Ocular Surface Disease Index Research Articles

The Relationship Between Anxiety Sensitivity, Emotional States, and Dry Eye Disease Symptom Severity: A Cross-Sectional Study

Dry eye disease (DED) is often comorbid with psychiatric conditions and psychological disturbances like anxiety and depression. The psychological symptoms are mostly considered to be a consequence of DED or a side-effect of medication. However, the possible psychological etiology of DED is seldom explored. This study explores the relationship between anxiety sensitivity (AS), unpleasant emotional states, and the severity of DED symptoms in a healthy general population sample in Croatia. A total of 766 adults (62.27% females) aged between 18 and 88 years completed an online survey consisting of the Ocular Surface Disease Index (OSDI), Anxiety Sensitivity Index (ASI), and Depression Anxiety Stress Scales (DASS21) together with socio-demographic data. The results revealed significant positive correlations between ASI, emotional states, and OSDI (r = 0.25–0.29, p < 0.01). Mediation analysis showed that DASS21 significantly mediates the relationship between ASI and OSDI (B = 0.1, CI = [0.004, 0.2]). Highly anxiety sensitive people are more sensitive to DED symptoms, which additionally increases in a state of emotional stress. Thus, DED symptoms are perceived more intensely and frequently than in less sensitive people. Understanding these associations is crucial for comprehensive DED management, indicating potential benefits from addressing psychological health in DED patients and eye health in psychiatric patients.

Role of oral bio-enhanced curcumin in dry eye disease.

To assess the role of oral bio-enhanced curcumin in dry eye disease (DED). Randomized, double-masked, placebo-controlled clinical study conducted at a tertiary eye center. Forty patients of bilateral mild to moderate DED were randomized in two groups - group A (topical carboxy methyl cellulose QID + oral placebo) and group B (topical carboxy methyl cellulose QID + oral bio-enhanced curcumin). The objective parameters of DED were quantified at baseline and compared at 3 months follow-up. At three months follow-up, there was significant improvement in curcumin group in terms of Ocular Surface Disease Index (OSDI) score (P = 0.002), tear meniscus height (TMH) (P = 0.002), tear volume (P = 0.006), tear break-up time (TBUT) (P < 0.001), non-invasive break-up time (NIBUT) (P = 0.026), lipid layer thickness (LLT) (P = 0.01), and decrease in bulbar redness (P = 0.002). There was no significant improvement in limbal redness (P = 0.097), corneal-staining score (P = 0.93), and Schirmer's test (P = 0.42). Mild adverse drug reaction was observed in three cases of the curcumin group and one case of group A. Oral bio-enhanced curcumin is a safe and effective treatment modality in cases of mild to moderate DED. It effectively improves the tear film stability, LLT, and TMH and reduces the bulbar redness.

Durability of Treatment with a Thermomechanical Device in Meibomian Gland Dysfunction: An Observational Extension Study.

Purpose: To evaluate the durability of thermomechanical device treatment effect in patients with meibomian gland dysfunction (MGD) at 6 months post-treatment. Methods: This was an extension of an initial 3-month, prospective, controlled, randomized, masked, multicenter pivotal study, in which subjects with MGD were randomized to thermomechanical device treatment (3 sessions, 2 weeks apart) or a single control treatment. The extension study was a single-arm, observational study in the same 5 sites of the pivotal study. A subset of subjects from the thermomechanical device group with an increase in tear break-up time (TBUT) of 2.5 s or greater in at least 1 eye at 1- or 3-month follow-up and able to attend the 6-month follow-up were included. Effectiveness endpoints included changes in TBUT, Meibomian gland score (MGS), and Ocular Surface Disease Index (OSDI) from baseline to 6 months. Device-related adverse events (AEs) were also assessed. Results: At 6 months post-treatment, 21 subjects (42 eyes) demonstrated significant improvements from baseline in mean TBUT (5.2 ± 3.8 s; P < 0.001), mean MGS (18.2 ± 10.9; P < 0.0001), and mean OSDI (-24.3 ± 26.5; P = 0.0004). Improvements in corneal staining scores were also observed. No ocular AEs were reported. Conclusions: The findings of the extension study demonstrate that the clinical benefit of the thermomechanical device, evaluated by TBUT, MGS, and OSDI, can be maintained out to 6 months and that the device is safe and effective in improving the signs and symptoms of evaporative dry eye disease in MGD.

Alterations in tear function and meibomian gland dysfunction across various phenotypes of polycystic ovary syndrome

The aim of this study was to investigate the relationship between tear function changes and meibomian gland dysfunction in various phenotypes of polycystic ovary syndrome (PCOS). In this prospective case–control study, 4 separate case groups were formed for 4 different phenotypes of PCOS, which are variants of clinical presentation. A total of 160 women were included in the study, 32 women for each group and 32 healthy women as control group. Ocular surface disease index (OSDI), Oxford score for corneal and conjunctival involvement, Schirmer 1 and 2 tests, noninvasive tear breakup time (NIBUT), lower lid meibomian drop-out grades by non-contact meibography, and meibomian gland disease (MGD) distortion and shortening scores were compared between all groups. When the PCOS group was compared with the control group, phenotype A showed the most significant differences in NIBUT (p = 0.003), MGD (p = 0.002) and OSDI (p = 0.004). Although the mean Schirmer 1 and Schirmer 2 tests value were lower in the PCOS group compared to the control group, no significant difference was detected in any phenotype (p = 0.911, p = 0.117). A statistically significant weak negative correlation was observed between NIBUT and OSDI values (r = − 0.206, p = 0.027). There was a statistically significant positive and very weak correlation between OSDI and BMI (r = 0.079, p = 0.041). Tear film instability attributed to MGD was found to be significantly different in all PCOS patients compared to healthy subjects regardless of phenotype, and this difference was statistically higher in phenotype A.

A pilot study of morphological features of the eyelid margin with conjunctival goblet cells and MUC5AC in tear film of dry eye.

This study aimed to investigate the morphological features of eyelid margin in dry eye patients and determine their correlations with conjunctival goblet cells, MUC5AC secretion, and clinical tests of tear film. Patients diagnosed with dry eye disease (DED) were asked to complete the evaluations of symptoms and signs of dry eye, including Ocular Surface Disease Index (OSDI) questionnaire, Lipid layer thickness (LLT), partial blinking (PB) rate, tear-film breakup time (TBUT), Schirmer's I test (SIt), and meiboscore. Marx line (ML), lid wiper epitheliopathy (LWE), and meibomian orifices (MOs) were used as indicators of morphological features of the eyelid margin. PAS staining of conjunctival goblet cells and MUC5AC measurementof the tear samples were also performed. A total of 30 patients diagnosed with DED were included. The ML score was correlated with the SIt. The MOs showed a significant negative correlation with the TBUT and LLT. The LWE was corrected to TBUT and meiboscore, and also associated with decreased conjunctival goblet cell density and MUC5AC concentration in the tear film rather than ML and MOs in the eyelid margin of dry eye patients. The tear MUC5AC concentration had a significant positive correlation with conjunctival goblet cell density. The eyelid margin is crucial for maintaining the integrity of tear film and ocular surface. Attracting more attention to the eyelid margin is beneficial to routine clinical practice, and lid wipers could be used to evaluate the secretion of MUC5AC in the tear film secreted by conjunctival goblet cells.

Optimising the methodology for assessing tear meniscus height using digital imaging.

To determine the optimum method for assessing tear meniscus height using digital imaging. The tear meniscus of 38 participants (mean age 32.5±10.6years, 45% male) was video recorded three times, each for a period of five seconds following two natural blinks using the Oculus Keratograph 5M, first with infrared and subsequently with visible (white) light. Still images at 0.5s intervals from the last blink, up to 5s, were extracted from the video recording and the lower eyelid tear meniscus height was measured using ImageJ at seven locations; immediately below pupil centre and at 1mm, 3mm and 6mm, nasally and temporally. Dryness symptoms were assessed with the Ocular Surface Disease Index (OSDI) and tear film stability with non-invasive tear breakup time with the Oculus Keratograph 5M. A significant difference in the tear meniscus height was measured with infrared (0.29±0.08mm) compared to white light (0.27±0.08mm; p<0.001). Tear meniscus height increased significantly with repeated measurement (first: 0.27±0.08mm; second 0.27±0.08; 0.28±0.09; p=0.005). In each case, following a significant decrease immediately after a blink, the tear meniscus height was stable between 1.0 and 2.5s and increased thereafter (p<0.001). A consistent tear meniscus height measurement was achieved by measuring within 1mm of the pupil midline, but increased more peripherally (p<0.001). Differences in height, while statistically significant, were not clinically significant except in the peripheral measurements. Tear meniscus height should be measured in a consistent manner, either with infrared or white light. A single measurement from the top of the meniscus to the eyelid margin within 1mm of the pupil midline, from an image captured 1.0 to 2.5s after two blinks, is sufficient.

Comparison of non-invasive and fluorescein tear film break-up time in a 65-year-old Norwegian population: a cross-sectional study

ObjectivesMeasurement of tear film stability is central in dry eye disease (DED) diagnosis. In this study, we aimed to compare the performance of two methods of tear film stability measurement:...

The prevalence of dry eye disease symptoms and its association with screen time in young adults aged 21–30 years

AbstractPurposeTo investigate the correlation between dry eye disease (DED) symptoms and academic performance in young adults aged 21–30 years, as well as to determine the relationship between screen time and DED symptoms.MethodsA total of 454 young adults, between 21 and 30 years of age, were initially enrolled in the study. Data collected included age, sex, grade point average (GPA), hours of contact lens wear, degree of compliance with the 20–20–20 rule, response to the Ocular Surface Disease Index (OSDI) questionnaire, as well as screen time for studying and engaging in social media activities. Spearman correlation analysis was conducted to investigate the relationship between DED symptoms and academic performance, screen time and contact lens usage.ResultsA total of 445 participants were included in the analysis, with 99.3% (n = 442) exhibiting DED symptoms (OSDI ≥13). The mean (standard deviation) OSDI score was 76.91 (17.89). Additionally, only 17.0% of participants adhered to the recommended 20–20–20 rule during screen usage. Mean daily screen time was 9.84 (3.73) h, with 2.97 (2.34) h for social media and 6.93 (3.48) h for study. OSDI scores were significantly correlated with study screen time (rs = 0.12, p = 0.01) and social media usage (rs = 0.13, p = 0.01), but not with GPA (rs = −0.07, p = 0.16) or contact lens daily wearing time (rs = 0.05, p = 0.43).ConclusionsThe prevalence of DED symptoms was found to be high amongst young adults. This study revealed a significant association between the duration of screen time and DED symptoms in this population. Prolonged screen exposure, both for academic purposes and social media engagement, was linked with more severe manifestations of DED. Notably, no significant correlation was observed between academic performance and DED symptoms in young adults.

Efficacy of 0.05% cyclosporine A on tear inflammatory cytokines and goblet cell function after corneal refractive surgery

BackgroundCorneal refractive surgeries offer rapid vision correction, while dry eye disease remains a common postoperative complication that significantly impacts patients' quality of life. The etiology of postoperative dry eye is multifactorial. Cyclosporine A (CsA) has been employed in the treatment of dry eye due to its ability to suppress T cell-mediated immune responses and reduce inflammation. The present study was designed to assess the early effect of 0.05% cyclosporine A (CsA) eye drops on tear film stability, ocular surface inflammation and goblet cell function in patients following corneal refractive surgery.MethodsOne hundred forty-four eyes of 72 participants undergoing corneal refractive surgery were enrolled and randomized into additional 0.05% CsA eye drops treated group or conventional schedule treated group. Ocular Surface Disease Index (OSDI), relevant ocular surface clinical parameters, tear inflammatory cytokine levels, conjunctival impression cytology, and gene expression of Keratin 7 (KRT-7) as well as Mucin5AC (Muc5AC) in conjunctival epithelial cells were measured before surgery (baseline) and at 1 month after surgery. All indicators and their changing value were compared against baseline or across different groups.Results0.05% CsA treatment exhibited greater changes in OSDI, NIBUT, LLT and CFS in the early postoperative period (P = 0.004, P = 0.002, P = 0.032, P = 0.008). Compared to control group, there was a more significant decrease in IFN-γ and TNF-α levels in tear fluid in CsA group after surgery (P = 0.012, p = 0.032). Additionally, KRT-7 and IFN-γ showed recovery in conjunctival cells with 0.05% CsA treatment (P = 0.003, P = 0.019). The postoperative KRT-7 and Muc5AC levels were negatively correlated with corresponding IFN-γ levels in tear fluid among all subjects (r = -0.200, p = 0.016; r = -0.229, p = 0.006).ConclusionsFor patients undergoing refractive surgery, the application of 0.05% CsA suppressed the expression of inflammatory cytokines such as IFN-γ and TNF-α, and preserved goblet cell function. These effects ultimately contribute to maintaining ocular surface stability and alleviating dry eye related symptoms during the early postoperative period following refractive surgery.

Prospective Sham-Controlled trial: acupuncture for symptom-relieving in patients with Sjögren's disease.

This study aimed to assess the clinical efficacy of acupuncture in relieving sicca symptoms of SjD. A prospective, single-center, randomized, double-blind, controlled trial was conducted on SjD patients experiencing dry eyes and dry mouth. Forty-six patients were randomized and 27 completed the study (acupuncture, n = 15; sham, n = 12). Patients received either acupuncture or sham acupuncture (control) weekly for 8weeks. Key outcomes, including Schirmer test (ST), corneal fluorescein staining score, tear film break-up time, Ocular Surface Disease Index, unstimulated whole salivary flow (UWSF), EULAR Sjögren's Syndrome Patient Reported Index (ESSPRI), Xerostomia Inventory (XI) score, Oral Health Impact Profile (OHIP-14) score, and Challacombe scale, were measured at baseline, immediately after treatment, and 4weeks later. Statistical analysis consisted of comparing outcomes between groups over time. The acupuncture group exhibited significant improvement in total ESSPRI and ESSPRI dryness scores. The positive effects persisted for at least 4weeks after the completion of treatment. Furthermore, the acupuncture group exhibited improvement over time in the ESSPRI fatigue domain, ESSPRI pain domain, OHIP-14, XI, UWSF, and ST. No other statistically significant differences were observed. Acupuncture is effective in relieving dryness in SjD patients. Larger samples and longer observation periods are necessary tobetter understand the effectiveness of this intervention in SjD. (NCT04056221/ 18/02/2019). Key Points • Acupuncture is a low-cost method with few side effects • Acupuncture exerts a symptom-relieving effect in primary Sjögren's disease patients.

The Influence of Time Spent Viewing the Video Display Terminal, Sleep, Anxiety and Depression on the Thickness of the Lipid Layer of the Tear Film.

To investigate the influence of time spent viewing a video display terminal (VDTt), sleep, anxiety, and depression on the thickness of the lipid layer of the tear film (LLT). This is a cross-sectional study. A total of 102 patients were enrolled. Their ocular surface disease index (OSDI), Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire, Pittsburgh Sleep Quality Index (PSQI), Hospital Anxiety and Depression Scale anxiety subscale (HADS-A), and depression subscale (HADS-D) were recorded. The LLT, meibomian gland secretion quality, tear film break-up time (TBUT), conjunctival hyperemia grade, corneal staining score, and VDTt were also evaluated. Spearman analysis was used to analyze the correlation. The patients were divided into the thinner LLT group (LLT < 75 nm) and the thicker LLT group (LLT ≥ 75 nm). The Mann-Whitney U test was used to analyze the characteristics and to compare the two groups. The receiver operating characteristic (ROC) curve was used to predict the relationship between VDTt and LLT. Spearman correlation analysis showed a significant positive correlation between TBUT and average LLT, and significant negative correlations between mean LLT and OSDI, SPEED, meibomian gland secretion quality, conjunctival hyperemia, corneal staining, VDTt, PSQI, and HADS-A. In comparison to the thick LLT group, the thin LLT group had a worse OSDI score, shorter TBUT, longer VDTt, worse PSQI and HADS-A scores. The ROC curve indicated that the optimal cutoff value for using VDT to predict LLT less than 75 nm is 8.25 hours. The thinner LLT had worse questionnaire scores and signs related to dry eye, which indicates that a thinner LLT is more prone to causing dry eye. Using VDTt for more than 8.25 hours is more likely to induce thinning of the LLT, thereby increasing the risk of dry eye. Patients with a sleep disorder and anxiety are more susceptible to thinning of the LLT, suggesting that they are prone to developing dry eye syndrome.

Postoperative Outcomes Regarding Tear Film Changes and Dry Eye Symptoms in Primary Pterygium Excision With Conjunctival Autograft.

To determine changes in tear film characteristics and dry eye symptoms in patients who underwent primary pterygium excision with conjunctival autograft. A prospective, descriptive, analytic study was performed. Patients with primary pterygium who underwent surgical excision with conjunctival autograft were included. Ocular surface disease index (OSDI) test, noninvasive break-up time (NIBUT), lipid layer interferometry, tear meniscus height, and meibomian gland dropout were evaluated preoperatively and at 1 week, 1 month, and 3 months postoperatively. Thirty-three eyes of 31 patients were included, 16 were right eyes, 20 patients were female, and with the average age of 51±9 years. The tear film and dry eye symptom findings before surgery were as follows: OSDI test 36.34±22.04, NIBUT 8.30±1.17 sec, interferometry 53.03±32.32 nm, tear meniscus height 29.90±10.01 mm, superior meibomian gland dropout 24.78%±9.86%, and inferior meibomian gland dropout 22.57%±14.62%. There was a significant decrease in the postop OSDI score to 23.12, as well as tear meniscus height to 24.36 at 3 months postop, and significant improvement in superior (21.03%) and inferior (15.06%) meibomian gland dropout in the final visit. Primary pterygium excision with conjunctival autograft seems to help improve dry eye-related symptoms and tear film characteristics, with a statistically significant change in postop OSDI scores, tear meniscus height, and meibomian gland dropout. Changes in other objective evaluations of tear film characteristics were not as evident.

A prospective self-controlled study on the alterations of the ocular surface and conjunctival transcriptomic profile associated with prolonged exposure to video display terminals.

A prospective self-controlled study on the alterations of the ocular surface and conjunctival transcriptomic profile associated with prolonged exposure to video display terminals.

Adjunct Topical Human Immunoglobulin IgG Therapy in Dry Eye Disease.

The aim of this study was to evaluate the role of topical human IgG eye drops (4 mg/mL) as adjunct therapy in eyes with moderate to severe refractory dry eye disease (DED). A prospective, longitudinal, open label, dual cohort study of patients with chronic DED of moderate to severe grade comprise of OSIG therapy group cohort on topical immunoglobulin IgG 0.4% four times daily, as adjunctive therapy for one year, to study the role of OSIG therapy in comparison with conventional treatment. Patients above 18 years of age with chronic moderate to severe grade DED with tear break-up time (TBUT) ≤7 seconds, Schirmer test ≤9 mm/5 minutes, ocular surface disease index (OSDI) score ≥13, National Eye Institute (NEI) corneal staining score >3, and conjunctival staining score >3 were recruited into the study. Study participants in the conventional treatment cohort group were on topical lubricants four hourly (carboxymethyl cellulose 0.5% and lubricant ointment at bedtime), topical steroids (prednisolone 1%/fluorometholone 0.1%/loteprednol 0.5%) therapy as per the severity of the DED requirement and topical immunomodulators (cyclosporine A 0.1% eye drops or tacrolimus 0.1% eye ointment) twice daily. Study participants in the OSIG treatment cohort group were started on topical human immunoglobulin IgG 0.4% four times daily as adjunct therapy in addition to the all the above-mentioned medications for a period of 12 months. Study parameters included DED severity level assessment, NIH score, ocular surface evaluation tests, Schirmer's I test, TBUT, corneal and conjunctival staining score, OSDI score, and conjunctival hyperemia score. Ocular surface imaging using LipiView and ocular surface analyzer imaging for non-invasive TBUT (NITBUT), meibomian gland, and tear imaging was performed for the OSIG treatment cohort. Study characteristics were evaluated at time of recruitment into the study (baseline visit) and at serial follow-up of months 3, 6, and 12 in OSIG treatment group and follow-up at month 6 in conventional treatment group. Treatment grading score was devised in accordance to the frequency of application of lubricants and steroids and potency of steroids. Our study of 71 eyes of 36 patients [mean age 39 ± 11.80 years] in OSIG treatment cohort group and 64 eyes of 32 patients [mean age 40 ± 11.53 years] in conventional treatment cohort group observed a significant reduction in the objective ocular surface symptom assessment parameters of OSDI scores, and dry eye severity level with improvement in clinical assessment parameters of TBUT, ocular surface staining scores, and conjunctival hyperemia grades in eyes on adjunct OSIG treatment cohort as compared to the conventional therapy cohort. The frequency of topical lubricants and steroids along with the potency of steroids used showed a decreasing trend with 45.28% noted to have become free of steroid dependence at the end of 12 months of OSIG therapy. Adjunct topical IgG therapy also enabled the shifting of 37.14% of eyes from higher to lower potency steroids by the end of 12 months of treatment with OSIG therapy. The frequency of administration of lubricants decreased in 83.33% of eyes 12 months follow-up. The success rate determined based on improvement in ocular surface evaluation was 75.76%, treatment scores improved in 74.98%, and symptoms evaluation (OSDI) was 75.76% in the OSIG therapy cohort. Topical immunoglobulin IgG 0.4% as adjunct therapy seems to have a definitive role in reducing topical steroid and lubricant dependency in moderate to severe chronic DED compared to conventional therapy.

Effect of hematopoietic stem cell transplantation on meibomian gland structure.

Effect of hematopoietic stem cell transplantation on meibomian gland structure.

Comparative evaluation of aqueous solution and oil emulsion formulations of 0.05% cyclosporine eye drops in dry eye disease - A randomized clinical trial.

To compare the clinical response of patients with moderate-to-severe dry eye disease to treatment with 0.05% cyclosporine eye drops as an aqueous solution or oil emulsion. Prospective randomized clinical trial. An institutional study where 88 patients with moderate-to-severe dry eye was enrolled after written informed consent and randomized to receive either aqueous solution (Group 1) or oil emulsion (Group 2) 0.05% cyclosporine eye drops in twice daily dosing in addition to lubricant eyedrop 0.5% carboxymethylcellulose six times/day in both eyes. Comprehensive eye examination and baseline parameters were recorded, and clinical assessment was repeated at 4, 8, and 12 weeks. Parameters evaluated included ocular surface disease index score (OSDI), Schirmer test, tear break-up time (TBUT), corneal fluorescein staining - National Eye Institute (NEI) scoring, lipid layer thickness (LLT), tear meniscus height (TMH), non-invasive tear break-up time (NIBUT), percentage loss of meibomian glands, and impression cytology (number of goblet cells/hpf). The mean age was 39 ± 15.6 years and 42 ± 17.7 years, and the M:F ratio was 26:19 and 20:24 in Groups 1 and 2, respectively. Both the groups showed comparable values at baseline. After treatment, there was statistically significant improvement over baseline values in both groups at 4, 8, and 12 weeks. At 12 weeks for the following parameters, there was no significant difference between the groups, though there was an improvement over baseline in Groups 1 and 2, respectively, as follows: OSDI score - 30.89, 33.28 (P < 0.001), Schirmer test - 5 mm, 4 mm (P < 0.001), TBUT - 2.65 sec, 3.07 sec (P < 0.001), NEI score - 2, 2 (P < 0.001) and the number of goblet cells/hpf - 1.5,9 (P = 0016, P = 0.001). A higher number of patients, by a value of 9, in Group 2 showed an increase in the number of goblet cells/hpf. The NIBUT value showed statistically significant improvement in Group 2 compared to Group 1 (P = 0.011). Group 2 also showed statistically significant improvement in TMH by the 8th week (P = 0.015) and in LLT by the 12th week (P < 0.001). Group 1 comparatively showed earlier improvement in LLT by the 4th week (P = 0.027). Both aqueous solution and oil emulsion 0.05% cyclosporine formulations appear to be equally effective in the management of dry eye disease with a comparatively better response with oil emulsion formulations.

Influence of dendritic cells on corneal nerve morphological analysis and clinical relevance in chronic dry eye disease after femtosecond laser-assisted laser in situ keratomileusis.

This study aims to investigate the influence of dendritic cells (DCs) on corneal nerve morphology and the clinical significance in chronic Femtosecond Laser-Assisted Laser in Situ Keratomileusis (FS-LASIK) related dry eye disease (DED). The cross-sectional study was conducted involving healthy control, DED without FS-LASIK group, and DED after FS-LASIK group. Clinical parameters such as ocular surface disease index (OSDI), fluorescein tear breakup time (FBUT), corneal fluorescein staining (CFS) scores, Schirmer I test (SIt), Cochet-Bonnet esthesiometer (C-BE) were recorded. DCs of in vivo confocal microscopy images were included or excluded during corneal nerve segmentation. Key morphological parameters, including corneal nerve fiber density (CNFD), corneal nerve branch density (CNBD), tortuosity, and box-count fractal dimension (Boxdim), were measured. The impact of DCs on nerve metrics and clinical parameters and the correlations between each other were assessed. The significant reduce in key morphological parameters was observed after eliminating DCs. Significant differences of morphological parameters were observed in DED after FS-LASIK group compared with other two groups. With the increased presence of DCs density in DED especially in DED after FS-LASIK group, the presence of DCs introduced false positives in the correlation analysis of DCs density with corneal morphology in DED after FS-LASIK and in the correlation analysis of corneal morphology with clinical characteristics in DED without FS-LASIK. The presence of DCs introduces significant biases in the assessments of corneal nerve morphology, primarily false-positive results in DED especially chronic FS-LASIK related DED. Their exclusion improves the precision of nerve measurements, which may enhance the clinical evaluation of corneal nerve morphology. These findings highlight the importance of precise segmentation techniques to minimize DCs related interference in clinical practice.

Effect of high and low molecular weight sodium hyaluronic acid eye drops on corneal recovery after crosslinking in keratoconus patients

ObjectiveTo assess the impact of eye drops containing high molecular weight hyaluronic acid (HMW-HA) and low molecular weight hyaluronic acid (LMW-HA) on corneal nerve regeneration, dendritic cell (DC) density, corneal...

Maqui de la Patagonia argentina

Objective. To evaluate oral consumption of a nutritional product called “Maquiphenol humectante” (MH), based on Aristotelia chilensis (fruit known as Maqui), from the Argentinean Patagonia, on the symptoms of dry eye disease (DED) patients. Methods. A prospective, multicenter clinical study was performed, including patients from six ophthalmologic centers of Argentina, between August and November 2024. Patients with DED, who consumed a daily capsule of MH for two months were included. The main parameter to be evaluated was the ocular surface disease index (OSDI). Additionally, tear break up time (BUT) and the Schirmer I test were evaluated. Single factor analysis of variance (ANOVA) was used to compare the differences between means. Results. Fifty-five people participated. The OSDI baseline value was 33.3 ±10.7 (20-30) improved to 20.4 ±7.7 (p&lt;0.001). Baseline BUT was 5.9 ±0.9 seconds (5-7) increased to 6.9 ±1.4 seconds (p&lt;0.01). The Schirmer had no statistically significant change (p: 0.1) although a slight increase was observed from 7.2 ±2.7 mm (2-9); to 8.2 ±2.7 mm (2-10) at 60 days. Conclusion. Consumption of one MH tablet per day for two months improved dry eye symptoms. Studies with a larger number of participants will be necessary to support the present findings.

Relationship between tear film stability, dry eye symptoms, and night driving vision among Malaysian adults

Background Dry eye disease, a prevalent condition globally, affects the quality of the tear film and, subsequently, vision, especially during visually demanding tasks like driving at night. This study aims to evaluate the relationship between tear film stability, dry eye symptoms, and self-reported difficulties in night driving among Malaysian adults. Methods: Ninety participants aged 18-40 years with at least one year of night driving experience were recruited. Tear film stability was assessed using non-invasive tear break-up time (NIBUT), while dry eye symptoms were measured with the Ocular Surface Disease Index (OSDI). Night driving vision difficulties were evaluated using the Vision and Night Driving Questionnaire (VND-Q). Results: Participants with shorter NIBUT (mean = 3.95 ± 1.32 s; median = 3.97 s, IQR: 2.87-5.03 s) reported significantly greater difficulties in night driving compared to those with normal NIBUT (mean = 9.80 ± 3.86 s; median = 8.23 s, IQR: 6.90-11.70 s) (p &lt; 0.001). Similarly, participants with severe dry eye symptoms had higher VND-Q scores (mean rank = 76.75) compared to those with asymptomatic to moderate symptoms (mean rank = 35.68–44.03) (p &lt; 0.001). Spearman’s correlation showed moderate negative associations between NIBUT (r = -0.327), OSDI (r = -0.538), and VND-Q scores. However, there was no significant correlation between NIBUT and OSDI score. Multiple regression analysis revealed that both NIBUT and OSDI significantly predicted the VND-Q score, explaining 43.2% of the variance (p &lt; 0.001). Conclusions: The findings suggest that poor tear film stability and severe dry eye symptoms contribute to night driving difficulties. Future studies should explore interventions aimed at improving tear film stability and dry eye symptoms to enhance driving safety at night.