scholarly journals Pharmacological safety of using medicinal drugs in patients with dry eye syndrome and in patients with the risk of dry eye syndrome development

2020 ◽  
pp. 94-103
Author(s):  
Yu. O. Tomashevska ◽  
O. V. Kryvoviaz

The dry eye syndrome (DES) belongs to the group of tear film disorders, which are caused by either lowering of tear secretion or by the tear film instability. DES lowers the working capacity, worsens the quality of life and, if its symptoms are ignored for a long time, may lead to serious vision disorders, including blindness. The influence of environmental factors may be one of the reasons for intensification of the DES caused symptoms. In addition, there is a concept of iatrogenic DES, caused by a systemic and local use of medicinal drugs, by contact lenses, and by ophthalmological surgical and non-surgical manipulations. The purpose of the research was to study the clinical-pharmacological characteristics of medicinal drugs in terms of peculiarities of their application in patients with DES who have adjoining disorders as well as to determine medicines that may contribute to DES occurrence and exacerbation causing secondary lowering of tear production and sensor glandular secretion, inflammation of Meibomian glands or direct irritation. Materials of the research included the data of the medicinal drugs’ register, the search database of medicinal drugs Compendium, prescribing information and labelling of the drugs. Methods of research: biblio-semantic, content-analysis, segmenting, graphic, system analysis. It has been determined that 194 medicinal drugs, which in accordance to the 1st level of ATC-classification system belong to 10 pharmaco-therapeutic groups, have certain treatment peculiarities in patients with dry eye syndrome. DES is mentioned in different sections of prescribing information and labelling of the drugs: «side effects» – 172 drugs, «peculiarities of use» – 21 drug, «drug-to-drug interaction» – 1 drug. Segmentation of the market by the type of medicinal form demonstrated a significant prevalence of eye drops and pills (34.02% and 33.50% respectively). Taking into consideration the prevailing share of eye drops among other medicinal forms, which cause iatrogenic DES, further research is required to study their composition and define the correlation between the content of excipients and the risk of development of side effects in the form of dry keratoconjunctivitis of local ophthalmological medicinal drugs. The results of the conducted complex research determine the groups of medicinal drugs that should be prescribed with special caution for pharmacotherapy of various organs and systems in patients with the risk of DES acquisition or exacerbation. The most numerous among them are such groups as S01E – Antiglaucoma drugs and myotics, L01X – Antineoplastic drugs and N02B – Analgesics and antipyretics, which account for 21.13%, 12.37% and 9.79%, respectively. Presence of information about the risk of DES development as a result of drug-to-drug interaction in only 1 of 194 prescribing information and labelling of the drugs signifies an extremely low level of attention to the issue of medicinal drugs’ synergy in terms of their side effects.

Reflection ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. 42-44
Author(s):  
L.I. Solovyova ◽  
◽  
T.V. Gavrilova ◽  
F.G. Mugumova ◽  
◽  
...  

The article presents the results of Ocuhyl C using in the treatment of «dry eye syndrome» (DES) in 47 eyes of 26 patients with different stages of compensated primary open-angle glaucoma. Experience of instillation of hypotensive eye drops with preservatives was from 1 year to 35 years. Assessment of subjective signs of DES was performed by questioning. Functional tests were performed (for the stability of the precorneal tear film –Norn test, for the level of total tear production –Shirmer test). Examinations were carried out at the first examination before prescribing the drug, then after 4 and 8 weeks of its use. All the patients noted good tolerability of the drug, no side effects. Indicators characterizing the feeling of a foreign body, dryness and redness of the eyes have significantly decreased. Precorneal tear film rupture time has significantly increased. Ocuhyl C can be recommended for clinical use. Key words: primary glaucoma; “dry eye” syndrome; tear forming; tear film rupture time; Ocuhyl C.


2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Emrullah Beyazyıldız ◽  
Ferda Alpaslan Pınarlı ◽  
Özlem Beyazyıldız ◽  
Emine Rümeysa Hekimoğlu ◽  
Uğur Acar ◽  
...  

Purpose. The current study was set out to address the therapeutic efficacy of topically applied mesenchymal stem cells (MSCs) on dry eye syndrome (DES) induced by benzalkonium chloride (BAC) in rats.Methods. Rats were divided into two groups just after establishment of DES. Eye drops containing either bromodeoxyuridine labeled MSCs (n=9) or phosphate buffer solution (n=7) were topically applied once daily for one week. Schirmer test, break-up time score, ocular surface evaluation tests, and corneal inflammatory index scoring tests were applied to all rats at baseline and after treatment. All rats were sacrificed after one week for histological and electron microscopic analysis.Results. Mean aqueous tear volume and tear film stability were significantly increased in rats treated with MSCs (P<0.05). Infiltration of bromodeoxyuridine labeled MSCs into the meibomian glands and conjunctival epithelium was observed in MSCs treated rats. Increased number of secretory granules and number of goblet cells were observed in MSCs treated rats.Conclusion. Topical application of MSCs could be a safe and effective method for the treatment of DES and could potentially be used for further clinical research studies.


The Eye ◽  
2020 ◽  
Vol 22 (4(132)) ◽  
pp. 36-41
Author(s):  
F. A. Bakhritdinova ◽  
F. A. Haydarova ◽  
K. I. Narzikulova ◽  
I. F. Nabieva

Significance. Prevalence of diabetes mellitus (DM) is increasing worldwide. People with diabetes are at higher risk to dry eye syndrome (DES). The increasing dependence of society on computers, air conditioning, and visual workload, etc. results in an increase in the manifestations of DES in diabetic patients. A significant part of the socially active population with diabetes requires prescription of drugs aimed at correcting disorders associated with both hyperglycemia and dry eyes. Conservative treatment of DES in case of diabetes includes prescription of artificial tears, metabolic, immunocorrecting, hormonal, antiallergic therapies as well as treatment of meibomian gland dysfunction (MGD). The tear substitutes, however, cannot always satisfy the needs of doctors and patients due to the imperfections of their formulas. Therefore, more and more new drugs are introduced to the market that require a comprehensive assessment.Purpose. To evaluate the clinical efficacy of Keratrop eye drops – a new artificial tear formulation – in dry eye syndrome treatment in patients with diabetes mellitus (DM).Methods. The study included 65 patients (130 eyes) with dry eye syndrome stages I and II associated with mild and moderate diabetes. These were adult patients of both sexes who had not previously received artificial tears as treatment and were undergoing either inpatient or domiciliary care. All studied patients provided a written informed consent and were divided into 2 groups by random sampling. The main group (35 patients) was receiving Keratrop instillations 2 times a day during 14 days, in the course of antidiabetic treatment. Instillations of “artificial tear” were not prescribed to patients of the control group (30 patients), and they only received antidiabetic treatment prescribed by the endocrinologist. Before and after treatment, all patients underwent standard ophthalmic examinations, meibography imaging, tear film assessment and filled in OSDI questionnaires.Results. The study showed that during treatment, in patients of the experimental group – with both I and II dry eye syndrome stages – a significant decrease in subjective and objective manifestations was observed, along with an improvement in the tear film stability. In the control group, positive dynamics was observed only in patients with the first stage of dry eye syndrome.Conclusion. Dry eye syndrome treatment in patients with diabetes should be comprehensive and must include both basic antidiabetic therapy and instillation of tear substitutes.


2021 ◽  
Vol 18 (1) ◽  
pp. 129-135
Author(s):  
V. V. Brzheskiy ◽  
I. N. Gorbachevskaya ◽  
S. Y. Golubev

The aim of the study was to evaluate the effectiveness of the preparations Optinol® Express Moisture (0.21 %) and Optinol® Deep Moisture (0.4 %) in the treatment of children with dry eye syndrome (DES) and to determine the indications for prescribing these drugs for various etiologies and clinical course of the disease.Patients and methods. The study involved 56 children aged 4–17 years with DES, which were divided into 3 groups, depending on its pathogenetic type. The first consisted of 24 children with DES, which developed on the basis of chronic blepharitis, the second — 12 children with neuroparalytic keratitis, and the third — 18 children with chronic uveitis, in whom DES was caused by prolonged instillations of eye drops with benzalkonium chloride. Each group was divided into 2 more equal subgroups, the first of which was prescribed the drug Optinol® Express Moisture, and the second — Optinol® Deep Moisture with a frequency of 4 times a day.Results. In all children, from the very first days of instillation of the studied drugs, a decrease in the severity of subjective signs of DES (OSDI) was noted, as well as a gradual decrease in the degree of xerotic changes in the ocular surface (severity of its staining with vital dyes) and an increase in the stability of the tear film (M.Norn). At the same time, the positive dynamics of the controlled parameters increased with the continuation of therapy, reaching a maximum by the 30th day of treatment. Moreover, the effectiveness of therapy depended on the severity of xerosis of the ocular surface: it was maximal in children with mild, and minimal in children with an extremely severe form of xerosis (with neuroparalytic keratitis). Moreover, the drug Optinol® Express Moisture was more effective in the treatment of children with mild and extremely severe forms of DES, and Optinol® Deep Moisture — with moderate and severe xerosis.Conclusion. The preparations Optinol® Express Moisture and Optinol® Deep Moisturization are effective in the treatment of children with DES, which has developed on the basis of pathology of the ocular surface of neurotrophic and artifact genesis, as well as increased volatility of the precorneal tear film against the background of chronic blepharitis.


2019 ◽  
Vol 16 (2) ◽  
pp. 236-243
Author(s):  
V. N. Trubilin ◽  
E. G. Polunina ◽  
D. V. Angelova ◽  
V. V. Kurenkov ◽  
S. G. Kapkova ◽  
...  

The revolution in understanding the etiology and clinical manifestations of the disruption of the tearing process and the development of dry eye syndrome (CVS) has occurred in last 20–30 years. It has been established that the loss of the tear film homeostasis can occur not only because of a violation of systemic and autoimmune disorders, but also as a result of a blinking disorder and distribution of the tear film over the ocular surface. Therefore, new pathogenetic disease development mechanisms have been identified. The prevalence of diseases of the ocular surface and CVD in recent years has increased significantly. It is mostly caused not only by scientific discoveries in the field of understanding, for example, the etiological and pathophysiological role of the neurosensory mechanism of development of CVS. An important aspect is the emergence of new risk factors that potentiate the development of ocular surface diseases and CVL. These factors include the use of various drugs — antidepressants, antihistamines, hormone therapy, and others; instillation of eye drops — antiglaucoma drugs, etc., as well as the appearance of little-studied factors such as cosmetology procedures (eyelids tattooing, eyelash extensions, botulinum toxin injections for aesthetic purposes, etc.). They are carried out in proximate close to the eye and eyelids, causing multiple pathological reaction. The experience of observing patients, literature data, and the conducted study have showed that various cosmetological effects in the periorbital zone, whose popularity has increased in recent years, may cause the appearance of iatrogenic dry eye syndrome. The following most vivid clinical examples will help, encountered in our practice, to illustrate the data presented. Collecting the anamnesis, it is necessary to identify the presence of risk factors for the development of diseases of the ocular surface and CVD, to eliminate them, if possible, and to carry out adequate pathogenically based therapy.


Author(s):  
Yun-Jung Yang ◽  
Won-Young Lee ◽  
Young-jin Kim ◽  
Yeon-pyo Hong

Hyaluronic acid (HA) is commonly used for treating dry eye syndrome (DES). This meta-analysis was performed to compare the efficacies of HA- and non-HA-based eye drops, including saline and conventional artificial tears (ATs), for the treatment of dry eye disease. Eight databases (PubMed, EMBASE, Cochrane Central Register of Controlled Trials, DBpia, KoreaMed, KMBASE, RISS, KISS) were searched for studies comparing the efficacies of HA- and non-HA-based ATs in patients with DES published up to September 2020. Two independent reviewers assessed the quality and extracted the relevant data. The mean differences of Schirmer’s (SH) test scores, tear breakup times (TBUT), corneal fluorescein staining scores (Oxford scale, 0–4), and ocular surface disease indexes were calculated. The standard mean difference and 95% confidence interval were calculated using a random effect model. Nineteen studies, including 2078 cases, were included. HA eye drops significantly improved tear production compared with non-HA-based eye drops (standard mean difference (SMD) 0.18; 95% confidence interval (CI) 0.03, 0.33). In a subgroup analysis, the SH test scores and TBUT values after using HA significantly increased compared to those measured after using saline (SMD 0.27; 95% CI 0.05, 0.49 and SMD 0.28; 95% CI 0.03, 0.52, respectively). Based on these results, HA eye drops may be superior to non-HA eye drops including normal saline and ATs. Further research is needed to assess the efficacies stratified by age, treatment duration, the severity of dry eye, and optimal dosages.


Author(s):  
Y.V. Kutuzova ◽  
◽  
I.V. Dutchin ◽  
E.L. Sorokin ◽  
◽  
...  

Purpose.To conduct a comparative analysis of the effectiveness of assessing the stability of the tear film using corneotopography and the classic Norn test in patients with myopia and myopic astigmatism before keratorefractive surgery. Material and methods. The study included 26 patients planned for keratorefractive surgery for myopia and myopic astigmatism, aged 18 to 47 years. 7 people there was a mild degree of myopia, in 14 people – medium degree, in 5 people – high degree. The average degree of corneal astigmatism was 2.25 diopters. The stability of the pre-corneal tear film was assessed using computed keratotopography and Norn's test – the tear film rupture time (TFRT) was deter- mined. A standard questionnaire was also used to assess the severity of symptoms of dry eye syndrome. A comparison was made of the indicators of the stability of the tear film obtained by the methods of corneotopography and the Norn's test, with their subsequent comparison with the data of the questionnaire. Results. In 17 patients (65.4%), the TFRT index corresponded to the age norm. In the remaining 9 people (34.6%), indicators of stability of the tear film were reduced both by corneotopography (12±4 sec) and by Norn's test (13.5±4.5 sec), and there were also subjective signs of dry eye syndrome according to data questionnaire. The data turned out to be comparable. Conclusions. 1. Among the total population of patients, 34.6% were persons with impaired tear film stability and subjective manifestations of dry eye syndrome. 2. Assessment of the stability of the tear film, determined using the method of corneal topography, showed a high degree of comparability with the results of Norn's test. A significant advantage of the keratotopography method is its non-invasiveness. 3. It is necessary to pay attention to the condition of the ocular surface and identify risk groups to avoid chronicity or aggravation of existing disorders. Key words: dry eye syndrome, tear film, keratotopography, Norn's test.


2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Mária Budai-Szűcs ◽  
Gabriella Horvát ◽  
Barnabás Áron Szilágyi ◽  
Benjámin Gyarmati ◽  
András Szilágyi ◽  
...  

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.


2018 ◽  
Vol 6 (3) ◽  
pp. 654
Author(s):  
Muhammad Syauqie ◽  
Ardizal Rahman ◽  
Getry Sukmawati

Permukaan okular rentan terhadap efek iritatif dari debu semen tersebut karena epitel konyungtiva dan kornea hanya dilapisi oleh lapisan tipis tear film. Paparan debu semen jangka panjang menyebabkan terjadinya inflamasi subklinis kronik yang dapat mempengaruhi transdiferensiasi epitel konyungtiva dan densitas sel goblet yang kemudian dapat menyebabkan timbulnya gejala dry eye syndrome. Tujuan penelitian ini adalah menilai status tear film pada masyarakat  yang  terpapar  emisi  debu  semen  dibandingkan  dengan  masyarakat  yang  tidak  terpapar.  Penelitian ini berupa analytic cross sectional study pada dua populasi yaitu kelompok terpapar dan tidak terpapar emisi debu pabrik semen. Semua sampel penelitian dari dua populasi menjalani pemeriksaan pH tear film, Schirmer, Ferning dan Tear Break Up Time (TBUT). Hasil studi mendapatkan peningkatan nilai pH tear film yang bermakna pada penduduk di kelompok terpapar dengan p=0.001. Terdapat juga penurunan kualitas Ferning yang bermakna pada penduduk di kelompok terpapar yang didominasi tipe III dengan p=0.005 dan 0.029. Sedangkan hasil pemeriksaan Schirmer dan TBUT masih dalam batas normal dan tidak terdapat perbedaan yang bermakna antara kedua kelompok. Simpulan studi ini ialah erdapat peningkatan rerata nilai pH tear film dan penurunan kualitas lapisan musin tear film yang bermakna pada masyarakat yang terpapar emisi debu semen namun tidak didapatkan peningkatan kejadian dry eye yang bermakna.


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