Benefits and Safety of Astaxanthin in the Treatment of Mild-To-Moderate Dry Eye Disease

Objectives: To evaluate the effect of astaxanthin in the treatment of mild-to-moderate dry eye disease (DED) in middle-aged and elderly patients.Methods: 120 eyes of 60 middle-aged and elderly patients with mild-to-moderate DED were enrolled in this prospective, one-group, quasi-experimental study. Six milligram Astaxanthin tablets (Weihong Haematococcus Pluvialis Astaxanthin, Hangzhou Xinwei Low Carbon Technology R&D Co., Ltd., China) were administered orally, twice daily for 30 ± 2 days. History of eye diseases, treatment, systemic disease, and medication before the test were recorded. In addition, the ocular surface disease index (OSDI) questionnaire, non-invasive tear break-up time (NIBUT), fluorescein break-up time (FBUT), corneal fluorescein staining (CFS) score, eyelid margin signs, meibomian gland (MG) expressibility, meibum quality, meibomian gland dropout (MGDR), Schirmer I test (SIt), tear meniscus height (TMH), bulbar conjunctiva congestion degree, blink frequency, incomplete blink rate, and thickness of tear film lipid layer were collected before treatment, 2 weeks after the initiation of treatment, and at the end of treatment. Visual acuity (VA), intraocular pressure (IOP), anterior segment, fundus, discomfort symptoms and other adverse reactions were also monitored throughout the study to assess the safety.Results: OSDI score, NIBUT, BUT, CFS score, eyelid margin signs, MG expressibility, meibum quality, and blink frequency improved significantly to varying degrees after treatment compared with those before the treatment (P < 0.05), while TMH, SIt, conjunctival congestion, the thickness of tear film lipid layer, MGDR, incomplete blink rate, VA and IOP did not differ (P > 0.05).Conclusions: Oral administration of astaxanthin improves the symptoms and signs of middle-aged and elderly patients with mild-to-moderate DED.

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Effects of warm compress on tear film, blink pattern and Meibomian gland function in dry eyes after corneal refractive surgery

BMC Ophthalmology ◽

10.1186/s12886-021-02091-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Xueyi Zhou ◽

Yang Shen ◽

Jianmin Shang ◽

Xingtao Zhou

Keyword(s):

Dry Eye ◽

Corneal Thickness ◽

Tear Film ◽

Meibomian Gland ◽

Blink Rate ◽

Lipid Layer ◽

Dry Eyes ◽

Mean Values ◽

Before And After ◽

Gland Function

Abstract Background To assess the effects of warm compress (WC) on tear film lipid layer, blink pattern and Meibomian gland function in patients with dry eye following femtosecond laser small incision lenticule extraction (SMILE) and laser-assisted subepithelial keratomileusis (LASEK). Methods We enrolled 37 eyes of 37 participants, each with dry eye for more than 2 years following SMILE (25 eyes) or LASEK (12 eyes). WC was performed using a spontaneously heating eye mask. Tear film break-up time (TBUT), tear film lipid layer thickness (TFLLT), blink pattern, Meibomian secretory function scores (MGS), visual acuity, spherical equivalent (SE), keratometry, central corneal thickness (CCT) and aberration were assessed before and after WC. Results After WC, the following mean values all increased relative to baselines: CCT, SE, minimum (Min-), maximum (Max-) and average (Ave-) TFLLT, TBUT, total MGS (TMGS), number of glands secreting any liquid (MGL), and complete blink rate (CBR) (p values ranging from < 0.001 to 0.042). Partial blink frequency (PBF) and partial blink rate (PBR) decreased (p = 0.002 in both cases). The decrease of PBF was higher in SMILE subgroup than in LASEK (p = 0.030). TBUT variation was positively correlated with that of Ave-TFLLT and TMGS (p = 0.046, 0.028, respectively). Max-TFLLT variation was correlated with that of TMGS (p = 0.020). Conclusions WC may temporarily increase tear film thickness and stability, decrease partial blink, and partly augment Meibomian gland function in dry eye patients after corneal refractive surgeries. Future studies are required to investigate long term clinical efficacy and safety.

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Effects of Warm Compress on Tear Film, Blink Pattern and Meibomian Gland Function in Dry Eyes After Corneal Refractive Surgery

10.21203/rs.3.rs-288555/v1 ◽

2021 ◽

Author(s):

Xueyi Zhou ◽

Yang Shen ◽

Jianmin Shang ◽

Xingtao Zhou

Keyword(s):

Dry Eye ◽

Refractive Surgery ◽

Corneal Thickness ◽

Tear Film ◽

Meibomian Gland ◽

Blink Rate ◽

Lipid Layer ◽

Mean Values ◽

Corneal Refractive Surgery ◽

Gland Function

Abstract Background To assess the effects of warm compress (WC) on tear film lipid layer, blink pattern and Meibomian gland function in patients with dry eye following femtosecond laser small incision lenticule extraction (SMILE) and laser-assisted subepithelial keratomileusis (LASEK). Methods We enrolled 37 eyes of 37 participants, each with dry eye for more than 2 years following SMILE (25 eyes) or LASEK (12 eyes). WC was performed using a spontaneously heating eye mask. Safety parameters and effectiveness parameters (tear film break-up time, TBUT; tear film lipid layer thickness, TFLLT; blink pattern, and Meibomian secretory function scores, MGS) were assessed before and after WC. Results After WC, the following mean values all increased relative to baselines: central corneal thickness, spherical equivalent, minimum (Min-), maximum (Max-) and average (Ave-) TFLLT, TBUT, total MGS (TMGS), number of glands secreting any liquid (MGL), and complete blink rate (CBR) (p values ranging from < 0.0001 to 0.042). Partial blink frequency (PBF) and partial blink rate (PBR) decreased (p = 0.002 in both cases). The decrease of PBF was higher in SMILE subgroup than in LASEK (p = 0.030). TBUT variation was positively correlated with that of Ave-TFLLT and TMGS (p = 0.046, 0.028, respectively). Max-TFLLT variation was correlated with that of TMGS (p = 0.020). Conclusions WC may temporarily improve tear film quality and blink pattern, augment Meibomian gland function, and relieve dry eye symptoms after corneal refractive surgery, particularly that using the SMILE technique.

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Assessment of tear film lipid layer thickness in patients with Meibomian gland dysfunction at different ages

BMC Ophthalmology ◽

10.1186/s12886-020-01667-8 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Junhua Li ◽

Jiling Ma ◽

Man Hu ◽

Jianqin Yu ◽

Yune Zhao

Keyword(s):

Layer Thickness ◽

Statistical Significance ◽

Tear Film ◽

Young Group ◽

Meibomian Gland ◽

Influential Factor ◽

Meibomian Gland Dysfunction ◽

Middle Aged ◽

Lipid Layer ◽

Eyelid Margin

Abstract Background To evaluate the correlations between lipid layer thickness (LLT) and morphology and function of the meibomian glands in patients who were diagnosed as meibomian gland dysfunction (MGD) in different age groups. Methods Patients who have diagnosed as obstructive MGD were included in this prospective, cross-sectional study. Patients were divided into three groups: young (ages 20–39 years), middle-aged (ages 40–59 years), and older (aged ≥60 years). All patients completed an Ocular Surface Disease Index (OSDI) questionnaire and were evaluated for LLT, tear meniscus height (TMH), noninvasive tear film break-up time (NI-BUT) measurement, invasive TBUT (ITBUT), corneal fluoresceinstaining (CFS) score, eyelid margin abnormalities, Schirmer I test, and MG function and morphology, by using the Keratograph 5 and LipiView interferometer. Results Two hundred and nine patients (209 eyes) were included. The median LLT of all patient was 57 nm (IQR, 36.5 nm), and the LLT values were significantly different among the young group (median, 51 nm; IQR, 23.5 nm), middle-aged group (median, 59.5 nm; IQR 46.5 nm) and older group (median, 62 nm; IQR, 42.5 nm) (P = 0.033, Kruskal-Wallis test). In regression analyses controlling for confounder factors sex and MG loss, the LLT was positively correlated with age (β = 5.539, P = 0.001). There was a negative correlation between LLT and MG dropout in the all (r = − 0.527, P < 0.001), young (r = − 0.536, P < 0.001), middle-aged (r = − 0.576, P < 0.001), and older (r = − 0.501, P < 0.001) groups. LLT was positively correlated with the MG expressibility in the all (r = 0.202, P = 0.003), middle-aged (r = 0.280, P = 0.044) and older (r = 0.452, p < 0.001) groups, but it was no statistical significance in the young group (r = 0.007, P = 0.949). Conclusions The thickness of LLT was increased with age and significantly correlated with both MG secretion and morphology in middle-aged and older patients with obstructive MGD. LLT measurement is a useful screening tool for detecting obstructive MGD and age as an influential factor should be accounted for when interpreting the meaning of the LLT value. Trial registration NCT02481167; Registered 25 June, 2015.

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Effect of 0.15% Preservative-free Sodium Hyaluronate on Dry Eye Disease after Femtosecond Laser-assisted Cataract Surgery

Journal of the Korean Ophthalmological Society ◽

10.3341/jkos.2021.62.7.922 ◽

2021 ◽

Vol 62 (7) ◽

pp. 922-930

Author(s):

Tae Hwan Kim ◽

Byunghoon Chung ◽

Kang Yoon Kim ◽

Ikhyun Jun ◽

Kyoung Yul Seo ◽

...

Keyword(s):

Treatment Group ◽

Dry Eye ◽

Sodium Hyaluronate ◽

Tear Film ◽

Meibomian Gland ◽

Dry Eye Disease ◽

Eye Disease ◽

Control Group ◽

Lipid Layer ◽

Preservative Free

Purpose: The efficacy of using preservative-free 0.15% sodium hyaluronate eyedrops for dry eye disease after femtosecond laser- assisted cataract surgery (FLACS) was evaluated. Methods: This prospective randomized study was conducted on patients with dry eye who were scheduled for FLACS among those with Tear Film & Ocular Surface Society Dry Eye Workshop II Dry Eye Levels 1 and 2. In total, 37 eyes scheduled for FLACS were randomized to the treatment group (n = 19) or control group (n = 18). Corneal and conjunctival fluorescein staining (CFS), tear breakup time (TBUT), Schirmer I test (SIT) value, ocular surface disease index (OSDI), meibomian gland evaluation result, and lipid layer thickness were evaluated for all patients, preoperatively and at 1 and 3 months postoperatively. Results: In the treatment group, the OSDI and CFS scores were significantly lower at 3 months postoperatively than at baseline, but the TBUT and SIT values were significantly increased. In the control group, TBUT was significantly shorter at 3 months postoperatively than at baseline, SIT values were significantly decreased at 1 and 3 months postoperatively compared with the baseline, and meibum quality was significantly aggravated at 1 month postoperatively compared with the baseline. In the treatment group, OSDI improved significantly from baseline at 1 and 3 months. TBUT increased significantly in the treatment group at postoperative 3 months. Meibomian gland quality showed clinically better results in the treatment group than in the control group at postoperative 3 months. There were no significant differences in corneal and CFS, lipid layer thickness, and other dry eye disease parameters between the treatment and control groups. Conclusions: Preservative-free 0.15% sodium hyaluronate eyedrops were effective for improving dry eye symptoms and tear film stability after FLACS.

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Dry eye disease and its treatment in women over 45 years

Clinical ophthalmology ◽

10.32364/2311-7729-2021-21-2-103-107 ◽

2021 ◽

Vol 21 (2) ◽

pp. 103-107

Author(s):

E.A. Drozdova ◽

◽

V.E. Balan ◽

Keyword(s):

Dry Eye ◽

Tear Film ◽

Meibomian Gland ◽

Dry Eye Disease ◽

High Rate ◽

Eye Disease ◽

Lipid Layer ◽

Age Related ◽

Meibomian Glands ◽

Nano Emulsion

Epidemiological studies demonstrate an increase in age-related prevalence of dry eye disease (DED) and its higher occurrence in women. In addition to age-related alterations of structures producing tear film, the reduction of androgen levels and other regulating hormones is important for DED development. The role of estrogens and progesterone in the regulation of lacrimal and meibomian gland activity is still disputable. Additional factors of DED development in women are a high rate of comorbidities affecting gland functions, use of cosmetics and cosmetic procedures, contact lens wearing. The results are partial atrophy of meibomian glands, changes in the quality and amount of their secret, increased tear evaporation. Cationic nano-emulsion that addresses the deficiency and stabilize the lipid layer, increases water content, and reduces tear osmolarity is recommended for DED in women. Keywords: dry eye disease, tear film, meibomian glands, postmenopausal, lipid layer, tear osmolarity, artificial tears, cationic nano-emulsion. For citation: Drozdova E.A., Balan V.E. Dry eye disease and its treatment in women over 45 years. Russian Journal of Clinical Ophthalmology. 2021;21(2):103–107. DOI: 10.32364/2311-7729-2021-21-2-103-107.

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Effects of a New Eyelid Shampoo on Lid Hygiene and Eyelash Length in Patients with Meibomian Gland Dysfunction: A Comparative Open Study

Journal of Ophthalmology ◽

10.1155/2016/4292570 ◽

2016 ◽

Vol 2016 ◽

pp. 1-7 ◽

Cited By ~ 7

Author(s):

Asuka Kobayashi ◽

Takeshi Ide ◽

Teruki Fukumoto ◽

Emiko Miki ◽

Kazuo Tsubota ◽

...

Keyword(s):

Dry Eye ◽

Tear Film ◽

Meibomian Gland ◽

Meibomian Gland Dysfunction ◽

Controlled Study ◽

Subjective Symptoms ◽

Eyelid Margin ◽

Before And After ◽

And Function ◽

Lid Hygiene

Purpose. Meibomian gland dysfunction (MGD) can lead to abnormalities in the composition and function of tear film, resulting in dry eye. Eyelid hygiene is a key to management of MGD. We tested a novel eyelid shampoo (Eye Shampoo Long, ESL) for its ability to maintain lid hygiene. This shampoo is nonirritating and can potentially lengthen eyelashes. This study was aimed to evaluate the efficacy of ESL in the treatment of MGD and its effects on eyelash length. Methods. Ten patients with MGD and 10 healthy subjects without MGD applied ESL twice daily for 8 weeks. Patients were examined for lid margin and dry eye before and after the trial. Subjective symptoms were evaluated. Eyelash length was measured at baseline and at the end of the trial. Results. In the MGD group, significant improvements were observed in subjective symptoms obstruction of the meibomian orifice, secretion of meibum, eyelashes contamination, eyelid margin foam, and SPK. Eyelash length became significantly longer. Conclusions. Maintaining eyelid hygiene using ESL improved the eyelid margins and symptoms of dry eye in MGD patients and increased eyelash length. These findings are promising and warrant confirmation in a larger randomized controlled study.

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Classifying signs and symptoms of dry eye disease according to underlying mechanism via the Delphi method: the DIDACTIC study

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2018-312581 ◽

2019 ◽

Vol 103 (10) ◽

pp. 1475-1480 ◽

Cited By ~ 1

Author(s):

Marc Labetoulle ◽

Tristan Bourcier ◽

Serge Doan

Keyword(s):

Dry Eye ◽

Signs And Symptoms ◽

Underlying Mechanism ◽

Meibomian Gland ◽

Dry Eye Disease ◽

Eye Disease ◽

Eyelid Margin ◽

Mixed Treatment ◽

Evaporative Dry Eye ◽

Initial List

Background/aimsDry eye disease (DED) is categorised by pathophysiology as aqueous deficient dry eye (ADDE), evaporative dry eye (EDE) or mixed. Treatment should be tailored to DED pathophysiology, but this is challenging to determine. This Delphi consultation aimed to categorise and weight signs and symptoms to help identify the evaporative or aqueous deficient DED origin.MethodsA panel of French DED experts created an initial list of 77 DED signs and symptoms. In a Delphi consultation, experts categorised items by DED pathophysiology. Likert scoring was used to indicate whether items were strongly or moderately indicative of ADDE or EDE. Items could also be judged non-applicable to DED, with the opportunity to suggest alternative diagnoses.ResultsExperts attributed 19 items (of which 11 were strongly indicative) to a pathophysiology of EDE and 12 items (of which four were strongly indicative) to ADDE. Items scored strongly indicative with agreement >90% for EDE were previous chalazia, rosacea/rhinophyma, telangiectasias of eyelid margin and thick non-expressible meibomian gland secretions, and for ADDE were Sjögren syndrome or associated disease, and Schirmer <5 mm after 5 min (without anaesthesia). Seventeen items indicated neither pathophysiology and 18 items were found to be suggestive of alternative diagnoses.ConclusionsThis Delphi consultation categorised signs and symptoms, using an innovative weighting system to identify DED pathophysiology. An algorithm integrating the weighting of each sign and symptom of an individual patient would be valuable to help general ophthalmologists to classify the DED subtype and tailor treatment to DED underlying mechanism.

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A Systematic Approach to Dry Eye using LipiFlow Treatment

US Ophthalmic Review ◽

10.17925/usor.2014.07.02.104 ◽

2014 ◽

Vol 07 (02) ◽

pp. 104 ◽

Cited By ~ 1

Author(s):

Mitchell A Jackson ◽

Keyword(s):

Dry Eye ◽

Ocular Surface ◽

Inflammatory Markers ◽

Systematic Approach ◽

Tear Film ◽

Meibomian Gland ◽

Diagnostic Methods ◽

Therapeutic Options ◽

Eye Disease ◽

Evaporative Dry Eye

The complex strategy to understanding dry eye syndrome has led to a widespread change in approaching this condition as an ocular surface disease, stratified as evaporative dry eye, aqueous deficient dry eye, and ocular allergy. The diagnostic armamentarium has vastly expanded to include tear osmolarity and inflammatory markers as redefined by the new International Dry Eye WorkShop (DEWS) in 2007. The Tear Film & Ocular Surface Society (TFOS) panel on meibomian gland dysfunction (MGD) further expanded the interpretation of evaporative dry eye and its therapeutic options, including the newest US Food and Drug Administration (FDA)-approved device known as LipiFlow Thermal Pulsation System. This paper will give an overview on understanding dry eye disease, its etiology, diagnostic methods, and current therapeutic options.

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