Therapeutic effects of 3% diquafosol ophthalmic solution in patients with short tear film break-up time-type dry eye disease

Yongseok Mun,Joo Youn Oh,Ji-Won Kwon

doi:10.1186/s12886-018-0910-3

Yongseok Mun, Joo Youn Oh + Show 1 more

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https://doi.org/10.1186/s12886-018-0910-3

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Journal: BMC Ophthalmology	Publication Date: Sep 5, 2018
Citations: 11	License type: open-access

Affiliation: Seoul National University Hospital

Abstract

BackgroundTo investigate therapeutic effects of topical diquafosol tetrasodium 3% ophthalmic solution in patients with short tear film break-up time (TFBUT)-type dry eye (DE).MethodsThe prospective study was performed in 70 eyes of 70 patients with short TFBUT-type DE. Diagnosis of short TFBUT-type DE was made based on the presence of DE symptoms, TFBUT value ≤5 s, corneoconjunctival staining score ≤ 2 (on a scale of 0 to 4), and Schirmer I value > 5 mm. Patients with systemic immunologic disorders or ocular graft-versus-host disease were excluded. Before and after instillation of 3% diquafosol ophthalmic solution six times per day for 4 weeks, subjective DE symptoms, TFBUT, corneoconjunctival staining score, and Schirmer I value were examined and compared. Also, demographic factors were compared between patients who showed improvement in each DE parameter by treatment and those who did not.ResultsFour-week treatment with 3% diquafosol ophthalmic solution significantly improved DE symptoms (p < 0.0001), increased TFBUT (p < 0.0001), and reduced corneoconjunctival staining scores (p < 0.0001). Schirmer I values were not changed by treatment. The age of patients who showed improvement in subjective DE symptoms after treatment was significantly lower than that of patients who did not (53.4 ± 27.5 vs. 63.3 ± 13.9 years, p = 0.012). Ocular side effects developed in 3 patients (4.3%), including conjunctival chemosis (n = 1) and persistent stinging sensation (n = 2).ConclusionsDiquafosol tetrasodium 3% ophthalmic solution is effective in improving subjective symptoms and tear film stability in short TFBUT-type DE patients.Trial registrationThe study was retrospectively registered on Clinical Research Information Service (CRiS), Republic of Korea.Trial registration number: KCT0003134.Date of registration: 2018-08-15.

Highlights

To investigate therapeutic effects of topical diquafosol tetrasodium 3% ophthalmic solution in patients with short tear film break-up time (TFBUT)-type dry eye (DE)
Aqueous deficient dry eye (ADDE) and evaporative dry eye (EDE) are not mutually exclusive and commonly overlapping, [1] both leading to tear film instability which can be measured by the tear break-up time (TFBUT)
This type of DE has been shown to be associated with visual display terminal (VDT) work and contact lens (CL) wear [4,5,6,7], and the prevalence of short TFBUT-type DE is rising with the widespread use of VDT and CL [8, 9]

Summary

Introduction

To investigate therapeutic effects of topical diquafosol tetrasodium 3% ophthalmic solution in patients with short tear film break-up time (TFBUT)-type dry eye (DE). A new concept of short tear film break-up time (TFBUT)-type dry eye (DE) has emerged as a potentially new type of DED [2, 3]. The short TFBUT-type DE is characterized by a short TFBUT and DE symptoms without ocular surface damage and tear deficiency [2, 3]. This type of DE has been shown to be associated with visual display terminal (VDT) work and contact lens (CL) wear [4,5,6,7], and the prevalence of short TFBUT-type DE is rising with the widespread use of VDT and CL [8, 9]. A few studies in a small number of patients showed the efficacy of 3% diquafosol ophthalmic solution in improving subjective symptoms and TFBUT in patients with short TFBUT-type DE [10,11,12]

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