Schirmer Test Research Articles

Evaluation of Ocular Surface Parameters and Systemic Inflammatory Biomarkers in Hazelnut Harvesters

ABSTRACT Aim To assess the relationship between systemic inflammation markers and ocular surface parameters in hazelnut harvesters. Material and Method This prospective study included 30 patients presenting with moderate ocular surface diseases during the hazelnut harvesting season. A detailed ophthalmological examination was performed during the harvesting season and the first month after the end of treatment (control). Schirmer test, tear break-up time (TBUT), and ocular surface disease index (OSDI) scores were determined. In complete blood count analysis, in addition to the evaluation of inflammatory cells, the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) were calculated. Results Eosinophil percentage had a high level of negative correlation with the TBUT and Schirmer values and a high level of positive correlation with the OSDI score during the hazelnut picking season (r = –0.727, r = –0.735, r = 0.750, respectively). During the hazelnut harvesting season, the NLR and SII parameters had a moderate level of negative correlation with the TBUT (r = –0.29 and r = −0.276) and Schirmer (r = –0.33 and r = −0.298) values and a moderate level of positive correlation with the OSDI score (r = 0.389 and r = 0.264). Conclusion In hazelnut harvesters, ocular allergy and inflammation may be associated with systemic biomarkers.

5 Janus Kinase 1/2 inhibition Effect on Cytokine Levels in Tears of Patients with Ocular Graft Versus Host Disease

OBJECTIVES/GOALS: The goal of this study is to identify if ocular graft versus host disease (oGVHD) patients treated with a systemic JAK inhibitor have a change in their tear cytokine profile (a possible bio-marker) and oGVHD score. oGHVD is a severe inflammatory dry eye disease and major cause of morbidity after a hematopoietic stem cell transplant. METHODS/STUDY POPULATION: Janus Kinase (JAK) is an upstream regulator of cytokine production. A JAK 1/2 inhibitor, Ruxolitinib, was recently FDA approved for the treatment of chronic GVHD. We propose that JAK inhibition results incytokine changes in tears and improvement of oGVHD. To study this, we will quantify tear cytokines in patients with oGVHD, with and without systemic JAK inhibition treatment. Patients with ‘definite’ oGVHD based on the international chronic oGVHD diagnostic criteria (ICOGVHD) whom we have collected tears will be grouped based on JAK inhibition treatment. Tear cytokines are analyzed using Iso spark Meteor bulk quantitative proteomic analysis. RESULTS/ANTICIPATED RESULTS: Seven patients were identified from our patient cohort who met inclusion criteria (oGVHD; tears collected while on Ruxolitinib), five patients were identified whom we have collected tears with oGVHD who have not taken ruxolitinib. The following 10 cytokines will be analyzed in the tears by the Iso spark Meteor bulk quantitative proteomic analysis: GM-CSF, IFN-g, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-17A, TNF-a. The change in cytokine levels will be compared with the ICOGVHD score, corneal fluorescein staining, schirmers test (measurement of tear production), conjunctival injection score, ocular surface disease index score (validated symptomatic score of dry eye disease). DISCUSSION/SIGNIFICANCE: OGVHD is a major cause of morbidity for patients who undergo a hematopoietic stem cell transplant and is the result of a highly complex immune process including dysregulation of pro-inflammatory cytokines. It is critical to understand the effect of cytokine changes on the eyes to potentially identify a biomarker and possible treatment targets.

Effect of Isotretinoin Treatment on Tear-Film Status and Ocular Surface Disease Index Score in Patients with Acne Vulgaris

Purpose: To determine tear film stability, tear secretion, volume, and dry eye symptoms according to the duration of isotretinoin use in treating acne vulgaris. Materials and Methods: In this cross-sectional comparison study, dry eye measurements were taken for 60 participants from patients who were diagnosed with acne vulgaris and were treated with isotretinoin from the dermatology clinic at Tishreen University Hospital-Lattakia during the period 2022-2023. The sample was examined before using isotretinoin, after a month and a half, and after three months. The sample underwent eye examinations that included the Schirmer 1 test, a tear film break-up time (BUT) examination using a slit lamp device, and Ocular Surface Disease Index (OSDI). Results: We noticed an increase in the intensity of dry eye as the duration of use increased, with statistically significant differences regarding the mean values of the tear film breakdown time (BUT) test, as it became less with the increase in the duration of isotretinoin (p=0.0001). The OSDI also showed an increase in the intensity of dryness as the duration of isotretinoin use increased, with statistically significant differences (p=0.0001). The Schirmer1 decreased as the duration of isotretinoin increased, with statistically insignificant differences regarding the mean values of the Schirmer1 test, as it became less as the duration of isotretinoin increased (p=0.07). Conclusion: The intensity of dry eye increases with the increasing duration of isotretinoin use in treating acne vulgaris in a statistically significant manner.

Peripheral hypertrophic subepithelial corneal opacification - Role of tear secretion, medication and systemic diseases.

Peripheral hypertrophic subepithelial corneal opacification (PHSCO) is a corneal disease that may severely affect vision. The major goal of this study was to test the hypothesis that tear secretion, medication and systemic diseases are associated with PHSCO. This is a retrospective, case-control study conducted at the Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz. We analysed medical records of patients diagnosed with PHSCO. Sex, age, Schirmer's test II, general medication and medical history were assessed and compared to an age- and sex-matched control group from the Gutenberg Health Study (GHS). One hundred ninety-five eyes of 112 patients with PHSCO were included. Eighty-eight patients were female with a mean age of 55.3 ± 14.7 years (23-89 years) and 24 patients were male with a mean age of 59.3 ± 12.6 years (38-84 years). In 83 patients (74.1%) both eyes were involved. The Schirmer's test II was significantly reduced in patients with PHSCO compared to the GHS control group (p < 0.001). Patients with PHSCO were more frequently administered artificial tears and steroid eye drops (p < 0.001) and were more hyperopic than healthy controls (p = 0.01). Systemic diseases or medication did not differ markedly between PHSCO and healthy controls. Reduced tear secretion and more frequent use of artificial tears in patients with PHSCO suggest a link between PHSCO and dry eye disease. The results of the study do not support our hypothesis that PHSCO is associated with systemic diseases. Interestingly, patients with PHSCO were less frequently on β-blockers than control subjects.

Frequency of dry eye syndrome in patients with multiple sclerosis: A cross-sectional case-control study

Introduction: Demyelination of the nerve fibers of the central nervous system is a main pathology of multiple sclerosis (MS), in which inflammation plays a major role. Studies have shown that inflammation is the leading cause of dry eye disorder. To investigate the association between inflammation and both diseases, we aimed to estimate the prevalence of dry eye syndrome (DES) in MS patients and its correlation with the severity of the disease and disability status. Methods: We enrolled 100 MS patients randomly and 100 healthy controls. DES was evaluated by Dry Eye questionnaire and Scoring System (DESS), tear break-up time (TBUT), tear meniscus height (TMH), and Schirmer 1 &amp; 2 tests in subjects. Furthermore, the leading disability in MS was assessed by a clinician (neurology professor) using the related questionnaire (Expanded Disability Status Scale). Results: According to the TBUT, THM, and Schirmer tests, the number of subjects with abnormal results was significantly higher in the MS group than in the control group. The severity of DES measured by the DESS was also higher in the MS group compared to control group. Also, there was a significant relationship between increasing disability and abnormal dry eye tests, especially in MS patients with EDSS scores&gt;4. Conclusion: The present study highlights the importance of considering dry eye disorder in MS patients as a possible consequence of inflammation. Also, our results suggested a significant relationship between dry eye disorder and the EDSS scores.

WIDENING OF THE NIKTITAN MEMBRANE IN THE EYE OF DOMESTIC CATS WITH CHLAMYDIOSIS SUSPECT

Feline chlamydiosis or chlamydia is an infection caused by a bacterial organism. A local cat named Mio, male, orange and white, aged about 4 months, weighing 1.2 kg, had complaints of sneezing, red eyes and runny nose in the left eye since 2 weeks ago. The condition of the eye has gotten worse since a week ago with the white membrane covering the eyeball. Respiratory examination showed abnormal results, namely the case cat experienced sneezing and had a serous discharge. On examination the eye looks swollen and there is a mucopurulent discharge. The pupil reflex of the left eye is not visible because the nictitan membrane covers almost the entire eyeball. The Schirmer test showed that the case cat was producing excessive tears. Examination using an ophthalmoscope, the pupil of the cat's eye in the left case was not detected due to being covered by a shifting nictitating membrane. the fluorescen test showed a negative result, which means that there was no ulcer on the cornea. CBC examination results showed that the cat had leukocytosis and thrombocytosis. The case cat was diagnosed with dilation of the nictitating membrane and unilateral conjunctivitis with suspected chlamydiosis. Therapy is carried out by administering antibiotics, anti-inflammatory drugs, and vitamins. Evaluation on the 8th day after administration of therapy showed slightly improved results. In the left eye inflammation has started to improve. In addition, the mucus in the left eye also began to decrease. We recommend that treatment of case cats be continued for up to 3 weeks and a PCR test should be carried out so that the cause of infection in case cats can be known for sure.

Neuropathic Corneal Pain: Tear Proteomic and Neuromediator Profiles, Imaging Features, and Clinical Manifestations

To investigate the tear proteomic and neuromediator profiles, in vivo confocal microscopy (IVCM) imaging features, and clinical manifestations in neuropathic corneal pain (NCP) patients. Cross-sectional study. Twenty NCP patients and twenty age-matched controls were recruited. All subjects were evaluated by corneal sensitivity, Schirmer's test, tear break-up time, corneal and ocular surface staining, Ocular Surface Disease Index and Ocular Pain Assessment Survey questionnaires, as well as IVCM examinations for corneal nerves, microneruomas, epithelial and dendritic cells. Tears were collected for neuromediator and proteomic analysis using enzyme-linked immunosorbent assay and data-independent acquisition mass spectrometry. Burning and sensitivity to light were the two most common symptoms in NCP. A total of 188 significantly dysregulated proteins, such as elevated metallothionein-2, creatine kinases B-type, vesicle-associated membrane protein 2, neurofilament light polypeptide, and myelin basic protein, were identified in the NCP patients. The top 10 dysregulated biological pathways in NCP include neurotoxicity, axonal signaling, wound healing, neutrophil degradation, apoptosis, thrombin signaling mitochondrial dysfunction, RHOGDI and P70S6K signaling pathways. Compared to controls, the NCP cohort presented with significantly decreased corneal sensitivity (P<0.001), decreased corneal nerve fiber length (P=0.003), corneal nerve fiber density (P=0.006), nerve fiber fractal dimension (P=0.033), as well as increased in corneal nerve fiber width (P=0.002), increased length, total area and perimeter of microneuromas (P<0.001, P<0.001, P=0.019), smaller corneal epithelial size (P=0.017), and higher nerve growth factor level in tears (p=0.006). These clinical manifestations, imaging features, and molecular characterizations would contribute to the diagnostics and potential therapeutic targets for NCP.

The prevalence of dry eye in patients with psoriasis attending a tertiary care hospital in western Maharashtra

: Psoriasis affects 0.5–11.4% of adults. Psoriasis is caused by a complicated chain of immune cells and cytokines, containing tumour necrosis factors (TNF), interleukin (IL)-17, 22, and 23. Psoriasis causes systemic inflammation, which can cause arthritis, cardiovascular disease, and metabolic syndrome. Our study explores dry eye in Western Maharashtra's psoriasis patients at a tertiary care hospital. A tertiary care hospital outpatient dermatology and ophthalmology department psoriasis patients were included in a cross-sectional research. Patient ages spanned from 20 to 60 years. The anterior and posterior ocular segments were examined, and dry eye was assessed. OSDI, Schirmer's test, TBUT, and corneal and conjunctiva staining has been scored. The PASI score has been received. Degree of dry eye was assessed using Dews dry eye grading system. Dry eye was present in 63.1 percent of people. Cases included 24.4% with mild dryness in their eyes. Moderate dryness made up 46.3% of cases, and severe dryness made up 29.3% of cases. The PASI score and dry eye did not have a statistically significant connection (P=0.355). A PASI score of 10 to 25 indicated the most severe case of dry eye, followed by a score of 10 (29 eyes) and &amp;#62;25. (23 eyes). A total of 81.5 percent of eyes had abnormal OSDI scores, 56.2 percent had abnormal TBUT scores, and 49.2 percent had abnormal Schirmer Test results. Dry eye in psoriasis patients requires dermatologist-ophthalmologist teamwork for comprehensive therapy. Psoriasis, especially in long-lasting cases, can lead to meibomian gland dysfunction.

Comparative efficacy of cyclosporine 0.1%, rebamipide 2%, and carboxymethylcellulose-cyclosporine 0.05% combination eye drops in the management of dry eye disease among the Indian population

This comparative research study aims to evaluate and compare the results of three different eye drop formulations of Cyclosporine 0.1%, Rebamipide 2%, and a combination of Carboxymethylcellulose &amp; Cyclosporine 0.05%, in treating dry eye cases among the Indian population. This investigation employed a randomized controlled trial design to assess the efficacy of three distinct eye drop formulations. A total of 120 patients diagnosed with dry eye disease participated in this study. Participants were assigned to one of three treatment groups: Group C (cyclosporine 0.1%), Group R (rebamipide 2%), or Group CC (combination of carboxymethylcellulose and cyclosporine 0.05%). Patients take prescribed medication for six weeks. Patients were evaluated at baseline for tear production time (TFBUT) at two weeks, four weeks, and six weeks, tear production score using the Schirmer test, and dry eye symptoms were assessed with the Ocular Surface Disease Index (OSDI). The collected data were analyzed using appropriate tests to compare the effectiveness of three eye drop formulations in treating dry eye in the Indian population. : Disease improvement compared to baseline was seen in all groups based on scoring of Schirmer's score, OSDI score, and TBUT. : All three treatment groups demonstrated improvements in tear film stability, tear production, and a reduction in dry eye symptoms over the six-week treatment period. However, further research with larger sample sizes and longer treatment durations is needed to establish the long-term efficacy and compare the effectiveness of these treatments.

Usefulness of Schirmer's tear strips and borosilicate glass tubes in chemical analysis of human tear fluid: A practical check in VEGF detection.

Human tears contain a number of agents which may play an important role in diagnosing local eye disorders as well as systemic diseases. The small amount of fluid obtained during the collection and the consequent difficulty in analysing it are the main problems encountered in the diagnostic process. We decided to investigate the practical usefulness of two simple methods of collecting tear fluid for chemical analysis, i.e., glass tubes and Schirmer's strips. The substance analyzed was vascular endothelial growth factor (VEGF), a compound commonly recognized in ophthalmology. We used standard Schirmer's tear test and calibrated glass tubes for tear fluid collection in healthy volunteers. The standard ELISA assay was used to check the effectiveness of the tear sampling by estimating the VEGF level. The results of the study show that Schirmer's tear strip test is a more effective tool of the two. Moreover, using Schirmer's strips to obtain tear fluid was found to be more patient friendly and amounts of the tear fluid collected with that test were enough and better for the VEGF detection. Our study indicates that the widely used Schirmer tear test may be the best method of tear collection for chemical analysis. However, further studies on test calibration are needed.

Effect of Mingmu nourishing cream on asthenopia

Purpose: To assess the therapeutic efficacy and safety of Mingmu nourishing cream in asthenopia. &#x0D; Methods: This study retrospectively analyzed data from 124 patients who were treated for asthenopia in the Affiliated Hospital of Shanxi University of Traditional Chinese Medicine, China from January 2015 to January 2018. Patients were divided into control group (n = 63; received conventional eye drops) and study group (n = 61; received Mingmu nourishing cream in addition to control group treatment). The ocular symptom scores and tear secretion test (Schirmer's I test (SIT)) were compared between the two groups before and after treatment. Furthermore, the clinical efficacy of Mingmu nourishing cream in the treatment of asthenopia was evaluated. &#x0D; Results: The differences in SIT, conjunctival congestion classification and ocular symptoms between the two groups after treatment were statistically significant (p &lt; 0.05). Moreover, the rate of total therapeutic efficacy in the study group was 86.9 % (53/61), which was significantly higher than the control group (p &lt; 0.05). &#x0D; Conclusion: Mingmu nourishing cream significantly improves symptoms and exhibits favourable tolerability profile. Multi-center large sample study is needed for further verifications of the findings of this study.

Effect of atmosphere on the tear film layer

Aim: to demonstrate the effect of the atmosphere (heat and humidity) on the eye by comparing the outdoor and indoor workers. Method: 120 eyes of 60 subjects volunteers from the Saudi electrical company (SECO), their age range was 24 to 40 years. The Schirmer strips test and break up time test were used to evaluates tear film quantity and quality. Result: The results demonstrate that there is a statistical significant difference in tear film quantity and quality between the outdoor and indoor subjects using the Schirmer test and break up time test. Conclusion: This study show the effect of atmosphere heat and humidity on the tear film layer, and the results demonstrate that there significant difference in the tear film quantity and quality between the outdoor and the indoor subjects.

Efficacy and safety of trigeminal parasympathetic pathway stimulation for dry eye: A systematic review and meta-analysis.

This study aimed to investigate the efficacy and safety of trigeminal parasympathetic pathway (TPP) stimulation in the treatment of dry eye. A comprehensive search for randomized clinical trials was performed in seven databases (MEDLINE, Embase, CENTRAL, etc.) up to 28 February 2023. After screening the suitable studies, the data were extracted and transformed as necessary. Data synthesis and analysis were performed using Review Manager 5.4, and the risk of bias and quality of evidence were evaluated with the recommended tools. Fourteen studies enrolling 1714 patients with two methods (electrical and chemical) of TPP stimulation were included. Overall findings indicate that TPP stimulation was effective in reducing subjective symptom score (standardized mean difference [SMD], -0.45; 95% confidence interval [CI], -0.63 to -0.28), corneal fluorescence staining (mean difference [MD], -0.78; 95% CI, -1.39 to -0.18), goblet cell area (MD, -32.10; 95% CI, -54.58 to -9.62) and perimeter (MD, -5.90; 95% CI, -10.27 to -1.53), and increasing Schirmer's test score (SMD, 0.98; 95% CI, 0.65 to 1.31) and tear film break-up time (SMD, 0.57; 95% CI, 0.19 to 0.95). Compared to inactive or low-activity stimulation controls, it has a higher incidence of adverse events. Therefore, TPP stimulation may be an effective treatment for dry eye, whether electrical or chemical. Adverse events are relatively mild and tolerable. Due to the high heterogeneity and low level of evidence, the current conclusions require to be further verified.

Does Radioactive Iodine Treatment Damage the Lacrimal System?

In this prospective study, we aimed to make a quantitative assessment of the lacrimal glands before and after radioactive iodine (RAI) treatment in patients with hyperthyroidism and thyroid cancer. The study included 80 eyes of 40 patients. There were 25 patients in group 1 (hyperthyroid group) and 15 patients in group 2 (thyroid cancer group). Group 1 has received low dose ( 131 I) and group 2 high dose ( 131 I). Before, and at the first and sixth month after RAI treatment, all patients underwent ophthalmological examinations, Schirmer tests, TBUT tests, tear osmolarity (TO), and ocular surface examinations. The age and sex characteristics of both groups were similar. Although no significant change was observed in tear film tests before and after treatment in group 1, a significant decrease in Schirmer and TBUT values and a significant increase in TO were observed in group 2 in the first month after treatment. These values returned to normal in the sixth month. Although no Schirmer test was observed lower than 10 mm in any patient before RAI treatment, the Schirmer test was measured 5 to 10 mm in 4 (10%) patients in group 2 in the first month after treatment. Again, in these patients, TBUT was below 10 seconds and TO was greater than 308 mOsm/L. In this study, although no change was observed in tear function tests in patients receiving low doses of RAI, a decrease in tear secretion and an increase in TO were detected in patients receiving high doses in the early period.

New Korean Guidelines for the Diagnosis and Management of Dry Eye Disease.

New Korean guidelines for the diagnosis and management of dry eye disease were developed based on literature reviews by the Korean Dry Eye Guideline Establishment Committee, a previous dry eye guideline by Korean Corneal Disease Study Group, a survey of Korean Dry Eye Society (KDES) members, and KDES consensus meetings. The new definition of dry eye was also proposed by KDES regular members. The new definition by the regular members of the KDES is as follows: "Dry eye is a disease of the ocular surface characterized by tear film abnormalities and ocular symptoms." The combination of ocular symptoms and an unstable tear film (tear breakup time &lt;7 seconds) was considered as essential components for the diagnosis of dry eye. Schirmer test and ocular surface staining were considered adjunctive diagnostic criteria. The treatment guidelines consisted of a simplified stepwise approach according to aqueous deficiency dominant, evaporation dominant, and altered tear distribution subtypes. New Korean guidelines can be used as a simple, valid, and accessible tool for the diagnosis and management of dry eye disease in clinical practice.

Formulation and evaluation of the effects of ophthalmic nanoemulsion of Nigella sativa seed extract on atropine-induced dry eye in mice

BackgroundNigella sativa L. seed from the Ranunculaceae family, whose many therapeutic effects have been stated in recent research, is one of the herbs with known anti-inflammatory effects. Nigella sativa L. seed may have therapeutic effects on dry eye, a disease that manifests with symptoms of redness, burning, foreign body sensation, and sensitivity to light. Aim of the studyTo evaluate the effects of Nigella sativa L. seed extract nanoemulsion on atropine-induced dry eye in mice. Material and methodsThe hydro-alcoholic extract of the Nigella sativa seed was prepared using the maceration method (10% w/w). Subsequently, by using Tween 20 and Tween 80 surfactants with different ratios, the desired nanoemulsion was achieved. DLS, Zeta potential, TEM, and FT-IR tests were used to determine the size and morphology of nanoparticles.A total number of 36 adult male mice were used in this study divided equally into six groups, each receiving a different compound according to the protocol with three groups receiving therapeutic nanoemulsion eye drops daily. Tear production was evaluated by Schirmer's test and reported as a ratio to the first-day tear production on days 1, 7, and 14. ResultsAccording to the investigations by the DLS method, the Nanoparticles' size was reported 10.4 nm. The TEM image revealed that the nanoparticle of Nigella sativa seed extract emulsion has a spherical shape with an approximate size of 10 nm. Zeta test results in -37.6 mv, which was evaluated as sufficient quality. The final composition of nanoemulsion was chosen as 5 % of Nigella sativa seed extract, 75 % of water, and 20 % of surfactant with a ratio of 1:4.Schirmer's test results indicated that the highest dose of nanoemulsion (1 %) resulted in the most significant amount of tear production, compared to lower doses (0.5 % and 0.1 %) and the control group. ConclusionThis study showed that Nigella sativa seed extract nanoemulsion has a potentially positive effect on the amount of tear production in atropine-induced dry eyes. Thus, the employment of this nanoemulsion should be considered in the treatment of dry eye.

Varenicline solution nasal spray for dry eye disease in Chinese patients: a randomized phase 3 trial

Dry eye disease has a high prevalence and exerts a significant negative effect on quality of life. In China, there are currently no available nasal sprays to promote natural tear production in patients with dry eye disease. We therefore evaluated the efficacy and safety of OC-01 (varenicline solution) nasal spray versus vehicle in Chinese patients with dry eye disease. This was a randomized, multicenter, double-masked, vehicle-controlled, phase 3 clinical trial conducted at ophthalmology departments in 20 hospitals across China (NCT05378945). Eligible patients had a diagnosis of dry eye disease based on patient symptoms, Eye Dryness Score (EDS), Schirmer's Test (with topical anesthesia) Score (STS), and corneal fluorescein staining (CFS) score. Participants were randomly assigned 1:1 using an Interactive Web Response System (IWRS) to receive OC-01 0.6mg/mL twice daily (BID) or vehicle nasal spray. Participants, investigators, and sponsor were all masked to treatment assignment. The primary endpoint was the percentage of subjects in the intention-to-treat population achieving ≥10mm improvement in STS from baseline at week4. In total, 340 patients were randomized from 21 July 2022 to 04 April 2023, 78.8% were female. Patients in the OC-01 group (n=176) had significantly higher achievement of ≥10mm improvement in STS (35.8% [n=63] versus 17.7% [n=29], stratified odds ratio: 2.67, 95% CI: 1.570-4.533, p=0.0002) and a significantly greater increase from baseline STS (least-squares mean difference [SE]: 3.87 [0.794], p<0.0001) at week 4 versus the vehicle group (n=164). In addition, OC-01 led to a numerically greater reduction in mean EDS from baseline at week 4 compared to the vehicle group (LS mean [SE] difference:-1.3 [2.20]; 95% CI:-5.64 to 2.99, p=0.5467). The most common adverse event was mild, transient sneezing (78% of OC-01 administrations). No serious adverse events related to nasal administration occurred. OC-01 (varenicline solution) nasal spray BID has clinically meaningful efficacy for reducing the signs (as measured by STS) and may improve the symptoms (as measured by EDS) of dry eye disease, with an excellent safety and tolerability profile, in the Chinese population. Jixing Pharmaceutical Co. Ltd.

Vision-Related Quality of Life in Patients with Systemic Lupus Erythematosus.

To assess vision-related quality of life (VRQoL) in patients with systemic lupus erythematosus (SLE) under treatment with hydroxychloroquine (HCQ), and to find the influencing factors. Cross-sectional study enrolling SLE patients for less than ten years (Group 1), SLE patients for more than ten years (Group 2), and healthy controls (Group 3). SLE patients should be under treatment with HCQ but without ophthalmological affection. Schirmer test, best-corrected visual acuity (BCVA), axial length (AL) with optical biometry, and swept-source optical coherence tomography-angiography (OCTA) Triton (Topcon) were performed. All participants fulfilled the Impact of Visual Impairment questionnaire, and SLE patients answered the Lupus Impact Tracker (LIT) questionnaire. Additional data were obtained from clinical records. A totals of 41 eyes (41 patients), 31 eyes (31 patients) and 45 eyes (45 volunteers) were enrolled in the study groups. The mean ages were 41.09 ± 9.56, 45.06 ± 8.47 and 40.25 ± 10.83 years, respectively (p = 0.10). The LIT outcomes were 33.49 ± 20.74 and 35.98 ± 22.66 (p = 0.63), respectively. Group 3 referred to a better VRQoL than Group 2 in all categories and than Group 1 in some of them. A linear regression analysis showed that serum ferritin, SLE activity scales, body-mass index (BMI), age, and BCVA influenced VRQoL. The LIT questionnaire was correlated to two categories of the Impact of Visual Impairment questionnaire (IVI). Despite no ophthalmological affection, SLE patients refer to poorer VRQoL because of disease activity and a low health-related quality of life, which has a negative influence on VRQoL. This masks the effect of other ophthalmological conditions such as dry eyes. Other variables influencing VRQoL are age and BMI, and BCVA, to a lesser extent.

Ocular surface changes in patients who have undergone head and neck radiation therapy.

Dry eye syndrome (DES) is a familiar sequelae of radiation therapy (RT) for head and neck cancers (HNC). Ocular surface changes such as DES occur due to injury to the conjunctival epithelium, goblet cells, corneal surface, lacrimal glands, and meibomian glands. This study aimed at the evaluation and early detection of changes in ocular surface parameters in patients receiving RT for extraocular HNC. Forty-two eyes of 21 patients undergoing HNC RT were evaluated. Radiation technique and dose of radiation to the lens and eye were recorded. Subjects were evaluated for meibomian gland changes by meiboscore grading, ocular surface disease index (OSDI) questionnaire, Schirmer's test, tear film break-up time (TBUT), and slit-lamp examination before RT, immediately post RT, and 6 weeks post RT. A comparison of the ipsilateral eye on the irradiated side to the contralateral eye was done. A significant reduction in TBUT was seen immediately post RT and 6 weeks post RT ( P < 0.001 and 0.008, respectively), with an increase in meiboscore at both visits ( P < 0.001). An OSDI score of >13 was seen in 23.80% of patients post RT, with a significant difference from baseline ( P < 0.001). On comparing ipsilateral and contralateral eye groups, a significant difference from baseline was seen in TBUT ( P < 0.001 and 0.033, respectively) and meiboscore ( P < 0.001 for both eyes). A significant change of >1 second in TBUT and >1.7 in meiboscore was seen with a mean dose of around 8 Gy to the lens. All patients undergoing HNC RT should be followed up for ocular surface and meibomian gland changes. The contralateral eye should also be evaluated. Patients receiving lower doses to the ocular structures should also be kept under follow-up.

Two-Year Progression of Dry Eye Disease in Dry Eye Assessment and Management Study.

The purpose of this study was to evaluate the progression of dry eye disease (DED) symptoms and signs over 2 years through a secondary analysis of data collected from the Dry Eye Assessment and Management study. Participants who were assigned to omega-3 fatty acid in the first year were rerandomized in the second year to either continue with omega-3 fatty acid or switch to placebo. At baseline, 3, 6, 12, 18, and 24 months, DED symptoms were evaluated by using the Ocular Surface Disease Index and the Brief Ocular Discomfort Index (BODI). DED signs were assessed using conjunctival staining, corneal staining, tear break-up time, Schirmer testing, and keratography measures. Medication usage was documented at each visit. Because the treatment and placebo groups displayed no statistical differences in both signs and symptoms, data from the 43 participants were combined to assess longitudinal changes in symptoms and signs. At 3 months after omega-3 fatty acid treatment, there were significant improvements from baseline in Ocular Surface Disease Index and Brief Ocular Discomfort Index scores (all P ≤ 0.002) and less use of artificial tears or gel ( P = 0.02), but between 3 and 24 months, no significant changes in symptoms and treatments were observed ( P ≥ 0.06). Except for a significant improvement in conjunctival staining score over 2 years ( P = 0.001), there were no significant sign changes in corneal staining ( P = 0.32), tear break-up time ( P = 0.43), Schirmer test ( P = 0.09), and additional measures (all P ≥ 0.07). We did not observe a progression of DED signs or symptoms over a 2-year period, except for a probable placebo response in symptoms in the first 3 months and an improvement in conjunctival staining score.