Ocular Surface Failure in Urban Syndrome.

Marco Antonini,Alessandra Micera,Giancarlo Sborgia,Daniele Gaudenzi,Sara Spelta,Antonio Di Zazzo,Marco Coassin,Roberto Sgrulletta,Maria Poddi

doi:10.3390/jcm10143048

Abstract

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

Highlights

In the ocular surface system, several tissues cooperate in order to maintain the critical homeostasis which allows its ultimate visual function and comfort
urban syndrome (US) may be considered as a transversal, cross-over condition that has some common features of allergy, dry eye, and toxic conjunctivitis, related to poor air conditions and urban environment [6]
Inclusion criteria required age ≥18 years, ocular surface disease index (OSDI) score >13 and alterations in clinical tests of ocular surface function (tear break up time (T-BUT) and Schirmer test) in conjunction with signs and symptoms suggestive of US

Summary

Introduction

In the ocular surface system, several tissues cooperate in order to maintain the critical homeostasis which allows its ultimate visual function and comfort This equilibrium is challenged daily by repetitive stimuli and insults, but homeostatic physiologic status is continuously preserved by a strictly regulated innate immune response termed “parainflammation” [1]. The continuous increase in air pollution has significantly changed air quality, leading to the onset of the so-called urban syndrome (US), an allergic-like conjunctivitis triggered by pollutants. These patients are characterized by persistent dysregulation of ocular surface para-inflammation, causing chronic low-grade inflammation and ocular discomfort, with significant consequences for occupational health and job productivity prospects. Conclusions: trice-daily topic instillation of 0.001% GPI in 0.02% HA vehicle resulted an effective and well tolerated treatment in US patients

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