Dupilumab-induced ocular surface disease (DIOSD) in patients with atopic dermatitis: clinical presentation, risk factors for development and outcomes of treatment with tacrolimus ointment

AimTo identify risk factors for the development of dupilumab-induced ocular surface disease (DIOSD) in adult patients with atopic dermatitis (AD) and describe outcomes of treatment.MethodsA retrospective institutional cohort study performed at the Rabin Medical Center, Petach Tikva, Israel. Adult patients with AD who received dupilumab from March 2018 to June 2019 were included. Demographics, AD severity scores, blood IgE levels, previous atopic keratoconjunctivitis (AKC), dermatological response to dupilumab, ophthalmological evaluation and treatment were noted. Univariate and multivariate analyses were used to identify risk factors for DIOSD.ResultsSixteen of 37 patients who were included in the study (43%) had new or exacerbated symptoms of ocular surface disease starting at 2 weeks following the first treatment. Three patients reported transient dry eye sensation which lasted 2 weeks; nine patients reported chronic dry eye sensation, and four patients (25%) had marked blepharoconjunctivitis. The presence of severe AD was the strongest predictor of DIOSD. Not a single patient with moderate AD had DIOSD. In multivariate analysis, prior AKC was a risk factor for DIOSD (R2=15.78, OR=23.28, p=0.005) while a family history of atopy was protective of DIOSD (R2=6.22, OR=0.13, p=0.05). All four patients with blepharoconjunctivitis had resolution of signs, and symptoms within days of starting periocular 0.03%–0.1% tacrolimus ointment.ConclusionsDIOSD is common in patients with AD receiving dupilumab. While most cases are mild, some patients can develop blepharoconjunctivitis which responds well to tacrolimus ointment. AD severity, and previous AKC are risk factors for DIOSD.

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Short-term changes in ocular surface signs and symptoms after phacoemulsification

European Journal of Ophthalmology ◽

10.1177/1120672119896427 ◽

2020 ◽

Vol 30 (6) ◽

pp. 1301-1307 ◽

Cited By ~ 1

Author(s):

María García Zamora ◽

Eugenia Francés Caballero ◽

Miguel J Maldonado

Keyword(s):

Dry Eye ◽

Ocular Surface ◽

Signs And Symptoms ◽

Disease Index ◽

Ocular Surface Disease ◽

Schirmer Test ◽

Short Term ◽

Ocular Surface Disease Index ◽

Fluorescein Staining ◽

Superficial Punctate Keratopathy

Purpose: The aim of this study is to evaluate the incidence, natural course, and distribution pattern of superficial punctate keratopathy and describe the changes in signs and symptoms of dry eye after cataract surgery. Setting: The setting of this study is University Hospital Rio Hortega and Instituto Universitario de Oftalmobiología Aplicada, Valladolid, Spain. Design: This is a prospective interventional study. Materials and Methods: In total, 55 eyes of 55 different patients with no history of dry eye underwent standard phacoemulsification through a 2.75-mm-wide corneal incision. We measured tear break-up time, Schirmer test I, and tear meniscus height, and recorded the Ocular Surface Disease Index score, fluorescein staining patterns, and photo documentation of the ocular surface before and 1 day, 1 week, and 1 month postoperatively. Patients were divided into two groups (with and without superficial punctate keratopathy development, 1 day postoperatively). Results: Patients (mean age: 75.75 ± 7.27 years) showed an incidence of 76.3% of superficial punctate keratopathy at 24 h. Location predominated in the center of the cornea until a week (32.7%) and then began to prevail in the inferior quadrant (21.8%) at 1 month. All dry eye tests were significantly worse after surgery. Ocular Surface Disease Index increased from 10.98 ± 5.05 to 15.87 ± 6.57 at 24 h ( p < .001), to 12.80 ± 5.77 at 7 days ( p < .001), and to 11.09 ± 4.63 at 1 month ( p = .90). Fluorescein staining patterns got worse 24 h postoperatively with a score of 2.12 using the National Eye Institute/Industry–recommended guidelines staining grid. Average break-up time values were significantly lower at 1 day (6.61 ± 2.68),1 week (6.98 ± 2.79), and 1 month (7.05 ± 2.86) postoperatively than preoperatively (8.78 ± 2.97) ( p < .001). The mean postoperative first month Schirmer test I value (8.32 ± 3.58) was significantly lower than preoperative value (9.05 ± 3.63) ( p < .001). Conclusion: Phacoemulsification tends to induce short-term transitory ocular surface impairment manifesting as both signs and symptoms. Superficial punctate keratopathy distribution has a characteristic pattern evolution according to the postoperative time. Those patients with altered preoperative values are more likely to develop ocular surface disease and for longer time.

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Ocular Surface Disease Signs and Symptoms of Glaucoma Patients and Their Relation to Glaucoma Medication in Finland

10.21203/rs.3.rs-845958/v1 ◽

2021 ◽

Author(s):

Minna Parkkari ◽

Petri Purola ◽

Hannu Uusitalo

Keyword(s):

Dry Eye ◽

Ocular Surface ◽

Open Angle Glaucoma ◽

Signs And Symptoms ◽

Ocular Surface Disease ◽

Pigmentary Glaucoma ◽

Eye Drops ◽

Glaucoma Medication ◽

Cross Sectional ◽

Active Compounds

Abstract Purpose: To evaluate the prevalence of ocular surface disease (OSD) signs and symptoms of glaucoma patients in relation to topical glaucoma treatment and to compare them to non-glaucomatous population. Methods: A multicenter, cross-sectional study consisting of private ophthalmology clinic visits in southern Finland. Glaucoma patients had a diagnosis of primary open-angle glaucoma, pseudoexfoliation glaucoma, pigmentary glaucoma or treated ocular hypertension. Control patients had no prior or current use of glaucoma medication. Recorded parameters included OSD signs and symptoms, used glaucoma medications during the past 6 months, and the product name and type of used antiglaucoma drugs.Results: Glaucoma patients (n = 564) showed higher severity of OSD sign parameters excluding Schirmer’s test, as well as increased dry eye sensation compared to controls (n = 51). Beta-blockers and preservative-free prostaglandins had the smallest effect on all parameters. The increasing number of active compounds and administered eye drops per day showed an association with increasing severity of OSD signs and symptoms.Conclusion: Glaucoma patients show higher prevalence of OSD signs and dry eye sensation compared to non-glaucomatous population. The use of preserved glaucoma medication, as well as high number of active compounds and eye drops increase the severity of these parameters. There are significant differences between the types of glaucoma medication used, and therefore the selection of them is important especially in patients suffering from OSD.

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Long-term Efficacy of Tacrolimus Ointment for Recalcitrant Facial Erythema Resistant to Topical Corticosteroids in Adult Patients With Atopic Dermatitis

Archives of Dermatology ◽

10.1001/archderm.136.8.1062 ◽

2000 ◽

Vol 136 (8) ◽

pp. 1062-1063 ◽

Cited By ~ 19

Author(s):

H. Sugiura

Keyword(s):

Atopic Dermatitis ◽

Adult Patients ◽

Tacrolimus Ointment ◽

Topical Corticosteroids ◽

Term Efficacy ◽

Facial Erythema

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Faculty Opinions recommendation of Chemokine receptors CCR6 and CXCR3 are necessary for CD4(+) T cell mediated ocular surface disease in experimental dry eye disease.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718174523.793497095 ◽

2014 ◽

Author(s):

Yoko Ogawa

Keyword(s):

T Cell ◽

Dry Eye ◽

Ocular Surface ◽

Chemokine Receptors ◽

Dry Eye Disease ◽

Cd4 T Cell ◽

Ocular Surface Disease ◽

Eye Disease

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Dry eye disease among Glaucoma patients on topical hypotensive medications, in a tertiary hospital, Ethiopia

BMC Ophthalmology ◽

10.1186/s12886-021-01917-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Miraf Sahlu ◽

Abeba T. Giorgis

Keyword(s):

Dry Eye ◽

Ocular Surface ◽

Signs And Symptoms ◽

Dry Eye Disease ◽

Eye Disease ◽

Eye Drops ◽

Schirmer Test ◽

Ocular Surface Disease Index ◽

Cross Sectional ◽

Corneal Staining

Abstract Background Dry eye disease is a multifactorial disease; causing various ocular symptoms with potential damage to the ocular surface. Applying hypotensive eye drops are presumed to initiate or exacerbate existing dry eye disease. The purpose of this study was to determine the frequency of signs and symptoms and severity of dry eye disease among glaucoma patients on topical hypotensive medications and controls. Methods A cross-sectional comparative study, involving 320 glaucoma patients and controls. Ocular Surface Disease Index (OSDI) symptoms score and Schirmer, tear breakup time and corneal staining tests were used to assess dry eye disease. Data was analyzed using SPSS version 24 software; p-value less than 0.05 was considered as statistically significant. Results Among the 160 study glaucoma patients, the mean duration of topical hypotensive medication use was 5.2 ± 5.21 years (range, 4 months - 32 years). Mild to severe level of OSDI score was found in 122 (76%) glaucoma patients and in 137 (86%) controls (p = 0.033). Mild to sever abnormal clinical tests in the glaucoma patients and control, respectively, were 106 (66%) vs 80 (50%) corneal staining (p = 0.045), 79 (49%) vs 72 (45%) TBUT (p = 0.021), and 91 (57%) vs 83 (52%) Schirmer test (p = 0.242). Test results at the level of sever: 2 (1%) vs 0 (0%) corneal staining, 50 (31%) vs 39 (24%) TBUT and 65 (41%) vs 60 (38%) Schirmer test in the glaucoma patents and controls, respectively. Corneal staining and TBUT had correlation with the number of drugs (p = 0.004 and 0.031, respectively), and more relationship of the two tests with total number of drops applied per day (p = 0.01 and p < 0.001, respectively). Patients on pilocarpine and timolol had more corneal staining and lower TBUT [(p = 0.011 and p < 0.001) and (p = 0.04 and 0.012), respectively]. Conclusions The study has identified glaucoma patients to be more affected by dry eye disease than non-glaucoma patients, and presence of significantly lower TBUT and higher corneal staining in the glaucoma patients on multidrops and multidose per day. We recommend consideration of evaluation and management of DED for glaucoma patients on multidrops and multidose hypotensive medications.

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Comparison of the Efficacy and Safety of 0.1% Tacrolimus Ointment with Topical Corticosteroids in Adult Patients with Atopic Dermatitis

Clinical Drug Investigation ◽

10.2165/00044011-200626050-00001 ◽

2006 ◽

Vol 26 (5) ◽

pp. 235-246 ◽

Cited By ~ 32

Author(s):

Hidemi Nakagawa

Keyword(s):

Atopic Dermatitis ◽

Adult Patients ◽

Efficacy And Safety ◽

Tacrolimus Ointment ◽

Topical Corticosteroids

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Optimum | Tangible Hydra-PEG™ – Gaining Momentum in the Industry

The Eye ◽

10.33791/2222-4408-2021-4-31-34 ◽

2021 ◽

Vol 23 (4) ◽

pp. 31-34

Author(s):

M. Conway

Keyword(s):

Dry Eye ◽

Ocular Surface ◽

Surface Coating ◽

Clinical Case ◽

Contact Lenses ◽

Ocular Surface Disease ◽

Corneal Ectasia ◽

Corneal Lens ◽

Eye Symptoms ◽

Dry Eye Symptoms

The issue of hydrophilicity of the surface of gas permeable contact lenses remains one of the persistent problems. Tangible Hydra-PEG™ surface coating is applied to gas permeable contact lenses to significantly improve wettability and wearing comfort. Although it is mainly used to alleviate dry eye symptoms in scleral and corneal lens users, particularly for those patients with corneal ectasia and/or Ocular Surface Disease (OSD), it can be used in other modalities. This article describes the development of the product and describes the benefits of its use in a clinical case.

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