Should we care about the ocular surface in the anophthalmic patient?

2021 ◽  
pp. 112067212110488
Author(s):  
Giulio Volpe ◽  
Maria De Piano ◽  
Giacomilde Mazzone ◽  
Alessandra Micera ◽  
Stefano Bonini ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Dry Eye ◽  
Ocular Surface ◽  
Bulbar Conjunctiva ◽  
Type I ◽  
Ocular Prosthesis ◽  
Fellow Eye ◽  
Markers Of Inflammation ◽  
Conjunctival Inflammation ◽  
Anophthalmic Socket

Purpose: To assess clinical and biomolecular changes of the conjunctival epithelium in anophthalmic patients wearing an ocular prosthesis. Methods: Thirty-five unilateral anophthalmic patients were enrolled. Patients with blepharitis, lid abnormalities, and topical/systemic medication affecting the ocular surface were excluded. Symptom Assessment in Dry Eye (SANDE) questionnaire and tear function test (Schirmer Test Type I) were recorded. Conjunctival inflammation and meibomian gland dysfunction (MGD) were graded in the anophthalmic side and fellow eye. Impression cytology sampling of the upper, lower tarsal, and posterior/bulbar conjunctiva from the anophthalmic socket were collected and compared to healthy controls. Results: Patients had significantly higher SANDE ( p < 0.001), Schirmer I test ( p = 0.004), conjunctival inflammation ( p < 0.001), and MGD scores ( p < 0.001) on the anophthalmic side compared to the fellow eye. Mucin 5AC, inflammatory markers (MMP-9, ICAM-1) expression ( p < 0.001), and response to oxidative stress (NRF2-KEAP1 signaling pathway) ( p < 0.05) were significantly upregulated in the posterior conjunctival surface in the anophthalmic socket. Conclusions: Anophthalmic patients complained of more pronounced dry eye symptoms and presented more significant signs of inflammation and MGD on the anophthalmic side. The bulbar conjunctiva, behind the prosthesis, showed more significant hyperexpression of mucins, markers of inflammation, and increased response to oxidative stress compared to the tarsal conjunctiva. Patients wearing ocular prosthesis had signs of inflammation resembling dry eye disease.

scholarly journals Trehalose for Ocular Surface Health

Biomolecules ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. 809
Author(s):  
Jarmo Laihia ◽  
Kai Kaarniranta
Keyword(s):  
Oxidative Stress ◽  
Clinical Trials ◽  
Animal Models ◽  
Dry Eye ◽  
Ocular Surface ◽  
Stress Protein ◽  
Life Forms ◽  
Beneficial Effects ◽  
Protein Clearance ◽  
Ocular Surface Health

Trehalose is a natural disaccharide synthesized in various life forms, but not found in vertebrates. An increasing body of evidence demonstrates exceptional bioprotective characteristics of trehalose. This review discusses the scientific findings on potential functions of trehalose in oxidative stress, protein clearance, and inflammation, with an emphasis on animal models and clinical trials in ophthalmology. The main objective is to help understand the beneficial effects of trehalose in clinical trials and practice, especially in patients suffering from ocular surface disease. The discussion is supplemented with an overview of patents for the use of trehalose in dry eye and with prospects for the 2020s.

Updated definition and classification of dry eye disease: Renewed proposals using the nominal group and Delphi techniques

2020 ◽  
pp. 112067212096058
Author(s):  
Stefano Barabino ◽  
Pasquale Aragona ◽  
Antonio di Zazzo ◽  
Maurizio Rolando ◽  
Keyword(s):  
Dry Eye ◽  
Ocular Surface ◽  
Dry Eye Disease ◽  
Nominal Group ◽  
Eye Disease ◽  
Type I ◽  
Disease Definition ◽  
Quality Of Vision

The aim of our research was to obtain expert consensus for updated definition and classification of dry eye disease using formal methodology. The nominal group technique (NGT) involved a steering committee of four ophthalmologists began with collection of ideas followed by group discussion. The ideas were collated, refined, and voted upon. The main characteristics considered, each with different degrees of severity in types I, II, and III, were the ability or not of the ocular surface to re-equilibrate itself, frequency of symptoms, presence of inflammation, epithelial alterations, and possible alterations in the quality of vision. This was followed by three rounds of a “mini-Delphi” involving an expert panel of 13 ophthalmologists, with the last round including all 17 ophthalmologists. Consensus in the final round of voting (⩾75% of votes) was reached on the definition of dry eye disease and on criteria for its classification in three forms. Type I is a transient and reversible form with subclinical inflammation, possible epithelial alterations, and occasional alterations in vision. Type II is a recurrent form characterized by a reduced ability to re-equilibrate the ocular surface, frequent symptoms and alterations in vision with clinically-evident inflammation, and clear evidence of epithelial alterations. Type III is a chronic form with inability to re-equilibrate the ocular surface and accompanied by clinically-evident and chronic inflammation, persistent epithelial alterations, and frequent alterations in quality of vision. The vast majority of patients with dry eye disease can be easily classified into one of these three forms. Dry eye disease definition was updated accordingly.

scholarly journals Mitochondria-Targeted Antioxidant SkQ1 Prevents Anesthesia-Induced Dry Eye Syndrome

2017 ◽  
Vol 2017 ◽  
pp. 1-17 ◽  
Author(s):  
Evgeni Yu. Zernii ◽  
Olga S. Gancharova ◽  
Viktoriia E. Baksheeva ◽  
Marina O. Golovastova ◽  
Ekaterina I. Kabanova ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Antioxidant Activity ◽  
General Anesthesia ◽  
Dry Eye ◽  
Ocular Surface ◽  
Protective Action ◽  
Dry Eye Syndrome ◽  
Clinical State ◽  
Ocular Surgery ◽  
Age Related

Dry eye syndrome (DES) is an age-related condition increasingly detected in younger people of risk groups, including patients who underwent ocular surgery or long-term general anesthesia. Being a multifactorial disease, it is characterized by oxidative stress in the cornea and commonly complicated by ocular surface inflammation. Polyetiologic DES is responsive to SkQ1, a mitochondria-targeted antioxidant suppressing age-related changes in the ocular tissues. Here, we demonstrate safety and efficacy of topical administration of SkQ1 at a dosage of 7.5 μM for the prevention of general anesthesia-induced DES in rabbits. The protective action of SkQ1 improves clinical state of the ocular surface by inhibiting apoptotic and prenecrotic changes in the corneal epithelium. The underlying mechanism involves the suppression of the oxidative stress supported by the stimulation of intrinsic antioxidant activity and the activity of antioxidant enzymes, foremost glutathione peroxidase and glutathione reductase, in the cornea. Furthermore, SkQ1 increases antioxidant activity and stability of the tear film and produces anti-inflammatory effect exhibited as downregulation of TNF-α and IL-6 and pronounced upregulation of IL-10 in tears. Our data suggest novel features of SkQ1 and point to its feasibility in patients with DES and individuals at risk for the disease including those subjected to general anesthesia.

scholarly journals Antioxidant Effects of the Prenylated Flavonoid, Xanthohumol, on Corneal Epithelial Cells in Experimental Dry Eye Disease

2021 ◽  
Author(s):  
Anita Kirti Ghosh ◽  
Rubina Thapa ◽  
Harsh Nilesh Hariani ◽  
Michael Volyanyuk ◽  
Karoline Anne Orloff ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Epithelial Cells ◽  
Dry Eye ◽  
Ocular Surface ◽  
Dry Eye Disease ◽  
Eye Disease ◽  
Related Factor ◽  
Corneal Epithelial Cells ◽  
Corneal Epithelial

Elevated levels of oxidative stress in the corneal epithelium contribute to the progression of dry eye disease pathology. Previous studies have shown that antioxidant therapeutic intervention is a promising avenue to reduce disease burden and slow disease progression. In this study, we evaluated the pharmacological efficacy of Xanthohumol in preclinical models for dry eye disease. Xanthohumol is a naturally occurring prenylated chalconoid that promotes the transcription of phase II antioxidant enzymes. Xanthohumol exerted a dose-response in preventing tert-butylhydroxide-induced loss of cell viability in human corneal epithelial (HCE-T) cells and resulted in a significant increase in expression of nuclear factor erythroid 2-related factor 2 (Nrf2), the master regulator of the endogenous antioxidant system. Xanthohumol-encapsulating poly(lactic-co-glycolic acid) nanoparticles (PLGA NP) were cytoprotective against oxidative stress in vitro, and significantly reduced corneal fluorescein staining in the mouse desiccating stress/ scopolamine model for dry eye disease in vivo by reducing oxidative stress-associated DNA damage in corneal epithelial cells. PLGA NP represent a safe and efficacious drug delivery vehicle for hydrophobic small molecules to the ocular surface. Optimization of NP-based antioxidant formulations with the goal to minimize instillation frequency may represent future therapeutic options for dry eye disease and related ocular surface disease.

scholarly journals Estimation of Prevalence of Dry Eye, and Ocular Surface Changes, in Patients of Diabetes Mellitus, in Vijaypur District, India

2021 ◽  
Vol 10 (32) ◽  
pp. 2559-2564
Author(s):  
Anand Gurabasappa Gannur ◽  
Madhu Guranna Patil ◽  
Prabhugouda Basangouda Lingadalli ◽  
Zameer Hassan Golewale
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Retinopathy ◽  
Dry Eye ◽  
Rose Bengal ◽  
Ocular Surface ◽  
Diabetic Patients ◽  
Type I ◽  
Type Ii ◽  
Dry Eyes ◽  
Surface Changes

BACKGROUND Diabetes mellitus (DM) is associated with a number of ocular complications such as diabetic retinopathy, cataract, refractory deviations, oculomotor nerve palsy etc. Recently, problems involving the ocular surface, dryness in particular, have been reported with dry eye symptoms, indicating a clear role for tear film abnormalities. The objectives of this study were to estimate the prevalence of dry eye and dry eye related ocular surface changes in diabetic patients, and to study the association between diabetic dry eyes and its relation to age, sex, glycemic control, duration of disease and diabetic retinopathy METHODS A hospital based clinical study of 100 diabetic patients who presented to the Department of Ophthalmology, Al Ameen Medical College and Hospital, Vijayapur from November 2019 to November 2020 was conducted. Detailed history was recorded. Assessment of anterior segment via slit lamp biomicroscopy was done. The examinations for dry eyes included Schirmer's test, tear break-up time, fluorescein and rose bengal staining and a questionnaire. The retinopathy was examined by ophthalmoscopy and was recorded. RESULTS Of the 100 diabetic patients, 2 (2 %) were type I and 98 (98 %) were type II diabetes. The mean age of type I group was 30 ± 0 years and 57.55 ± 27.07 years in type II group. 50 % were males in type I group, and 51.47 % in type II. Fifty nine (59 %) patients had dry eye. The prevalence in type I was 100 % and in type II was 58.16 %. Dry eye prevalence was maximum in those between 51 to 60 years of age (55.77 %). A 2.65 fold increase was found in the odds for dry eye in those with > 5 years of diabetic duration. The association of dry eye among uncontrolled was statistically highly significant with P value less than 0.001. The tear break up time was found to be ≤ 10 sec in 26 % (26/100). Schirmers test was found to be ≤ 10 mm in 27 % (27/100). Stains (Rose Bengal and fluorescein stain) were found to be abnormal in 18 %. Retinopathy was seen in 100 % of type I and 9.18 % of type II group. Statistically highly significant association was found between retinopathy and dry eyes (P < 0.001). CONCLUSIONS Diabetes and dry eye appears to have common association. Highly significant statistical correlation was found between retinopathy and dry eyes. Examination for dry eyes should be an integral part of the assessment of diabetic eye disease. KEY WORDS Diabetes, Dry Eye, Diabetic Retinopathy

scholarly journals Retinoid Regulation of Ocular Surface Innate Inflammation

2021 ◽  
Vol 22 (3) ◽  
pp. 1092
Author(s):  
Jehan Alam ◽  
Zhiyuan Yu ◽  
Cintia S. de Paiva ◽  
Stephen C. Pflugfelder
Keyword(s):  
Dry Eye ◽  
Ocular Surface ◽  
Vitamin A Deficiency ◽  
Myeloid Cells ◽  
Myeloid Cell ◽  
Cell Loss ◽  
Cell Number ◽  
Immunomodulatory Effects ◽  
Retinoid Receptors ◽  
Conjunctival Inflammation

Corneal and conjunctival inflammation and dry eye develop in systemic vitamin A deficiency (VAD). The objective of this study was to investigate the lacrimal ocular surface retinoid axis, particularly immunomodulatory effects of retinoic acid (RA) and change in conjunctival myeloid cell number and phenotype in VAD. We discovered that ocular surface epithelial and myeloid cells express retinoid receptors. Both all trans- and 9-cis-RA suppressed production of dry eye relevant inflammatory mediators [interleukin(IL)-1β, IL-12, regulated upon activation, normal T cell expressed and secreted (RANTES)] by myeloid cells. Systemic VAD was associated with significant goblet cell loss and an increased number of CD45+ immune cells in the conjunctiva. MHCII−CD11b+ classical monocytes were significantly increased in the conjunctiva of VAD C57BL/6 and RXR-α mutated Pinkie strains. RNA seq revealed significantly increased expression of innate immune/inflammatory genes in the Pinkie conjunctiva. These findings indicate that retinoids are essential for maintaining a healthy, well-lubricated ocular surface and have immunomodulatory effects in the conjunctiva that are mediated in part via RXR-α signaling. Perturbation of the homeostatic retinoid axis could potentiate inflammation on the ocular surface.

scholarly journals Isolated bilateral congenital lacrimal gland agenesis presenting as dry eye in childhood: a rare entity

2020 ◽  
Vol 17 (1) ◽  
pp. 74-77
Author(s):  
Anitha Venugopal ◽  
Sowmya Peri ◽  
Ravi Chandra ◽  
Meenakshi Ravindran ◽  
Rengappa Ramakrishnan
Keyword(s):  
Salivary Glands ◽  
Dry Eye ◽  
Lacrimal Gland ◽  
Ocular Surface ◽  
Vitamin Supplementation ◽  
Bulbar Conjunctiva ◽  
Eye Drops ◽  
Rare Entity ◽  
Permanent Occlusion ◽  
Functional Vision

We report the case of a 1-year-old child who presented with complaints of redness and defective vision since birth. The child had no systemic abnormalities. On examination, complete keratinization of the bulbar conjunctiva and cornea was noted with dry, lustreless and irregular surface. Corneal sensation was intact. Orbital MRI revealed bilateral agenesis of the lacrimal gland with normal salivary glands. The child was given vitamin supplementation, cyclosporine eye drops along with lubricants and tape tarsorrhaphy in the night. Permanent occlusion of both the lower puncta was done. There was decreased ocular surface congestion, with frequent wetting of the ocular surface, which continued in the months to follow. We present a case of isolated bilateral lacrimal gland agenesis with normal salivary glands, a rare cause of dry eye in children. An early diagnosis and conservative management can help in maintaining functional vision in such cases.

scholarly journals Ipsilateralna operacija primarnog pterigijuma, senzorne ezotropije i konjuktivalni autotransplatant u istom aktu

2003 ◽  
Vol 50 (4) ◽  
pp. 143-145
Author(s):  
Dusica Risovic ◽  
Lj. Nikolic
Keyword(s):  
Dry Eye ◽  
Ocular Surface ◽  
Vascular Diseases ◽  
Rectus Muscle ◽  
Bulbar Conjunctiva ◽  
Cytostatic Drugs ◽  
Collagen Vascular Diseases ◽  
Conjunctival Autograft ◽  
The Right

The purpose of this study was to find out whether a conjunctival autograft over the recessed bulbomotor muscle can prevent a recidive of an inflamatory internal pterygium associated with strabismus. The fast growing internal pterygium (crossing corneoscleral limbus of the right eye 3-4mm towards the centre of the cornea) in a 42 years old patient, was removed by superficial keratectomy, while strabismus was corrected by the recession of the internal rectus muscle and covered with an autograft of the upper bulbar conjunctiva. Neither collagen vascular diseases, nor dry eye were present. Horizontal deviation was lessened from +12 to +6, after surgery, and the regrowth of the inflamatory pterygium was not observed during a five years follow up. The risk of the reapperance of pterygium at the site of muscle surgery for strabismus might have been avoided by creating a smooth ocular surface over a thin conjunctival autograft without Tenon's capsule. We believe that conjunctival autograft in such eyes, carrying a higher risk for pterygium regrowth, may help in the avoidance of the use of cytostatic drugs and on their untoward effects.

scholarly journals Poly(lactic-co-glycolic acid) Nanoparticles Encapsulating the Prenylated Flavonoid, Xanthohumol, Protect Corneal Epithelial Cells from Dry Eye Disease-Associated Oxidative Stress

Pharmaceutics ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 1362
Author(s):  
Anita Kirti Ghosh ◽  
Rubina Thapa ◽  
Harsh Nilesh Hariani ◽  
Michael Volyanyuk ◽  
Sean David Ogle ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Antioxidant Enzymes ◽  
Epithelial Cells ◽  
Dry Eye ◽  
Ocular Surface ◽  
Glycolic Acid ◽  
Dry Eye Disease ◽  
Eye Disease ◽  
Corneal Epithelial Cells ◽  
Corneal Epithelial

Oxidative stress is a known contributor to the progression of dry eye disease pathophysiology, and previous studies have shown that antioxidant intervention is a promising therapeutic approach to reduce the disease burden and slow disease progression. In this study, we evaluated the pharmacological efficacy of the naturally occurring prenylated chalconoid, xanthohumol, in preclinical models for dry eye disease. Xanthohumol acts by promoting the transcription of phase II antioxidant enzymes. In this study, xanthohumol prevented tert-butyl hydroperoxide-induced loss of cell viability in human corneal epithelial (HCE-T) cells in a dose-dependent manner and resulted in a significant increase in expression of the transcription factor nuclear factor erythroid 2-related factor 2 (Nrf2), the master regulator of phase II endogenous antioxidant enzymes. Xanthohumol-encapsulating poly(lactic-co-glycolic acid) nanoparticles (PLGA NP) were cytoprotective against oxidative stress in vitro, and significantly reduced ocular surface damage and oxidative stress-associated DNA damage in corneal epithelial cells in the mouse desiccating stress/scopolamine model for dry eye disease in vivo. PLGA NP represent a safe and efficacious drug delivery vehicle for hydrophobic small molecules to the ocular surface. Optimization of NP-based antioxidant formulations with the goal to minimize instillation frequency may represent future therapeutic options for dry eye disease and related ocular surface disease.

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