conducted a prospective experimental research, in which an older building served as an experimental site, and a newer building served as the control site. Indoor air quality was monitored in both buildings. One-hundred-and-ninety-four randomly selected individuals were interviewed in the afternoon exiting the buildings and de-identified responses were recorded. Self-reported DE symptoms were modeled with respect to experimental and control buildings, adjusting for potential confounders. The experimental site had 2-fold higher concentration of airborne particulate matter (24,436 vs. 12,213 ≥ 0.5 µm/ft3) and microbial colonies (1066 vs. 400/m3), as compared to the control building. DE symptoms were reported by 37.5% of individuals exiting the experimental and 28.4% exiting the control building. In the univariate analysis, subjects exiting the experimental building were 2.21× more likely to report worsening of DE symptoms since morning compared to the control building (p < 0.05). When adjusting for confounders, including a history of eye allergy, subjects from the experimental building were 13.3× more likely to report worsening of their DE symptoms (p < 0.05). Our findings suggest that short-term exposure to adverse indoor environmental conditions, specifically air pollution and bioaerosols, has an acutely negative impact on DE symptoms.
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Affiliation(s)
- Maria A. Idarraga
- Bascom Palmer Eye Institute, University of Miami, Miami, FL 33136, USA; (M.A.I.); (J.S.G.)
| | - Juan S. Guerrero
- Bascom Palmer Eye Institute, University of Miami, Miami, FL 33136, USA; (M.A.I.); (J.S.G.)
| | - Samantha G. Mosle
- Environmental Health Division, University of Miami, Miami, FL 33136, USA; (S.G.M.); (F.M.); (N.K.)
| | - Frank Miralles
- Environmental Health Division, University of Miami, Miami, FL 33136, USA; (S.G.M.); (F.M.); (N.K.)
| | - Anat Galor
- Bascom Palmer Eye Institute, University of Miami, Miami, FL 33136, USA; (M.A.I.); (J.S.G.)
- Department of Ophthalmology, Miami Veterans Administration Medical Center, Miami, FL 33125, USA
| | - Naresh Kumar
- Environmental Health Division, University of Miami, Miami, FL 33136, USA; (S.G.M.); (F.M.); (N.K.)
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Short-Term Effects of Ground-Level Ozone in Patients With Dry Eye Disease: A Prospective Clinical Study. Cornea 2020; 38:1483-1488. [PMID: 31299662 DOI: 10.1097/ico.0000000000002045] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To investigate changes in the clinical features of patients with dry eye disease (DED) according to short-term outdoor ground-level ozone exposure. METHODS This prospective observational study included patients with DED who were treated with the same topical drugs (0.05% cyclosporine or 3% diquafosol) and visited the hospital twice at 2-month intervals. Patients who showed a short tear film breakup time and positive ocular surface staining were assigned to the diquafosol and cyclosporine groups, respectively. The ocular surface disease index (OSDI) score, tear secretion, tear film breakup time, and corneal fluorescein staining score were measured at each visit. The mean ground-level ozone concentration for 1 week before the ocular examinations was used as the ozone exposure level. Changes in dry eye parameters according to changes in ozone concentration were analyzed using univariate and multivariate linear analyses. RESULTS Thirty-three patients were included in the analysis. The mean age was 55.2 ± 10.5 years. Ozone concentrations were significantly associated with increased OSDI scores (R = 0.304, P = 0.0006) and a decreased tear secretion (R = -0.355, P = 0.0012) in univariate models. In multivariate models, the results were consistent; the OSDI score increased by 3.43 points (β = 3.43, P = 0.002), and tear secretion decreased by 1.43 mm (β = -1.43, P = 0.015) per 0.01 ppm increase in ozone concentrations over a 2-month interval. Notably, the cyclosporine group showed more prominent changes in the OSDI score and tear secretion with changes in the ozone concentration (P < 0.05). CONCLUSIONS Short-term exposure to increased ground-level ozone concentration led to increased ocular discomfort and decreased tear secretion in patients with DED.
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Kuo YK, Lin IC, Chien LN, Lin TY, How YT, Chen KH, Dusting GJ, Tseng CL. Dry Eye Disease: A Review of Epidemiology in Taiwan, and its Clinical Treatment and Merits. J Clin Med 2019; 8:E1227. [PMID: 31443274 PMCID: PMC6722537 DOI: 10.3390/jcm8081227] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 08/06/2019] [Accepted: 08/08/2019] [Indexed: 12/11/2022] Open
Abstract
Dry eye disease (DED) has become common on a global scale in recent years. There is a wide prevalence of DED in different countries based on various ethnicities and environment. DED is a multifactorial ocular disorder. In addition to advanced age and gender, such factors as living at high altitude, smoking, pterygium, prolonged use of consumer electronics or overingesting of caffeine or multivitamins are considered to be the major risk factors of DED. We report the DED epidemiology in Taiwan firstly in this article. According to the pathophysiological factors and changes inthe composition of the tear film in DED, it can be categorized into several subtypes, including lipid anomaly dry eye, aqueous tear deficiency, allergic and toxic dry eye among others. Each subtype has its own cause and disease management; therefore, it is important for ophthalmologists to identify the type through literature review and investigation. The management of DED, relies not only on traditional medications such as artificial tears, gels and ointments, but also newer treatment options such as acupuncture, SYL1001, and nanomedicine therapy. We also conducted a comprehensive literature review including common subtypes and treatment of DED. Clearly, more clinical trials are needed to assess the efficacy and safety of the various treatments and common subtypes of DED.
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Affiliation(s)
- Yu-Kai Kuo
- School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - I-Chan Lin
- Department of Ophthalmology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan
- Department of Ophthalmology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Li-Nien Chien
- School of Health Care Administration, College of Management, , Taipei Medical University, Taipei 11031, Taiwan
- Health and Clinical Data Research Center, College of Public Health, Taipei Medical University, Taipei 11031, Taiwan
| | - Tzu-Yu Lin
- Department of Ophthalmology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan
- Department of Ophthalmology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Ying-Ting How
- Graduate Institute of Biomedical Materials & Tissue Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 11031, Taiwan
| | - Ko-Hua Chen
- Department of Ophthalmology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
- Department of Ophthalmology, Taipei Veterans General Hospital, Taipei 11217, Taiwan
| | - Gregory J Dusting
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, VIC 3002, Australia
- Ophthalmology, Department of Surgery, University of Melbourne, East Melbourne, VIC 3002, Australia
| | - Ching-Li Tseng
- Graduate Institute of Biomedical Materials & Tissue Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 11031, Taiwan.
- Institute of International PhD Program in Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 11031, Taiwan.
- Research Center of Biomedical Device, College of Biomedical Engineering, Taipei Medical University, Taipei 11031, Taiwan.
- International PhD Program in Cell Therapy and Regenerative Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan.
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