Cationic Thiolated Poly(aspartamide) Polymer as a Potential Excipient for Artificial Tear Formulations

Dry eye disease is a relatively common ocular problem, which causes eye discomfort and visual disorders leading to a decrease in the quality of life. The aim of this study was to find a possible excipient for eye drop formulations, which is able to stabilize the tear film. A cationic thiolated polyaspartamide polymer, poly[(N-mercaptoethylaspartamide)-co-(N-(N′,N′-dimethylaminoethyl)aspartamide)] (ThioPASP-DME), was used as a potential vehicle. Besides satisfying the basic requirements, the chemical structure of ThioPASP-DME is similar to those of ocular mucins as it is a protein-like polymer bearing a considerable number of thiol groups. The solution of the polymer is therefore able to mimic the physiological properties of the mucins and it can interact with the mucus layer via disulphide bond formation. The resultant mucoadhesion provides a prolonged residence time and ensures protective effect for the corneal/conjunctival epithelium. ThioPASP-DME also has an antioxidant effect due to the presence of the thiol groups. The applicability of ThioPASP-DME as a potential excipient in eye drops was determined by means of ocular compatibility tests and through examinations of the interactions with the mucosal surface. The results indicate that ThioPASP-DME can serve as a potential eye drop excipient for the therapy of dry eye disease.

Download Full-text

Frequency and impact of individual symptoms on quality of life in dry eye disease in patients presenting to a tertiary care hospital

Journal of the Pakistan Medical Association ◽

10.47391/jpma.952 ◽

2021 ◽

pp. 1-16

Author(s):

Saba Ali Arif ◽

Muhammad Ifraheem Khan ◽

Muhammad Salman Abid ◽

Ayla Babar ◽

Mohammad Ali Arif ◽

...

Keyword(s):

Quality Of Life ◽

Dry Eye ◽

Tertiary Care ◽

Tear Film ◽

Dry Eye Disease ◽

Eye Disease ◽

Care Hospital ◽

Cross Sectional ◽

Department Of Ophthalmology

Abstract Objective: To assess the frequency of symptoms and impact on quality of life in individuals with dry eye disease. Methods: The cross-sectional, study was conducted from December 2018 to June 2019 at the outpatient clinic of the Department of Ophthalmology, Pakistan Institute of Medical Sciences, Islamabad, Pakistan, and comprised dry eye disease patients aged at least 13 years with ocular burning sensation, lacrimation, grittiness, photophobia, redness or itching. Tear Film Breakup time <10 sec and / or positive ocular surface staining >5 corneal spots, >9 conjunctival spots, lid margin staining ?2mm in length were used to diagnose the disease. Data was collected using the Dry Eye Quality of Life Score questionnaire. Data was analysed using SPSS 25. Results: of the 191 patients, 135(71%) were females and 56(29%) were males. The overall mean age was 39.8±16.6 years. Itching 155(81.2%), watering 151(79.1%) and burning 124(64.9%) were the most frequent symptoms, with watering (p<0.001) and photophobia (p=0.012) significantly impacting quality of life. Conclusions: The most common symptoms among patients of dry eye disease affecting their quality of life were itching, watering, burning, photophobia and low mood. Key Words: Quality of life in dry eye disease, Dry eye disease, Lacrimation, Photophobia, Continuous...

Download Full-text

Current treatment modalities for dry eye disease

Clinical ophthalmology ◽

10.32364/2311-7729-2021-21-1-18-23 ◽

2021 ◽

Vol 21 (1) ◽

pp. 18-23

Author(s):

E.B. Tatarnikova ◽

◽

O.I. Krivosheina ◽

Keyword(s):

Dry Eye ◽

Ocular Surface ◽

Tear Film ◽

Current Treatment ◽

Dry Eye Disease ◽

Treatment Modalities ◽

Eye Disease ◽

Published Data ◽

Eye Drops ◽

Anti Inflammatory

For many years, dry eye disease (DED) is a common ophthalmic condition associated with ocular surface damage and loss of homeostasis of the tear film. The key pathogenic factors of DED are tear film instability and tear hyperosmolarity, ocular surface inflammation and damage, and neurosensory alterations. Current treatment for DED consists of non-medical therapies, tear substitutes, anti-inflammatory agents, and surgical procedures. These treatments improve disease course and quality of life. However, these treatments are largely palliative as long-term (and even life-long) installation of eye drops is required. Modern and effective treatments for DED are needed. This paper reviews domestic and foreign published data on the important therapies for DED and novel tools to promote symptom relief. These data are required for the understanding of the pharmacological effects of various drug classes prescribed for DED and early treatment initiation. Keywords: dry eye disease, tear replacement therapy, anti-inflammatory treatment, surgery, hyaluronic acid, preservatives. For citation: Tatarnikova E.B., Krivosheina O.I. Current treatment modalities for dry eye disease. Russian Journal of Clinical Ophthalmology. 2021;21(1):18–23. DOI: 10.32364/2311-7729-2021-21-1-18-23.

Download Full-text

Dry eye disease in students with myopia during COVID-19 pandemic

Archive of Ukrainian Ophthalmology ◽

10.22141/2309-8147.9.3.2021.247907 ◽

2021 ◽

Vol 9 (3) ◽

pp. 34-37

Author(s):

M.V. Panchenko ◽

P.A. Bezditko

Keyword(s):

Distance Learning ◽

Dry Eye ◽

Contact Lenses ◽

Tear Film ◽

Face Mask ◽

Corneal Topography ◽

Dry Eye Disease ◽

Eye Disease ◽

Eye Drops ◽

Ocular Surface Disease Index

Background. Today, the urgent problem is coronavirus disease 2019 pandemic in the whole world. Safety measures such as the use of masks, distance learning have been implemented. However, ophthalmologists, as well as the general population, should know that a face mask together with prolonged use of digital devices leads to an increase in the number of dry eye cases in many patients. The purpose was to study the frequency of dry eye disease in students with myopia. Materials and methods. The study involved 96 medical students diagnosed with myopia taken by random sampling, who were examined by an ophthalmologist. Apart from the standard ophthalmologic examination, all patients underwent the evaluation of the stability of the precorneal tear film by means of corneal topography, and Norn test (tear break-up time (TBUT)). There was also used a standard questionnaire designed to assess the severity of dry eye disease symptoms (Ocular Surface Disease Index). Results. The corneal topography of the 47 patients did not demonstrate any reduction in TBUT. The average time of the concentric ring remained stable for 20.2 ± 3.0 seconds. But 49 individuals exhibited signs of tear film instability over time compared to 47 patients without TBUT impairment. In 47 people without impairments, corneal topography demonstrated that this indicator in Norn test varied from 25 to 18 seconds, i.e. was within the age norm (21.5 ± 3.5 seconds on average). In 3 patients with a minimum TBUT on keratotopography, its value during the Norn test was 9 seconds. In 36 patients with reduced TBUT according to both methods, there was a weak degree of dry eyes, in 10 — moderate, in 3 — severe. The most common complaints were a sandy, gritty sensation in the eyes, visual discomfort when working at a computer and in windy weather, and with prolonged use of a protective mask. Conclusions. Among students who were on distance learning, 51.04 % of individuals have objectively confirmed dry eye disease. People wearing contact lenses have a more pronounced degree of dry eye, so it is mandatory for ophthalmologists to prescribe lubricating eye drops.

Download Full-text

The Efficacy and Safety of Qiming Granule for Dry Eye Disease: A Systematic Review and Meta-Analysis

Frontiers in Pharmacology ◽

10.3389/fphar.2020.00580 ◽

2020 ◽

Vol 11 ◽

Author(s):

Maoyi Yang ◽

Zhipeng Hu ◽

Rensong Yue ◽

Liangjun Yang ◽

Boxun Zhang ◽

...

Keyword(s):

Dry Eye ◽

Meta Analysis ◽

Tear Film ◽

Dry Eye Disease ◽

Eye Disease ◽

Efficacy And Safety ◽

Chinese Patent ◽

Traditional Chinese Patent Medicine ◽

Positive Results

BackgroundDry eye disease (DED) is a common complication in clinical practice. Qiming granule, a traditional Chinese patent medicine, is widely used in treating DED in China. However, its effect is still largely unknown.ObjectivesThis research aims to evaluate the efficacy and safety of QG on DED.MethodsThree English database and four Chinese databases without restriction on language and publication bias were searched. Qualified literature was selecting according to inclusion and exclusion criteria, extracted the data, and conducted a meta-analysis.ResultsA total of 11 articles were included in this meta-analysis. The methodological quality of included studies was low. The results showed that QG was effective for DED (RR:1.26, 95%CI:1.12 to 1.41, P=0.0001). The results combined with random effects model showed that QG could significantly prolong the tear film break up time (MD: 2.93, 95% CI: 2.22 to 3.65, P < 0.00001), increase the amount of tears in patients with DED (MD: 2.94, 95% CI: 1.83 to 4.04, P < 0.00001) and repair the corneal defects in patients (MD: -0.71, 95% CI: -1.25 to -0.17, P < 0.00001).ConclusionsThis study found that despite of the apparently positive results of some outcomes, it is premature to confirm the efficacy of QG in treating DED. More high-quality studies are still needed in the future to further confirm the efficacy and safety.

Download Full-text

The effect of preservative free hydrocortisone 0.335% eye drops on tear film thickness in patients with moderate to severe dry eye disease

Acta Ophthalmologica ◽

10.1111/j.1755-3768.2019.5126 ◽

2019 ◽

Vol 97 (S263) ◽

Author(s):

Doreen Schmidl ◽

Martin Kallab ◽

Nikolaus Hommer ◽

Stephan Szegedi ◽

Hannes Stegmann ◽

...

Keyword(s):

Film Thickness ◽

Dry Eye ◽

Tear Film ◽

Dry Eye Disease ◽

Eye Disease ◽

Eye Drops ◽

Preservative Free

Download Full-text

The HYLAN M Study: Efficacy of 0.15% High Molecular Weight Hyaluronan Fluid in the Treatment of Severe Dry Eye Disease in a Multicenter Randomized Trial

Journal of Clinical Medicine ◽

10.3390/jcm9113536 ◽

2020 ◽

Vol 9 (11) ◽

pp. 3536 ◽

Cited By ~ 1

Author(s):

Gysbert-Botho van Setten ◽

Christophe Baudouin ◽

Jutta Horwath-Winter ◽

Daniel Böhringer ◽

Oliver Stachs ◽

...

Keyword(s):

Molecular Weight ◽

High Molecular Weight ◽

Dry Eye ◽

Tear Film ◽

Dry Eye Disease ◽

Eye Disease ◽

Control Group ◽

Eye Drops ◽

Artificial Tears ◽

Ocular Surface Disease Index

The aim of the HYLAN M study was to investigate if symptoms and/or signs of patients suffering from severe dry eye disease (DED) can be improved by substituting individually optimized artificial tear therapy by high molecular weight hyaluronan (HMWHA) eye drops. In this international, multicenter study, patients with symptoms of at least ocular surface disease index (OSDI) 33 and corneal fluorescein staining (CFS) of at least Oxford grade 3 were included. A total of 84 per-protocol patients were randomized in two study arms. The control group continued to use their individual optimum artificial tears over the study period of eight weeks; in the verum group, the artificial tears were substituted by eye drops containing 0.15% HMWHA. At the week 8 visit, the average OSDI of the verum group had improved by 13.5 as compared to the control group (p = 0.001). The best corrected visual acuity (BCVA) had improved by 0.04 logMAR (p = 0.033). CFS, tear film break-up time (TBUT), Schirmer I, lid wiper epitheliopathy (LWE), mucocutaneous junction (Yamaguchi score), and tear osmolarity were not significantly different between the verum and control groups (p > 0.050). We conclude that for most patients with severe DED, 0.15% HMWHA eye drops provide excellent improvement of symptoms without impairment of dry eye signs.

Download Full-text

Reducing omission of eye drops during hospital admission

British Journal of Hospital Medicine ◽

10.12968/hmed.2021.0577 ◽

2022 ◽

pp. 1-7

Author(s):

Charlotte S Ho ◽

Darren SJ Ting ◽

Devina Gogi

Keyword(s):

Hospital Admission ◽

Dry Eye ◽

Substantial Reduction ◽

Dry Eye Disease ◽

National Standards ◽

Eye Disease ◽

Eye Drops ◽

National Guidelines ◽

Before And After

Background/aims Chronic ophthalmic conditions, such as glaucoma and dry eye disease, are frequently encountered debilitating eye conditions that can lead to substantial reduction in vision and quality of life. However, there is ongoing evidence to suggest that topical ophthalmic therapy is inappropriately omitted on admission to hospital. The primary aim of this audit was to investigate the trust adherence to the National Institute for Health and Care Excellence guideline on the prescribing standard of eye drops during hospital admission. The secondary aim was to raise awareness and ensure successful compliance with national standards to reduce unintentional omission of eye drops on admission and subsequent complications. Method Electronic medical records of all medical and surgical adult inpatients were studied prospectively on two different occasions. The quality of documentation of eye drops in clerking notes, the length of time taken between the admission and prescription of eye drops, and the accuracy of the prescription were examined. Following the initial audit, interventions focusing on clinician education were implemented. This includes highlighting the importance of eye drops in all departmental mandatory introductory sessions and putting up posters on all the wards as prompts. The same data collection method was used in the reaudit. Results In the initial audit, 64 (mean age 81.8±8.9 years) patients with regular prescriptions for eye drops were identified; 38 (59.4%) patients had eye drops for dry eye disease only, 20 (31.3%) patients had eye drops for glaucoma only, and six (9.4%) patients had eye drops for both. In the reaudit, 57 (mean age 76.7±15.3 years) patients were identified; 42 (73.7%) patients had eye drops for dry eye disease only, 10 (17.5%) patients had eye drops for glaucoma only, and five (8.8%) patients had eye drops for both. Following the intervention, there was a significant improvement in documentation of ocular diagnosis and eye drops on clerking notes from 41% to 65% (P=0.008), and eye drop reconciliation within 24 hours of admission improved from 45% to 75% (P=0.0008). All patients (100%) received the correct eye drop prescription before and after the intervention. Conclusions Education is effective in promoting adherence to national guidelines and reducing the incidence of inappropriate omission of eye drops on admission to hospital.

Download Full-text

Association of Systemic Comorbidities with Dry Eye Disease

Journal of Clinical Medicine ◽

10.3390/jcm9072040 ◽

2020 ◽

Vol 9 (7) ◽

pp. 2040

Author(s):

Motoko Kawashima ◽

Masakazu Yamada ◽

Chika Shigeyasu ◽

Kazuhisa Suwaki ◽

Miki Uchino ◽

...

Keyword(s):

Quality Of Life ◽

Dry Eye ◽

Tear Film ◽

Health Utility ◽

Dry Eye Disease ◽

Background Information ◽

Eye Disease ◽

Cross Sectional ◽

Significant Difference

We investigated the association between dry eye disease and systemic comorbidities, including dry eye subtype, quality of life (QOL) and health utility among patients with dry eye disease. This cross-sectional, observational study enrolled 449 patients with dry eye disease (386 females; mean age, 62.6 ± 15.7 [range, 21–90] years). Ophthalmic examination findings included tear film break-up time (TBUT), Schirmer I value and keratoconjunctival staining score. QOL and health utility were evaluated using the Dry Eye-Related Quality-of-Life Score (DEQS) and Human Utility Index Mark 3 (HUI-3), respectively. Background information, including systemic comorbidities, was obtained. Prevalence of systemic comorbidities was 48.8% (219/449). No significant difference occurred between DEQS and systemic comorbidity. However, patients with dry eye disease and systemic comorbidities (depression and insomnia) exhibited significantly worse ocular surface parameters, particularly regarding TBUT, than those without. Dry eye disease with insomnia or depression comorbidity significantly correlated with friction-related diseases (including conjunctivochalasis or lid wiper epitheliopathy). A high prevalence of several systemic comorbidities occurred in patients with dry eye disease. This study shows an association between ocular signs and systemic comorbidities, particularly depression and insomnia. Ophthalmologists should be aware of patients’ systemic comorbidities in the diagnosis and management of dry eye disease.

Download Full-text