scholarly journals Ocular Surface Pathology in Patients Suffering From Mercury Intoxication Is Consistent With Neurogenic Dry Eye Disease

2021 ◽  
Author(s):  
Pilar Cañadas ◽  
Yrbani Lantigua Dorville ◽  
Amalia Enríquez-de-Salamanca ◽  
Itziar Fernandez ◽  
Salvador Pastor-Idoate ◽  
...  
Keyword(s):  
Dendritic Cells ◽  
Dry Eye ◽  
Ocular Surface ◽  
Inorganic Mercury ◽  
Corneal Sensitivity ◽  
Ocular Surface Disease Index ◽  
Mercury Intoxication ◽  
Cytokine Levels ◽  
Density Analysis ◽  
Lysozyme Concentration

Abstract Purpose: To report ocular surface pathology of patients with acute/subacute mercury intoxication.Methods: Male workers intoxicated with inorganic mercury were examined for dry eye (DE)-related symptoms. Examinations included Ocular Surface Disease Index questionnaire; tear osmolarity, tear break-up time (T-BUT) and production; mechanical and thermal corneal sensitivity; corneal nerve and dendritic cell density analysis; and analysis of 23 tear cytokines.Results: Most patients, 63.6%, had severe DE-related symptoms. Tear osmolarity was elevated in 83.4%, and T-BUT was low in 22.7% of patients. Tear production and tear lysozyme concentration were low in 13.6% and 27.3% of cases, respectively. Corneal sensitivity thresholds for mechanical, heat and cold stimuli were higher than controls. Densities of nerves, nerve branching, and dendritic cells were lower than in controls. Patient tear levels of IL-12p70, IL1-RA, RANTES, and VEGF were increased, whereas EGF, IL-6, and IP-10/CXCL10 were decreased. Based on cytokine levels, two clusters of patients were identified. Cluster 2 patients had significantly increased tear levels of 18 cytokines, decreased tear lysozyme, lower nerve branching density, fewer dendritic cells, and higher urine mercury levels.Conclusions: Mercury poisoning produced previously undescribed ocular surface pathology, similar to neurogenic inflammatory type of DE and different from the more common DE subtypes.

scholarly journals Ocular Surface Pathology in Patients Suffering from Mercury Intoxication

Diagnostics ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1326
Author(s):  
Pilar Cañadas ◽  
Yrbani Lantigua ◽  
Amalia Enríquez-de-Salamanca ◽  
Itziar Fernandez ◽  
Salvador Pastor-Idoate ◽  
...  
Keyword(s):  
Dendritic Cell ◽  
Cell Density ◽  
Ocular Surface ◽  
Inorganic Mercury ◽  
Principal Component ◽  
Corneal Sensitivity ◽  
Cross Sectional ◽  
Thermal Thresholds ◽  
Mercury Intoxication

Purpose: To report the ocular surface pathology of patients suffering from acute/subacute mercury vapor intoxication. Design: Cross-sectional study. Participants: Male workers intoxicated with inorganic mercury referred for ophthalmic involvement and healthy control subjects. Methods: The following tests were performed: dry eye (DE)-related symptoms indicated by the ocular surface disease (OSDI) index questionnaire; tear osmolarity; analysis of 23 tear cytokine concentrations and principal component and hierarchical agglomerative cluster analyses; tear break-up time (T-BUT); corneal fluorescein and conjunctival lissamine green staining; tear production by Schirmer and tear lysozyme tests; mechanical and thermal corneal sensitivity (non-contact esthesiometry); and corneal nerve analysis and dendritic cell density by in vivo confocal microscopy (IVCM). Results: Twenty-two out of 29 evaluated patients entered the study. Most had DE-related symptoms (OSDI values > 12), that were severe in 63.6% of them. Tear osmolarity was elevated (>308 mOsms/L) in 83.4% of patients (mean 336.23 (28.71) mOsm/L). Corneal and conjunctival staining were unremarkable. T-BUT was low (<7 s) in 22.7% of patients. Schirmer test and tear lysozyme concentration were low in 13.6% and 27.3% of cases, respectively. Corneal esthesiometry showed patient mechanical (mean 147.81 (53.36) mL/min) and thermal thresholds to heat (+2.35 (+1.10) °C) and cold (−2.57 (−1.24) °C) to be significantly higher than controls. Corneal IVCM revealed lower values for nerve density ((6.4 (2.94) n/mm2), nerve branching density (2 (2.50) n/mm2), and dendritic cell density (9.1 (8.84) n/mm2) in patients. Tear levels of IL-12p70, IL-6, RANTES, and VEGF were increased, whereas EGF and IP-10/CXCL10 were decreased compared to controls. Based on cytokine levels, two clusters of patients were identified. Compared to Cluster 1, Cluster 2 patients had significantly increased tear levels of 18 cytokines, decreased tear lysozyme, lower nerve branching density, fewer dendritic cells, and higher urine mercury levels. Conclusions: Patients suffering from systemic mercury intoxication showed symptoms and signs of ocular surface pathology, mainly by targeting the trigeminal nerve, as shown by alterations in corneal sensitivity and sub-basal nerve morphology.

scholarly journals Evaluation of Dry Eye after Implantable Collamer Lens Surgery

2020 ◽  
Author(s):  
Haiting Chen ◽  
Xueyan Feng ◽  
Guangzeng Niu ◽  
Yuxiang Fan
Keyword(s):  
Dry Eye ◽  
Ocular Surface ◽  
Case Series ◽  
Meibomian Gland ◽  
Quality Score ◽  
Control Group ◽  
Ocular Surface Disease Index ◽  
Implantable Collamer Lens ◽  
Lens Surgery ◽  
Breakup Time

<b><i>Objectives:</i></b> To evaluate dry eye (DE) and associated meibomian gland dysfunction parameters after Implantable Collamer Lens (ICL) surgery. <b><i>Methods:</i></b> This is a prospective observational case series. Patients who underwent ICL implantation without previous ocular diseases or ophthalmic treatments were enrolled. Their Ocular Surface Disease Index (OSDI), noninvasive breakup time (NIBUT), meibography, slit-lamp examination of the lid margin, corneal fluorescein staining (CFS), and Schirmer test I were examined preoperatively and at 1 and 3 months postoperatively. <b><i>Results:</i></b> A total of 117 eyes of 60 patients were enrolled, and 107 eyes completed 3-month follow-up period. OSDI, lid marginal abnormality, and meibomian gland (MG) secretion, and meibum quality score were significantly higher at 1 month postoperatively and recovered partially at 3 months after surgeries, while NIBUT was significantly decreased all the time. Patients with previous DE symptoms (OSDI score ≥12) showed not only lower Schirmer and TBUT values but also higher CFS, lid margin score, MG loss, MG secretion, and meibum quality scores compared with those in the control group after operations. Low Schirmer, NIBUT values, and high meibum quality score were determined as risk factors for DE symptoms after ICL surgery. <b><i>Conclusions:</i></b> ICL implantation has a bad influence on the ocular surface and MG functions. The influence may be more obvious in patients with existing DE.

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

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.

scholarly journals Reliability and validity of the Japanese version of the Ocular Surface Disease Index for dry eye disease

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e033940 ◽  
Author(s):  
Akie Midorikawa-Inomata ◽  
Takenori Inomata ◽  
Shuko Nojiri ◽  
Masahiro Nakamura ◽  
Masao Iwagami ◽  
...  
Keyword(s):  
Internal Consistency ◽  
Dry Eye ◽  
Ocular Surface ◽  
Discriminant Validity ◽  
Reliability And Validity ◽  
Japanese Version ◽  
Disease Index ◽  
Eye Disease ◽  
Ocular Surface Disease Index ◽  
Test Retest Reliability

ObjectivesThe Ocular Surface Disease Index (OSDI) questionnaire is widely used to evaluate subjective symptoms of dry eye disease (DED) as a primary diagnostic criterion. This study aimed to develop a Japanese version of the OSDI (J-OSDI) and assess its reliability and validity.Design and settingHospital-based cross-sectional observational study.ParticipantsA total of 209 patients recruited from the Department of Ophthalmology at Juntendo University Hospital.MethodsWe translated and culturally adapted the OSDI into Japanese. The J-OSDI was then assessed for internal consistency, reliability and validity. We also evaluated the optimal cut-off value to suspect DED using an area under the receiver operating characteristic curve (AUC) analysis.Primary outcome measuresInternal consistency, test–retest reliability and discriminant validity of the J-OSDI as well as the optimal cut-off value to suspect DED.ResultsOf the participants, 152 had DED and 57 did not. The J-OSDI total score showed good internal consistency (Cronbach's alpha=0.884), test–retest reliability (interclass correlation coefficient=0.910) and discriminant validity by known-group comparisons (non-DED, 19.4±16.0; DED, 37.7±22.2; p<0.001). Factor validity was used to confirm three subscales within the J-OSDI according to the original version of the questionnaire. Concurrent validity was assessed by Pearson correlation analysis, and the J-OSDI total score showed a strong positive correlation with the Dry Eye-Related Quality-of-Life Score (γ=0.829). The optimal cut-off value of the J-OSDI total score was 36.3 (AUC=0.744).ConclusionsThe J-OSDI was developed and validated in terms of reliability and validity as an effective tool for DED assessment and monitoring in the Japanese population.

Dry Eye Syndrome-Related Quality of Life in Glaucoma Patients

2009 ◽  
Vol 19 (4) ◽  
pp. 572-579 ◽  
Author(s):  
Gemma Caterina Maria Rossi ◽  
Carmine Tinelli ◽  
Gian Maria Pasinetti ◽  
Giovanni Milano ◽  
Paolo Emilio Bianchi
Keyword(s):  
Quality Of Life ◽  
Dry Eye ◽  
Ocular Surface ◽  
Cross Sectional Study ◽  
Dry Eye Syndrome ◽  
Control Group ◽  
Ocular Surface Disease Index ◽  
Symptom Scale ◽  
Cross Sectional

Purpose To verify the presence of dry eye syndrome (DES) in treated patients with glaucoma and to analyze DES's impact on the patients' quality of life (QOL) versus the control group. Methods In this observational cross-sectional study, 61 patients were enrolled at a clinical practice. Patients were divided into three groups by number of glaucoma drops instilled per day (G1=1 drop/day, G2=2 drops/day, G3=3 drops/day). A control group of 20 subjects was also selected (G0). All subjects were submitted to a complete ocular examination (including tear function and ocular surface status) and completed the 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ), Glaucoma Symptom Scale (GSS) questionnaire, and Ocular Surface Disease Index (OSDI). DES was defined as presence of punctate keratitis and decreased break-up time. Statistical analysis was performed applying the Kruskal-Wallis analysis of variance and Mann-Whitney U tests (to compare median values between groups) as well as the χ2 and Fisher test (to verify significant differences). Results A total of 40% of G3 and 39% of G2 patients presented DES versus 11% of G1 and 5% of G0 (p=0.01). QOL was significantly influenced and altered (NEI-VFQ 25 total mean and GSS total mean and symptoms average: p=0.0085, p=0.006, and p=0.03, respectively). OSDI pointed out differences by group: 26% of G2 and 15% of G3 presented moderate OSDI and 15% of G3 and 8.7% of G2 severe OSDI (p>0.05). Conclusions Patients with topically treated glaucoma present DES more often than a similar control group (p=0.01). The presence of DES negatively influences the patient's QOL. The patients with glaucoma's ocular surface status should be evaluated regularly to ensure the timely detection and treatment of pathologic signs on the ocular surface.

The Effect of Low-Dose Aspirin on Dry Eye Parameters and Ocular Surface Disease Index Questionnaire

2018 ◽  
Vol 34 (3) ◽  
pp. 256-259 ◽  
Author(s):  
Alper Yazıcı ◽  
Esin Sarı ◽  
Erkan Ayhan ◽  
Gözde Şahin ◽  
Nesime Setge Tıskaoğlu ◽  
...  
Keyword(s):  
Dry Eye ◽  
Ocular Surface ◽  
Low Dose ◽  
Disease Index ◽  
Ocular Surface Disease ◽  
Ocular Surface Disease Index ◽  
Dose Aspirin ◽  
Low Dose Aspirin

Efficacy of eyedrops containing cross-linked hyaluronic acid and coenzyme Q10 in treating patients with mild to moderate dry eye

2018 ◽  
Vol 28 (1) ◽  
pp. 25-31 ◽  
Author(s):  
Elisa I. Postorino ◽  
Laura Rania ◽  
Emanuela Aragona ◽  
Carmen Mannucci ◽  
Angela Alibrandi ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Hyaluronic Acid ◽  
Dry Eye ◽  
Coenzyme Q10 ◽  
Ocular Surface ◽  
Fundus Examination ◽  
Ocular Surface Disease Index ◽  
Corneal Confocal Microscopy ◽  
Group A

Purpose: Dry eye disease (DED) is a common condition causing substantial burden. A randomized, controlled, single-masked study was performed in 40 patients with mild to moderate DED to evaluate the efficacy and safety of a collyrium based on crosslinked hyaluronic acid (XLHA) with coenzyme Q10 (CoQ10). Methods: Enrolled subjects were divided into 2 groups: group A, treated with XLHA + CoQ10; and group B, treated with hyaluronic acid (HA). Eyedrops were administered 4 times daily for 3 months. The Ocular Surface Disease Index (OSDI) questionnaire, tear break-up time (TBUT), corneal and conjunctival staining, and meibomian gland assessment (MGD) were evaluated; furthermore, corneal aesthesiometry, in vivo corneal confocal microscopy, visual acuity, intraocular pressure (IOP), and fundus examination were performed. Results: At the end of treatment, OSDI score significantly decreased in groups A and B (p<0.01 and p<0.05, respectively); the decrease was significantly higher in group A. Corneal staining decreased in both groups, with lower scores in group A. The MGD was significantly ameliorated in group A patients. No differences were found for corneal aesthesiometry or TBUT. Epithelial cell reflectivity was significantly reduced only in group A. For keratocytes and stromal matrix parameters, there was a significant improvement in group A. No changes were found for visual acuity, IOP, or fundus examination. Conclusions: The XLHA + CoQ10 treatment showed greater effectiveness in DED compared to HA alone, probably due to the longer permanency on ocular surface and the antioxidant activity of CoQ10. Therefore, XLHA + CoQ10 eyedrops could represent a new possibility in dry eye treatment.

scholarly journals Changes of Dry Eye Related Markers and Tear Inflammatory Cytokines After Upper Blepharoplasty

2021 ◽  
Vol 8 ◽  
Author(s):  
Songjiao Zhao ◽  
Nan Song ◽  
Lan Gong
Keyword(s):  
Inflammatory Cytokines ◽  
Dry Eye ◽  
Ocular Surface ◽  
Clinical Manifestations ◽  
Tear Film ◽  
Ocular Surface Disease Index ◽  
Necrosis Factor Alpha ◽  
Tnf Α ◽  
Break Up ◽  
Upper Blepharoplasty

Objectives: To investigate the changes of dry eye-related clinical manifestations, ocular surface parameters, and tear inflammatory cytokines after upper blepharoplasty.Methods: Forty eyes of 20 who underwent upper blepharoplasty were divided into either the group with or the group without preexisting dry eye before upper blepharoplasty. Ocular Surface Disease Index (OSDI), Schirmer I test, tear meniscus height, lipid layer thickness, non-invasive tear break-up time (NIKBUT), fluorescein tear film break-up time (FBUT), corneal fluorescein staining, meibum expression, lid margin changes, and tear inflammatory cytokines were assessed preoperatively and at 1, 3, and 6 months postoperatively. Correlations between inflammatory cytokines and dry eye-related parameters were determined.Results: The OSDI scores increased significantly at 1 month (p = 0.040) and subsequently decreased to the preoperative levels at 6 months postoperatively in subjects with dry eye. First (f)-NIKBUT and FBUT were significantly shortened at 1, 3, and 6 months postoperatively in subjects with dry eye (f-NIKBUT: p &lt;0.001, p = 0.010, p = 0.042; FBUT: p = 0.002, p = 0.005, p = 0.037, respectively), but were only shortened at 1 month (p = 0.028, p = 0.005) and returned to baseline levels at 6 months postoperatively in subjects without preexisting dry eye. A significant increasing trend of interleukin (IL)-6 was found in both dry eye and subjects without preexisting dry eye (p = 0.016, p = 0.008), while IL-8 and tumor necrosis factor alpha (TNF-α) were only found to be increased in subjects with dry eye postoperatively (p = 0.031, p = 0.031). The levels of IL-8 and TNF-α were positively correlated with OSDI scores (p = 0.046, p = 0.043, respectively) and negatively correlated with f-NIKBUT and FBUT (p = 0.026, p = 0.006, respectively).Conclusions: Upper blepharoplasty might increase the release of tear inflammatory cytokines and tear film instability that contribute to the development of postoperative dry eye in the early postoperative period and the changes most relieved in 6 months. Preexisting dry eye is a higher risk factor for worse and persistent ocular surface damage after upper blepharoplasty.

scholarly journals Safety and Efficacy of Pilocarpine, Cevimeline and Diquafosol Compared to Artificial Tears for the Treatment of Dry Eye: Protocol for a Systematic Review.

2020 ◽  
Author(s):  
José Gerardo Serrano-Robles ◽  
Ana Karen Pérez-Vázquez ◽  
Alejandro Navas-Pérez ◽  
Enrique O Graue-Hernandez ◽  
Arturo Ramirez-Miranda ◽  
...  
Keyword(s):  
Systematic Review ◽  
Dry Eye ◽  
Ocular Surface ◽  
Data Extraction ◽  
Meta Analysis ◽  
Cochrane Collaboration ◽  
Risk Of Bias ◽  
Review Author ◽  
Artificial Tears ◽  
Ocular Surface Disease Index

Abstract Background: Dry eye disease (DED) is a condition that affects the ocular surface and affects millions of people around the world. In recent years a stepped scheme has been proposed for the treatment of DED, with the use of an artificial tear being the mainstay of treatment. In this scheme, the use of secretagogues is suggested as part of the treatment for patients with moderate to severe affectation. With this systematic review we aim to evaluate the effectiveness and safety of secretagogues for DED.Methods: Electronic databases will be searched; we will include randomized controlled trials that compare secretagogues and artificial tears. Study inclusion will not be restricted on the basis of language or publication status. We will use Google Translate to assess studies written in languages other than English and Spanish. Identification, evaluation, data extraction and assessment of risk of bias will be conducted by two authors of the review, a third review author will resolve any disagreement. The outcomes will be the ocular surface disease index score, osmolarity and tear film break-up time. We will use the Cochrane Collaboration Risk of Bias (RoB) tool for assessing the risk of bias of the included studies. Based on the heterogeneity of the included studies, we will combine the findings in a meta-analysis using a random versus a fixed effect model. If we deem meta-analysis as inappropriate, we will document the reasons and report findings from the individual studies narratively.Discussion: Based on the evidence obtained we will evaluate the effect of Pilocarpine, Cevimeline and Diquafosol and compare it to artificial tears on multiple outcome measures.This systematic review aims to determine the efficacy and safety of the secretagogues pilocarpine, cevimeline and diquafosol to help clinicians in the decision-making process.Registration: PROSPERO CRD42020218407

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