Ocular Surface Failure in Urban Syndrome

Background: Nowadays, the continuous increase in air pollution has significantly changed air quality, leading to the onset of the so-called urban syndrome (US), an allergic-like conjunctivitis triggered by pollutants. These patients are characterized by persistent dysregulation of ocular surface para-inflammation, causing chronic low-grade inflammation and ocular discomfort, with significant consequences for occupational health and job productivity prospects. This study aims to investigate the effects of topical glycerophosphoinositol (GPI) eye drops on the signs and symptoms of US. Methods: A multicenter prospective open interventional study was performed. Patients affected by US, enrolled from occupational medicine clinics, were treated with eye drops containing 0.001% GPI in 0.2% HA vehicle three times a day. Ocular surface disease index (OSDI), tear break-up time (T-BUT), Schirmer test, Oxford score, hyperemia and ocular surface symptoms were recorded at patient enrolment (T0), after 1 week (T1) and after 1 month (T2) of treatment. Results: A total of 113 consecutive patients (226 eyes) were included. OSDI score displayed a significant improvement after one week (T0: 39.9 ± 19, T1: 20.8 ± 17.9, T2: 18.4 ± 15.6, p < 0.0001); T-BUT (T0: 5.2 ± 2, T1: 7.7 ± 2.2, T2: 9.7 ± 1.8, p < 0.0001) and Schirmer Test (T0: 6.6 ± 2.4, T1: 9.7 ± 2.7, T2: 12.6 ± 2.6, p < 0.0001) progressively improved from T0 to T2. Conclusions: trice-daily topic instillation of 0.001% GPI in 0.02% HA vehicle resulted an effective and well tolerated treatment in US patients.

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

BMC Ophthalmology ◽

10.1186/s12886-021-01917-3 ◽

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.

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Short-term changes in ocular surface signs and symptoms after phacoemulsification

European Journal of Ophthalmology ◽

10.1177/1120672119896427 ◽

2020 ◽

Vol 30 (6) ◽

pp. 1301-1307 ◽

Cited By ~ 1

Author(s):

María García Zamora ◽

Eugenia Francés Caballero ◽

Miguel J Maldonado

Keyword(s):

Dry Eye ◽

Ocular Surface ◽

Signs And Symptoms ◽

Disease Index ◽

Ocular Surface Disease ◽

Schirmer Test ◽

Short Term ◽

Ocular Surface Disease Index ◽

Fluorescein Staining ◽

Superficial Punctate Keratopathy

Purpose: The aim of this study is to evaluate the incidence, natural course, and distribution pattern of superficial punctate keratopathy and describe the changes in signs and symptoms of dry eye after cataract surgery. Setting: The setting of this study is University Hospital Rio Hortega and Instituto Universitario de Oftalmobiología Aplicada, Valladolid, Spain. Design: This is a prospective interventional study. Materials and Methods: In total, 55 eyes of 55 different patients with no history of dry eye underwent standard phacoemulsification through a 2.75-mm-wide corneal incision. We measured tear break-up time, Schirmer test I, and tear meniscus height, and recorded the Ocular Surface Disease Index score, fluorescein staining patterns, and photo documentation of the ocular surface before and 1 day, 1 week, and 1 month postoperatively. Patients were divided into two groups (with and without superficial punctate keratopathy development, 1 day postoperatively). Results: Patients (mean age: 75.75 ± 7.27 years) showed an incidence of 76.3% of superficial punctate keratopathy at 24 h. Location predominated in the center of the cornea until a week (32.7%) and then began to prevail in the inferior quadrant (21.8%) at 1 month. All dry eye tests were significantly worse after surgery. Ocular Surface Disease Index increased from 10.98 ± 5.05 to 15.87 ± 6.57 at 24 h ( p < .001), to 12.80 ± 5.77 at 7 days ( p < .001), and to 11.09 ± 4.63 at 1 month ( p = .90). Fluorescein staining patterns got worse 24 h postoperatively with a score of 2.12 using the National Eye Institute/Industry–recommended guidelines staining grid. Average break-up time values were significantly lower at 1 day (6.61 ± 2.68),1 week (6.98 ± 2.79), and 1 month (7.05 ± 2.86) postoperatively than preoperatively (8.78 ± 2.97) ( p < .001). The mean postoperative first month Schirmer test I value (8.32 ± 3.58) was significantly lower than preoperative value (9.05 ± 3.63) ( p < .001). Conclusion: Phacoemulsification tends to induce short-term transitory ocular surface impairment manifesting as both signs and symptoms. Superficial punctate keratopathy distribution has a characteristic pattern evolution according to the postoperative time. Those patients with altered preoperative values are more likely to develop ocular surface disease and for longer time.

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Comparison of ocular surface assessment and adherence between preserved and preservative-free latanoprost in glaucoma: a parallel-grouped randomized trial

Scientific Reports ◽

10.1038/s41598-021-94574-x ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Dai Woo Kim ◽

Jonghoon Shin ◽

Chang Kyu Lee ◽

Myungjin Kim ◽

Sohyeon Lee ◽

...

Keyword(s):

Free Group ◽

Ocular Surface ◽

Open Angle Glaucoma ◽

Drug Tolerance ◽

Adherence Rate ◽

Eye Drops ◽

Ocular Surface Disease Index ◽

Significant Difference ◽

Surface Assessment ◽

Preservative Free

AbstractGiven that nonadherence is related to subject characteristics and drug tolerance and preserved eye drops tend to be more intolerable than preservative-free ones, we conducted a phase 4, parallel-grouped, investigator-blind, active-control, randomized, multicenter study. A total of 51 patients with intraocular pressure (IOP) ≥ 15 mmHg diagnosed with open-angle glaucoma or ocular hypertension were randomly assigned to the preserved latanoprost group (n = 26) and the preservative-free latanoprost group (n = 25). The efficacy variables were corneal/conjunctival staining grade, Ocular Surface Disease Index (OSDI), adherence at 12 weeks after the first administration; corneal/conjunctival staining grade at 4 weeks; and IOP, tear break-up time (TBUT), and hyperemia score at 4 and 12 weeks. The safety variables included visual acuity and drug tolerance questionnaire results. There was no statistically significant difference in corneal/conjunctival staining grade, OSDI, or TBUT between the groups at 4 and 12 weeks. However, the adherence rate was higher and the hyperemia score was lower in the preservative-free group than in the preserved group. The severity and duration of stinging/burning sensation were lower in the preservative-free group than in the preserved group. Overall, preservative-free latanoprost showed better ocular tolerance assessed by hyperemia scores and stinging/burning symptoms following higher adherence than preserved latanoprost.

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Efficacy of cyclic therapy with terpinen-4-ol in Demodex blepharitis

European Journal of Ophthalmology ◽

10.1177/1120672120919085 ◽

2020 ◽

pp. 112067212091908 ◽

Cited By ~ 2

Author(s):

Özlem Evren Kemer ◽

Emine Esra Karaca ◽

Dilay Özek

Keyword(s):

Ocular Surface ◽

Meibomian Gland ◽

Disease Index ◽

Ocular Surface Disease ◽

Schirmer Test ◽

Ocular Surface Disease Index ◽

Tea Tree ◽

Cyclic Treatment ◽

Pre Treatment ◽

Breakup Time

Purpose To describe the effectiveness of cyclic treatment with terpinen-4-ol, a tea tree oil component, on Demodex blepharitis. Methods The presence of Demodex was determined by eyelash rotation as proposed by Mastrota. Schirmer test, tear breakup time, ocular surface disease index, lid margin score, meibomian gland expressibility score, and Oxford grade were performed. Patients were advised to apply heat followed by terpinen-4-ol soaked wipes to eyelids twice a day for 2 weeks. At the end of 2 weeks, treatment was interrupted for 7–10 days. The same treatment was repeated once again. The patients were examined after the first and second cycle of treatment and after 1 year. Results There was a statistically significant improvement in Schirmer test (10.37 ± 4.73 and 13.13 ± 3.44 mm/5 min), tear breakup time (6.47 ± 3.31 and 7.6 ± 2.89 s), ocular surface disease index (47.94 ± 19.77 and 34.28 ± 13.40), lid margin score (3.2 ± 0.7 and 2.63 ± 0.71), meibomian gland expressibility scores (1.93 ± 0.64 and 1.4 ± 0.67), and Oxford grade (0.9 ± 0.8 and 0.5 ± 0.63) after the first cycle of treatment ( p < 0.05). The improvement in symptoms and tear function tests of the patients after the second cycle was significantly better than in pre-treatment levels. At 12-month follow-up, symptoms of two patients (93%) relapsed. Conclusion The administration of terpinen-4-ol to the eyelid margins in a cyclic manner in Demodex blepharitis is effective against adult and hatching Demodex and breaks the vicious cycle.

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Efficacy of eye drops containing crosslinked hyaluronic acid and CoQ10 in restoring ocular health exposed to chlorinated water

European Journal of Ophthalmology ◽

10.1177/1120672120907311 ◽

2020 ◽

Vol 30 (3) ◽

pp. 430-438

Author(s):

Costanza Tredici ◽

Romina Fasciani ◽

Antonio Villano ◽

Gloria Gambini ◽

Aldo Caporossi

Keyword(s):

Hyaluronic Acid ◽

Ocular Surface ◽

Prolonged Exposure ◽

Ophthalmic Solution ◽

Disease Index ◽

Eye Drops ◽

Ocular Surface Disease Index ◽

Vitamin E Tpgs ◽

Grading Scale ◽

Breakup Time

Purpose: A prospective, open-label study in 20 professional swimmers evaluated the efficacy and safety of an ophthalmic solution containing crosslinked hyaluronic acid, coenzyme Q10, and vitamin E TPGS in releasing eye irritation and restoring ocular surface damages after prolonged exposure to chlorinated water. Methods: Individually, one eye was instilled with the ophthalmic solution and the other used as a comparator. Eye drops were self-administered three times a day for 2 months. Tear film breakup time (primary endpoint), Schirmer I test, beating of eyelashes/min, tear osmolarity, corneal and conjunctival staining with fluorescein, Ocular Surface Disease Index questionnaire, subject satisfaction, visual acuity (secondary endpoints), and Efron Grading Scale were evaluated at screening/baseline (V1), week 1 (V2), week 2 (V3), week 4 (V4), and week 8 (V5). Results: After 2 months, breakup time test significantly improved in the treated eyes (+1.67 s) compared to control (−3.00 s) ( p = 0.0002). Corneal and conjunctival surfaces of treated eyes recovered significantly compared to control eyes when assessed by fluorescein staining ( p < 0.0001), Ocular Surface Disease Index ( p < 0.05), and visual analog scale ( p = 0.0348) scores. Improvements were also observed with Schirmer I test, beating of eyelashes, and tear osmolarity, despite without statistical significance. Efron Grading Scale was consistent with the other tests. The ocular tolerability was excellent. Conclusion: The adequate combination of crosslinked hyaluronic acid, coenzyme Q10, and vitamin E TPGS, contained in the ophthalmic solution VisuXL®, has been shown to protect ocular surface from potential damages originating from prolonged exposure to chlorinated water. VisuXL may represent a compelling treatment in other situations beyond dry eye syndrome.

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Evaluation of the Efficacy of 50% Autologous Serum Eye Drops in Different Ocular Surface Pathologies

BioMed Research International ◽

10.1155/2014/826970 ◽

2014 ◽

Vol 2014 ◽

pp. 1-11 ◽

Cited By ~ 18

Author(s):

Francesco Semeraro ◽

Eliana Forbice ◽

Osvaldo Braga ◽

Alessandro Bova ◽

Attilio Di Salvatore ◽

...

Keyword(s):

Ocular Surface ◽

Conventional Therapy ◽

Keratoconjunctivitis Sicca ◽

Signs And Symptoms ◽

Autologous Serum ◽

Eye Drops ◽

Blurred Vision ◽

Group 2 ◽

Serum Eye Drops ◽

Group 1

Purpose. This study evaluated the efficacy of 50% autologous serum eye drops in ocular surface diseases not improved by conventional therapy.Methods. We analyzed two groups: (1) acute eye pathologies (e.g., chemical burns) and (2) chronic eye pathologies (e.g., recurrent corneal erosion, neurotropic keratitis, and keratoconjunctivitis sicca). The patients were treated for surface instability after conventional therapy. The patients received therapy 5 times a day until stabilization of the framework; they then reduced therapy to 3 times a day for at least 3 months. We analyzed the best corrected visual acuity, epithelial defects, inflammation, corneal opacity, and corneal neovascularization. We also analyzed symptoms such as tearing, burning, sense of foreign body or sand, photophobia, blurred vision, and difficulty opening the eyelids.Results. We enrolled 15 eyes in group 1 and 11 eyes in group 2. The average therapy period was 16 ± 5.86 weeks in group 1 and 30.54 ± 20.33 weeks in group 2. The epithelial defects all resolved. Signs and symptoms improved in both groups. In group 2, the defect recurred after the suspension of therapy in 2 (18%) patients; in group 1, no defects recurred.Conclusions. Autologous serum eye drops effectively stabilize and improve signs and symptoms in eyes previously treated with conventional therapy.

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Comparison of 0.05% cyclosporine and 3% diquafosol solution for dry eye patients: A randomized, blinded, multicenter clinical trial

10.21203/rs.2.487/v2 ◽

2019 ◽

Author(s):

Chang Hyun Park ◽

Hyung Keun Lee ◽

Mee Kum Kim ◽

Eun Chul Kim ◽

Jae Yong Kim ◽

...

Keyword(s):

Dry Eye ◽

Safety Evaluation ◽

Clinical Effectiveness ◽

Prospective Clinical Study ◽

Eye Drops ◽

Schirmer Test ◽

Ocular Surface Disease Index ◽

Drug Usage ◽

Early Improvement ◽

Treatment Groups

Abstract Background This study is aim to compare the clinical effectiveness between the two most prominent dry eye disease (DED)-specific eye drops, 0.05% cyclosporine (CN) and 3% diquafosol (DQ). Methods This is a multi-centered, randomized, masked, prospective clinical study. A total of 153 DED patients were randomly allocated to use CN twice per day or DQ six times daily. Cornea and conjunctival staining scores (NEI scale), tear break-up time (TBUT), Schirmer test scores, and ocular surface disease index (OSDI) score were measured at baseline, 4 and 12 weeks after treatment. Results At 12 weeks after treatment, NEI scaled scores were significantly reduced from the baseline by -6.60 for CN and -6.63 for DQ group (all P<0.0001, P=0.9739 between groups). TBUT and Schirmer values for CN were significantly improved from the baseline at 4 and 12 weeks (P=0.0034, P<0.0001 for TBUT, P=0.0418, P=0.0031 for Schirmer test). However, for DQ, TBUT showed significant improvement at 12 weeks only (P=0.0281). Mean OSDI score differences from the baseline to 12 weeks were improved by -13.03±19.63 for CN and -16.11±20.87 for DQ, respectively (all P<0.0001, P=0.854 between groups). Regarding drug compliance, the mean instillation frequency of CN was less than that of DQ (P<0.001). There were no statistically significant intergroup differences in safety evaluation. Conclusions The level of improvement regarding NEI, TBUT, and OSDI scores were not significantly different between the two treatment groups. However, with regards to the early improvement of TBUT and patient compliance, patients using CN improved faster and with greater adherence to drug usage than did those treated with DQ.

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Zdravljenje glavkoma in suho oko

Slovenian Medical Journal ◽

10.6016/zdravvestn.1531 ◽

2016 ◽

Vol 85 (4) ◽

Author(s):

Barbara Cvenkel

Keyword(s):

Ocular Surface ◽

Clinical Signs ◽

Tear Film ◽

Signs And Symptoms ◽

Surface Damage ◽

Eye Drops ◽

Film Instability ◽

Asymptomatic Patients

Patients with glaucoma have increased prevalence of dry eye (DE) compared to age-matched population without glaucoma. Clinical presentation of DE varies among individuals and may significantly reduce quality of life. The onset and deterioration of DE is caused by the toxic-inflammatory effects of preservatives in eye drops, active substance itself, and added, pharmacologically inactive substances or excipients. Ocular surface changes most frequently include superficial punctate keratitis, tear film instability, and allergic reactions. Despite the lack of symptoms, clinical signs may indicate ocular surface damage. Discordance between signs and symptoms is partly caused by decreased corneal sensitivity induced by neurotoxicity of the preservative benzalkonium chloride (BAK). Therefore, it is important to evaluate ocular surface before initiating glaucoma therapy and during follow-up also in asymptomatic patients. Preservative-free and/or BAK-free therapy is indicated in patients with severe DE and allergy to preservatives, and recommended in patients with DE of moderate severity, blepharitis, in symptomatic patients, before filtering surgery to reduce preoperative inflammation, in those with moderate fluorescein staining of grade 2 on Oxford scheme, and reduced tear film break-up time.

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Comparison of 0.05% cyclosporine and 3% diquafosol solution for dry eye patients: A randomized, blinded, multicenter clinical trial

10.21203/rs.2.487/v3 ◽

2019 ◽

Author(s):

Chang Hyun Park ◽

Hyung Keun Lee ◽

Mee Kum Kim ◽

Eun Chul Kim ◽

Jae Yong Kim ◽

...

Keyword(s):

Dry Eye ◽

Safety Evaluation ◽

Clinical Effectiveness ◽

Prospective Clinical Study ◽

Eye Drops ◽

Schirmer Test ◽

Ocular Surface Disease Index ◽

Drug Usage ◽

Early Improvement ◽

Treatment Groups

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Prospective study comparing Xalatan® eye drops and two similar generics as to the efficacy and safety profile

European Journal of Ophthalmology ◽

10.1177/1120672117747030 ◽

2018 ◽

Vol 28 (4) ◽

pp. 378-384 ◽

Cited By ~ 2

Author(s):

Andreas Diagourtas ◽

Kostantinos Kagelaris ◽

Kostantinos Oikonomakis ◽

Andreas Droulias ◽

Nikolaos Kokolakis ◽

...

Keyword(s):

Intraocular Pressure ◽

Safety Profile ◽

Ocular Surface ◽

Disease Index ◽

Ocular Surface Disease ◽

Eye Drops ◽

Efficacy And Safety ◽

Ocular Surface Disease Index ◽

Significant Difference ◽

The Mean

Purpose: To evaluate the efficacy and safety between two generic prostaglandins Lataz–Xalaprost (Greece) and the corresponding original drops (Xalatan®). Material and methods: In this prospective randomized study, 60 patients diagnosed with open-angle glaucoma or ocular hypertension were enrolled, who had never received antiglaucoma treatment. Subjects were divided randomly into three groups (Xalatan, Lataz, and Xalaprost groups) and they were studied over 16 weeks. At each visit, the mean applanation tonometry values and tear break-up time were measured. The Ocular Surface Disease Index questionnaire was used to evaluate patient’s symptoms. Results: There was a statistically significant difference (p < 0.001) in the mean values of the intraocular pressure between the baseline and the last visit (Xalatan group: from 23.11 ± 1.61 mmHg to 15.81 ± 1.22 mmHg, Lataz group: from 23.26 ± 1.33 mmHg to 15.80 ± 1.47 mmHg, and Xalaprost group: from 23.08 ± 1.45 mmHg to 16.08 ± 1.38 mmHg). Both generic eye drops showed mean percentage intraocular pressure reduction comparable to the standards of prostaglandin analogues (Xalatan: 31.57%, Lataz: 32.06%, and Xalaprost: 30.34%). Xalatan reduced the tear break-up time less, followed by Lataz and then by Xalaprost (Xalatan: from 8.5 to 8 s, Lataz: from 8.2 to 7.4 s, and Xalaprost: from 8.7 to 7.7 s). Xalatan presented the best safety profile, followed by Lataz and least was Xalaprost, according to Ocular Surface Disease Index questionnaire’s results. Conclusion: No significant difference was recorded in the effectiveness of each generic prostaglandin compared to the original. Furthermore, no patient had to change medication. The differences that arose in the safety profile of the three eye drops suggest a prompt closer initial monitoring of patients who are administered generic eye drops.

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