Evaluation of oxidative stress levels in the conjunctival epithelium of patients with or without dry eye, and dry eye patients treated with preservative-free hyaluronic acid 0.15 % and vitamin B12 eye drops

Abstract Purpose To study the treatment efficacy of hyaluronic acid 0.3%, cyanocobalamin (vitamin B12), electrolytes, and P-Plus in menopausal patients with moderate dry eye disease. Methods Thirty female patients of mean age 53.06 ± 5.20 years (45–65) were enrolled in this prospective longitudinal study. Meibomian gland loss assessment was determined using a scale with four levels. The Ocular Surface Disease Index (OSDI) questionnaire, phenol red thread (PRT) test, and tear film break-up time (TFBUT) were also completed by the patients. Tear eye drops were formulated with 0.3 g of sodium hyaluronate, P-Plus ™, vitamin B12, sodium chloride, potassium chloride, calcium chloride, magnesium chloride, and SCO® (stabilized complex oxychloride). After 30 days, the patients were re-evaluated. Results The mean meibomian gland loss percentage was 37.97 ± 19.02 % (7.20 to 88.30%). Before treatment, the OSDI was 22.53 ± 14.03 score points (6.25 to 77.08). Posterior OSDI decreased to 16.26 ± 13.69 score points (0.00 to 70.83) (W = 58.00, P < 0.01). Before treatment, PRT was 10.31 ± 4.48 mm (4.00 to 21.00). Posterior PRT increased to 15.41 ± 6.27 mm (4.00 to 21.00) (W = 1520.50, P < 0.01). Before treatment, TFBUT was 6.23 ± 1.75 s (3.00 to 9.00). The posterior TFBUT increased to 8.10 ± 2.06 s (4.00 to 14.00) (W= 1382.50, P < 0.01). Conclusion The hyaluronic acid 0.3% and vitamin B12 eye drops effectively decreased dry eye symptoms in menopausal women and improved tear stability and volume.

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A Meta-Analysis of the Efficacy of Hyaluronic Acid Eye Drops for the Treatment of Dry Eye Syndrome

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18052383 ◽

2021 ◽

Vol 18 (5) ◽

pp. 2383

Author(s):

Yun-Jung Yang ◽

Won-Young Lee ◽

Young-jin Kim ◽

Yeon-pyo Hong

Keyword(s):

Hyaluronic Acid ◽

Confidence Interval ◽

Dry Eye ◽

Test Scores ◽

Meta Analysis ◽

Mean Difference ◽

Dry Eye Syndrome ◽

Eye Drops ◽

Cochrane Central Register ◽

Standard Mean Difference

Hyaluronic acid (HA) is commonly used for treating dry eye syndrome (DES). This meta-analysis was performed to compare the efficacies of HA- and non-HA-based eye drops, including saline and conventional artificial tears (ATs), for the treatment of dry eye disease. Eight databases (PubMed, EMBASE, Cochrane Central Register of Controlled Trials, DBpia, KoreaMed, KMBASE, RISS, KISS) were searched for studies comparing the efficacies of HA- and non-HA-based ATs in patients with DES published up to September 2020. Two independent reviewers assessed the quality and extracted the relevant data. The mean differences of Schirmer’s (SH) test scores, tear breakup times (TBUT), corneal fluorescein staining scores (Oxford scale, 0–4), and ocular surface disease indexes were calculated. The standard mean difference and 95% confidence interval were calculated using a random effect model. Nineteen studies, including 2078 cases, were included. HA eye drops significantly improved tear production compared with non-HA-based eye drops (standard mean difference (SMD) 0.18; 95% confidence interval (CI) 0.03, 0.33). In a subgroup analysis, the SH test scores and TBUT values after using HA significantly increased compared to those measured after using saline (SMD 0.27; 95% CI 0.05, 0.49 and SMD 0.28; 95% CI 0.03, 0.52, respectively). Based on these results, HA eye drops may be superior to non-HA eye drops including normal saline and ATs. Further research is needed to assess the efficacies stratified by age, treatment duration, the severity of dry eye, and optimal dosages.

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The Effects of High Molecular Weight Hyaluronic Acid Eye Drop Application in Environmental Dry Eye Stress Model Mice

International Journal of Molecular Sciences ◽

10.3390/ijms21103516 ◽

2020 ◽

Vol 21 (10) ◽

pp. 3516 ◽

Cited By ~ 6

Author(s):

Takashi Kojima ◽

Taeko Nagata ◽

Haruka Kudo ◽

Wolfgang G. K. Müller-Lierheim ◽

Gysbert-Botho van Setten ◽

...

Keyword(s):

Molecular Weight ◽

Hyaluronic Acid ◽

High Molecular Weight ◽

Dry Eye ◽

Ophthalmic Solution ◽

Low Molecular Weight ◽

Eye Drops ◽

Office Work ◽

Lissamine Green ◽

Inflammatory Effect

Hyaluronic acid (HA) ophthalmic solution is widely used in dry eye treatment worldwide. However, there are no reports comparing the dry eye treatment effects of high molecular weight HA with low molecular weight HA. Sixty eight-week-old C57BL/6 mice were assigned to the following 6 groups and exposed to environmental dry eye stress (EDES) that mimics office work environment: (1) 0.1% low molecular weight HA (LMWHA) eye drops, (2) 0.3% LMWHA eye drops, (3) 3% diquafosol sodium (DQ) eye drops, (4) 0.15% high molecular weight HA (HMWHA) eye drops, (5) no treatment with exposure to EDES (EDES+/Treatment−), and (6) no treatment without exposure to EDES (EDES−/Treatment−). After EDES, the HMWHA group had significantly longer break-up time (BUT) than the 0.1%, 0.3% LMWHA groups and the DQ group. After EDES, the HMWHA group had significantly lower lissamine green staining scores than the LMWHA and DQ groups. Subepithelial presumed dendritic cell density in the HMWHA group was significantly lower than the EDES+/Treatment− group. After EDES exposure, Conjunctival Muc5AC mRNA expression in the HMWHA group was significantly higher than the 0.1 and 0.3% LMWHA groups. Ophthalmic HMWHA solution may have a better dry eye treatment effect than LMWHA or DQ solution, owing to its anti-inflammatory effect.

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Efficacy of the Mineral Oil and Hyaluronic Acid Mixture Eye Drops in Murine Dry Eye

Korean Journal of Ophthalmology ◽

10.3341/kjo.2015.29.2.131 ◽

2015 ◽

Vol 29 (2) ◽

pp. 131 ◽

Cited By ~ 7

Author(s):

Jung Han Choi ◽

Jung Han Kim ◽

Zhengri Li ◽

Han Jin Oh ◽

Kyu Youn Ahn ◽

...

Keyword(s):

Hyaluronic Acid ◽

Dry Eye ◽

Mineral Oil ◽

Acid Mixture ◽

Eye Drops

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Effectiveness of a Preservative-Free Eye Drop, Cyclosporine 0.05% Emulsion, and Omega-3 Supplementation as a Fixed Combination in Dry Eye Disease – a Pilot Study

Current Trends in Ophthalmology ◽

10.18314/ctoy.v1i1.151 ◽

2018 ◽

Vol 1 (1) ◽

pp. 01-06

Author(s):

Tokko HA ◽

Al-Awadi A ◽

Somani S

Keyword(s):

Dry Eye ◽

Fixed Combination ◽

Case Series ◽

Secondary Outcome ◽

Combination Regimen ◽

Eye Drops ◽

Secondary Outcome Measure ◽

Omega 3 ◽

The Impact ◽

Preservative Free

Purpose: We aim to evaluate the impact of combining a preservative-free drop, cyclosporine 0.05% emulsion, and omega-3 oral supplementation on the signs and symptoms of dry eye in a typical ophthalmic practice.Design: A retrospective case series conducted on patients with dry eye disease.Methods: Patients diagnosed with dry eye in a typical ophthalmology practice were initiated on a fixed combination regimen which included a preservative-free eye drop (I-DROP ® PUR GEL, I-MED pharma), cyclosporine 0.05% ophthalmic emulsion, and oral omega-3 supplement(Dry Eye Omega Benefits®, PRN)for 3 monthsconsecutively. The primary outcome measured was a symptom score using the Canadian Dry Eye Assessment Tool (CDEA). Secondary outcome measure was Non-invasive Keratograph Break-up Time (NIKBUT). Primary and secondary outcomes measured at baseline and 3 months following intervention were compared.Results: Thirty-six patients were included with a female male ratio of 2.6:1 and average age of 64.Patient symptoms improved significantly following the intervention as demonstrated by a lower CDEA score during the second visit compared to the first visit (16.11 vs. 19.50, respectively) (p< .05). NIKBUT scores were also significantly improved as demonstrated by a higher score during the second visit compared to the first in both the right (13.18 vs. 11.44) (p< .05) and left (14.62 vs. 12.78) (p< .01) eyes, respectively.Conclusion: A fixed combination of preservative-free eye drops, cyclosporine 0.05% and omega-3 supplementation may be an effective first line treatment option in alleviating symptoms and improving signs of patients suffering from dry eye.

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Analysis of treatment results in dry eye syndrome patients after phacoemulsification by preservative-free 0.3% sodium hyaluronate eye drops

Ophthalmology journal ◽

10.17816/ov10273-77 ◽

2017 ◽

Vol 10 (2) ◽

pp. 73-77

Author(s):

Yury I Pirogov ◽

Galina M Butina ◽

Aleksandr A Oksentjuk ◽

Ekaterina S Khromova

Keyword(s):

Dry Eye ◽

Sodium Hyaluronate ◽

Dry Eye Syndrome ◽

Surgical Trauma ◽

Eye Drops ◽

Mean Values ◽

Tear Secretion ◽

Mild Degree ◽

Patient Symptom ◽

Preservative Free

Postsurgical dry eye syndrome is found in a substantial proportion of patients after phacoemulsification. Its onset could be explained by surgical trauma and by use of preservative-containing eye drops. In some patients, it causes substantial discomfort that continues unabated after 3-4 weeks after surgery. Purpose. To investigate the results of 0.3% sodium hyaluronate instillation therapy used to treat dry eye syndrome after phacoemulsification. Materials and methods. Basal tear secretion (Schirmer II test) and tear breakup time (TBUT) test were investigated in 33 patients with symptoms characteristic of dry eye syndrome in 1 month after phacoemulsification. These patients received 0.3% preservative-free sodium hyaluronate instillations for 30 days, whereupon Schirmer II and TBUT tests were repeated. Symptom dynamics was estimated according to the OSDI questionnaire scale. Results. Mean values of basal tear secretion and TBUT tests were slightly below normal ones. In one month of treatment, the TBUT index associated with “Gilan Ultra Comfort” use became somewhat better: mean TBUT value appeared to be 9.8 ± 2.5 sec. OSDI questionnaire patient symptom score evaluation also revealed in patients a mild degree of xerosis severity. Mean score before treatment was 19.6 ± 10.0. Positive disease dynamics after “Gilan Ultra Comfort” use is confirmed by a significant decrease of OSDI score index up to 12.3 ± 6.3.

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Effects of Eye Drops Containing Hyaluronic Acid-Nimesulide Conjugates in a Benzalkonium Chloride-Induced Experimental Dry Eye Rabbit Model

Pharmaceutics ◽

10.3390/pharmaceutics13091366 ◽

2021 ◽

Vol 13 (9) ◽

pp. 1366

Author(s):

Tzu-Yang Chen ◽

Ching-Li Tseng ◽

Chih-An Lin ◽

Hua-Yang Lin ◽

Parthiban Venkatesan ◽

...

Keyword(s):

Hyaluronic Acid ◽

Dry Eye ◽

Goblet Cell ◽

Corneal Epithelium ◽

Benzalkonium Chloride ◽

Immunofluorescent Staining ◽

Prolonged Treatment ◽

Eye Drops ◽

Cell Recovery ◽

Anti Inflammatory

Dry eye syndrome (DES) is a common ocular disease worldwide. Currently, anti-inflammatory agents and immunosuppressive drugs, such as cyclosporine A, have been widely used to treat this chronic condition. However, the multifactorial etiology of DES, poor tolerance, low bioavailability, and prolonged treatment to response time have limited their usage. In this study, nimesulide, a cyclooxygenase (COX)-2 selective inhibitor, was conjugated with hyaluronic acid (HA), and the HA-nimesulide conjugates were expected to increase the solubility and biocompatibility for alleviating the DES in the benzalkonium chloride (BAC)-induced goblet cell-loss dry eye model. The therapeutic efficacy of HA-nimesulide was assessed using fluorescein staining, goblet cell density by conjunctival impression cytology, and histology and immunohistochemistry of corneal tissues. Compared to commercial artificial tears and Restasis®, the HA-nimesulide conjugates could promote goblet cell recovery and enhance the regeneration of the corneal epithelium. Importantly, immunofluorescent staining studies demonstrated that the HA-nimesulide conjugates could decrease the number of infiltrating CD11b-positive cells after two weeks of topical application. In the anti-inflammatory test, the HA-nimesulide conjugates could inhibit the production of pro-inflammatory cytokines and prostaglandin E2 (PGE2) in the lipopolysaccharide (LPS)-stimulated Raw 264.7 cell model. In conclusion, we demonstrated that HA-nimesulide conjugates had anti-inflammatory activity, and promoted goblet cell recovery and corneal epithelium regeneration when used as topical eye drops; accordingly, the HA-nimesulide conjugates could potentially be effective for the treatment of DES.

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