scholarly journals Comparative characteristics of osmolarity, tear production and state of the corneal epithelium after instillations of the preparations Visomitin and hypromellose

2021 ◽  
pp. 249-255
Author(s):  
T. N. Safonova ◽  
Z. V. Surnina ◽  
G. V. Zaitseva
Keyword(s):  
Ocular Surface ◽  
Tear Film ◽  
Quantitative Composition ◽  
Blurred Vision ◽  
Ocular Symptoms ◽  
Increased Sensitivity ◽  
Corneal Staining ◽  
Positive Effect ◽  
Inflammatory Action

Introduction. Dry eye syndrome (DES) is a multifactorial disease of the ocular surface, characterized by changes in its homeostasis and accompanied by ocular symptoms, the etiology of which is associated with destabilization of the tear film, hyperosmolarity, inflammation, damage to the structures of the ocular surface and neurosensory disorders.Objective. To study the effect of a drug containing plastoquinonyldecyltriphenylphosphonium bromide (PDTP, SkQ1) on dynamics of osmolarity and reparative properties of the cornea.Materials and methods. The study included 23 patients (46 eyes) aged 23 to 49 years. All patients presented complaints of dryness, burning sensation, cramps and discomfort in the eyes, increased sensitivity with instillation of drops, periodic blurred vision. Patients underwent standard and special ophthalmic examinations. The patients were divided into two groups comparable in gender and quantitative composition.Results. Based on the results of the examination at the starting visit, all patients were diagnosed with DES mild or moderate study. After one week of therapy, a significant decrease in subjective complaints was noted patients who received the drug with PDTF. All patients tolerated the drug well. In the group of patients who received a tear replacement therapy with hypromellose, in most patients, while complaints of dryness persist, decreased a feeling of pain in the eyes. A month later, complaints persisted only in patients of this group, but their intensity was known significantly reduced compared to the visit after a week. Against the background of therapy with the drug with PDTP, significant improvement of the Schirmer test, Norn test and corneal staining, as well as with the help of a in vivo confocal microscopy shows a decrease in the number of Langerhans cells.Conclusion. The results obtained indicate a positive effect of PDTP on the structure of the ocular surface even with its short-term use due to its keratoprotective and anti-inflammatory action. 

Ocular Surface Disease in Patients under Topical Treatment for Glaucoma

2017 ◽  
Vol 27 (6) ◽  
pp. 694-704 ◽  
Author(s):  
Francisco Pérez-Bartolomé ◽  
Jose M. Martínez-de-la-Casa ◽  
Pedro Arriola-Villalobos ◽  
Cristina Fernández-Pérez ◽  
Vicente Polo ◽  
...  
Keyword(s):  
Ocular Surface ◽  
Treatment Duration ◽  
Open Angle Glaucoma ◽  
Tear Film ◽  
Older Age ◽  
Ocular Surface Disease ◽  
Medication Group ◽  
Pressure Lowering ◽  
Tear Meniscus Height ◽  
Corneal Staining

Purpose To examine the relationship between ocular surface disease (OSD) and topical antiglaucoma therapy. Methods A total of 211 eyes of 211 patients with open-angle glaucoma or ocular hypertension on topical medication were recruited over 10 months. Controls were 51 eyes of 51 healthy age- and sex-matched volunteers. In each patient, we recorded the intraocular pressure-lowering eyedrops used, the number of medications used, and daily and cumulative preservative concentrations (PC). Main outcome measures were fluorescein corneal staining score (Oxford scale), lower tear meniscus height (LTMH) (spectral-domain optical coherence tomography), noninvasive tear film breakup time (NI-TBUT) (Oculus Keratograph 5M), and OSD symptom questionnaire index (OSDI). Results Compared to controls, significantly higher OSDI (median [interquartile range] 10.24 [4.54-18.94] vs 2.5 [0-12.5]; p<0.001) and corneal staining (≥1: 64.93% vs 32.61%; p<0.001) scores were recorded in the medication group. The NI-TBUT and LTMH failed to vary between the groups (p>0.05). A higher daily PC was associated with a lower LTMH (R −0.142; p = 0.043). In the medication group, multivariate analysis identified correlations between benzalkonium chloride (BAK) (odds ratio [OR] 1.56) and BAK plus polyquaternium-containing drops (OR 5.09) or higher OSDI (OR 1.06) and abnormal corneal staining test results and between older age (mean ratio [MR] 1.05), longer treatment duration (MR 1.02), or corneal staining presence (MR 1.22) and a higher OSDI score. Conclusions Ocular surface disease was more prevalent in the medication group. The main factors impacting OSD were drops with preservatives, longer treatment duration, and older age.

scholarly journals Role of ion channels in the functional response of conjunctival goblet cells to dry eye

2018 ◽  
Vol 315 (2) ◽  
pp. C236-C246 ◽  
Author(s):  
Donald G. Puro
Keyword(s):  
Ion Channels ◽  
Dry Eye ◽  
Ocular Surface ◽  
Adaptive Response ◽  
Tear Film ◽  
Goblet Cells ◽  
Cation Conductance ◽  
Conjunctival Goblet Cells

Optimal vision requires an ocular surface with a stable tear film whose many critical tasks include providing >70% of the eye’s refractive power. However, for millions, tear film instability produces uncomfortable sight-impairing dry eye. Despite the multitude of etiologies for dry eye, a universal hallmark is hyperosmolarity of the tear film. Presently, knowledge of how the ocular surface responds to hyperosmolarity remains incomplete with little understood about the role of ion channels. This bioelectric analysis focused on conjunctival goblet cells whose release of tear-stabilizing mucin is a key adaptive response to dry eye. In freshly excised rat conjunctiva, perforated-patch recordings demonstrated that a ≥10% rise in osmolarity triggers goblet cells to rapidly generate a ~15-mV hyperpolarization due to the oxidant-dependent activation of ATP-sensitive K+ (KATP) channels. High-resolution membrane capacitance measurements used to monitor exocytosis revealed that this hyperpolarization results in an approximately fourfold boost in exocytotic activity evoked by cholinergic input, which in vivo occurs via a neural reflex and depends chiefly on calcium influxing down its electro-gradient. We discovered that this adaptive response is transient. During 30–80 min of hyperosmolarity, development of a depolarizing nonspecific cation conductance fully counterbalances the KATP-driven hyperpolarization and thereby eliminates the exocytotic boost. We conclude that hyperosmotic-induced hyperpolarization is a previously unappreciated mechanism by which goblet cells respond to transient ocular dryness. Loss of this voltage increase during long-term dryness/hyperosmolarity may account for the clinical conundrum that goblet cells in chronically dry eyes can remain filled with mucin even though the tear film is hyperosmotic and mucin-deficient.

scholarly journals Morphological and Functional Assessment of Meibomian Glands in Keratoconus

2021 ◽  
Author(s):  
Ömür Ö Uçakhan ◽  
Gökçen Özcan
Keyword(s):  
Ocular Surface ◽  
Tear Film ◽  
Early Screening ◽  
Ocular Surface Disease Index ◽  
Non Invasive ◽  
The Mean ◽  
Meibomian Glands ◽  
Break Up ◽  
And Function ◽  
Corneal Staining

Abstract Purpose: To evaluate the morphology and function of the meibomian glands (MG) in keratoconus patients.Methods: One hundred eyes of 100 keratoconus patients and 100 eyes of 100 age-matched healthy subjects were included into this study. Ocular Surface Disease Index (OSDI) scores, non-invasive break up time (NIBUT), meibography findings, fluorescein staining of the ocular surface, tear film break-up time (TBUT), and Schirmer I test were recorded in all patient eyes and were compared with controls.Results: The mean TBUT and NIBUT were significantly lower, corneal staining and OSDI scores were statistically higher in the keratoconus group (p<0.05). The mean meiboscore, partial gland, gland dropout and gland thickening scores of the upper and lower eyelids were significantly higher in keratoconus patients compared to controls (p<0.05). The NIBUT measurements significantly correlated with MG loss in both upper and lower eyelids (p<0.05). The severity of keratoconus seemed to correlate with meiboscore, partial gland, gland thickening scores in both upper and lower eyelids. Conclusion: Our data suggest that corneal ectasia in keratoconus is associated with alterations in ocular surface, tear film function and MG morphology. Early screening and treatment of MG dysfunction may improve ocular surface quality and allow better disease management in keratoconus patients.

scholarly journals The Effects of Topical Antiglaucoma Drugs as Monotherapy on the Ocular Surface: A Prospective Study

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Sevda Aydin Kurna ◽  
Semih Acikgoz ◽  
Ahmet Altun ◽  
Nurver Ozbay ◽  
Tomris Sengor ◽  
...  
Keyword(s):  
Prospective Study ◽  
Ocular Surface ◽  
Beta Blockers ◽  
Squamous Metaplasia ◽  
Tear Film ◽  
Eye Drops ◽  
Group 2 ◽  
A Prospective Study ◽  
Breakup Time ◽  
Corneal Staining

Purpose. The aim was to compare the effects of antiglaucoma eye drops on the tear functions and ocular surface.Method. Eighty-five eyes of 43 patients with glaucoma were included into this randomized prospective study. Timolol without preservative (1), timolol with benzododecinium bromide (2), latanoprost (3), bimatoprost (4), travoprost with benzalkonium chloride (5), and brimonidine with purite (6) were given to 6 groups. Schirmer I, tear film breakup time (TBUT), staining scores, and impression cytology samples were evaluated before and during 12-month-follow-up period.Results. At the end of 12 months, there was no detected change in Schirmer I and TBUT tests indicating dry eye. Corneal staining scores were higher in groups 1 and 2, while conjunctival staining scores were higher in group 6. Goblet cell count decreased in groups 1 and 5 in superior and inferior, group 2 in superior, and groups 3 and 6 in inferior conjunctiva. Squamous metaplasia grades showed a significant increase in groups 1 and 2 at 3rd, 6th, and 12th month controls (P<0.05).Conclusion. We observed nonserious impact on tear functions and ocular surface with antiglaucoma monotherapy. Beta blockers induced more damage on the ocular surface suggesting the role of the dosing and active substances beside preservatives.

scholarly journals Risk Factors and Symptoms of Meibomian Gland Loss in a Healthy Population

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Anna Machalińska ◽  
Aleksandra Zakrzewska ◽  
Krzysztof Safranow ◽  
Barbara Wiszniewska ◽  
Bogusław Machaliński
Keyword(s):  
Ocular Surface ◽  
Current Knowledge ◽  
Tear Film ◽  
Meibomian Gland ◽  
Multivariate Logistic Regression Model ◽  
Healthy Population ◽  
Ocular Surface Disease Index ◽  
Ocular Symptoms ◽  
Ocular Surface Health ◽  
Age And Sex

Purpose. The aim of this study was to investigate the relationships between MGL and ocular symptoms, several systemic conditions, and key markers of ocular surface health.Methods. We included into the study 91 healthy volunteers between the ages of 20 and 77 years. We analyzed meibomian gland morphology, function, and lid margin alterations. We correlated our findings with self-reported ocular symptoms, systemic medical history, lifestyle factors, and tear film abnormalities.Results. We observed that a high ocular surface disease index, a history of either chalazion or hordeolum, experience of puffy eyelids upon waking, and foreign body sensation all appeared to be predictors of an abnormal meiboscore after adjusting for age and sex (p=0.0007;p=0.001;p=0.02;p=0.001, resp.). Multivariate logistic regression model including age and sex showed that there were three independent predictors of abnormal meiboscore: older age (OR = 1.03, 95% CI = 1.01–1.04 per year,p=0.006), postmenopausal hormone therapy (OR = 4.98, 95% CI = 1.52–16.30,p=0.007), and the use of antiallergy drugs (OR = 5.85, 95% CI = 2.18–15.72,p=0.0004).Conclusion. Our findings extend current knowledge on the pathophysiology of MGL.

scholarly journals A comparative study of efficacy of chloroquine phosphate 0.03% and sodium carboxymethylcellulose 1% in dry eye

2021 ◽  
Vol 7 (2) ◽  
pp. 302-307
Author(s):  
Vandana Sharma ◽  
Parag Tyagi ◽  
J P Chugh ◽  
R S Chauhan ◽  
Ashok Rathi
Keyword(s):  
Drug Therapy ◽  
Comparative Study ◽  
Dry Eye ◽  
Ocular Surface ◽  
Tear Film ◽  
Eye Drops ◽  
Onset Of Action ◽  
Dry Eyes ◽  
Ocular Symptoms ◽  
Group 2

Dry eye disease (DED) is a multifactorial disease of the tear film which leads to ocular discomfort, visual disturbances and damage to ocular surface. The objective of treatment of DED has now shifted from managemnt of ocular symptoms and patient relief to attainment of normal physiological composition of the tear film.Aim of this study was to compare the efficacy of chloroquine phosphate 0.03% (CQP) eye drops with sodium carboxymethyl cellulose 1% (CMC) eye drops in the management of DED. A single blind, prospective and comparative study including 100 patients of dry eyes was planned. The patients were randomly divided into two groups, each comprising of 50 patients. Group-1 patients were given CMC 1% eye drops 4 times a day for 12 weeks and Group-2 patients were given CQP 0.03% eye drops as the treatment modality 2 times a day for 12 weeks. The efficacy of both the drugs was compared and evaluated statistically. The study showed that both CQP and CMC eye drops are effective in treating DED, although faster onset of action was observed with CQP on ocular surface staining tests and Schirmer’s test. Also, it was noted that patients with severe DED showed least improvement in both the groups suggesting that mono-drug therapy is least effective in treatment of severe DED and multi drug therapy should be used early in treatment of severe DED.

scholarly journals In VivoLaser Scanning Confocal Microscopy of Human Meibomian Glands in Aging and Ocular Surface Diseases

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Vincenzo Fasanella ◽  
Luca Agnifili ◽  
Rodolfo Mastropasqua ◽  
Lorenza Brescia ◽  
Federico Di Staso ◽  
...  
Keyword(s):  
Confocal Microscopy ◽  
Dry Eye ◽  
Ocular Surface ◽  
Tear Film ◽  
Response To Therapy ◽  
Tissue Response ◽  
Scanning Confocal Microscopy ◽  
Ocular Surface Diseases ◽  
Meibomian Glands

Meibomian glands (MGs) play a crucial role in the ocular surface homeostasis by providing lipids to the superficial tear film. Their dysfunction destabilizes the tear film leading to a progressive loss of the ocular surface equilibrium and increasing the risk for dry eye. In fact, nowadays, the meibomian gland dysfunction is one of the leading causes of dry eye. Over the past decades, MGs have been mainly studied by using meibography, which, however, cannot image the glandular structure at a cellular level. The diffusion of thein vivolaser scanning confocal microscopy (LSCM) provided a new approach for the structural assessment of MGs permitting a major step in the noninvasive evaluation of these structures. LSCM is capable of showing MGs modifications during aging and in the most diffuse ocular surface diseases such as dry eye, allergy, and autoimmune conditions and in the drug-induced ocular surface disease. On the other hand, LSCM may help clinicians in monitoring the tissue response to therapy. In this review, we summarized the current knowledge about the role ofin vivoLSCM in the assessment of MGs during aging and in the most diffuse ocular surface diseases.

scholarly journals Contribution of Mucins towards the Physical Properties of the Tear Film: A Modern Update

2019 ◽  
Vol 20 (24) ◽  
pp. 6132 ◽  
Author(s):  
Georgi As. Georgiev ◽  
Petar Eftimov ◽  
Norihiko Yokoi
Keyword(s):  
Ocular Surface ◽  
Tear Film ◽  
The Novel ◽  
Mucin Secretion ◽  
Lipid Layer ◽  
The Impact ◽  
Ophthalmic Disease

Instability of the tear film (TF) protecting the ocular surface results in dry eye syndrome (DES), the most prevalent public health ophthalmic disease affecting the quality of life of 10 to 30% of the human population worldwide. Although the impact of the tear film lipid layer (TFLL) and of the aqueous tears (AT) to the TF stability is extensively studied, in contrast the contribution of the secretory mucins (SM) and of the membrane-associated mucins (MAM), i.e., one of the most abundant molecular classes in AT and in the corneal epithelium respectively, remains poorly defined. However, it is well known that in DES both types of mucins are quantitatively or qualitatively deficient. Numerous studies since the 1990s until now have proposed direct involvement of SM and MAM in the material properties (viscoelasticity, hydration, and protection of the ocular surface; synergistic cooperation with the rest of the TF layers; etc.) and stability of TF. These theories will be reviewed here in the context of the classical and modern in vitro and in vivo results that allow their reappraisal and in view of the novel mucin secretion enhancing pharmaceuticals, which have opened innovative routes for the therapy of DES.

Efficacy of omega-3 fatty acids and punctal plugs in the prevention of isotretinoin-associated ocular surface disease

2020 ◽  
pp. 112067212094565
Author(s):  
Tarek Roshdy Elhamaky
Keyword(s):  
Ocular Surface ◽  
Tear Film ◽  
Meibomian Gland ◽  
Omega 3 ◽  
Surface Parameters ◽  
Punctal Plugs ◽  
Staining Score ◽  
Group A ◽  
Corneal Staining

Purpose: To investigate the effects of omega-3 fatty acids and punctal plugs on tear film and ocular surface parameters in patients receiving systemic isotretinoin therapy. Methods: This is a prospective randomized study that included 180 eyes of 90 patients who had systemic isotretinoin therapy (120–150 mg/kg for at least 4–6 months). Exclusion criteria: DED according to the diagnostic criteria of TFOS DEWS II. Patients were assigned into three groups; (1) O3FAs/PPs group: A soft preloaded silicone plug was inserted in the inferior punctum of both eyes and received oral O3FAs two capsules twice daily total daily dose of 1040 mg/day for 6 months. (2) PPs group: A soft preloaded silicone plug was inserted in the inferior punctum of both eyes and received oral placebo. (3) Isotretinoin group: No intervention was done. At baseline, 1 week, 1, 3, and 6 months of study, Ocular surface evaluation tests were done in following order: OSDI, tear osmolarity, Schirmer’s I test, TBUT, ocular surface staining score, and meibomian gland expression. Primary outcome measures: The changes in measurement of ocular surface evaluation tests including ocular surface disease index (OSDI), tear film breakup time (TFBUT), corneal staining, tear osmolarity, and meibomian gland expression at 6 months. Results: There are significant changes between all groups at 6 months follow-up. The ocular surface parameters were better for the PPs and O3FAs/PPs groups than the isotretinoin group. The isotretinoin group showed worsening of ocular surface parameters including a significant decrease of FTBUT and an increase of OSDI score, corneal staining score, tear osmolarity, and meibomian expression score. There was no significant difference in ST1 throughout the whole study in all groups. At 6 months follow-up, there were no statistically significant differences between PPs and O3FAs/PPs groups except meibomian expression score which showed a significant increase in PPs group. Conclusion: Our cohort highlights the beneficial effects of the combination of O3FAs supplementation with PPs in the prevention of isotretinoin-associated OSD in this sample study.

scholarly journals A model for tear film dynamics during a realistic blink

2019 ◽  
Vol 2 (3) ◽  
pp. 21-27
Author(s):  
Kara Lee Maki ◽  
William Henshaw ◽  
Alex McManus ◽  
Richard Braun ◽  
Dylan Chapp ◽  
...  
Keyword(s):  
Ocular Surface ◽  
Tear Film ◽  
Grid Method ◽  
Theoretical Studies ◽  
Overset Grid ◽  
Overset Grid Method

Each time one blinks, a stable tear film (TF) must reestablish itself on the ocular surface to ensure the function and health of the eye. Although the formation of the TF has been extensively studied both experimentally and theoretically, the influence of the lid dynamics on the TF formation is still not fully understood. Experimental instrumentation does not yet have the capability to estimate the TF thickness in vivo over the entire front of the eye, especially near the lids during a blink, where the eyelashes obstruct the view of the ocular surface. Additionally, a realistic blinking eyeshaped domain presents challenges in approximating themotion of the TF in theoretical studies. In thiswork,we overcome these theoretical challenges by implementing a moving overset grid method to study the influence of the lid motion on the formation of TF.

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