Botulinum Toxin A Injection for the Treatment of Intractable Dry Eye Disease

Background and Objectives: To evaluate the clinical efficacy of periocular botulinum toxin A (BTA) injection in patients with intractable dry eye disease (DED). Materials and Methods: Medical records of patients with intractable DED who underwent periocular BTA injection from December 2019 to March 2020 were reviewed retrospectively. Patients were injected with 2.5 units of BTA in the medial part of the lower eyelids. The clinical data collected included age, sex, ocular surface disease index (OSDI) score, tear film break up time (TBUT), Schirmer test results, tear osmolarity (I-PEN), and tear meniscus height (TMH) measured by anterior segment optical coherence tomography. All subjective and objective data were collected before treatment and at 1 month after treatment. Results: Twenty-eight consecutive patients were eligible for chart review and analysis. Significant improvements in OSDI, tear osmolarity, and TMH were observed at 1 month after periorbital BTA injection. At the baseline and 1-month follow-up examinations, OSDI scores were 62.22 ± 21.30 and 47.98 ± 17.23, respectively (p < 0.001). TMH increased significantly after treatment (82.25 ± 40.50 at baseline vs. 138.02 ± 66.62 1-month after treatment; p < 0.001). Tear osmolarity using I-PEN showed a significant decrease after treatment (320.82 ± 24.66 at baseline vs. 302.75 ± 22.33 at 1 month after treatment; p < 0.001). No significant differences were found in TBUT or Schirmer test results before and after BTA injection. Conclusions: BTA injection into the medial part of the eyelid improves dry eye symptoms, the amount of tear retention, and tear osmolarity. Based on the objective parameters of the tear condition, this study supports the idea of BTA use as a potential treatment option for patients with intractable DED.

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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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Changes in anterior segment parameters and presence of dry eye disease in patients with acromegaly: A Sirius topography study combined with meibography

Growth Hormone & IGF Research ◽

10.1016/j.ghir.2021.101424 ◽

2021 ◽

pp. 101424

Author(s):

Deniz Kilic ◽

Berkay Akmaz ◽

Fahrettin Akay ◽

Yusuf Ziya Guven ◽

Guzide Gonca Oruk

Keyword(s):

Dry Eye ◽

Anterior Segment ◽

Dry Eye Disease ◽

Eye Disease ◽

Anterior Segment Parameters

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Photophobia and sensations of dryness in patients with migraine occur independent of baseline tear volume and improve following botulinum toxin A injections

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2018-312649 ◽

2018 ◽

Vol 103 (8) ◽

pp. 1024-1029 ◽

Cited By ~ 7

Author(s):

Ryan J Diel ◽

Jodi Hwang ◽

Zachary A Kroeger ◽

Roy C Levitt ◽

Constantine D Sarantopoulos ◽

...

Keyword(s):

Botulinum Toxin ◽

Chronic Migraine ◽

Dry Eye ◽

Botulinum Toxin A ◽

Demographic Data ◽

Tear Film ◽

Phenol Red ◽

Toxin A ◽

Eye Symptoms ◽

Dry Eye Symptoms

BackgroundTo evaluate the efficacy of botulinum toxin A (BoNT-A) in reducing photophobia and dry eye symptoms in individuals with chronic migraine. Additionally, we aimed to evaluate tear film volume as a potential contributor to symptoms in these patients.MethodsRetrospective review of 76 patients who received BoNT-A for chronic migraine between 23 August 2017 and 13 December 2017 at the Miami Veterans Affairs Medical Center Neurotoxin Clinic. Demographic data and all comorbidities were queried via chart review. Standardised validated surveys were administered to assess symptoms prior to and after BoNT-A injection. Preinjection tear volumes were obtained using the phenol red thread (PRT) test.ResultsPreinjection migraine, photophobia and dry eye symptom scores were all significantly correlated, p<0.05, and none were associated with preinjection PRT results. After BoNT-A, improvements in migraine, photophobia and dry eye symptoms were also significantly correlated, p<0.05 and similarly did not associate with preinjection PRT results. Photophobia scores significantly improved following BoNT-A, while dry eye symptoms significantly improved in those with severe symptoms at baseline (DEQ-5 score ≥12), p=0.027. In logistic regression analysis of all individuals with dry eye symptoms (DEQ-5 ≥6), individuals with more severe dry eye symptoms were more likely improve, OR 1.27, 95% CI 1.06 to 1.51, p<0.01.ConclusionsBoNT-A significantly improved photophobia in patients being treated for migraine and also improved dry eye symptoms in patients with severe symptoms at baseline, independent of baseline tear film volume. These improvements may be due to modulation of shared trigeminal neural pathways.

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Botulinum Toxin A for the Treatment of Photophobia and Dry Eye

Ophthalmology ◽

10.1016/j.ophtha.2017.09.031 ◽

2018 ◽

Vol 125 (1) ◽

pp. 139-140 ◽

Cited By ~ 8

Author(s):

Ryan J. Diel ◽

Zachary A. Kroeger ◽

Roy C. Levitt ◽

Constantine Sarantopoulos ◽

Heather Sered ◽

...

Keyword(s):

Botulinum Toxin ◽

Dry Eye ◽

Botulinum Toxin A ◽

Toxin A

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Tear evaluation by anterior segment OCT in dry eye disease

Romanian Journal of Ophthalmology ◽

10.22336/rjo.2021.6 ◽

2021 ◽

Vol 65 (1) ◽

pp. 25-30

Author(s):

Diana Mădălina Popovici ◽

Ana Banc

Keyword(s):

Dry Eye ◽

Anterior Segment ◽

Dry Eye Disease ◽

Eye Disease ◽

Anterior Segment Oct

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Crosslinked hyaluronic acid with liposomes and crocin for management symptoms of dry eye disease caused by moderate meibomian gland dysfunction

10.21203/rs.2.17536/v1 ◽

2019 ◽

Author(s):

José-María Sánchez-González ◽

Concepción De-Hita-Cantalejo ◽

María Carmen Sánchez-González

Keyword(s):

Hyaluronic Acid ◽

Dry Eye ◽

Meibomian Gland ◽

Dry Eye Disease ◽

Eye Disease ◽

Schirmer Test ◽

Ocular Surface Disease Index ◽

Artificial Tear ◽

Before And After ◽

Contralateral Eye

Abstract Background: To study the effect of uncrosslinked and crosslinked hyaluronic acid combined with other artificial tear components in patients with dry eye caused by moderate meibomian gland dysfunction.Method: Prospective, single-blind, contralateral eye study. Fifty eyes were analyzed (25 patients). Eye selection for each tear type was random, and the eye drop formulations Aquoral Forte® (artificial tear A) and Aquoral Lipo® (artificial tear B) were used. The determined dosing schedule was three times a day for six weeks, and the study participants underwent a clinical examination before and 45 days after lubricant treatment. The Schirmer test, tear breakup time (TBUT) test, and Ocular Surface Disease Index (OSDI) questionnaire were applied before and after instillation period with both types of artificial tears. Results: On the Schirmer test, a significant improvement was obtained with both tear A (p < 0.01) and tear B (p < 0.01). On the TBUT test, a significant improvement was obtained with tear A (p < 0.01) and tear B (p < 0.01). The OSDI score significantly decreased after instillation period with both artificial tear types (p < 0.01). Conclusion: Uncrosslinked hyaluronic acid combined with other components, such as tamarind seed polysaccharide, and crosslinked hyaluronic acid combined with liposomes and crocin are effective for management symptoms of dry eye disease.

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