Ocular Surface Disease Index Score Research Articles

The association of pre-photorefractive keratectomy Schirmer-1 test value with postoperative corneal epithelial thickness, ocular surface discomfort, and visual acuity.

To investigate the association of pre-photorefractive keratectomy Schirmer-1 test value with post-photorefractive keratectomy central corneal epithelial thickness, ocular surface disease index score, and uncorrected distance visual acuity. Patients were categorized according to preoperative Schirmer-1 value: the normal Schirmer Group (n=54; Schirmer-1 test value, >10 mm) and the low Schirmer Group (n=52; Schirmer-1 test value, between 6 and 10 mm). We analyzed ablation depth, visual acuity, result of Schirmer-1 test (with anesthesia), tear film break-up time, ocular surface disease index score, central corneal epithelial thickness, and spherical equivalent refraction. We found significant differences between the groups in Schirmer-1 test value, tear film break-up time, and ocular surface disease index score, both preoperatively and postoperatively (p<0.001). The preoperative central corneal epithelial thicknesses of the two groups were similar (p>0.05). After photorefractive keratectomy, the Schirmer-1 test value and spherical equivalent refraction decreased in both groups (p<0.05), and ocular surface disease index scores and central corneal epithelial thickness values increased in the low Schirmer Group (p<0.001) but not in the normal Schirmer Group (p>0.05). The postoperative central corneal epithelial thicknesses of the low Schirmer Group were significantly higher than those of the normal Schirmer Group (p<0.001). Postoperative uncorrected distance visual acuity did not differ significantly between the two groups (p>0.05). In patients with low Schirmer-1 test values before photorefractive keratectomy, the corneal epithelium thickened and ocular surface complaints increased during the postoperative period. However, changes in the corneal epithelium did not affect the postoperative uncorrected distance visual acuity. To reduce postoperative problems on the ocular surface in these patients, we recommend that dry eye be treated before photorefractive keratectomy.

Оценка эффективности бромфенака натрия в лечении синдрома «сухого глаза»

Background: to date, the efficacy of anti-inflammatory treatment in dry eye disease (DED) is still relevant. Aim: to evaluate the efficacy and safety of bromfenac sodium 0.09% ophthalmic solution plus artificial tears in patients with DED. Patients and Methods: 175 patients (350 eyes) with DED receiving artificial tears were enrolled. Subjective and objective assessment of symptom severity was performed and DED stage was determined before and 4 weeks after treatment with bromfenac sodium 0.09% ophthalmic solution based on the results of the Ocular Surface Disease Index (OSDI) questionnaire, Schirmer's test and Norn's test. Adverse events were registered to assess the safety of bromfenac sodium 0.09%. Results: complex treatment of DED resulted in a 1.4-fold increase in Schirmer's test and Norn's test score and a significant improvement in typical symptoms based on the OSDI score. The average OSDI score decreased by 56% compared to baseline. The number of patients with moderate to severe DED decreased by 7% and 55% respectively. The number of patients with mild DED increased by 21%. After 4 weeks of treatment, 41% of patients were symptom free. All changes during the study were significant (p&lt;0.05). No adverse events were reported with the use of bromfenac sodium 0.09%. Conclusion: bromfenac sodium 0.09% ophthalmic solution is clinically effective in DED. This medication increases total tear production, reduces the severity of symptoms and decreases the number of patients with severe and moderate disease, thereby improving the quality of life of these patients. KEYWORDS: bromfenac sodium, OSDI, dry eye disease, Schirmer's test, treatment efficacy. FOR CITATION: Loskutov I.A., Semashko E.F., Khomyakova E.N., Makukha E.I., Kostina N.E. Evaluation of the efficacy of bromfenac sodium in the treatment of dry eye disease. Russian Journal of Clinical Ophthalmology. 2024;24(1):7–13 (in Russ.). DOI: 10.32364/2311-7729-2024- 24-1-2.

Evaluation of early ocular discomfort after glaucoma surgery: trabeculectomy versus Ahmed glaucoma valve implantation.

This study aims to compare the initial ocular discomfort symptoms resulting from trabeculectomy and Ahmed glaucoma valve implantation surgeries. A prospective comparative study was conducted. The evaluation of ocular discomfort employed a questionnaire designed to identify the frequency and severity of distinct symptoms: ocular pain, general discomfort, tearing, foreign body sensation, and burning. This questionnaire was administered prior to surgery as a baseline, and subsequently at 7, 30, and 90 days post-surgery. Simultaneously, the Ocular Surface Disease Index (OSDI) was applied at these same time intervals. The study encompassed a total of 17 patients (9 undergoing trabeculectomy and 8 undergoing Ahmed glaucoma valve implantation). The Ahmed glaucoma valve implantation group exhibited higher tearing levels at baseline (p=0.038). However, no statistically significant differences in symptoms were observed between the two surgeries at 7 and 30 days post-surgery. At the 90-day mark following surgery, patients who had undergone trabeculectomy reported a significantly higher foreign body sensation (p=0.004). Although OSDI scores did not differ between groups at baseline, the trabeculectomy group showed significantly higher OSDI scores than the Ahmed glaucoma valve implantation group at 7, 30, and 90 days after surgery (p<0.05). Post-surgery, patients who had undergone trabeculectomy experienced increased foreign body sensation. Trabeculectomy appears to cause greater early postoperative ocular discomfort compared to the Ahmed glaucoma valve implantation group.

Dry Eye and Some Related Factors in Patients with Type 2 Diabetic Nephropathy: A Cross-Sectional Study in Vietnam.

To determine the prevalence of dry eye (DE) and some related factors in patients with type 2 diabetic nephropathy (T2DN). We performed a cross-sectional study on 338 people, who were divided into 2 groups: 169 T2DN patients and 169 patients diagnosed with type 2 diabetic mellitus (T2DM) without renal complications as a control group. The Ocular Surface Disease Index (OSDI) and test fluorescein tear-film break-up time (TBUT) were done in all 338 subjects. Patients with OSDI scores < 13 and TBUT values equal to or under 10 seconds were diagnosed with dry eye. The prevalence of DE in T2DN patients was significantly higher than T2DM group (55.6% versus 37.3%). The T2DN groups with dry eye had a median duration of DM, the proportion of hypertension, peripheral nerve complications, anemia, proportion of using insulin, and concentration of plasma glucose, HbA1C, urea, creatinine, CRP-hs significantly higher than those of T2DN without dry eye. Advanced age, high HbA1C level, and decreased eGFR were independent factors associated with dry eye in T2DN patients. Dry eye was a common condition associated with advanced age, high HbA1C levels, and decreased GFR in T2DN patients.

Quality of life improvement in dry eye patients after intense pulsed light therapy compared to punctal plugs.

The purpose of the study was to evaluate the quality of life (QOL) improvement in evaporative dry eye patients after treatment with intense pulsed light (IPL) therapy compared to punctal plug insertion. A prospective comparative interventional study included 30 patients with moderate-to-severe evaporative dry eye. Patients' QOL affection before and after treatment was assessed by the Ocular Surface Disease Index (OSDI) questionnaire. Fifteen patients were treated with IPL therapy (Group 1). The other 15 patients were treated with silicone punctal plug insertion (Group 2). Improvement of patients' QOL was noticed in all patients of Group 1, with significant improvement of OSDI score from a mean value of 56.9 to 22.9 (P = 0.001). Improvement was noticed in 80% of Group 2 patients (mean OSDI score pretreatment: 53.8 and posttreatment: 31.7, P = 0.017). The tear breakup time (TBUT) in Group 1 significantly improved from a mean of 3.2 s to 5.9 s (P = 0.001), whereas it showed no significant changes in Group 2 (mean TBUT pretreatment: 3.6 s and posttreatment: 3.9 s, P = 0.654). Complications occurred in 13.3% in Group 2, including punctal granuloma and proximal canalicular obstruction. No adverse effects were recorded in Group 1. IPL therapy had better results with more improvement of patients' QOL compared to punctal plugs. It also showed a better safety profile with no reported complications.

High‐intensity physical activity seems to be associated to a higher basal parasympathetic activity and to a reduced OSDI score in young adults

Aims/Purpose: To identify if the habitual practice of physical activity is associated to the basal parasympathetic activity and to dry eye disease‐related symptoms.Methods: Eleven adults (82% women; age: 30.7 ± 4.9 years; BMI 22.2 ± 1.9 kg m−2) responded the Ocular Surface Disease Index (OSDI), the Dry‐Eye 5 (DEQ5) and the International Physical Activity (IPAQ) questionnaires. Subsequently: a) the inferior tear meniscus height (ITMH) and the automated non‐invasive break‐up time (NIBUT) of both eyes; b) the heart rate variability (Polar H10 chest band; Kubios HRV software) and, simultaneously, the Schirmer test; and, c) the tear film break‐up time (BUT) were measured. Correlational analyses were performed among the measured variables.Results: The total weekly physical activity was of 3420 ± 3302 metabolic equivalents (MET) min−1 week−1, with a weekly high‐intensity physical activity (HIPA) of 567 ± 661 MET min−1 week−1. The OSDI score was 14.1 ± 8.3, the DEQ5 score was 7.2 ± 4.8, the ITMH was 229.3 ± 40.7 (OD) and 252.7 ± 51.2 (OS) μm, the NIBUT was 8.5 ± 5.7 (OD) and 8.8 ± 6.1 (OS) s, and the BUT was 9.7 ± 4.1 (OD) and 8.3 ± 3.9 (OS) s. Two surrogates of the parasympathetic activity (the PNS index, and the root‐squared mean of successive standard deviations, RMSSD) showed values of 0.762 ± 1.899 and 60.1 ± 37.8 ms, respectively. The HIPA showed a direct correlation with the parasympathetic activity surrogates (r = 0.784, p = 0.004, PNS index; r = 0.737, p = 0.009, RMSSD). Similarly, the HIPA showed an inverse correlation with the OSDI (r = −0.759, p = 0.006) and the DEQ5 (r = −587, p = 0.07). No other correlations were found, neither among the HIPA nor among the parasympathetic surrogates with the ITMH, the NIBUT, the BUT or the Schirmer test.Conclusions: These preliminary results suggest that in young subjects HIPA seems to be associated to an increased basal parasympathetic activity and to a reduced perception of dry‐eye symptomatology.

The Effect of Vidian Neurectomy on the Ocular Surface - The Primary Results from a Six-Month Pilot Study.

To evaluate the effect of vidian neurectomy (VN) on the ocular surface and the possibility of dry eye in the treatment of allergic rhinitis. Twelve participants were recruited in this prospective study. Prior to and after 1 and 6 months of VN, an ocular surface disease index (OSDI) questionnaire was obtained, and the Schirmer's tear test (STT), break-up time (BUT), corneal fluorescence staining (CFS) score, and Keratograph 5M were used to evaluate the ocular surface condition. Two patients (16.67%) met the dry eye diagnosis criteria one month after surgery; however, their symptoms were relieved after to 3-4 months and none of them met the diagnostic criteria for dry eye after six months. Compared with the baseline values, the STT was significantly reduced (P=0.002), while the tear meniscus height (TMH) (P=0.262), break-up time (BUT) (P=0.916), first keratographic tear film break-up time (NK-BUTfirst) (P=0.791), and average keratographic break-up time (NK-BUTave) (P=0.970) did not change significantly 6 months after surgery. The degree of STT decreased from baseline to 6-month and was related to the basic STT (ρ= 0.837, P=0.001) and sex (ρ= -0.584, P= 0.026) but not to age, OSDI score, BUT, NK-BUTfirst, NK-BUTave or CFS (all P>0.05). Among these factors, STT at baseline was confirmed to be a predictor of a decline in tear secretion after surgery (B = 0.731, P<0.001). In this 6-month prospective pilot study, decreased tearing was observed after VN, but this decrease did not increase the possibility of dry eyes.

Comparison of a single-dose vectored thermal pulsation procedure with 5-day course of daily oral azithromycin for meibomian gland dysfunction.

This study aims at comparing the efficacy of a single-dose vectored thermal pulsation (VTP) procedure versus 5 days once daily oral azithromycin in patients with meibomian gland disease (MGD) by measuring the symptomatology and ocular surface parameters. The study was conducted as a prospective, nonrandomized, comparative study over a period of 17 months at a tertiary care center. In this study, 60 patients with MGD were enrolled after they gave their informed consent according to the inclusion-exclusion criteria and were divided into two groups, 30 each in the azithromycin group and the VTP, i.e., the LipiFlow group. One group was treated with oral azithromycin for 5 days and the other group was given LipiFlow treatment. Postprocedure, follow-up was done for 2 weeks, 3 months, and 6 months. A statistically significant difference was noted in the score Standard Patient Evaluation of Eye Dryness questionnaire after 3 months of treatment in both the azithromycin and LipiFlow group (P < 0.0001), and the LipiFlow group showed sustained improvement at 6-month follow-up as score improved to 8.83 ± 2.32, whereas it deteriorated in azithromycin group to 13.77 ± 1.65. Pretreatment Ocular Surface Disease Index score (P = 0.126) and posttreatment (P < 0.0001) showed significant differences in both groups. The LipiFlow group showed an improved score of 25.65 ± 6.11 after 6 months of treatment, whereas it deteriorated to 34.79 ± 4.98 in the azithromycin group. Pretreatment, tear film break-up time (P = 0.28) and 6 months posttreatment score (P < 0.0001) showed significant differences in both groups, but in the LipiFlow group, it improved to 15.30 ± 1.76 after 6 months, whereas in the azithromycin group, it was 10.07 ± 1.60. The pretreatment MG score was 4.10 ± 0.99 and 4.23 ± 1.07 (P = 0.62) in the azithromycin and LipiFlow group, respectively. After 2 weeks, 3 months, and 6 months, the MG score was 24.20 ± 3.38, 21.67 ± 3.46, and 15.83 ± 2.41, respectively, in azithromycin group. In the LipiFlow group, the score was 13 ± 1.88, 14.27 ± 2.07, and 14.37 ± 1.85 at 2 weeks, 3 months, and 6 months, respectively, suggestive of improvement in all visits. Both oral azithromycin and LipiFlow treatment are effective in patients with MGD. The effect of LipiFlow treatment lasted longer as compared to azithromycin. The efficacy of azithromycin in resolving the symptoms of MGD was greater compared to LipiFlow in the initial 2 weeks of treatment. However, the effect deteriorated in the subsequent follow-up at 3 months and 6 months.

Autologous serum eye drops for patients with dry eye disease: a systematic review and meta-analysis of randomized controlled trials.

Dry eye disease (DED) is highly prevalent worldwide, leading to increased medical costs, economic burdens on families and society, and a diminished quality of life for patients. The utilization of autologous serum eye drops (ASEDs) for the treatment of DED is progressively rising. To further evaluate the efficacy and safety of ASEDs in the treatment of DED. A thorough search for randomized controlled trials (RCTs) was conducted across eight databases, including PubMed, EMBASE, the Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wanfang, SinoMed, and VIP. This search encompassed the inception of each database up to April 1, 2024, with a specific focus on identifying RCTs evaluating the efficacy and safety of ASEDs for the treatment of DED. Data analysis was conducted utilizing Stata 15.0 software and the Cochrane Risk of Bias Assessment Tool was utilized to appraise the literature's quality. The study encompassed 12 RCTs. In comparison to the use of artificial tears (AT), patients diagnosed with DED who utilized ASEDs displayed elevated the Schirmer test (ST) scores [WMD = 2.35, 95% CI (1.45, 3.24), p < 0.001] and tear-film breakup time (TBUT) scores [WMD = 2.83, 95% CI (2.27, 3.39), p < 0.001], decreased Corneal fluorescence staining (CFS) scores [SMD = -2.11, 95% CI (-3.07, -1.15), p < 0.001] and the Ocular Surface Disease Index (OSDI) scores [WMD = -10.54, 95% CI (-13.31, -7.77), p < 0.001], and experienced a reduced frequency of adverse events [RR = 0.36, 95% CI (0.13, 0.99), p = 0.048]. In this study, ASEDs had been shown to enhance tear secretion, extend tear film break-up time, mitigate corneal epithelial damage, ameliorate OSDI scores, and exhibit greater safety compared to AT.

Comparison between 100% autologous serum and 100% platelet‐rich plasma eye drops and their impact on the treatment efficacy of dry eye in primary Sjogren syndrome

Purpose: The aim of the study was to compare the difference in the composition of 100% autologous serum (AS) and 100% platelet‐rich plasma (PRP) eye drops and assess their impact on the clinical out‐comes after the treatment of severe dry eye (DE) in primary Sjogren Syndrome patients (pSS).Methods: 22 patients with severe DE in pSS were treated with 100% AS (22 eyes) and 100% PRP (22 eyes) eye drops 5 times per day as monotherapy. The quantification of growth factors (GFs) as fibroblast growth factor (FGF), epidermal growth factor (EGF), vascular endothelial growth factor (VEGF), platelet‐derived growth factor (PDGF), nerve growth factor (NGF), transforming growth factor (TGF‐b), insulin‐like growth factor(IGF), fibronectin and substance P in hemoderivates was performed. The main outcomes: Ocular Surface Disease Index (OSDI), Best Corrected Visual Acuity (BCVA), the Schirmer test, tear break‐up time (TBUT), corneal and conjunctival staining according to the Oxford scale, conjunctival hyperaemia and Meibomian gland parameters. The results were compared at the baseline, 1 and 3 months after the treatment. The clinical results were correlated with the concentration of GFs.Results: Significant differences were observed in the concentration of FGF, EGF, fibronectin, VEGF, PDGF AB, NGF, PDGF, substance P, TGF‐β in PRP compared to AS. There was a statistically significant improvement in BCVA, the Schirmer test, TBUT, Meibomian gland parameters, and the reduction of the OSDI scores, Oxford staining and conjunctiva hyperaemia in each group. There were many correspondences between the level of GFs and the mean change of the clinical outcomes. No adverse events were reported.Conclusions: Despite the fact that blood derivatives differ in their composition, they seem to be effective, safe in the treatment of severe DE in pSS patients. The signs and symptoms of DE were reduced in both groups. The obtained clinical results and the composition of hemoderivates may indicate the superiority of PRP in relieving the signs and symptoms of DE in pSS patients.

Impact of TearCare on Reading Speed in Patients with Dry Eye Disease.

To evaluate the impact of TearCare (TC) treatment on clinical, quality of life, and functional visual outcome metrics in patients with dry eye disease (DED) and meibomian gland disease (MGD). This is a prospective, single-center clinical trial. Adults with MGD and a DED diagnosis and tear break-up time (TBUT) <10seconds were included. All subjects had at least 20/40 vision and no surgery or new treatment for DED within 60 days prior to enrollment. All patients had one baseline visit prior to undergoing TC and one follow-up visit 1 month after TC. At each visit, the meibomian gland secretion score (MGSS), TBUT, and corneal fluorescein staining (KFL) were assessed. DED symptoms were evaluated using the Ocular Surface Disease Index (OSDI) questionnaire, Visual Function Questionnaire 25 (VFQ-25), and the Fatigue Severity Scale. Reading speed was determined through the International Reading Speed Texts (IReST), Minnesota Low Vision Reading Test (MNREAD), and Wilkins Rate of Reading Test (WRRT). Thirty-two subjects were included. The average age was 55.9 years. Sixteen (52%) participants had a clinically significant improvement in reading speed after treatment with TC, defined as >10 words per minute increase in their IReST score. Improvement on the IReST and the MNREAD reached statistical significance (p = 0.012 and p = 0.028, respectively). OSDI scores significantly decreased and VFQ-25 scores significantly increased after TC treatment (p < 0.001). All of the clinical exam parameters showed statistically significant improvements after treatment (p < 0.001). TC is an effective treatment both clinically and with respect to visual function. Patients who had TC exhibited improvements in quality of life and improved reading speed after a single treatment. This treatment should be frequently considered and utilized to reduce the disease burden of DED related to MGD.

Prevalence of Face Mask-Induced Dry Eye and Ocular Irritation Amid COVID-19 Among Health Workers in Jazan

Background: One of the most important defenses against the COVID-19 pandemic is the use of facemasks. Long-term facemask use can result in mask-associated dry eyes. This study explored the prevalence of face mask-associated dry eyes (MADE) and associated factors among health workers in Jazan. Methods: This prospective cross-sectional clinical study was carried out among healthcare workers (Physicians, Dentists, Pharmacists, Technicians, Nurses, and Administrative staff) who wore facemasks during duties at Prince Mohammed Bin Nair Hospital in Jazan, Sudi Arabia, from 2020 to 2022. Two hundred ninety-eight participants were randomly selected. The participants were given a questionnaire about their socio-demographic characteristics, occupational information, health information, and the duration they had used glasses, masks, and technological devices. The daily average quantity of time spent sleeping was also investigated. The severity of dry eye disease was determined using OSDI scores. The chi-square test and Fisher's exact test examined categorical variable connections. Mean differences were calculated using an independent -test. Logistic regression will discover COVID-19 severity predictors. A statistically significant P-value is . Result: Among 298 health workers in this study fulfilling the inclusion criteria. The mean age of the respondents was years old, consisting of 61.3% male and 38.7% female out of 298 respondents whom the majority of them were Saudi (89.6%) and the rest non-Saudi (10.4%). Based on the Ocular Surface Disease Index (OSDI) score, almost half of the respondents (49.0%) obtained an average score in terms of dry eye disease. Only gender and marital status were significantly associated with OSDI score and respectively). From the Health Information provided, most of the variables were significantly associated with the OSDI score. Conclusion: This study concluded that face mask-associated dry eye (MADE) prevalence among health practitioners stands at 51%, partly explaining the worsening dry eye disease symptoms among mask wearers.

Symptomatic dry eye disease among university students.

Dry eye disease (DED) is a multifactorial condition often characterized by a reduction in tear film quantity or quality. This study aimed to determine the frequency of DED and its associated subjective symptoms among students of Mu'tah University. In this cross-sectional study conducted at Mu'tah University, Mu'tah, Jordan, from January to April 2022, 489 students completed an online patient-reported DED symptom questionnaire and the ocular surface disease index (OSDI) questionnaire. Moreover, 106 participants underwent clinical examinations using the Schirmer test I and fluorescein tear breakup time (TBUT). Approximately 74.6% of the students self-reported experiencing DED symptoms, and 72.6% had an OSDI score > 12, which is considered the threshold for an abnormal ocular surface. Clinical examinations revealed low Schirmer test scores ( < 10 mm) in 26.4% (n = 28) and 25.5% (n = 27) of the right and left eyes, respectively. We observed low TBUT scores ( < 5 s) in 19.8% (n = 21) and 18.9% (n = 20) of the right and left eyes, respectively. We noted significant differences between the self-reported DED symptoms and the Schirmer test scores (P = 0.003 for both right and left eyes), TBUT (P < 0.001 for both right and left eyes), and OSDI score (P < 0.001 for each self-reported DED symptom). We observed a weak significant positive correlation between Schirmer test scores and TBUT in the right (r = + 0.30; P = 0.002) and left (r = + 0.34; P < 0.001) eyes; a negligible significant inverse correlation between OSDI scores and Schirmer test scores in the right (r = - 0.24; P = 0.013) and left (r = - 0.23; P = 0.019) eyes; and a negligible significant inverse correlation between the OSDI score and TBUT of the left eye (r = - 0.25; P = 0.011) but not of the right eye (r = - 0.17; P = 0.077). The frequency of DED symptoms in this study was higher than that previously reported based on foreign statistics. The presence of self-reported DED symptoms was significantly associated with higher OSDI scores. Self-reported DED symptoms were more frequent than the abnormalities detected using objective methods. Therefore, a combination of subjective and objective measures may provide higher diagnostic yield for DED. Further studies are required to confirm this hypothesis.

Quantum Molecular Resonance Effects on Patients With Dry Eye Disease: A Randomized Controlled Trial.

The aim of the study was to evaluate the efficacy and safety of quantum molecular resonance in the treatment of dry eye disease. This study was a double-blind randomized control trial in 1 academic medical center, for 2 years. Participants received treatment or a placebo with the Rexon-Eye device, once per week for 4 weeks. The primary outcome was the change in dry eye symptoms assessed by the Ocular Surface Disease Index (OSDI). Secondary outcomes were clinical findings associated with the dry eye such as meibomian gland dysfunction (MGD) score, tear break-up time (TBUT), corneal fluorescein staining, Schirmer test, and best-corrected visual acuity (BCVA). Forty patients were recruited, 20 in each arm. The mean age was 63.5 ± 15.1 years and 27 (67.5%) were female. The mean OSDI score significantly improved in the intervention group from 19.15 ± 10.3 to 10.5 ± 7.0 ( P < 0.001), whereas the control group showed no significant change (14.4 ± 8.4 to 15.5 ± 8.6, P = 0.830). MGD scores significantly improved in the intervention group (1.57 ± 1.2 to 0.8 ± 0.9, P = 0.006), whereas showing no significant change in the control group (1.60 ± 0.9 to 1.99 ± 1.0, P = 0.244). The corneal staining score also showed significant improvement in the intervention group ( P = 0.045) and a nonsignificant decline in the placebo group ( P = 0.50). No significant difference was seen in TBUT, visual acuity, and Schirmer scores between groups. No harm resulting from treatment was reported during the duration of the trial. High-frequency electrotherapy may have a positive effect on symptoms and signs of dry eye. This emerging technology may become part of the arsenal of therapeutic modalities for this condition.

Contralateral eye comparison of the efficacy and safety of two artificial tear formulations for corneal subbasal nerve fiber regeneration after photorefractive keratectomy

Background: Currently, artificial tears (ATs) are the first-line agents for managing dry eye disease (DED). This study compared the efficacy and safety of two different AT formulations, Systane® Hydration (SH) and Systane® Ultra (SU), on symptoms of DED and regeneration of the subbasal corneal nerve fiber length (CNFL) in photorefractive keratectomy (PRK)-treated eyes.&#x0D; Methods: This prospective contralateral comparative study recruited myopic eyes scheduled for PRK, and either SH or SU were administered for up to 3 months postoperatively. All participants underwent a standard comprehensive preoperative ophthalmological examination, in vivo confocal microscopy to evaluate the subbasal CNFL, and completed Ocular Surface Disease Index (OSDI) questionnaire for assessing dry eye symptoms. Image analysis software was used to calculate the subbasal CNFL (micrometer/mm2). Assessments were repeated at the 1- and 3-month follow-up visits. Pre- and postoperative subbasal CNFL and OSDI scores were compared to determine inter- and intra-group differences.&#x0D; Results: Fifty eyes of 25 participants were included in this study. The mean (standard deviation) age of the participants was 22.7 (3.8) years. The OSDI scores for both groups increased significantly at 1 month (both P&lt;0.05), followed by a decrease at 3 months to values comparable to the preoperative scores (both P&gt;0.05). Although OSDI scores were comparable at baseline and at the 1-month postoperative visit (both P&gt;0.05), the SU-treated eyes had a significantly better OSDI score at the 3-month visit (P&lt;0.05), despite being clinically insignificant. Preoperative subbasal CNFL differed significantly between the groups (P=0.001), yet the mean values at both postoperative visits were comparable (both P&gt;0.05). In both groups, subbasal CNFL was significantly reduced at 1 month, followed by a significant increase at the 3-month postoperative visit compared to baseline (all P&lt;0.05). No treatment-related complications were observed at the end of the study period.&#x0D; Conclusions: No significant difference was found between the preoperative and 3-month postoperative OSDI scores in the SH- or SU-treated eyes. Subbasal CNFL regeneration indicated a positive effect of both ATs, with a longer mean CNFL noted in the SH-treated eyes at the final visit. This suggests that SH may be a better option for improving corneal reinnervation after PRK. These observations must be verified in further trials with longer follow-up periods and larger sample sizes.

Dry eye in mind: Exploring the relationship between sleep and ocular surface diseases.

Dry Eye Disease (DED) is regarded as the most common ocular surface disease worldwide, entailing symptoms that have a major impact on the physical and psychological well-being of DED patients. In this context, the impact of sleep quality on DED has recently attracted attention. Indeed, although little is known about the mechanisms underlying the relationship between sleep and ocular surface diseases, recent evidence suggests that a reciprocal relationship exists between sleep quality and DED. Aim of the study was to investigate such relationship by means of both survey-based and instrumental analysis in a large population. The present cross-sectional study included 1182 DED patients who completed the Insomnia Severity Index (ISI) and the Ocular Surface Disease Index (OSDI) questionnaires. Moreover, tear break-up time (TBUT) and ocular surface staining (OSS) data of included patients were collected by physicians. According to the findings of this study, in DED patients, the severity of dry eye symptoms and signs, assessed by OSDI score, TBUT, and ocular surface staining, is associated with more severe insomnia symptoms. Furthermore, higher severity of DED symptoms seems to be associated with the occurrence of nocturnal awakenings rather than with problems in falling asleep. Present work contributes to the understanding of the complex relationship between DED and insomnia by showing that in a large population of DED patients, the more severe the insomnia, the more severe the DED symptoms and signs.

Ocular surface changes in primary open-angle glaucoma on anti-glaucoma medications versus treatment-naïve patients.

To examine the ocular surface disease in primary open-angle glaucoma (POAG) patients already on treatment versus POAG patients without treatment. A prospective cohort study was conducted on 120 eyes of 60 POAG patients: 60 treatment-naïve eyes (group I) and 60 eyes already on topical anti-glaucoma medications (AGMs) (group II). All patients had filled out the Ocular Surface Disease Index (OSDI) questionnaire and underwent a comprehensive glaucoma workup. Tear break-up time (TBUT) test, Schirmer's test (type I), corneal sensitivity, anterior segment-optical coherence tomography (AS-OCT), and corneal and conjunctival staining were done at day 1, 1 month, 3 months, 6 months, and 12 months follow-up. On presentation, TBUT, Schirmer's test, tear meniscus height (TMH), and tear meniscus depth (TMD) were significantly higher in group I compared to group II. No significant difference was noted in OSDI score, corneal sensitivity, and tear meniscus area (TMA) between the groups on presentation. Both, lissamine green and rose bengal staining, had higher grades in group II compared to group I. Worsening of ocular surface disease was noted in both groups on follow-up. OSDI score, TBUT, Schirmer's test, TMH, and TMD had better values in group I in comparison to group II on follow-up. The study has identified glaucoma patients on AGMs to be more affected by dry eye disease (DED) compared to treatment-naive glaucoma patients. We found statistically significant differences in values of TBUT, Schirmer tests, lissamine and rose bengal staining, and AS-OCT parameters at baseline and 3, 6, and 12 months follow-up. OSDI scores showed significant differences at 6 and 12 months of follow-up. We recommend consideration of evaluation and management of DED/ocular surface disease in glaucoma patients on topical AGMs, particularly multiple drugs and doses.

Assessment of mask associated dry eye among doctors and medical students at a tertiary care centre

When faced with outbreaks of infectious respiratory diseases in the past, the use of face masks has often been mandated. The world collectively experienced the devastating COVID-19 pandemic, which originated in Wuhan, China, in October 2019 and rapidly spread across the globe. Wearing face masks became the primary defense against infection. However, during this period, many individuals reported experiencing symptoms of dry eye. This study aimed to investigate the correlation between mask usage and dryness among healthcare workers.A hospital-based cross-sectional study was conducted using an online survey, which included a modified version of the Ocular Surface Disease Index (OSDI) questionnaire. Electronic consent was obtained to gather information about the occurrence of dryness while wearing masks.Among the 284 participants, females exhibited a higher OSDI score (12.5) compared to males. Notably, individuals with pre-existing dry eye conditions had a significantly higher OSDI score (23.96) when wearing face masks. Across different age groups, no significant variations were observed. In terms of the duration of face mask use, those who wore masks for less than 4 hours and more than 6 hours had an OSDI score of 12.5, whereas individuals wearing masks for 4 to 6 hours had a score of 8.3.Wearing face masks may pose a risk for dryness, particularly among females, and can exacerbate dryness symptoms in individuals with pre-existing dry eye conditions.

Isotretinoin-Related Eye Dryness in Acne Patients in Qassim, Saudi Arabia.

Background Isotretinoin is a commonly prescribed agent mainly used to treat acne vulgaris. Since its Food and Drug Administration (FDA) approval, the subject of its associations with various medical conditions has become a growing interest in many investigational studies. Methodology A retrospective study was conducted using the validated Standardized Patient Evaluation of Eye Dryness (SPEED) questionnaire. All statistical calculations were performed using the Statistical Package for the Social Sciences (SPSS)version 27.0.1 (IBM SPSS Statistics, Armonk, NY). Results The research study involved 107 participants, predominantly Saudi nationals (98.1%), with an average age of 22 years. Regarding the total cumulative dose (TCD), 40.2% had less than 50 mg/kg, 33.6% had between 50 and 100 mg/kg, and 15.9% had more than 100 mg/kg. The majority (73.8%) did not stop using isotretinoin. The average Ocular Surface Disease Index (OSDI) score, indicating ocular surface disease symptoms, was 26.78. There was no significant association between gender, dose/duration of isotretinoin, TCD, and age, and OSDI scores. However, participants with severe OSDI scores were more likely to have worsened pre-existing eye symptoms compared to those with non-severe OSDI scores (35.1% versus 11.4%, p = 0.011). Conclusions This study contributes to the understanding of the impact of isotretinoin usage on ocular surface health. While no significant associations were found between gender, dose, duration, TCD, and age, and OSDI scores, participants with pre-existing eye symptoms were more likely to experience worsened symptoms during isotretinoin treatment.

Allogeneic mesenchymal stem cell therapy for dry eye disease in patients with Sjögren's syndrome: A randomized clinical trial

PurposeThis double-blinded randomized clinical trial aimed to evaluate the efficacy of injecting allogeneic adipose-derived mesenchymal stem cells (ASCs) into the lacrimal gland (LG) for the treatment of dry eye disease (DED) secondary to Sjögren's syndrome (SS). MethodsFifty-four participants with severe DED secondary to SS were included and allocated to either ASCs (n = 20), vehicle (n = 20), or a non-randomized observation group (n = 14). The intervention groups received a single injection of either ASCs or an active comparator (vehicle, Cryostor® CS10) into the LG in one eye, while the observation group received lubricating eye drops only. The primary outcome measure was changes in Ocular Surface Disease Index (OSDI) score and secondary outcome measures were non-invasive tear break-up time, tear meniscus height, Schirmer's test, and Oxford score within a 12-month follow-up. ResultsA significant reduction in OSDI score was observed in the ASCs and vehicle groups compared to the observation group. In addition, the ASCs group demonstrated a significant increase in non-invasive tear break-up time compared to the vehicle group at the 4-week follow-up and to the observation group at the 12-month follow-up. A significant improvement in ocular surface staining, tear osmolarity, and Schirmer test score from baseline was also observed in the ASCs group; however, these changes were not significant compared to the other groups. ConclusionImprovement of subjective and objective signs and symptoms of DED was observed in both intervention groups following injection into the LG compared to the observation group. Future studies should investigate the mode-of-action of both injection treatments.