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Vestnik Oftalmologii 2018The article reviews the particularities of development and pathogenesis of secondary dry eye syndrome (DES) after refractive surgeries including a complex of problems... (Review)
Review
The article reviews the particularities of development and pathogenesis of secondary dry eye syndrome (DES) after refractive surgeries including a complex of problems related to changes in tear film content, damage of eye surface and neurotrophic epitheliopathy. Additionally, modern algorithms of treatment and prevention of secondary DES in patients after refractive surgeries are described. Despite the transient nature of the changes, excimer-laser surgery can lead to lasting deficiencies of eye surface in some patients. Therefore, intensive and early treatment of secondary DES during the early follow-up period after refractive surgery may significantly reduce risks of tear dysfunction and neurotrophic epitheliopathy development in the long term.
Topics: Dry Eye Syndromes; Humans; Lasers, Excimer; Refractive Surgical Procedures; Tears
PubMed: 30499532
DOI: 10.17116/oftalma2018134051294 -
Clinical and Experimental Rheumatology 2020Primary Sjögren's syndrome is a complex systemic autoimmune disorder that primarily affects exocrine glands such as the lacrimal glands. Dry eye disease is one of the... (Review)
Review
Primary Sjögren's syndrome is a complex systemic autoimmune disorder that primarily affects exocrine glands such as the lacrimal glands. Dry eye disease is one of the most prevalent complications of Sjögren's syndrome, affecting most patients. It significantly impairs quality of life and management is often difficult and unsatisfactory, in part due to weak correlation between symptoms and signs and poor recognition of the three main subtypes aqueous-deficient, evaporative and neuropathic dry eye. This review provides an overview of key aspects of dry eye disease, such as its multifactorial aetiology and recent insights into pathophysiology. The uses and pitfalls of commonly-used diagnostic tests for dry eye are reviewed, as well as the increasing number of new imaging technologies and biomarkers to refine diagnosis. There are many current and emerging treatment options for dry eye in Sjögren's syndrome, but high-level evidence of efficacy is mostly lacking, as are evidence-based treatment algorithms. All these aspects make the management of dry eye in Sjögren's syndrome challenging.
Topics: Dry Eye Syndromes; Humans; Lacrimal Apparatus; Prevalence; Quality of Life; Sjogren's Syndrome
PubMed: 33025899
DOI: No ID Found -
Journal of Optometry 2021Cases of dry eye disease involving a neuropathic basis for symptoms and a poor correlation between symptoms and objective signs of dry eye disease can be associated with... (Review)
Review
Cases of dry eye disease involving a neuropathic basis for symptoms and a poor correlation between symptoms and objective signs of dry eye disease can be associated with unsatisfactory responses to treatments which are limited to attempts to restore lacrimal function unit deficiencies. This review examines a wider range of circumstances under which the same kind of poor correlation between signs, symptoms and treatment results can be found. Some cases of computer vision syndrome can present for examination at times when objective signs related to reported symptoms have dissipated. A thorough history should explain this type of presentation for which symptoms might otherwise appear to be unexplained. However, mental health disorders can also be the basis for apparently unexplained levels of symptoms of dry eye disease. Anxiety, depression, hypochondriasis, stress, sleep and mood disorders as well as neuroticism for example, may be associated with exacerbation of symptoms to degrees that are not consistent with the levels of tear homeostasis anomalies that are assessed. The conclusion is drawn that failure to consider mental health comorbidities may result in symptomatic patients being exposed to less successful attempts to remediate tear dysfunctions when, for example, the symptoms have a somatic basis. Appropriate screening and referral to a psychologist or psychiatrist may be the key to managing some patients whose symptoms do not correlate with objective evidence of dry eye disease.
Topics: Anxiety; Dry Eye Syndromes; Humans; Peripheral Nervous System Diseases; Tears; Treatment Outcome
PubMed: 33243674
DOI: 10.1016/j.optom.2020.10.002 -
Korean Journal of Ophthalmology : KJO Jun 2020To evaluate the correlations between tear osmolarity and matrix metallopeptidase-9 (MMP-9) and dry eye (DE) indices in patients with DE associated with Sjögren's...
PURPOSE
To evaluate the correlations between tear osmolarity and matrix metallopeptidase-9 (MMP-9) and dry eye (DE) indices in patients with DE associated with Sjögren's syndrome (SS).
METHODS
Sixty-three patients with DE associated with SS who underwent tear analysis were included. DE tests performed were ocular surface disease index, tear break-up time, Schirmer's test, ocular staining score, and tear osmolarity and MMP-9 tests. Correlations between tear osmolarity and DE indices, differences between patients with abnormal and normal tear osmolarity, and those between positive and negative MMP-9 patients were analyzed. Patients were classified into four groups according to tear osmolarity and MMP-9 results, and between-group differences were analyzed (group 1: abnormal tear osmolarity, MMP-9 positive; group 2: abnormal tear osmolarity, MMP-9 negative; group 3: normal tear osmolarity, MMP-9 positive; group 4: normal tear osmolarity, MMP-9 negative).
RESULTS
Mean age of patients was 54.2 ± 13.9 years, and 96.2% were female. Thirty-five patients had abnormal tear osmolarity and 40 patients were MMP-9 positive. DE indices differed between groups with abnormal and normal tear osmolarity ( < 0.01), but not between positive and negative MMP-9 groups. There were 22 patients in group 1, 13 in group 2, 18 in group 3, and 10 in group 4. Compared to group 4, tear break-up time was shorter in groups 1 ( < 0.01) and 2 ( = 0.02). Schirmer's test values in group 1 were lower than those in group 4 ( = 0.03). Ocular staining score was higher in groups 1 ( < 0.01) and 2 ( < 0.05) than in group 4.
CONCLUSIONS
Tear osmolarity was correlated with ocular surface indices in DE associated with SS. Combination of tear osmolarity and MMP-9 test results may be helpful to determine the severity of DE associated with SS.
Topics: Biomarkers; Dry Eye Syndromes; Female; Humans; Male; Matrix Metalloproteinase 9; Middle Aged; Osmolar Concentration; Sjogren's Syndrome; Surveys and Questionnaires; Tears
PubMed: 32495525
DOI: 10.3341/kjo.2019.0145 -
Frontiers in Public Health 2022This umbrella review aimed to summarize the available evidence on the association between dry eye disease and depression.
PURPOSE
This umbrella review aimed to summarize the available evidence on the association between dry eye disease and depression.
METHODS
We searched the Pubmed, Embase, and Cochrane databases using the search string "(Dry eye syndrome OR Keratoconjunctivitis sicca OR KCS OR Aqueous tear deficiency OR Sjogren syndrome) AND (depression OR depressive symptoms) AND (meta-analysis OR systematic review)" from inception to 20 July 2022. We considered all meta-analyses investigating the association between dry eye disease and depression.
RESULTS
After summarizing the included meta-analyses, it was concluded that dry eye disease is associated with depression. The symptoms of dry eye disease affect the daily lives of patients, thus affecting their mood. However, further evidence is required to confirm this association.
CONCLUSION
This finding highlights the importance of psychological support for patients with dry eye disease. Future clinical studies should investigate the mechanism underlying the association between dry eye disease and depression.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42022320619.
Topics: Humans; Affect; Databases, Factual; Depression; Dry Eye Syndromes
PubMed: 36466469
DOI: 10.3389/fpubh.2022.910608 -
Scientific Reports Jul 2022We aimed to investigate the density and morphology of corneal dendritic cells (DCs) in dry eye (DE) patients with or without Sjogren's syndrome (SS). This study included...
We aimed to investigate the density and morphology of corneal dendritic cells (DCs) in dry eye (DE) patients with or without Sjogren's syndrome (SS). This study included 28 patients with Sjogren's syndrome dry eye (SSDE), 33 patients with non-Sjogren's syndrome dry eye (NSSDE), and 30 age and sex matched healthy volunteers. In vivo confocal microscopy (IVCM) was used to investigate density and morphology (size, dendrites, and field) of DC. Compared with NSSDE and healthy group, SSDE showed significantly higher DC density, larger DC size, more DC dendrites with larger DC field (all P < 0.001). Comparison between NSSDE and healthy group demonstrated that DC density, dendrites and field were significantly higher in NSSDE. However, there was no significant difference in DC size (P = 0.076). DC density and morphological parameters showed significant associations with the systemic severity (salivary gland biopsy and serum antibodies) and ocular surface damage. The corneal epithelium DC density and morphological alterations were obvious in SSDE, which reflected higher level of immune activation and inflammatory response in SS. Marked correlations were found between DC density/morphology and systemic/ocular severity. Dynamic assessment of corneal DC may facilitate to clarify pathogenesis, stratify patient, and tailor treatment in SS patients.
Topics: Cell Count; Dendritic Cells; Dry Eye Syndromes; Epithelium, Corneal; Humans; Microscopy, Confocal; Sjogren's Syndrome
PubMed: 35778532
DOI: 10.1038/s41598-022-15537-4 -
Current Opinion in Ophthalmology Jul 2011Essential fatty acids have been of interest in the treatment of systemic and ocular diseases, and is most recently of interest in the area of dry eye disease. (Review)
Review
PURPOSE OF REVIEW
Essential fatty acids have been of interest in the treatment of systemic and ocular diseases, and is most recently of interest in the area of dry eye disease.
RECENT FINDINGS
Systemic and topical omega-3 fatty acids and omega-6 fatty acids have been used recently as an adjunctive treatment for patients with dry eye disease. They appear to have efficacy against the symptoms of dry eye that many patients experience. This symptom is postulated to be secondary to the anti-inflammatory effects that have been previously described. Although this effect is promising, more investigation is warranted in order to standardize indication for use, and composition and dosing for treatment.
SUMMARY
The use of essential fatty acids as a nutritional supplement is a novel treatment for patients with dry eye syndrome.
Topics: Dietary Fats; Dietary Supplements; Dry Eye Syndromes; Fatty Acids, Omega-3; Fatty Acids, Omega-6; Humans; Nutritional Physiological Phenomena
PubMed: 21597374
DOI: 10.1097/ICU.0b013e3283477d23 -
Eye (London, England) Feb 2018The topic of the 1984 Cambridge Ophthalmological Symposium was 'The Dry Eye'; it was chaired by my colleague and mentor Mr Peter Wright. In the 33 years that have passed... (Review)
Review
The topic of the 1984 Cambridge Ophthalmological Symposium was 'The Dry Eye'; it was chaired by my colleague and mentor Mr Peter Wright. In the 33 years that have passed since then we have learned a great deal more about this condition. This short paper sets out to review some of the more recent developments.
Topics: Diagnostic Techniques, Ophthalmological; Dietary Supplements; Dry Eye Syndromes; Fatty Acids, Omega-3; Humans; Lipids; Lubricant Eye Drops; Osmolar Concentration; Tears
PubMed: 29303149
DOI: 10.1038/eye.2017.289 -
Clinical & Experimental Optometry Mar 2022Dry Eye Disease (DED) is a complex and multifactorial disorder of tear homoeostasis that results in pain, visual disturbance, and ocular surface damage. It is highly... (Review)
Review
Dry Eye Disease (DED) is a complex and multifactorial disorder of tear homoeostasis that results in pain, visual disturbance, and ocular surface damage. It is highly prevalent around the world and is associated with many co-morbidities that may contribute to or exacerbate symptoms and signs of disease and affect disease phenotype. However, DED is not one disease and can manifest with a variety of symptoms and/or signs. In this review, we discuss relationships between various co-morbidities and DED phenotypes. For example, individuals with immune mediated diseases, like Sjögren's Syndrome and Graft versus Host Disease, often present with aqueous tear deficiency (ADDE) in the setting of lacrimal gland dysfunction. Individuals with disorders that affect the periocular skin, like rosacea and seborrhoeic dermatitis, often present with evaporative dry eye (EDE) in the setting of eyelid and/or meibomian gland abnormalities. Individuals with pain related disorders, such as chronic pain syndrome and migraine, often present with ocular pain out of proportion to tear film abnormalities, often with accompanying corneal nerve hypersensitivity. Individuals with diabetes mellitus often present with an epitheliopathy in the setting of decreased sensation (neurotrophic keratitis). While not absolute, understanding relationships between co-morbidities and DED phenotypes can help tailor a therapeutic plan to the individual patient.
Topics: Dry Eye Syndromes; Humans; Meibomian Glands; Morbidity; Phenotype; Tears
PubMed: 34369296
DOI: 10.1080/08164622.2021.1962210 -
Eye & Contact Lens Nov 2018To survey ophthalmologists about current practice patterns regarding the evaluation of dry eye patients and referrals for a Sjogren syndrome (SS) workup.
OBJECTIVE
To survey ophthalmologists about current practice patterns regarding the evaluation of dry eye patients and referrals for a Sjogren syndrome (SS) workup.
METHODS
An online survey was sent to ophthalmologists affiliated with the Scheie Eye Institute or Wills Eye Hospital using REDCap in August 2015. Descriptive statistics were used to summarize the data.
RESULTS
Four hundred seventy-four survey invitations were sent out and 101 (21%) ophthalmologists completed the survey. The common traditional dry eye test performed was corneal fluorescein staining (62%) and the most common newer dry eye test performed was tear osmolarity (18%). Half of respondents (51%) refer fewer than 5% of their dry eye patients for SS workups, with 18% reporting that they never refer any patients. The most common reasons for referrals included positive review of systems (60%), severe dry eye symptoms (51%) or ocular signs (47%), or dry eye that is refractory to treatment (42%). The majority (83%) felt that there is a need for an evidence-based standardized screening tool for dry eye patients to decide who should be referred for evaluation for SS.
CONCLUSIONS
Ophthalmologists continue to prefer the use of traditional dry eye tests in practice, with the most common test being corneal fluorescein staining. There is an underreferral of dry eye patients for SS workups, which is contributing to the continued underdiagnosis of the disease. Most respondents felt that there was a need for an evidence-based standardized screening tool to decide which dry eye patients should be referred for SS evaluations.
Topics: Adult; Diagnostic Techniques, Ophthalmological; Dry Eye Syndromes; Female; Fluorescein; Humans; Male; Middle Aged; Ophthalmologists; Practice Patterns, Physicians'; Referral and Consultation; Sjogren's Syndrome; Staining and Labeling; Tears
PubMed: 29369232
DOI: 10.1097/ICL.0000000000000448