scholarly journals Sex hormones and dry eye disease: Current update

2021 ◽  
Vol 7 (2) ◽  
pp. 139-150
Author(s):  
Rajendra Prakash Maurya ◽  
Ashish Gupta ◽  
Shivani Verma ◽  
Virendra P Singh ◽  
Anup Singh ◽  
...  

Dry eye disease (DED) is a multifactorial disorder of the ocular surface that results in ocular discomfort, visual disturbance and damage to the ocular surface. It is one of the most common complaints in daily ophthalmic practice. The greater prevalence of dry eye in women compared to men suggests that sex hormones may have a role in this condition. Sex hormones; estrogen and androgens influence production of all components of the tear film including aqueous layer, lipid layer, and mucin layer. Various mechanisms such as decrease in hormonal levels, shift in feedback mechanisms, and changes in receptor receptivity interplay to alter the ocular surface homeostasis and subsequently result in DED. The purpose of this review is to briefly outline current scientific evidence on the influence of androgen and estrogen on the lacrimal and meibomian glands as well as on the ocular surface epithelia including conjunctival goblet cells during reproductive and menopausal periods. This article also outlines the updates regarding role of gonadal hormones in the treatment of dry eye.

2014 ◽  
Vol 08 (02) ◽  
pp. 87
Author(s):  
Gysbert van Setten ◽  
Marc Labetoulle ◽  
Pasquale Aragona ◽  
Andrea Leonardi ◽  
◽  
...  

Dry eye disease (DED) is a multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbance and tear instability with potential damage to the ocular surface. It is often accompanied by hyperosmolarity of the tear film and inflammation of the ocular surface. The symposium ‘Severe Dry Eye Disease – Facing the Treatment Challenges’ held at the International Symposium on Ocular Pharmacology and Therapeutics (ISOPT) included four presentations from ophthalmological experts. The first presented a clinicalbased approach to facilitate the evaluation of DED in clinical practice and to provide ophthalmologists with straightforward tools to address objective signs of the disease and to alleviate subjective patients’ symptoms. This was followed by a description of a stepwise approach to anti-inflammatory treatment of severe DED, highlighting the usefulness of topical ciclosporin for treating inflammatory conditions of the ocular surface such as severe DED. This was illustrated by the third speaker who presented the results of a clinical study (SICCANOVE) showing that, compared with vehicle, treatment with ciclosporin 0.1% yielded reduced corneal damage in patients with severe DED that appeared to be enhanced in patients with more severe keratitis. Last, a diagnostic algorithm of severe DED provided by a group of European experts (ODISSEY) was presented to facilitate important decision-making in advanced stages of the disease. The need for a consensus in diagnosis, terminology and therapy at a European and international level was emphasised. Aside from the intention to make diagnosis less complicated and technically advanced, the aspects of immunomodulatory treatment were addressed as an area for future research. Other future objectives in the treatment of DED include detection of possible precursor stages to offer the possibility of preventative care. Social economic effects are also important and increased international collaboration will be needed to address global inconsistencies in treatment.


2021 ◽  
Vol 22 (1) ◽  
pp. 422
Author(s):  
Ming-Tse Kuo ◽  
Po-Chiung Fang ◽  
Shu-Fang Kuo ◽  
Alexander Chen ◽  
Yu-Ting Huang

Most studies about dry eye disease (DED) chose unilateral eye for investigation and drew conclusions based on monocular results, whereas most studies involving tear proteomics were based on the results of pooling tears from a group of DED patients. Patients with DED were consecutively enrolled for binocular clinical tests, tear biochemical markers of DED, and tear proteome. We found that bilateral eyes of DED patients may have similar but different ocular surface performance and tear proteome. Most ocular surface homeostatic markers and tear biomarkers were not significantly different in the bilateral eyes of DED subjects, and most clinical parameters and tear biomarkers were correlated significantly between bilateral eyes. However, discrepant binocular presentation in the markers of ocular surface homeostasis and the associations with tear proteins suggested that one eye’s performance cannot represent that of the other eye or both eyes. Therefore, in studies for elucidating tear film homeostasis of DED, we may lose some important messages hidden in the fellow eye if we collected clinical and proteomic data only from a unilateral eye. For mechanistic studies, it is recommended that researchers collect tear samples from the eye with more severe DED under sensitive criteria for identifying the more severe eye and evaluating the tear biochemical and proteomic markers with binocular concordance drawn in prior binocular studies.


2019 ◽  
Vol 17 ◽  
pp. 205873921881868
Author(s):  
Limei Liu ◽  
Dongdong Wei ◽  
Hongkun Xu ◽  
Changhui Liu

To study the effects of apigenin on dry eye disease (DED) in rats. Rats were divided into six groups: (I) normal control group, (II) DED control group, (III) vehicle control group, (IV) DED + apigenin 10 mg/kg, (V) DED + apigenin 20 mg/kg, and (VI) DED + apigenin 50 mg/kg. Schirmer test, tear film break-up time (BUT), and corneal fluorescein staining were used to evaluate the effects of apigenin on the ocular surface. The related inflammatory cytokines were detected by enzyme-linked immunosorbent assay (ELISA). Histopathological examination and inflammatory index were also performed. The results showed that administration of apigenin was shown a significant effect on the recovery of ocular surface function. Compared to the control group, apigenin treatment in DED rats significantly decreased the level of the tumor necrosis factor-alpha (TNF-α), interleukin-1β (IL-1β), and interleukin-6 (IL-6); however, the interleukin-10 (IL-10) level was increased. Histopathological examination further verified the anti-inflammatory effects of apigenin on DED rats. The results demonstrated that apigenin could protect DED rats via inhibition of inflammation, suggesting that it may have potential as a therapy for DED.


2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Snježana Kaštelan ◽  
Martina Tomić ◽  
Jasminka Salopek-Rabatić ◽  
Branko Novak

Dry eye disease or dysfunctional tear syndrome is among the most frequent diagnoses in ophthalmology. It is a multifactorial disease of the ocular surface and tear film which results in ocular discomfort, visual disturbances, and tear instability with potential damage to the cornea and conjunctiva. Risk factors for dry eye syndrome include age, sex (female gender), race, contact lens wear, environment with low humidity, systemic medications, and autoimmune disorders. The aim of this paper is to present the systematic classification, epidemiology, diagnostic procedures, and advances in the management of dry eye disease. The recent improvements in comprehending the underlying etiologic factors will inevitably improve future classifications and diagnostic abilities leading to more effective therapeutic options. Treatment of this highly prevalent condition can drastically improve the quality of life of individuals and prevent damage to the ocular surface.


2011 ◽  
Vol 37 (1) ◽  
pp. 12-17 ◽  
Author(s):  
Won Choi ◽  
Zhengri Li ◽  
Han-Jin Oh ◽  
Seong-Kyu Im ◽  
Seung-Hyun Lee ◽  
...  

Author(s):  
Dorota Kopacz ◽  
Łucja Niezgoda ◽  
Ewa Fudalej ◽  
Anna Nowak ◽  
Piotr Maciejewicz

The tear film is a thin fluid layer covering the ocular surface. It is responsible for ocular surface comfort, mechanical, environmental and immune protection, epithelial health and it forms smooth refractive surface for vision. The traditional description of the tear film divides it into three layers: lipid, aqueous and mucin. The role of each layer depends on the composition of it. Tear production, evaporation, absorption and drainage concur to dynamic balance of the tear film and leads to its integrity and stability. Nonetheless, this stability can be disturb in tear film layers deficiencies, defective spreading of the tear film, in some general diseases and during application of some general and/or topical medications. Dry eye disease is the result of it. In this review not only physiology of the tear film is presented. Moreover, we would like to discuss the influence of various diseases and conditions on the tear film and contrarily, spotlight tear film disorders as a manifestation of those diseases.


2021 ◽  
Vol 6 (3) ◽  
pp. 53-64
Author(s):  
E. S. Protsenko ◽  
◽  
N. A. Remnyova ◽  
N. V. Panchenko

SARS-CoV-2 is a new coronavirus causing global pandemic COVID-19 throughout the world, the clinical manifestations of which may include not only respiratory syndrome and systemic manifestations, but also eye symptoms. The purpose of the study. This study processed and presented to the scientific community the latest scientific evidence from the world literature regarding the effect of tear film quality on protective properties against SARS-CoV-2 and on further risks of COVID-19 infection in dry eye disease. Many studies have proven the presence of ACE2 as well as TMPRSS2 expression in the conjunctival and corneal epithelium and detection of SARS-CoV-2 RNA in the tear fluid of infected patients, which indicates the ocular tissue tropism to the virus and its possible transmission through the ocular surface. The detection of SARS-CoV-2 in conjunctival or tear samples may depend on viral load and secretion, as well as on sampling time during the course of the disease. It has been suggested that SARS-CoV-2 is prone to exist on the surface of the eye in the early stages of conjunctivitis, and the viral load decreases after a few days. However, cases of virus detection without conjunctivitis may indicate that SARS-CoV-2 can cause latent and asymptomatic infection. With the introduction of protective anti-epidemic measures such as protective masks, the rapid increase and progression of dry eye disease has begun, which leads to decreased ocular surface immune mechanisms, and could potentially increase the risks of SARS-CoV-2 virus transmission. The mechanisms of protection of the healthy ocular surface and possible ways to combat SARS-CoV-2 were reviewed. And the potential causes of increased ocular surface infections during a pandemic were also shown. Through wearing of protective masks, there is additional dispersion of air around the eyes and accelerated evaporation of tear fluid with its thinning and rupture, which contributes to the progression of the prevalence of dry eye disease. The information confirmed by research has already appeared in the literature. This ocular surface condition has been defined by the term "MADE" – dry eye associated with wearing a mask. Dry eye disease, in turn, is a multifactorial ocular surface disease that results in tear film instability, hyperosmolar stress, and a cascade of inflammatory responses. This initiates ocular surface damage, impaired immune status, pathological apoptosis of conjunctival and corneal cells, and loss of basic protective function. Conclusion. Thus, given the obvious decrease in the immune defense mechanisms of the ocular surface in dry eye disease, which is a vulnerable place for virus penetration, this area deserves further in-depth study


2020 ◽  
Vol 21 (23) ◽  
pp. 9271
Author(s):  
Kazuo Tsubota ◽  
Stephen C. Pflugfelder ◽  
Zuguo Liu ◽  
Christophe Baudouin ◽  
Hyo Myung Kim ◽  
...  

Over the past decades, the number of patients with dry eye disease (DED) has increased dramatically. The incidence of DED is higher in Asia than in Europe and North America, suggesting the involvement of cultural or racial factors in DED etiology. Although many definitions of DED have been used, discrepancies exist between the various definitions of dry eye disease (DED) used across the globe. This article presents a clinical consensus on the definition of DED, as formulated in four meetings with global DED experts. The proposed new definition is as follows: “Dry eye is a multifactorial disease characterized by a persistently unstable and/or deficient tear film (TF) causing discomfort and/or visual impairment, accompanied by variable degrees of ocular surface epitheliopathy, inflammation and neurosensory abnormalities.” The key criteria for the diagnosis of DED are unstable TF, inflammation, ocular discomfort and visual impairment. This definition also recommends the assessment of ocular surface epitheliopathy and neurosensory abnormalities in each patient with suspected DED. It is easily applicable in clinical practice and should help practitioners diagnose DED consistently. This consensus definition of DED should also help to guide research and clinical trials that, to date, have been hampered by the lack of an established surrogate endpoint.


2019 ◽  
Vol 35 (1) ◽  
Author(s):  
Sameera Irfan

Dry eyes is a common, chronic condition that has a prevalence of about 5- 50%.1 According to the Dry Eye Workshop II report (DEWS II report), published in 2017, the updated definition of Dry Eye Disease is, “a multifactorial disease of the ocular surface characterised by a loss of homeostasis of the tear film, and accompanied by ocular symptoms, in which tear film instability and hyper-osmolarity, ocular surface inflammation and damage, and neurosensory abnormalities play etiological roles.” The Tear Film & Ocular Surface Society (TFOS) released their report on the international work on Meibomian Gland Dysfunction (MGD)2 in 2011, which defined MGD, classified it and considered it as the primary cause of dry eye disease worldwide. Previously dry eye disease was considered as an aqueous deficiency problem, but after this report by TFOS, there is a paradigm shift towards “not producing enough lipids to retain the tears that are being produced”. This has led to a huge impact on the treatment protocols which were previously focused on managing the sequelae and symptoms of dry eyes rather than targeting directly on the underlying cause, the MGD. It has now been accepted worldwide that dry eye occurs when the ocular surface system cannot adequately protect itself from the desiccating stress due to the lack of a healthy meibomian gland secretion. This article is mainly focussed on the Meibomian Gland Dysfunction, discussing the normal anatomy of the glands, how they are affected by disease, its implications on the ocular surface and finally, the various treatment strategies. Key words: Blepharitis, Dry eyes, Meibomian gland dysfunction, blepharospasm.


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