Dry eye disease(DED)is a major ocular pathology worldwide,causing serious ocular discomfort and even visual impairment.The incidence of DED is gradually increasing with the highfrequency use of electronic products.Alt...Dry eye disease(DED)is a major ocular pathology worldwide,causing serious ocular discomfort and even visual impairment.The incidence of DED is gradually increasing with the highfrequency use of electronic products.Although inflammation is core cause of the DED vicious cycle,reactive oxygen species(ROS)play a pivotal role in the vicious cycle by regulating inflammation from upstream.Therefore,current therapies merely targeting inflammation show the failure of DED treatment.Here,a novel dual-atom nanozymes(DAN)-based eye drops are developed.The antioxidative DAN is successfully prepared by embedding Fe and Mn bimetallic single-atoms in N-doped carbon material and modifying it with a hydrophilic polymer.The in vitro and in vivo results demonstrate the DAN is endowed with superior biological activity in scavenging excessive ROS,inhibiting NLRP3 inflammasome activation,decreasing proinflammatory cytokines expression,and suppressing cell apoptosis.Consequently,the DAN effectively alleviate ocular inflammation,promote corneal epithelial repair,recover goblet cell density and tear secretion,thus breaking the DED vicious cycle.Our findings open an avenue to make the DAN as an intervention form to DED and ROSmediated inflammatory diseases.展开更多
AIM:To evaluate dry eye disease(DED)symptomatology and mental health status in different COVID-19 patients.METHODS:A cross-sectional observational design was used.Totally 123 eligible adults(46.34%of men,age range,18-...AIM:To evaluate dry eye disease(DED)symptomatology and mental health status in different COVID-19 patients.METHODS:A cross-sectional observational design was used.Totally 123 eligible adults(46.34%of men,age range,18-59y)with COVID-19 included in the study from August to November,2022.Ocular Surface Disease Index(OSDI),Five-item Dry Eye Questionnaire(DEQ-5),Hospital Anxiety and Depression Scale(HADS),and Pittsburgh Sleep Quality Index(PSQI)were used in this study.RESULTS:OSDI scores were 6.82(1.25,15.91)in asymptomatic carriers,7.35(2.50,18.38)in mild cases,and 16.67(4.43,28.04)in recurrent cases,with 30.00%,35.56%,and 57.89%,respectively evaluated as having DED symptoms(χ2=7.049,P=0.029).DEQ-5 score varied from 2.00(0,6.00)in asymptomatic carriers,3.00(0,8.00)in mild cases,and 8.00(5.00,10.00)in recurrent cases,with 27.50%,33.33%,and 55.26%,respectively assessed as having DED symptoms(χ2=8.532,P=0.014).The prevalence of clinical anxiety(50.00%)and depression(47.37%)symptoms were also significantly higher in patients with recurrent infection(χ2=24.541,P<0.001;χ2=30.871,P<0.001).Recurrent infection was a risk factor for high OSDI scores[odds ratio,2.562;95%confidence interval(CI),1.631-7.979;P=0.033]and DEQ-5 scores(odds ratio,3.353;95%CI,1.038-8.834;P=0.043),whereas having a fixed occupation was a protective factor for OSDI scores(odds ratio,0.088;95%CI,0.022-0.360;P=0.001)and DEQ-5 scores(odds ratio,0.126;95%CI,0.039-0.405;P=0.001).CONCLUSION:Patients with recurrent COVID-19 have more severe symptoms of DED,anxiety,and depression.展开更多
AIM:To report ocular changes in rabbits after the implementation of three different induction methods to create dry eye(DE)conditions and provides evidence of DErelated disease evolution.METHODS:Experimental methods w...AIM:To report ocular changes in rabbits after the implementation of three different induction methods to create dry eye(DE)conditions and provides evidence of DErelated disease evolution.METHODS:Experimental methods were divided into 3 models.The first model used involved triple injection of complete Freund’s adjuvant,50µL each,also called the meibomian gland dysfunction(MGD)model.In the second model,DE conditions were created by the resection of nictitating membranes(NM),Harderian glands(HG),and main lacrimal glands(LG),also called the LGR model.The third model involved the topical administration of benzalkonium chloride(BAK)0.1%solution.The Schirmer test,ocular surface staining with fluorescein,and tear breakup time tests were implemented before and after excision.After euthanasia,the ocular tissues were dissected.Cornea,conjunctiva,and meibomian glands were treated with periodic acid–Schiff(PAS)staining and haematoxylin–eosin staining.RESULTS:The MGD model triggered inflammation of meibomian glands.It detected changes in the lipid layer of the tear film.The bilateral resection of NM,HG,and LG reduced the watering layer of the tear film.The topical administration of BAK of 0.1%solution impacted the mucosal layer of the tear film.CONCLUSION:Different changes are observed with different DE syndrome models.The composition of the tear film differ depending on which part of the eye is targeted.More studies need to be done to confirm whether an increased thickness of the cornea has any impact on the DE disease.展开更多
AIM:To investigate the effects of diquafosol sodium(DQS)for dry eye model induced with povidone-iodine(PI)solution.METHODS:Ten Sprague Dawley rats as the control group.Thirty Sprague Dawley rats were used to establish...AIM:To investigate the effects of diquafosol sodium(DQS)for dry eye model induced with povidone-iodine(PI)solution.METHODS:Ten Sprague Dawley rats as the control group.Thirty Sprague Dawley rats were used to establish the dry eye model with stimulation of 10 g/L PI for 14d,then divided rats into three groups:dry eye group with no treatment(DED group,n=10);phosphate buffer saline treated group(PBS group,n=10);diquafosol treated group(DQS group,n=10).Clinical changes were observed by tear production test,fluorescein staining,tear breakup time(TBUT)test,corneal confocal microscope and ocular surface comprehensive analyzer.Eyeballs were collected on day 10 of treatment for hematoxylin-eosin(HE),periodic acid-Schiff(PAS),and alcian blue staining.TUNEL assay,polymorphonuclear(PMN)and mucin 1(MUC1)immunofluorescence were performed and corneal ultrastructural changes were detected by electron microscopy.RESULTS:Compared with DED and PBS groups,tear production(7.26±0.440 vs 4.07±0.474 mm;7.26±0.440 vs 3.74±0.280 mm;all P<0.01)and TBUT(7.37±0.383s vs 1.49±0.260s;7.37±0.383s vs 1.42±0.437s;all P<0.01)were significantly increased in DQS group.HE,PAS,and alcian blue staining and MUC1 immunofluorescence showed mucins and conjunctival goblet cells density(8.45±0.718 vs 5.21±0.813 cells/0.1 mm^(2);8.45±0.718 vs 5.36±0.615 cells/0.1 mm^(2);all P<0.01)increased in DQS group.Confocal microscopy,PMN immunofluorescence and TUNEL staining showed inflammatory infiltration and corneal epithelial cells apoptosis decreased in DQS group.The increased number of microvilli in corneal epithelial and the recovered cell junction were observed in DQS group.CONCLUSION:PI instillation can induce goblet cells and mucin loss,epithelial cell apoptosis and inflammation,which are consistent with the pathological manifestations of dry eye.Diquafosol can repair the ocular surface damage caused by PI,reduce corneal inflammation,inhibit corneal epithelial cell apoptosis,promote mucin secretion and maintain tear film stability.展开更多
AIM:To evaluate the efficacy and tolerability of administering a combined therapy in patients with dry eye syndrome(DES)and associated laryngopharyngeal reflux(LPR).METHODS:The study was retrospective,open,observation...AIM:To evaluate the efficacy and tolerability of administering a combined therapy in patients with dry eye syndrome(DES)and associated laryngopharyngeal reflux(LPR).METHODS:The study was retrospective,open,observational,and conducted in a real-life setting.Patients had pathological symptom assessment in dry eye(SANDE)and reflux symptom index(RSI)at baseline.Patients were re-assessed after 1mo and at the end of treatment.The treatment consisted of a three-month course based on the combined therapy:Gastroftal eye drops,one drop three times a day,and Gastroftal tablets,two tablets after lunch and two tablets after dinner.Tear break-up-time(TBUT)test,Schirmer test,RSI,and SANDE questionnaire were evaluated.RESULTS:The study included 253 patients.The mean age was 58±11.19y.TBUT test score and Schirmer’s test significantly increased(both P<0.001)after 1mo and at the end of treatment.The RSI score and SANDE scores significantly decreased(both P<0.001)after 1mo and at the end of treatment.CONCLUSION:The current,retrospective,and open study shows that combined therapy using Gastroftal eye drops and tablets could represent a valuable option in managing patients with DES associated with LPR.展开更多
AIM:To evaluate the effect of lid scrubbing using a gel combining different natural extracts on ocular signs and symptoms of dry eye patients.METHODS:A retrospective study was performed on 19 dry eye patients(51.1...AIM:To evaluate the effect of lid scrubbing using a gel combining different natural extracts on ocular signs and symptoms of dry eye patients.METHODS:A retrospective study was performed on 19 dry eye patients(51.1±16.0y).Non-invasive tear break-up time,tear meniscus height,meibomian gland loss,lipid layer thickness,conjunctival redness,corneal staining,ocular surface disease index(OSDI),and ocular pain intensity were measured before(baseline),1wk,and 2mo after lid scrubbing with a gel containing different natural extracts(okra extract,aloe vera leaf juice,hydrolysed soy protein,caffeine,citrus unshiu peel extract,and raspberry seed oil).RESULTS:Compared with the baseline,there was a statistically significant improvement in both first(P=0.048)and average(P=0.026)non-invasive tear break-up time 2mo after treatment,as well as in corneal staining(P=0.043,0.012),OSDI(P<0.001),and ocular pain intensity(P<0.001)after 1wk and 2mo.In addition,there was no correlation between ocular signs and symptoms.CONCLUSION:The lid scrubbing with a gel combining different natural extracts show beneficial effects on tear film stability,corneal damage,and ocular symptoms,which is the reason why this therapeutic procedure is proposed as an alternative for dry eye management.However,it is not possible to attribute this beneficial effect solely to the presence of the natural extracts in the gel,primarily due to the absence of a negative control group.展开更多
Dry eye disease(DED),primarily classified as multifactorial ocular surface disorder,afflicts tens of millions of individuals worldwide,adversely impacting their quality of life.Extensive research has been conducted on...Dry eye disease(DED),primarily classified as multifactorial ocular surface disorder,afflicts tens of millions of individuals worldwide,adversely impacting their quality of life.Extensive research has been conducted on tear film analysis over the past decades,offering a range of tests to evaluate its volume,health,and integrity.Yet,early diagnosis and effective treatment for DED continue to pose significant challenges in clinical settings.Nevertheless,by recognizing key phenomena in DED such as ocular surface inflammation,hyperosmolarity,and tear film instability,this article provides a comprehensive overview of both traditional and recently developed methods for diagnosing and monitoring DED.The information serves as a valuable resource not only for clinical diagnosis but also for further research into DED.展开更多
AIM:To observe ocular surface changes after phacovitrectomy in patients with mild to moderate meibomian gland dysfunction(MGD)-type dry eye and track clinical treatment response using a Keratograph 5M and a Lipi View ...AIM:To observe ocular surface changes after phacovitrectomy in patients with mild to moderate meibomian gland dysfunction(MGD)-type dry eye and track clinical treatment response using a Keratograph 5M and a Lipi View interferometer.METHODS:Forty cases were randomized into control group A and treatment group B;the latter received meibomian gland treatment 3d before phacovitrectomy and sodium hyaluronate before and after surgery.The average non-invasive tear film break-up time(NITBUTav),first noninvasive tear film break-up time(NITBUTf),non-invasive measured tear meniscus height(NTMH),meibomian gland loss(MGL),lipid layer thickness(LLT)and partial blink rate(PBR)were measured preoperatively and 1wk,1 and 3mo postoperatively.RESULTS:The NITBUTav values of group A at 1wk(4.38±0.47),1mo(6.76±0.70),and 3mo(7.25±0.68)were significantly lower than those of group B(7.45±0.78,10.46±0.97,and 11.31±0.89;P=0.002,0.004,and 0.001,respectively).The NTMH values of group B at 1wk(0.20±0.01)and 1mo(0.22±0.01)were markedly higher than those of group A(0.15±0.01 and 0.15±0.01;P=0.008 and P<0.001,respectively);however,there was no difference at 3mo.The LLT of group B at 3mo[91.5(76.25-100.00)]significantly exceeded that of group A[65.00(54.50-91.25),P=0.017].No obvious intergroup difference was found in MGL or PBR(P>0.05).CONCLUSION:Mild to moderate MGD dry eye worsens in the short term after phacovitrectomy.Preoperative cleaning,hot compresses,and meibomian gland massage as well as preoperative and postoperative sodium hyaluronate promote the rapid recovery of tear film stability.展开更多
AIM:To investigate the relationship between dynamic tear meniscus parameters and dry eye using an automated tear meniscus segmentation method.METHODS:The analysis of tear meniscus videos captured within 5s after a com...AIM:To investigate the relationship between dynamic tear meniscus parameters and dry eye using an automated tear meniscus segmentation method.METHODS:The analysis of tear meniscus videos captured within 5s after a complete blink includes data from 38 participates.By processing video data,several key parameters including the average height of the tear meniscus at different lengths,the curvature of the tear meniscus’s upper boundary,and the total area of the tear meniscus in each frame were calculated.The effective values of these dynamic parameters were then linearly fitted to explore the relationship between their changing trends and dry eye disease.RESULTS:In 94.74%of the samples,the average height of central tear meniscus increased over time.Moreover,97.37%of the samples exhibited an increase in the overall tear meniscus height(TMH)and area from the nasal to temporal side.Notably,the central TMH increased at a faster rate compared to the nasal side with the temporal side showing the slowest ascent.Statistical analysis indicates that the upper boundary curvature of the whole tear meniscus as well as the tear meniscus of the nasal side(2,3,and 4 mm)aid in identifying the presence of dry eye and assessing its severity.CONCLUSION:This study contributes to the understanding of tear meniscus dynamics as potential markers for dry eye,utilizing an automated and non-invasive approach that has implications for clinical assessment.展开更多
AIM:To elucidate the profiles of commensal bacteria on the ocular surfaces of patients with varying severity of dry eye(DE).METHODS:The single-center,prospective,case-control,observational study categorized all partic...AIM:To elucidate the profiles of commensal bacteria on the ocular surfaces of patients with varying severity of dry eye(DE).METHODS:The single-center,prospective,case-control,observational study categorized all participants into three distinct groups:1)control group(n=61),2)mild DE group(n=56),and 3)moderate-to-severe DE group(n=82).Schirmer’s tear secretion strips were used,and the bacterial microbiota was analyzed using 16S ribosomal ribonucleic acid gene sequencing.RESULTS:The three groups had significant differences in alpha diversity:the control group had the highest richness(Chao1,Faith’s phylogenetic diversity),the mild DE group showed the highest diversity(Shannon,Simpson),and the moderate-to-severe DE group had the lowest of the above-mentioned indices.DE severity was positively correlated with a reduction in beta diversity of the microbial community,with the moderate-to-severe DE group exhibiting the lowest beta diversity.Linear discriminant analysis effect size presented distinct dominant taxa that significantly differed between each.Furthermore,the exacerbation of DE corresponded with the enrichment of certain pathogenic bacteria,as determined by random forest analysis.CONCLUSION:As DE severity worsens,microbial community diversity tends to decrease.DE development corresponds with changes in microbial constituents,primarily characterized by reduced microbial diversity and a more homogenous species composition.展开更多
AIM:To investigate the incidence of dry eye disease(DED)and relevant risk factors among patients infected with the severe acute respiratory syndrome coronavirus 2(SARSCoV-2)Omicron variant.METHODS:This cross-sectional...AIM:To investigate the incidence of dry eye disease(DED)and relevant risk factors among patients infected with the severe acute respiratory syndrome coronavirus 2(SARSCoV-2)Omicron variant.METHODS:This cross-sectional,observational analysis included 993 patients with corona virus disease 2019(COVID-19)treated at the National Exhibition and Convention Center(Shanghai)Fangcang Shelter Hospital,from April 10 to May 26,2022.Totally 944 uninfected control participants were recruited.All participants completed ocular surface disease index(OSDI)questionnaires,and DED symptoms were determined using OSDI scores.The demographic characteristics,length of hospital stay and in nasopharyngeal swabs were performed using questionnaires.SARS-CoV-2 Omicron variant infection was confirmed by nucleic acid-based detection in nasopharyngeal swabs using a 2019-nCoV nucleic acid detection kit.The risk factors for DED symptoms among patients with COVID-19 and control participants were determined by logistic regression analysis.RESULTS:Patients with COVID-19 showed a higher incidence of DED than controls(64.9%vs 55.1%,P<0.001).SARS-CoV-2 infection[odds ratios(ORs)(95%CI):1.271(1.038,1.556)],use of contact lenses[ORs(95%CI):9.350(3.676,23.783)],history of corneal refractive surgery[ORs(95%CI):2.047(1.494,2.804)],poor sleep quality[ORs(95%CI):2.657(2.029,3.480)],and video display terminal(VDT)use for more than 8h per day[ORs(95%CI):6.348(4.720,8.538)]were found to be risk factors for DED symptoms in patients with COVID-19 as well as controls.For patients with COVID-19,the length of hospital stay[ORs(95%CI):1.196(1.134,1.262)],use of contact lenses[ORs(95%CI):20.423(2.680,155.632)],history of corneal refractive surgery[ORs(95%CI):2.166(1.321,3.553)],poor sleep quality[ORs(95%CI):3.650(2.381,5.597)],and VDT use for more than 8h per day[ORs(95%CI):7.740(4.918,12.180)]were significant risk factors for DED symptoms.CONCLUSION:Patients with COVID-19 are more prone to develop symptomatic DED.SARS-CoV-2 infection and length of hospital stay are important risk factors for DED symptoms.展开更多
BACKGROUND Autologous serum eye drops(ASEDs),a novel treatment derived from blood serum,have emerged as a groundbreaking solution for managing dry eye syndrome(DES).These drops have shown significant promise in reliev...BACKGROUND Autologous serum eye drops(ASEDs),a novel treatment derived from blood serum,have emerged as a groundbreaking solution for managing dry eye syndrome(DES).These drops have shown significant promise in relieving the distressing symptoms of DES.This study aimed to evaluate the safety and effectiveness of ASEDs compared to traditional treatments,which often prove inadequate or result in unwanted side effects,particularly in individuals with moderate-to-severe DES.AIM To evaluate whether ASEDs are safer and more effective than conventional artificial tears in the treatment of moderate-to-severe DES.METHODS This multi-centered randomized controlled trial included 240 patients with moderate-to-severe DES from three ophthalmology clinics in China.They were randomly assigned to receive either ASEDs or artificial tears for 12 wk.The primary outcome was the change in the ocular surface disease index(OSDI)score,with secondary outcomes including tear break-up time(TBUT),Schirmer I test,corneal fluorescein staining(CFS),and conjunctival impression cytology(CIC).Statistics analysis was performed using an analysis of covariance with adjustments made for baseline values.RESULTS Our findings revealed that both ASEDs and artificial tears significantly improved the OSDI score,TBUT,Schirmer I test,CFS,and CIC from baseline to week 12.The ASEDs group showed significantly greater improvement in all these measures than the artificial tears group(all P values<0.05).The average difference in the OSDI score between the two cohorts was-10.3(95%confidence interval:-13.6 to-7.0),indicating a substantial improvement in the ASEDs group.The occurrence of adverse events was comparable between cohorts,with no reports of severe adverse events.CONCLUSION ASEDs are more effective and safer than artificial tears for mitigating symptoms of moderate-to-severe DES.ASEDs could be an alternative/supplementary therapy for patients with DES less responsive to traditional treatments.展开更多
Dry eye disease(DED),a chronic multifactorial illness of the ocular surface with itching,burning,irritation,eye fatigue and ocular inflammation,may result in potential damage,such as cornea and conjunctiva,and even de...Dry eye disease(DED),a chronic multifactorial illness of the ocular surface with itching,burning,irritation,eye fatigue and ocular inflammation,may result in potential damage,such as cornea and conjunctiva,and even decreased vision.With the global prevalence of DED on the rise,it is crucial to find treatment options with minimal side effects.Natural plant products have shown promise in alleviating DED symptoms and may serve as a potential approach for its treatment.However,their application as instilled drugs is limited by solubility,stability and biological barriers.This review summarizes recent studies(published in the last 5 years)on natural plant products and their derivatives for the treatment of DED,focusing on efficacy,mechanism,drug delivery systems.Meanwhile,their shortcomings are also discussed.By exploring these aspects,we find polyphenol,flavonoid and others natural plant products can effectively improve or treat DED by different mechanisms,and suitable delivery system and structural modification can enhance their therapeutic effect,suggesting they are likely to become candidates for the treatment of DED.展开更多
Background:Dry eye is a chronic inflammatory disease of the ocular surface that is caused by multiple factors,characterized by pain,visual disturbance,and ocular damage.It is a common ophthalmic disease worldwide and ...Background:Dry eye is a chronic inflammatory disease of the ocular surface that is caused by multiple factors,characterized by pain,visual disturbance,and ocular damage.It is a common ophthalmic disease worldwide and a hot research field for scholars both domestically and internationally.This article employs network pharmacology methods to analyze the mechanism of Chrysanthemum in treating dry eye,which is a promising approach.Methods:The TCMSP(http://tcmspw.com/tcmsp.php)was used to screen for candidate active ingredient molecules of chrysanthemum with oral bioavailability≥30%and drug similarity to chrysanthemum≥0.18 as parameters.The active ingredients of chrysanthemum were searched using the“Related Targets”column in the TCMSP,followed by target prediction.Subsequently,Cytoscape 3.6.0 was employed to construct a compound-target network for chrysanthemum.The Online Mendelian Inheritance in Man and DisGeNET databases were used to identify pathogenic genes associated with dry eye.Furthermore,the STRING database was used to construct an interaction network and bar graph of intersecting target proteins in chrysanthemum to analyze protein interactions and core targets.To obtain key targets of active ingredients of chrysanthemum for treating dry eye,active ingredients targets of chrysanthemum and dry eye targets were intersected using Venny.Finally,a drug-active ingredient-key target-disease network was constructed.Gene Ontology functional annotation of key targets was performed using the WEBGESTALT database,and Kyoto Encyclopedia of Genes and Genomes pathway enrichment was performed using the REACTOM database.Results:Eighty active ingredients of chrysanthemum corresponding to targets were obtained.Among active ingredients,508 predicted targets were identified,along with 4180 genes associated with dry eye and 45 key targets of chrysanthemum for treating dry eye.The functions of key targets primarily include regulation of gene expression,oxidative stress,immune response,apoptosis,proliferation,regulation of cellular inflammation-related factors,and angiogenesis.The primary pathways associated with key targets include interleukin signaling,metabolism,cytokine signaling in the immune system,immune system,and signal transduction.Conclusion:Chrysanthemum facilitates regulation through multiple molecules,targets,and pathways for treating dry eye,primarily inhibiting inflammation-related factors and pathways,thereby reducing inflammation of lacrimal gland tissue and improving dry eye.展开更多
Background:Neuroinflammation is an essential event in Parkinson’s disease(PD).Identifying affordable and less invasive biomarkers to make an early diagnosis and monitor therapeutic strategies should be a priority amo...Background:Neuroinflammation is an essential event in Parkinson’s disease(PD).Identifying affordable and less invasive biomarkers to make an early diagnosis and monitor therapeutic strategies should be a priority among researchers.The study’s objective was to measure tear levels of cytokines in subjects with PD and their association with motor features and the presence of dry eye symptoms.Methods:A total of 16 subjects with PD and 16 age-and sex-matched controls were included.Movement Disorders Society-Unified Parkinson’s Disease Rating Scale(MDS-UPDRS),Hoehn and Yahr(HY)stage scale,Montreal Cognitive Assessment(MoCA),tear break-up time(TBUT),blink rate(BR),Dry Eye Questionnaire 5(DEQ-5)were examined,and pro-inflammatory cytokines[interleukin(IL)-1β,IL-6,IL-8,IL-10,IL-12p70 and tumor necrosis factor-alpha(TNF-α)]were quantified in tears using the BD Cytometric Bead Array Human Inflammatory Cytokine Kit.Results:Higher tear TNF-αwere quantified in PD compared to controls(2.94±3.95 vs.0.33±0.49 pg/mL,P=0.008).According to DEQ-5,50.0%(n=8)of PD subjects and 12.5%(n=2)controls had dry eye disease(DED).No differences were found in cytokines concentrations between PD patients with DED compared to those without DED.IL-8 was associated with the HY stage,TBUT,DEQ-5,and a better MoCA score.A higher BR correlated moderately with a lower HY stage(r=−0.645,P=0.007),and DED patients have lower BR in PD(12.14±2.54 vs.9.0±2.06 blinks/minute,P=0.031).Conclusions:PD patients have higher levels of TNF-αin tears than age-and sex-matched HC.IL-8 in tears may be both involved in the severity of the disease and in the development of DED in PD.In addition,our findings suggest that as HY stage increases,indicating a more advanced stage,BR decreases,indicating greater motor impairment.Conversely,the presence of DED is associated with higher levels of bradykinesia in PD patients,suggesting a potential relationship between DED and motor impairment severity.展开更多
AIM:To determine the possibility of the development of dry eye disease(DED) as a result of persistent infection with Chlamydia trachomatis and Ureaplasma urealyticum in the conjunctiva of patients.METHODS: This study ...AIM:To determine the possibility of the development of dry eye disease(DED) as a result of persistent infection with Chlamydia trachomatis and Ureaplasma urealyticum in the conjunctiva of patients.METHODS: This study was conducted on 58 patients of age range 20-50 y,diagnosed with DED confirmed by Schirmer I test and tear breakup time.The non-dry eye control group included 27 subjects of the same age.Ocular specimens were collected as conjunctival scrapings and swabs divided into three groups: the first used for bacterial culture,the second and third taken to detect Chlamydia trachomatis and Ureaplasma urealyticum by direct fluorescent antibody(DFA) assay and polymerase chain reaction(PCR) method. RESULTS: Chlamydia trachomatis was detected in 65.5% and 76% of DED patients by DFA and PCR methods respectively.Ureaplasma urealyticum was found in 44.8% of DED infected patients using the PCR method.Both organisms were identified in only 37.9% of DED patients found to be infected.Control subjects had a 22%detection rate of Chlamydia trachomatis by DFA assay versus a 7% detection rate by PCR; while Ureaplasma urealyticum was detected in 3.7% of the controls by PCR method.The conjunctival culture revealed that gram positive microorganisms represented 75% of isolates with coagulase negative Staphylococci the most common(50%) followed by Staphylococcus aureus(20%),whereas gram negative microorganisms occurred in 25% of cases,isolating Moraxella spp.as the most frequent organism. CONCLUSION: Our results tend to point out that Chlamydia trachomatis and Ureaplasma urealyticum were detected in a moderate percentage of patients with DED,and could be a fair possibility for its development.PCR is more reliable in detecting Chlamydia trachomatis than DFA technique.The presence of isolated conjunctival bacterial microflora can be of some potential value.展开更多
AIM: To investigate the regulatory roles of the members of the peroxisome proliferator-activated receptor(PPAR)family in lacrimal gland dysfunction under conditions of desiccating stress or diabetes.METHODS: Quantitat...AIM: To investigate the regulatory roles of the members of the peroxisome proliferator-activated receptor(PPAR)family in lacrimal gland dysfunction under conditions of desiccating stress or diabetes.METHODS: Quantitative polymerase chain reaction(qPCR) was used to examine the expression of PPARs in the cornea, conjunctiva, meibomian gland, and lacrimal gland in adult rats. The rats were divided into 3 groups:a control group, dry eye group, and diabetic group. The phenol red threads test, tear film break-up time(BUT) test and fluorescein staining were carried out to evaluate the development of dry eye. Based on bioinformatics research,qP CR was used to examine the expression level of PPARγ,tumor necrosis factor-α(TNF-α), interleukin-1β(IL-1β),interleukin-6(IL-6), sirtuin 1(Sirt1), myeloid differentiation factor 88(MyD88) and transforming growth factor-β(TGF-β)in the lacrimal glands.RESULTS: PPARα and PPARβ/δ were mainly expressed in the conjunctiva and the lacrimal gland, respectively.However, PPARγ was expressed in both the conjunctiva and lacrimal gland, at much higher levels than those measured for PPARα and PPARβ/δ. Dry eye rats and diabetic rats both showed decreased tear secretion, shortened BUT,and increased corneal staining. Significant changes in gene expression were observed compared with the control group. In the lacrimal glands of dry eye rats and diabetic rats, expression of PPARγ decreased(P<0.05), expression of Sirt1 also decreased(P<0.01), whereas expression of TNF-α, IL-1β, IL-6, MyD88, and TGF-β increased(P<0.05).CONCLUSION: Among PPARs, PPARγ might play a dominant role in the regulation of metabolic-and inflammatorysignaling pathways on the ocular surfaces and in lacrimal glands. Down-regulation of PPARγ is highly relevant to lacrimal gland dysfunction under desiccating-stress and diabetic conditions. PPARγ, thus, is a potential therapeutic target in the treatment of environment-or diabetes-induced dry eye diseases.展开更多
AIM: To explore a new diagnostic index for differentiating the evaporative dry eye(EDE) subtypes by analysis of their respective clinical characteristics. METHODS: A cross-sectional study of 139 patients(139 eyes) wit...AIM: To explore a new diagnostic index for differentiating the evaporative dry eye(EDE) subtypes by analysis of their respective clinical characteristics. METHODS: A cross-sectional study of 139 patients(139 eyes) with EDE who were enrolled and classified as obstructive meibomian gland dysfunction(MGD)(n=81) and non-obstructive MGD(n=58) EDE. All patients completed a Standard Patient Evaluation of Eye Dryness(SPEED) questionnaire and were evaluated for average lipid layer thickness(LLT), tear meniscus height measurements(TMH), tear break-up time(TBUT), ocular surface staining score, Schirmer I test(SIT), lid margin abnormalities, and meibomian gland function and morphology. RESULTS: Age, average LLT, TMH, scores of lid margin abnormalities, meibum quality, meibomian gland loss(MGL)(all P≤0.001), and TBUT(P=0.03) were all significantly different between obstructive MGD EDE patients and nonobstructive MGD EDE patients. Average LLT in obstructive MGD EDE was correlated with meibomian expressibility(r=-0.541, P≤0.001), lid margin abnormalities were marginally not significant(r=0.197, P=0.077), and TMH was correlated with MGL(total MGL: r=0.552, P≤0.001; upper MGL: r=0.438, P≤0.001; lower MGL: r=0.407, P≤0.001). Average LLT in non-obstructive MGD EDE, was correlated with meibomian expressibility and Oxford staining(r=-0.396, P=0.002; r=-0.461, P≤0.001). The efficiency of combining average LLT and TMH was optimal, with a sensitivity of 80.2% and a specificity of 74.1%. Obstructive MGD EDE patients had an average LLT≥69 nm and TMH≥0.25 mm, while non-obstructive MGD EDE patients had an average LLT<69 nm and TMH<0.25 mm.CONCLUSION: Obstructive MGD EDE and nonobstructive MGD EDE have significantly different clinical characteristics. Combining average LLT and TMH measurements enhanced their reliability for differentiating these two subtypes and provided guidance for offering more precise treatments for EDE subtypes.展开更多
AIM:To quantify the association between alcohol consumption and dry eye syndrome(DES) with Meta-analysis of published case-control and cross-sectional studies. METHODS: Three databases were screened for potentially el...AIM:To quantify the association between alcohol consumption and dry eye syndrome(DES) with Meta-analysis of published case-control and cross-sectional studies. METHODS: Three databases were screened for potentially eligible studies through Nov.30,2015,Pub Med,Web of Science,and the Cochrane Library.Odds ratios(ORs) were pooled with 95% confidence intervals(CIs) to evaluate the relationship between alcohol consumption and DES risk.Subgroup analyses were performed according to diagnostic criteria,publication year,sample size,alcohol intake and adjusted factors.RESULTS: A total of 10(9 case-control and 1 crosssectional) studies from 8 articles were included in this Meta-analysis.The pooled results showed that alcohol consumption would significantly increase the risk of DES(OR 1.15,95% CI: 1.02-1.30),and the results were independent of smoking,hypertension,diabetes and thyroid disease history.And the results of subgroup analyses indicated an increased incidence of DES diagnosed by typical DES symptoms and positive objective tests together(OR 1.18,95% CI: 1.01-1.39)among drinkers,but not by typical DES symptoms alone(OR 1.11,95% CI: 0.94-1.32).What's more,any drinkers were at higher risk of suffering from DES(OR 1.33,95%CI: 1.31-1.34),while heavy drinkers not(OR 1.01,95% CI:0.86-1.18).CONCLUSION: The present Meta-analysis suggests that alcohol consumption may be a significant risk factor for DES.Alcohol-induced peripheral neuropathymay falsely reduce the prevalence of DES among heavy drinkers.Future prospective studies of alcohol consumption and DES risk are needed to confirm our results.展开更多
The presence of inflammation in dry eye disease(DED)results in increased patient symptomatology,ocular surface damage and worsening tear dysfunction.It also affects the health of meibomian glands and their secretions ...The presence of inflammation in dry eye disease(DED)results in increased patient symptomatology,ocular surface damage and worsening tear dysfunction.It also affects the health of meibomian glands and their secretions which further aggravates ocular surface disease.This article reviews current knowledge regarding ocular surface inflammation in DED and explores the relationships between the vicious cycles of DED,inflammation and meibomian gland dysfunction(MGD).The clinical evaluation of eyes with such changes,markers that identify the presence of inflammation on the ocular surface and current treatment options are discussed.展开更多
基金supported by the National Natural Science Foundation of China(52173143 and 82371108)Natural Science Foundation of Henan Province(232300421176)Basic Science Key Project of Henan Eye Hospital(20JCZD002 and 23JCZD003).
文摘Dry eye disease(DED)is a major ocular pathology worldwide,causing serious ocular discomfort and even visual impairment.The incidence of DED is gradually increasing with the highfrequency use of electronic products.Although inflammation is core cause of the DED vicious cycle,reactive oxygen species(ROS)play a pivotal role in the vicious cycle by regulating inflammation from upstream.Therefore,current therapies merely targeting inflammation show the failure of DED treatment.Here,a novel dual-atom nanozymes(DAN)-based eye drops are developed.The antioxidative DAN is successfully prepared by embedding Fe and Mn bimetallic single-atoms in N-doped carbon material and modifying it with a hydrophilic polymer.The in vitro and in vivo results demonstrate the DAN is endowed with superior biological activity in scavenging excessive ROS,inhibiting NLRP3 inflammasome activation,decreasing proinflammatory cytokines expression,and suppressing cell apoptosis.Consequently,the DAN effectively alleviate ocular inflammation,promote corneal epithelial repair,recover goblet cell density and tear secretion,thus breaking the DED vicious cycle.Our findings open an avenue to make the DAN as an intervention form to DED and ROSmediated inflammatory diseases.
文摘AIM:To evaluate dry eye disease(DED)symptomatology and mental health status in different COVID-19 patients.METHODS:A cross-sectional observational design was used.Totally 123 eligible adults(46.34%of men,age range,18-59y)with COVID-19 included in the study from August to November,2022.Ocular Surface Disease Index(OSDI),Five-item Dry Eye Questionnaire(DEQ-5),Hospital Anxiety and Depression Scale(HADS),and Pittsburgh Sleep Quality Index(PSQI)were used in this study.RESULTS:OSDI scores were 6.82(1.25,15.91)in asymptomatic carriers,7.35(2.50,18.38)in mild cases,and 16.67(4.43,28.04)in recurrent cases,with 30.00%,35.56%,and 57.89%,respectively evaluated as having DED symptoms(χ2=7.049,P=0.029).DEQ-5 score varied from 2.00(0,6.00)in asymptomatic carriers,3.00(0,8.00)in mild cases,and 8.00(5.00,10.00)in recurrent cases,with 27.50%,33.33%,and 55.26%,respectively assessed as having DED symptoms(χ2=8.532,P=0.014).The prevalence of clinical anxiety(50.00%)and depression(47.37%)symptoms were also significantly higher in patients with recurrent infection(χ2=24.541,P<0.001;χ2=30.871,P<0.001).Recurrent infection was a risk factor for high OSDI scores[odds ratio,2.562;95%confidence interval(CI),1.631-7.979;P=0.033]and DEQ-5 scores(odds ratio,3.353;95%CI,1.038-8.834;P=0.043),whereas having a fixed occupation was a protective factor for OSDI scores(odds ratio,0.088;95%CI,0.022-0.360;P=0.001)and DEQ-5 scores(odds ratio,0.126;95%CI,0.039-0.405;P=0.001).CONCLUSION:Patients with recurrent COVID-19 have more severe symptoms of DED,anxiety,and depression.
文摘AIM:To report ocular changes in rabbits after the implementation of three different induction methods to create dry eye(DE)conditions and provides evidence of DErelated disease evolution.METHODS:Experimental methods were divided into 3 models.The first model used involved triple injection of complete Freund’s adjuvant,50µL each,also called the meibomian gland dysfunction(MGD)model.In the second model,DE conditions were created by the resection of nictitating membranes(NM),Harderian glands(HG),and main lacrimal glands(LG),also called the LGR model.The third model involved the topical administration of benzalkonium chloride(BAK)0.1%solution.The Schirmer test,ocular surface staining with fluorescein,and tear breakup time tests were implemented before and after excision.After euthanasia,the ocular tissues were dissected.Cornea,conjunctiva,and meibomian glands were treated with periodic acid–Schiff(PAS)staining and haematoxylin–eosin staining.RESULTS:The MGD model triggered inflammation of meibomian glands.It detected changes in the lipid layer of the tear film.The bilateral resection of NM,HG,and LG reduced the watering layer of the tear film.The topical administration of BAK of 0.1%solution impacted the mucosal layer of the tear film.CONCLUSION:Different changes are observed with different DE syndrome models.The composition of the tear film differ depending on which part of the eye is targeted.More studies need to be done to confirm whether an increased thickness of the cornea has any impact on the DE disease.
文摘AIM:To investigate the effects of diquafosol sodium(DQS)for dry eye model induced with povidone-iodine(PI)solution.METHODS:Ten Sprague Dawley rats as the control group.Thirty Sprague Dawley rats were used to establish the dry eye model with stimulation of 10 g/L PI for 14d,then divided rats into three groups:dry eye group with no treatment(DED group,n=10);phosphate buffer saline treated group(PBS group,n=10);diquafosol treated group(DQS group,n=10).Clinical changes were observed by tear production test,fluorescein staining,tear breakup time(TBUT)test,corneal confocal microscope and ocular surface comprehensive analyzer.Eyeballs were collected on day 10 of treatment for hematoxylin-eosin(HE),periodic acid-Schiff(PAS),and alcian blue staining.TUNEL assay,polymorphonuclear(PMN)and mucin 1(MUC1)immunofluorescence were performed and corneal ultrastructural changes were detected by electron microscopy.RESULTS:Compared with DED and PBS groups,tear production(7.26±0.440 vs 4.07±0.474 mm;7.26±0.440 vs 3.74±0.280 mm;all P<0.01)and TBUT(7.37±0.383s vs 1.49±0.260s;7.37±0.383s vs 1.42±0.437s;all P<0.01)were significantly increased in DQS group.HE,PAS,and alcian blue staining and MUC1 immunofluorescence showed mucins and conjunctival goblet cells density(8.45±0.718 vs 5.21±0.813 cells/0.1 mm^(2);8.45±0.718 vs 5.36±0.615 cells/0.1 mm^(2);all P<0.01)increased in DQS group.Confocal microscopy,PMN immunofluorescence and TUNEL staining showed inflammatory infiltration and corneal epithelial cells apoptosis decreased in DQS group.The increased number of microvilli in corneal epithelial and the recovered cell junction were observed in DQS group.CONCLUSION:PI instillation can induce goblet cells and mucin loss,epithelial cell apoptosis and inflammation,which are consistent with the pathological manifestations of dry eye.Diquafosol can repair the ocular surface damage caused by PI,reduce corneal inflammation,inhibit corneal epithelial cell apoptosis,promote mucin secretion and maintain tear film stability.
文摘AIM:To evaluate the efficacy and tolerability of administering a combined therapy in patients with dry eye syndrome(DES)and associated laryngopharyngeal reflux(LPR).METHODS:The study was retrospective,open,observational,and conducted in a real-life setting.Patients had pathological symptom assessment in dry eye(SANDE)and reflux symptom index(RSI)at baseline.Patients were re-assessed after 1mo and at the end of treatment.The treatment consisted of a three-month course based on the combined therapy:Gastroftal eye drops,one drop three times a day,and Gastroftal tablets,two tablets after lunch and two tablets after dinner.Tear break-up-time(TBUT)test,Schirmer test,RSI,and SANDE questionnaire were evaluated.RESULTS:The study included 253 patients.The mean age was 58±11.19y.TBUT test score and Schirmer’s test significantly increased(both P<0.001)after 1mo and at the end of treatment.The RSI score and SANDE scores significantly decreased(both P<0.001)after 1mo and at the end of treatment.CONCLUSION:The current,retrospective,and open study shows that combined therapy using Gastroftal eye drops and tablets could represent a valuable option in managing patients with DES associated with LPR.
文摘AIM:To evaluate the effect of lid scrubbing using a gel combining different natural extracts on ocular signs and symptoms of dry eye patients.METHODS:A retrospective study was performed on 19 dry eye patients(51.1±16.0y).Non-invasive tear break-up time,tear meniscus height,meibomian gland loss,lipid layer thickness,conjunctival redness,corneal staining,ocular surface disease index(OSDI),and ocular pain intensity were measured before(baseline),1wk,and 2mo after lid scrubbing with a gel containing different natural extracts(okra extract,aloe vera leaf juice,hydrolysed soy protein,caffeine,citrus unshiu peel extract,and raspberry seed oil).RESULTS:Compared with the baseline,there was a statistically significant improvement in both first(P=0.048)and average(P=0.026)non-invasive tear break-up time 2mo after treatment,as well as in corneal staining(P=0.043,0.012),OSDI(P<0.001),and ocular pain intensity(P<0.001)after 1wk and 2mo.In addition,there was no correlation between ocular signs and symptoms.CONCLUSION:The lid scrubbing with a gel combining different natural extracts show beneficial effects on tear film stability,corneal damage,and ocular symptoms,which is the reason why this therapeutic procedure is proposed as an alternative for dry eye management.However,it is not possible to attribute this beneficial effect solely to the presence of the natural extracts in the gel,primarily due to the absence of a negative control group.
文摘Dry eye disease(DED),primarily classified as multifactorial ocular surface disorder,afflicts tens of millions of individuals worldwide,adversely impacting their quality of life.Extensive research has been conducted on tear film analysis over the past decades,offering a range of tests to evaluate its volume,health,and integrity.Yet,early diagnosis and effective treatment for DED continue to pose significant challenges in clinical settings.Nevertheless,by recognizing key phenomena in DED such as ocular surface inflammation,hyperosmolarity,and tear film instability,this article provides a comprehensive overview of both traditional and recently developed methods for diagnosing and monitoring DED.The information serves as a valuable resource not only for clinical diagnosis but also for further research into DED.
基金Supported by the Natural Science Foundation of Tianjin City(No.20JCZXJC00040)Tianjin Key Medical Discipline(No.Specialty)Construction Project(No.TJYXZDXK-037A)The Science&Technology Development Fund of Tianjin Education Commission for Higher Education(No.2022ZD058)。
文摘AIM:To observe ocular surface changes after phacovitrectomy in patients with mild to moderate meibomian gland dysfunction(MGD)-type dry eye and track clinical treatment response using a Keratograph 5M and a Lipi View interferometer.METHODS:Forty cases were randomized into control group A and treatment group B;the latter received meibomian gland treatment 3d before phacovitrectomy and sodium hyaluronate before and after surgery.The average non-invasive tear film break-up time(NITBUTav),first noninvasive tear film break-up time(NITBUTf),non-invasive measured tear meniscus height(NTMH),meibomian gland loss(MGL),lipid layer thickness(LLT)and partial blink rate(PBR)were measured preoperatively and 1wk,1 and 3mo postoperatively.RESULTS:The NITBUTav values of group A at 1wk(4.38±0.47),1mo(6.76±0.70),and 3mo(7.25±0.68)were significantly lower than those of group B(7.45±0.78,10.46±0.97,and 11.31±0.89;P=0.002,0.004,and 0.001,respectively).The NTMH values of group B at 1wk(0.20±0.01)and 1mo(0.22±0.01)were markedly higher than those of group A(0.15±0.01 and 0.15±0.01;P=0.008 and P<0.001,respectively);however,there was no difference at 3mo.The LLT of group B at 3mo[91.5(76.25-100.00)]significantly exceeded that of group A[65.00(54.50-91.25),P=0.017].No obvious intergroup difference was found in MGL or PBR(P>0.05).CONCLUSION:Mild to moderate MGD dry eye worsens in the short term after phacovitrectomy.Preoperative cleaning,hot compresses,and meibomian gland massage as well as preoperative and postoperative sodium hyaluronate promote the rapid recovery of tear film stability.
基金Supported by Medical-Engineering Interdisciplinary Research Foundation of Shenzhen University and Research Development Fund of Beijing Municipal Health Commission(No.2019-4).
文摘AIM:To investigate the relationship between dynamic tear meniscus parameters and dry eye using an automated tear meniscus segmentation method.METHODS:The analysis of tear meniscus videos captured within 5s after a complete blink includes data from 38 participates.By processing video data,several key parameters including the average height of the tear meniscus at different lengths,the curvature of the tear meniscus’s upper boundary,and the total area of the tear meniscus in each frame were calculated.The effective values of these dynamic parameters were then linearly fitted to explore the relationship between their changing trends and dry eye disease.RESULTS:In 94.74%of the samples,the average height of central tear meniscus increased over time.Moreover,97.37%of the samples exhibited an increase in the overall tear meniscus height(TMH)and area from the nasal to temporal side.Notably,the central TMH increased at a faster rate compared to the nasal side with the temporal side showing the slowest ascent.Statistical analysis indicates that the upper boundary curvature of the whole tear meniscus as well as the tear meniscus of the nasal side(2,3,and 4 mm)aid in identifying the presence of dry eye and assessing its severity.CONCLUSION:This study contributes to the understanding of tear meniscus dynamics as potential markers for dry eye,utilizing an automated and non-invasive approach that has implications for clinical assessment.
基金Supported by Shanghai Municipal Health Commission(No.201940243).
文摘AIM:To elucidate the profiles of commensal bacteria on the ocular surfaces of patients with varying severity of dry eye(DE).METHODS:The single-center,prospective,case-control,observational study categorized all participants into three distinct groups:1)control group(n=61),2)mild DE group(n=56),and 3)moderate-to-severe DE group(n=82).Schirmer’s tear secretion strips were used,and the bacterial microbiota was analyzed using 16S ribosomal ribonucleic acid gene sequencing.RESULTS:The three groups had significant differences in alpha diversity:the control group had the highest richness(Chao1,Faith’s phylogenetic diversity),the mild DE group showed the highest diversity(Shannon,Simpson),and the moderate-to-severe DE group had the lowest of the above-mentioned indices.DE severity was positively correlated with a reduction in beta diversity of the microbial community,with the moderate-to-severe DE group exhibiting the lowest beta diversity.Linear discriminant analysis effect size presented distinct dominant taxa that significantly differed between each.Furthermore,the exacerbation of DE corresponded with the enrichment of certain pathogenic bacteria,as determined by random forest analysis.CONCLUSION:As DE severity worsens,microbial community diversity tends to decrease.DE development corresponds with changes in microbial constituents,primarily characterized by reduced microbial diversity and a more homogenous species composition.
基金Supported by the Natural Science Foundation of Chongqing(No.cstc2020jcyj-msxmX0241).
文摘AIM:To investigate the incidence of dry eye disease(DED)and relevant risk factors among patients infected with the severe acute respiratory syndrome coronavirus 2(SARSCoV-2)Omicron variant.METHODS:This cross-sectional,observational analysis included 993 patients with corona virus disease 2019(COVID-19)treated at the National Exhibition and Convention Center(Shanghai)Fangcang Shelter Hospital,from April 10 to May 26,2022.Totally 944 uninfected control participants were recruited.All participants completed ocular surface disease index(OSDI)questionnaires,and DED symptoms were determined using OSDI scores.The demographic characteristics,length of hospital stay and in nasopharyngeal swabs were performed using questionnaires.SARS-CoV-2 Omicron variant infection was confirmed by nucleic acid-based detection in nasopharyngeal swabs using a 2019-nCoV nucleic acid detection kit.The risk factors for DED symptoms among patients with COVID-19 and control participants were determined by logistic regression analysis.RESULTS:Patients with COVID-19 showed a higher incidence of DED than controls(64.9%vs 55.1%,P<0.001).SARS-CoV-2 infection[odds ratios(ORs)(95%CI):1.271(1.038,1.556)],use of contact lenses[ORs(95%CI):9.350(3.676,23.783)],history of corneal refractive surgery[ORs(95%CI):2.047(1.494,2.804)],poor sleep quality[ORs(95%CI):2.657(2.029,3.480)],and video display terminal(VDT)use for more than 8h per day[ORs(95%CI):6.348(4.720,8.538)]were found to be risk factors for DED symptoms in patients with COVID-19 as well as controls.For patients with COVID-19,the length of hospital stay[ORs(95%CI):1.196(1.134,1.262)],use of contact lenses[ORs(95%CI):20.423(2.680,155.632)],history of corneal refractive surgery[ORs(95%CI):2.166(1.321,3.553)],poor sleep quality[ORs(95%CI):3.650(2.381,5.597)],and VDT use for more than 8h per day[ORs(95%CI):7.740(4.918,12.180)]were significant risk factors for DED symptoms.CONCLUSION:Patients with COVID-19 are more prone to develop symptomatic DED.SARS-CoV-2 infection and length of hospital stay are important risk factors for DED symptoms.
文摘BACKGROUND Autologous serum eye drops(ASEDs),a novel treatment derived from blood serum,have emerged as a groundbreaking solution for managing dry eye syndrome(DES).These drops have shown significant promise in relieving the distressing symptoms of DES.This study aimed to evaluate the safety and effectiveness of ASEDs compared to traditional treatments,which often prove inadequate or result in unwanted side effects,particularly in individuals with moderate-to-severe DES.AIM To evaluate whether ASEDs are safer and more effective than conventional artificial tears in the treatment of moderate-to-severe DES.METHODS This multi-centered randomized controlled trial included 240 patients with moderate-to-severe DES from three ophthalmology clinics in China.They were randomly assigned to receive either ASEDs or artificial tears for 12 wk.The primary outcome was the change in the ocular surface disease index(OSDI)score,with secondary outcomes including tear break-up time(TBUT),Schirmer I test,corneal fluorescein staining(CFS),and conjunctival impression cytology(CIC).Statistics analysis was performed using an analysis of covariance with adjustments made for baseline values.RESULTS Our findings revealed that both ASEDs and artificial tears significantly improved the OSDI score,TBUT,Schirmer I test,CFS,and CIC from baseline to week 12.The ASEDs group showed significantly greater improvement in all these measures than the artificial tears group(all P values<0.05).The average difference in the OSDI score between the two cohorts was-10.3(95%confidence interval:-13.6 to-7.0),indicating a substantial improvement in the ASEDs group.The occurrence of adverse events was comparable between cohorts,with no reports of severe adverse events.CONCLUSION ASEDs are more effective and safer than artificial tears for mitigating symptoms of moderate-to-severe DES.ASEDs could be an alternative/supplementary therapy for patients with DES less responsive to traditional treatments.
文摘Dry eye disease(DED),a chronic multifactorial illness of the ocular surface with itching,burning,irritation,eye fatigue and ocular inflammation,may result in potential damage,such as cornea and conjunctiva,and even decreased vision.With the global prevalence of DED on the rise,it is crucial to find treatment options with minimal side effects.Natural plant products have shown promise in alleviating DED symptoms and may serve as a potential approach for its treatment.However,their application as instilled drugs is limited by solubility,stability and biological barriers.This review summarizes recent studies(published in the last 5 years)on natural plant products and their derivatives for the treatment of DED,focusing on efficacy,mechanism,drug delivery systems.Meanwhile,their shortcomings are also discussed.By exploring these aspects,we find polyphenol,flavonoid and others natural plant products can effectively improve or treat DED by different mechanisms,and suitable delivery system and structural modification can enhance their therapeutic effect,suggesting they are likely to become candidates for the treatment of DED.
基金This study was supported by the following grants:National Natural Science Foundation of China General Program funded projects(30772824,81574031)Hunan Provincial Key Laboratory Construction Project for Traditional Chinese Medicine Prevention and Treatment of Ophthalmic Diseases(2017TP1018)+3 种基金Key Discipline Construction Project of Traditional Chinese Medicine Ophthalmology from State Administration of Traditional Chinese Medicine(ZK 1801YK015)Changsha Science and Technology Plan Projects(K1501014-31,KC1704005)Hunan Provincial Graduate Research and Innovation Projects(CX20220780)Research Innovation Projects for Graduate Students at Hunan University of Chinese Medicine(2022YF01).
文摘Background:Dry eye is a chronic inflammatory disease of the ocular surface that is caused by multiple factors,characterized by pain,visual disturbance,and ocular damage.It is a common ophthalmic disease worldwide and a hot research field for scholars both domestically and internationally.This article employs network pharmacology methods to analyze the mechanism of Chrysanthemum in treating dry eye,which is a promising approach.Methods:The TCMSP(http://tcmspw.com/tcmsp.php)was used to screen for candidate active ingredient molecules of chrysanthemum with oral bioavailability≥30%and drug similarity to chrysanthemum≥0.18 as parameters.The active ingredients of chrysanthemum were searched using the“Related Targets”column in the TCMSP,followed by target prediction.Subsequently,Cytoscape 3.6.0 was employed to construct a compound-target network for chrysanthemum.The Online Mendelian Inheritance in Man and DisGeNET databases were used to identify pathogenic genes associated with dry eye.Furthermore,the STRING database was used to construct an interaction network and bar graph of intersecting target proteins in chrysanthemum to analyze protein interactions and core targets.To obtain key targets of active ingredients of chrysanthemum for treating dry eye,active ingredients targets of chrysanthemum and dry eye targets were intersected using Venny.Finally,a drug-active ingredient-key target-disease network was constructed.Gene Ontology functional annotation of key targets was performed using the WEBGESTALT database,and Kyoto Encyclopedia of Genes and Genomes pathway enrichment was performed using the REACTOM database.Results:Eighty active ingredients of chrysanthemum corresponding to targets were obtained.Among active ingredients,508 predicted targets were identified,along with 4180 genes associated with dry eye and 45 key targets of chrysanthemum for treating dry eye.The functions of key targets primarily include regulation of gene expression,oxidative stress,immune response,apoptosis,proliferation,regulation of cellular inflammation-related factors,and angiogenesis.The primary pathways associated with key targets include interleukin signaling,metabolism,cytokine signaling in the immune system,immune system,and signal transduction.Conclusion:Chrysanthemum facilitates regulation through multiple molecules,targets,and pathways for treating dry eye,primarily inhibiting inflammation-related factors and pathways,thereby reducing inflammation of lacrimal gland tissue and improving dry eye.
基金supported by Hospital Fundacion Nuestra Senora de la Luz,Private Assistance Institution.
文摘Background:Neuroinflammation is an essential event in Parkinson’s disease(PD).Identifying affordable and less invasive biomarkers to make an early diagnosis and monitor therapeutic strategies should be a priority among researchers.The study’s objective was to measure tear levels of cytokines in subjects with PD and their association with motor features and the presence of dry eye symptoms.Methods:A total of 16 subjects with PD and 16 age-and sex-matched controls were included.Movement Disorders Society-Unified Parkinson’s Disease Rating Scale(MDS-UPDRS),Hoehn and Yahr(HY)stage scale,Montreal Cognitive Assessment(MoCA),tear break-up time(TBUT),blink rate(BR),Dry Eye Questionnaire 5(DEQ-5)were examined,and pro-inflammatory cytokines[interleukin(IL)-1β,IL-6,IL-8,IL-10,IL-12p70 and tumor necrosis factor-alpha(TNF-α)]were quantified in tears using the BD Cytometric Bead Array Human Inflammatory Cytokine Kit.Results:Higher tear TNF-αwere quantified in PD compared to controls(2.94±3.95 vs.0.33±0.49 pg/mL,P=0.008).According to DEQ-5,50.0%(n=8)of PD subjects and 12.5%(n=2)controls had dry eye disease(DED).No differences were found in cytokines concentrations between PD patients with DED compared to those without DED.IL-8 was associated with the HY stage,TBUT,DEQ-5,and a better MoCA score.A higher BR correlated moderately with a lower HY stage(r=−0.645,P=0.007),and DED patients have lower BR in PD(12.14±2.54 vs.9.0±2.06 blinks/minute,P=0.031).Conclusions:PD patients have higher levels of TNF-αin tears than age-and sex-matched HC.IL-8 in tears may be both involved in the severity of the disease and in the development of DED in PD.In addition,our findings suggest that as HY stage increases,indicating a more advanced stage,BR decreases,indicating greater motor impairment.Conversely,the presence of DED is associated with higher levels of bradykinesia in PD patients,suggesting a potential relationship between DED and motor impairment severity.
文摘AIM:To determine the possibility of the development of dry eye disease(DED) as a result of persistent infection with Chlamydia trachomatis and Ureaplasma urealyticum in the conjunctiva of patients.METHODS: This study was conducted on 58 patients of age range 20-50 y,diagnosed with DED confirmed by Schirmer I test and tear breakup time.The non-dry eye control group included 27 subjects of the same age.Ocular specimens were collected as conjunctival scrapings and swabs divided into three groups: the first used for bacterial culture,the second and third taken to detect Chlamydia trachomatis and Ureaplasma urealyticum by direct fluorescent antibody(DFA) assay and polymerase chain reaction(PCR) method. RESULTS: Chlamydia trachomatis was detected in 65.5% and 76% of DED patients by DFA and PCR methods respectively.Ureaplasma urealyticum was found in 44.8% of DED infected patients using the PCR method.Both organisms were identified in only 37.9% of DED patients found to be infected.Control subjects had a 22%detection rate of Chlamydia trachomatis by DFA assay versus a 7% detection rate by PCR; while Ureaplasma urealyticum was detected in 3.7% of the controls by PCR method.The conjunctival culture revealed that gram positive microorganisms represented 75% of isolates with coagulase negative Staphylococci the most common(50%) followed by Staphylococcus aureus(20%),whereas gram negative microorganisms occurred in 25% of cases,isolating Moraxella spp.as the most frequent organism. CONCLUSION: Our results tend to point out that Chlamydia trachomatis and Ureaplasma urealyticum were detected in a moderate percentage of patients with DED,and could be a fair possibility for its development.PCR is more reliable in detecting Chlamydia trachomatis than DFA technique.The presence of isolated conjunctival bacterial microflora can be of some potential value.
基金Supported by the National Natural Science Foundation of China(No.81970769,No.81770890,No.81900891)。
文摘AIM: To investigate the regulatory roles of the members of the peroxisome proliferator-activated receptor(PPAR)family in lacrimal gland dysfunction under conditions of desiccating stress or diabetes.METHODS: Quantitative polymerase chain reaction(qPCR) was used to examine the expression of PPARs in the cornea, conjunctiva, meibomian gland, and lacrimal gland in adult rats. The rats were divided into 3 groups:a control group, dry eye group, and diabetic group. The phenol red threads test, tear film break-up time(BUT) test and fluorescein staining were carried out to evaluate the development of dry eye. Based on bioinformatics research,qP CR was used to examine the expression level of PPARγ,tumor necrosis factor-α(TNF-α), interleukin-1β(IL-1β),interleukin-6(IL-6), sirtuin 1(Sirt1), myeloid differentiation factor 88(MyD88) and transforming growth factor-β(TGF-β)in the lacrimal glands.RESULTS: PPARα and PPARβ/δ were mainly expressed in the conjunctiva and the lacrimal gland, respectively.However, PPARγ was expressed in both the conjunctiva and lacrimal gland, at much higher levels than those measured for PPARα and PPARβ/δ. Dry eye rats and diabetic rats both showed decreased tear secretion, shortened BUT,and increased corneal staining. Significant changes in gene expression were observed compared with the control group. In the lacrimal glands of dry eye rats and diabetic rats, expression of PPARγ decreased(P<0.05), expression of Sirt1 also decreased(P<0.01), whereas expression of TNF-α, IL-1β, IL-6, MyD88, and TGF-β increased(P<0.05).CONCLUSION: Among PPARs, PPARγ might play a dominant role in the regulation of metabolic-and inflammatorysignaling pathways on the ocular surfaces and in lacrimal glands. Down-regulation of PPARγ is highly relevant to lacrimal gland dysfunction under desiccating-stress and diabetic conditions. PPARγ, thus, is a potential therapeutic target in the treatment of environment-or diabetes-induced dry eye diseases.
基金Supported by the Provincial Frontier and Key Technology Innovation Special Fund of Guangdong Province(No.2015B020227001)the Guangzhou Science and Technology Plan Scientific Research Projects(No.201504010023)
文摘AIM: To explore a new diagnostic index for differentiating the evaporative dry eye(EDE) subtypes by analysis of their respective clinical characteristics. METHODS: A cross-sectional study of 139 patients(139 eyes) with EDE who were enrolled and classified as obstructive meibomian gland dysfunction(MGD)(n=81) and non-obstructive MGD(n=58) EDE. All patients completed a Standard Patient Evaluation of Eye Dryness(SPEED) questionnaire and were evaluated for average lipid layer thickness(LLT), tear meniscus height measurements(TMH), tear break-up time(TBUT), ocular surface staining score, Schirmer I test(SIT), lid margin abnormalities, and meibomian gland function and morphology. RESULTS: Age, average LLT, TMH, scores of lid margin abnormalities, meibum quality, meibomian gland loss(MGL)(all P≤0.001), and TBUT(P=0.03) were all significantly different between obstructive MGD EDE patients and nonobstructive MGD EDE patients. Average LLT in obstructive MGD EDE was correlated with meibomian expressibility(r=-0.541, P≤0.001), lid margin abnormalities were marginally not significant(r=0.197, P=0.077), and TMH was correlated with MGL(total MGL: r=0.552, P≤0.001; upper MGL: r=0.438, P≤0.001; lower MGL: r=0.407, P≤0.001). Average LLT in non-obstructive MGD EDE, was correlated with meibomian expressibility and Oxford staining(r=-0.396, P=0.002; r=-0.461, P≤0.001). The efficiency of combining average LLT and TMH was optimal, with a sensitivity of 80.2% and a specificity of 74.1%. Obstructive MGD EDE patients had an average LLT≥69 nm and TMH≥0.25 mm, while non-obstructive MGD EDE patients had an average LLT<69 nm and TMH<0.25 mm.CONCLUSION: Obstructive MGD EDE and nonobstructive MGD EDE have significantly different clinical characteristics. Combining average LLT and TMH measurements enhanced their reliability for differentiating these two subtypes and provided guidance for offering more precise treatments for EDE subtypes.
基金Supported by Zhejiang Key Laboratory Fund of China(No.2011E10006)
文摘AIM:To quantify the association between alcohol consumption and dry eye syndrome(DES) with Meta-analysis of published case-control and cross-sectional studies. METHODS: Three databases were screened for potentially eligible studies through Nov.30,2015,Pub Med,Web of Science,and the Cochrane Library.Odds ratios(ORs) were pooled with 95% confidence intervals(CIs) to evaluate the relationship between alcohol consumption and DES risk.Subgroup analyses were performed according to diagnostic criteria,publication year,sample size,alcohol intake and adjusted factors.RESULTS: A total of 10(9 case-control and 1 crosssectional) studies from 8 articles were included in this Meta-analysis.The pooled results showed that alcohol consumption would significantly increase the risk of DES(OR 1.15,95% CI: 1.02-1.30),and the results were independent of smoking,hypertension,diabetes and thyroid disease history.And the results of subgroup analyses indicated an increased incidence of DES diagnosed by typical DES symptoms and positive objective tests together(OR 1.18,95% CI: 1.01-1.39)among drinkers,but not by typical DES symptoms alone(OR 1.11,95% CI: 0.94-1.32).What's more,any drinkers were at higher risk of suffering from DES(OR 1.33,95%CI: 1.31-1.34),while heavy drinkers not(OR 1.01,95% CI:0.86-1.18).CONCLUSION: The present Meta-analysis suggests that alcohol consumption may be a significant risk factor for DES.Alcohol-induced peripheral neuropathymay falsely reduce the prevalence of DES among heavy drinkers.Future prospective studies of alcohol consumption and DES risk are needed to confirm our results.
文摘The presence of inflammation in dry eye disease(DED)results in increased patient symptomatology,ocular surface damage and worsening tear dysfunction.It also affects the health of meibomian glands and their secretions which further aggravates ocular surface disease.This article reviews current knowledge regarding ocular surface inflammation in DED and explores the relationships between the vicious cycles of DED,inflammation and meibomian gland dysfunction(MGD).The clinical evaluation of eyes with such changes,markers that identify the presence of inflammation on the ocular surface and current treatment options are discussed.
