Advances in the Noninvasive Diagnosis of Dry Eye Disease

Dry eye disease (DED) is a multifactorial disease that represents one of the most common ophthalmologic conditions encountered in everyday clinical practice. Traditional diagnostic tests for DED, such as subjective questionnaires, tear film break-up time and the Schirmer test, are often associated with poor reproducibility and reliability, which make the diagnosis, follow-up, and management of the disease challenging. New advances in imaging technologies enable objective and reproducible measurements of DED parameters, thus making the diagnosis a multimodal imaging-based process. The aim of this review is to summarize all the current and emerging diagnostic tools available for the diagnosis and monitoring of DED, such as non-invasive tear breakup time, thermography, anterior segment optical coherence tomography, meibography, interferometry, in vivo confocal microscopy, and optical quality assessment. Although there is not a gold standard imaging technique, new multi-imaging-integrated devices are precious instruments to help clinicians to better cope with the diagnostic complexity of DED.

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Objective Imaging Diagnostics for Dry Eye Disease

Journal of Ophthalmology ◽

10.1155/2020/3509064 ◽

2020 ◽

Vol 2020 ◽

pp. 1-11 ◽

Cited By ~ 1

Author(s):

Sang Beom Han ◽

Yu-Chi Liu ◽

Karim Mohamed-Noriega ◽

Louis Tong ◽

Jodhbir S. Mehta

Keyword(s):

Dry Eye ◽

Clinical Symptoms ◽

Imaging Techniques ◽

Anterior Segment ◽

Tear Film ◽

Optical Quality ◽

Dry Eye Disease ◽

Eye Disease ◽

Break Up

Traditional diagnostic tests for dry eye disease (DED), such as fluorescein tear film break-up time and the Schirmer test, are often associated with poor reproducibility and reliability, which make the diagnosis, follow-up, and management of the disease challenging. Advances in ocular imaging technology enables objective and reproducible measurement of changes in the ocular surface, tear film, and optical quality associated with DED. In this review, the authors will discuss the application of various imaging techniques, such as, noninvasive tear break-up time, anterior segment optical coherence tomography, in vivo confocal microscopy, meibography, interferometry, aberrometry, thermometry, and tear film imager in DED. Many studies have shown these devices to correlate with clinical symptoms and signs of DED, suggesting the potential of these imaging modalities as alternative tests for diagnosis and monitoring of the condition.

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Effects of Cyclosporine 0.05% ophthalmic solution on diagnostic parameters of dry eye disease

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20174160 ◽

2017 ◽

Vol 5 (10) ◽

pp. 4289

Author(s):

Maneesha Sethi ◽

Amarjeet Singh Bali ◽

P. Sadhotra

Keyword(s):

Dry Eye ◽

Tear Film ◽

Ophthalmic Solution ◽

Dry Eye Disease ◽

Diagnostic Tools ◽

Eye Disease ◽

Inclusion Criteria ◽

Ocular Surface Disease Index ◽

Diagnostic Parameters ◽

A Prospective Study

Background: Dry eye is a multifactorial disease particularly prevalent in Asia for which there are several treatments. Among anti-inflammatory treatment, cyclosporine 0.05% is preferred therapy. Our study evaluated effects of cyclosporine 0.05% ophthalmic solution on the diagnostic tools of dry eye.Material & Methods: A prospective study was carried out in ophthalmological outpatient department of ASCOMS and Hospital. Total 60 patients of dry eye disease who fulfilled the inclusion criteria were treated with cyclosporine 0.05% ophthalmic solution twice a day. The diagnostic parameters of dry eye were assessed at baseline, at month 1 and 3. Patients underwent Ocular Surface Disease Index (OSDI) score, Schirmer’s test, Tear film break up time (TBUT) .Results: After three months, mean OSDI score was significantly improved (p < 0.001). There was significant improvement in mean Schirmer score (p < 0.001). Baseline TBUT also increased significantly (p < 0.001). Conclusion: Cyclosporine 0.05% ophthalmic solution has significant effect on diagnostic parameters of dry eye disease.

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Location and pattern of non‐invasive keratographic tear film break‐up according to dry eye disease subtypes

Acta Ophthalmologica ◽

10.1111/aos.14129 ◽

2019 ◽

Vol 97 (8) ◽

Cited By ~ 1

Author(s):

Jieun Kim ◽

Jung Yong Kim ◽

Kyoung Yul Seo ◽

Tae‐im Kim ◽

Hee Seung Chin ◽

...

Keyword(s):

Dry Eye ◽

Tear Film ◽

Dry Eye Disease ◽

Eye Disease ◽

Non Invasive ◽

Disease Subtypes ◽

Break Up

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An investigation of non-invasive tear break up time and tear meniscus height of keratoconic versus non-keratoconic individuals

African Vision and Eye Health ◽

10.4102/aveh.v75i1.339 ◽

2016 ◽

Vol 75 (1) ◽

Author(s):

Deanne L. Nicholas ◽

Wayne D.H. Gillan

Keyword(s):

Dry Eye ◽

Tear Film ◽

Dry Eye Disease ◽

Eye Disease ◽

Non Invasive ◽

Control Subjects ◽

Tear Meniscus ◽

Break Up ◽

Tear Meniscus Height ◽

And Control

Keratoconus is a debilitating condition where the cornea develops a conical shape rather than the characteristic round shape due to various physiological and structural changes taking place within the layers of the cornea. As a result of the pathogenesis of keratoconus, there are numerous changes that may occur within the tears of these patients. Research has shown changes in the tear metabolome, the presence of degradation products as well as loss of goblet cells into the tears. Could the changes occurring within the tear structure of these patients affect the results of various tear quantity and quality tests? Non-invasive tear break up time (NTBUT) is a diagnostic test used to determine the quality of the tear film and has been used extensively when diagnosing dry eye disease. This test is utilised in order to determine the time taken for the tear film to begin breaking apart, signalling thinning of the tears. Shorter break up times are therefore indicative of instability or changes occurring within the tear film which could be diagnostic of dry eye disease. Tear meniscus height (TMH) measurements have also been utilised in clinical practice, where these measurements provide an indication of the volume of tears contained within the upper and lower menisci. Lower tear volumes have been shown to be present in cases of dry eye disease where either tear production or tear drainage may be affected. Changes in the quality and quantity of the tear film in subjects with dry eye disease have been thoroughly investigated; however, the same cannot be said for subjects with keratoconus. Could the same findings be possible in subjects with keratoconus? Is it possible that the changes occurring within the tears of keratoconic subjects could lead to abnormal NTBUT and TMH measurements when compared to those of control subjects? Could the results of the NTBUT and TMH tests be related to one another? This study compares the NTBUT and TMH measurements of both keratoconic and control subjects by making use of a single type of instrumentation, namely the Oculus Keratograph 4 (OK4). The results of this study reveal that the values obtained for each of the two subject groups are not shown to be statistically significantly different and that there is no significant correlation between the NTBUT and TMH measurements when comparing keratoconic and control subjects.

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Polydatin Inhibits NLRP3 Inflammasome in Dry Eye Disease by Attenuating Oxidative Stress and Inhibiting the NF-κB Pathway

Nutrients ◽

10.3390/nu11112792 ◽

2019 ◽

Vol 11 (11) ◽

pp. 2792 ◽

Cited By ~ 5

Author(s):

Bongkyun Park ◽

Kyuhyung Jo ◽

Tae Gu Lee ◽

Soo-Wang Hyun ◽

Jin Sook Kim ◽

...

Keyword(s):

Dry Eye ◽

Nlrp3 Inflammasome ◽

Tear Film ◽

Cell Loss ◽

Dry Eye Disease ◽

Eye Disease ◽

Tnf Α ◽

Induced Changes

Polydatin (also named pieceid, (E)-piceid, (E)-polydatin, trans-polydatin, or 3,5,4’-trihydroxystilbene-3-b-D-glucoside) is a monocrystalline compound isolated from the root and rhizome of Polygonum cuspidatum Sieb. et Zucc. (Polygonaceae). A previous study showed that polydatin has antioxidant and anti-inflammatory effects. However, the effect of polydatin in dry eye disease (DED) has not been elucidated. DED rat models were induced by exorbital lacrimal gland-excision. In vivo, the present study showed that the excision of lacrimal glands induced changes such as reduced tear fluid, severe corneal irregularity, damage, tear film break, and goblet cell loss as well as increased inflammation cytokine and NLRP3 expression in conjunctival tissue. However, these changes were restored by polydatin eye dropping. In vitro, polydatin inhibited hyperosmolar stress-induced inflammation through attenuation of the translocation of NF-κB to the nucleus and the mRNA expression of TNF-α, IL-6, IL-1β, and MMP9. In addition, the hyperosmolar stress-induced NLRP3 inflammasome pathway and ROS production were inhibited by polydatin. Our findings provided insight into the effect of polydatin as a candidate reagent for the treatment of DED.

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Advances in dry eye imaging: the present and beyond

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2017-310759 ◽

2017 ◽

Vol 102 (3) ◽

pp. 295-301 ◽

Cited By ~ 12

Author(s):

Tommy C Y Chan ◽

Kelvin H Wan ◽

Kendrick C Shih ◽

Vishal Jhanji

Keyword(s):

Dry Eye ◽

Dynamic Properties ◽

Imaging Techniques ◽

Meibomian Gland ◽

Optical Quality ◽

Eye Disease ◽

In Vivo Confocal Microscopy ◽

Non Invasive ◽

Breakup Time

New advances in imaging allow objective measurements for dry eye as well as define new parameters that cannot be measured by clinical assessment alone. A combination of these modalities provides unprecedented information on the static and dynamic properties of the structural and functional parameters in this multifactorial disease. A literature search was conducted to include studies investigating the use of imaging techniques in dry eye disease. This review describes the application of non-invasive tear breakup time, optical coherence tomography, meibomian gland imaging, interferometry, in vivo confocal microscopy, thermography and optical quality assessment for this condition.

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Evidence of Polyphenols Efficacy against Dry Eye Disease

Antioxidants ◽

10.3390/antiox10020190 ◽

2021 ◽

Vol 10 (2) ◽

pp. 190

Author(s):

Gaia Favero ◽

Enrico Moretti ◽

Kristína Krajčíková ◽

Vladimíra Tomečková ◽

Rita Rezzani

Keyword(s):

Dry Eye ◽

Ocular Surface ◽

Tear Film ◽

Dry Eye Disease ◽

Eye Disease ◽

Beneficial Effects ◽

Underlying Causes ◽

Ophthalmic Drug

Dry eye disease is a multifactorial pathology compromising the quality of life of patients, resulting in significant damage of the ocular surface and discomfort. The current therapeutical strategies are not able to definitively resolve the underlying causes and stop the symptoms. Polyphenols are promising natural molecules that are receiving increasing attention for their activity/effects in counteracting the main pathologic mechanisms of dry eye disease and reducing its symptoms. In the present review, a deep literature search focusing on the main polyphenols tested against dry eye disease was conducted, analyzing related in vitro, in vivo, and clinical studies to provide a comprehensive and current review on the state of the art. Polyphenols present multiple effects against dry eye diseases-related ocular surface injury. In particular, the observed beneficial effects of polyphenols on corneal cells are the reduction of the pathological processes of inflammation, oxidative stress, and apoptosis and modulation of the tear film. Due to numerous studies reporting that polyphenols are effective and safe for treating the pathological mechanisms of this ocular surface disease, we believe that future studies should confirm and extend the evidence of polyphenols efficacy in clinical practice against dry eye disease and help to develop new ophthalmic drug(s).

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Tear Proteomics Study of Dry Eye Disease: Which Eye Do You Adopt as the Representative Eye for the Study?

International Journal of Molecular Sciences ◽

10.3390/ijms22010422 ◽

2021 ◽

Vol 22 (1) ◽

pp. 422

Author(s):

Ming-Tse Kuo ◽

Po-Chiung Fang ◽

Shu-Fang Kuo ◽

Alexander Chen ◽

Yu-Ting Huang

Keyword(s):

Dry Eye ◽

Ocular Surface ◽

Tear Film ◽

Dry Eye Disease ◽

Eye Disease ◽

Mechanistic Studies ◽

Clinical Tests ◽

Tear Proteins ◽

Proteomic Data ◽

Surface Performance

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.

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