Tear Break-up Time Test Research Articles

In Vivo Effect of RSH-12, a Novel Selective MMP-9 Inhibitor Peptide, in the Treatment of Experimentally Induced Dry Eye Model

ABSTRACT Purpose To investigate the efficacy of RSH-12, a novel selective matrix metalloproteinase 9 (MMP-9) inhibitor peptide in rabbit models of dry eye syndrome (DES). Methods In vitro toxicity of RSH-12 on cultured human corneal fibroblasts was investigated with MTT. Ocular toxicity of RSH-12 was investigated by clinical examinations, histology, and TUNEL assay. Experimental model of dry eye was induced by 1.0% atropine sulfate administration followed after 15 min by treatment with PBS, RSH-12, and Restasis in individual groups, three times a day for 7 days. In addition to performing Schirmer’s test for evaluating basic tear secretion and tear break-up time test for investigating tear stability, the occurrence of superficial punctate keratopathy was also investigated in the study groups. Results MTT assay demonstrated that RSH-12 was not toxic to human corneal fibroblasts in different concentrations. During the administration of atropine, TBUT values and tear volume were decreased in vehicle group while these indices improved significantly in groups treated with RSH-12 in a promising manner. RSH-12 increased the mean value of tear volume from 4.85 to 10.75 mm (P = .0001) and mean of TBUT values from 20.3 s to 34.5 s (P = .0001) compared with the vehicle. In contrast to the presence of severe superficial punctate keratopathy in the controls, no significant dotted staining was observed in the RSH-12 and Restasis groups. Conclusions These outcomes propose that RSH-12 has a therapeutic effect in the rabbit model of dry eye and might be a potential treatment for severe DES.

Climatic and Environmental Correlates of Dry Eye Disease Severity: A Report From the Dry Eye Assessment and Management (DREAM) Study.

PurposeCorrelate climate, weather parameters, and environmental exposures with the severity of symptoms and signs of dry eye disease (DED) in Dry Eye Assessment and Management (DREAM) study participants.MethodsParticipants from five distinct climates completed the Ocular Surface Disease Index (OSDI) and were examined for corneal and conjunctival staining, tear breakup time (TBUT), and Schirmer's testing at baseline, 3, 6, and 12 months. Climate, weather parameters, and pollutants including ozone (O3), carbon monoxide (CO), nitrous oxides (NO2, NOx, NOy), sulfur dioxide (SO2), particulate matter, and optical depth were obtained from governmental databases. Multivariate analysis and partial correlation coefficients (ρ) were used to assess associations, adjusted for age, sex, and the presence of Sjögren disease.ResultsAmong 535 participants, 81% were female and mean age was 58 years. Participants from the Mediterranean climate demonstrated better corneal fluorescein staining, better TBUT, and higher Schirmer's test scores throughout the calendar year (each P < 0.0001). Greater corneal fluorescein staining was associated with lower humidity (P < 0.0038). TBUT measurements positively correlated with temperature, humidity, and dewpoint and inversely correlated with NO2 levels (P < 0.0038). Paradoxically, some airborne pollutants were associated with less severe signs of dry eye (P < 0.0038). Windspeed was not correlated with signs of DED, and OSDI scores did not correlate with individual environmental exposures.ConclusionsDry eye signs differed between climates and local humidity levels. With the exception of NO2, airborne pollutants were not associated with detrimental dry eye features.Translational RelevanceThese results support limiting dry air exposure for patients with DED.

EFFECT OF PANRETINAL PHOTOCOAGULATION ON CORNEAL SENSATION AND TEAR FUNCTION IN PATIENTS WITH DIABETIC RETINOPATHY.

To evaluate the early effects of panretinal photocoagulation (PRP) on corneal sensation and dry eye signs in patients with diabetic retinopathy. Fifty patients with Type 2 diabetes mellitus and very severe nonproliferative or non-high-risk proliferative diabetic retinopathy who required PRP for the treatment of their retinal condition were enrolled. All patients were treated using a pattern PRP device. Esthesiometry, tear breakup time test, Schirmer test, and corneal staining pattern were evaluated at baseline and 2 months after the last session of PRP. Data from 88 eyes of 50 patients (41 right eyes and 47 left eyes) were analyzed. The mean tear breakup time test (right eyes) was decreased from 9.51 at baseline to 7.66 seconds after PRP (P < 0.001). The post-PRP eyes showed more advanced grades of corneal staining than pre-PRP assessment (P < 0.001). The average value of Schirmer test was 14.39 versus 12.29 mm (without anesthesia; P < 0.001) and 8.17 versus 7.15 mm (with anesthesia, P < 0.001) for baseline versus post-PRP measurements, respectively. The corneal sensation also showed decrease after laser therapy (4.93 versus 4.31 cm; P < 0.001). This study demonstrates that decreased corneal sensation and signs of dry eye are more common immediately after PRP for diabetic retinopathy. These conditions should be discussed with the patient preoperatively and managed postoperatively.

Corneal Sensitivity and Tear Function in Recurrent Corneal Erosion Syndrome.

PurposeTo determine the association of corneal sensitivity and tear functions on the prognosis of eyes after posttraumatic recurrent corneal erosion syndrome (RCES).MethodsPatients were enrolled retrospectively and had unilateral RCES and a history of ocular surface trauma. A corneal sensitivity test and tear function test (tear break-up time and Schirmer test) were performed at three time points (month 1 to month 3, month 3 to month 6, and month 6 to month 12). Depending on the number of recurrences during the follow-up, patients were divided into group A (n > 2) or group B (n = 2). A comparison between diseased and normal fellow eyes in each patient was performed.ResultsA total of 31 patients were enrolled and divided into group A (n = 14) and group B (n = 17). The mean age was 40.3 ± 12.2 years, whereas the mean follow-up was 28.0 ± 3.6 months. During the study period, corneal sensitivity, tear break-up time, and the Schirmer test results were all lower in diseased eyes than in normal fellow eyes in both groups. Compared to the first time point, recovery of corneal sensitivity and the Schirmer test values were observed in diseased eyes in group B at the second and third time points.ConclusionsPoor corneal sensitivity and tear function are associated with posttraumatic RCES. Recovery of corneal sensitivity and tear function may be associated with a reduction of recurrence in eyes with posttraumatic RCES.

Endocrine disrupting chemicals associated with dry eye syndrome

BackgroundDry eye syndrome (DES) is a multifactorial disease that causes changes in the tear film and occurs more frequently in women. Sex hormones (SHs) influence tear production, and SHs imbalance is associated with DES. Endocrine-disrupting chemicals (EDCs) are compounds that can bind to SHs receptors, changing the SHs action in several organs and tissues. MethodsThe levels of 21 EDCs were measured in the urine of DES patients and healthy controls. All individuals were submitted to eye exams for DES and responded to the questionnaire “Ocular Surface Disease Index (OSDI)”. DES was considered present when the OSDI score was >20 and one of the DES tests surpassed the established thresholds. ResultsMethyl-protocatechuic acid (OHMeP), had higher urine levels in DES individuals than in control individuals (p = 0.0189). On the other hand, triclocarban (TCC) exhibited lower urine levels in DES individuals than in control individuals (p = 0.0081). Statistically significant positive associations were found between Methyl Paraben (MeP), EtP (ethyl paraben) and OHMeP with fluorescein staining test; between TCC and Tear breakup time test and between OHMeP and OSDI score. Significant negative associations were found between EtP and OHMeP and schirmer test; between OHMeP and Tear breakup time test; between TCC and the OSDI score and fluorescein and lissamine staining test.The quadratic discriminant function classified 94.4% of individuals in their groups based on the urine levels of EDCs. ConclusionThe following EDCs, MeP, EtP, and OHMeP, were associated with signs and symptoms of DES. TCC had a paradoxical protective effect against DES. These findings suggest that EDCs are associated with DES and the exposure should be included in the investigation of causes and risk factors for DES.

Evaluation of the ocular surface by impression cytology in patients with endometriosis.

The aim of this study was to investigate the effect of endometriosis on the ocular surface. A total of 50 patients were included in the study and divided into two groups. Group 1 consisted of 25 patients with endometriosis. Group 2 had 25 control patients. All patients underwent complete ophthalmic examination, and the right eyes were included in the study. To evaluate the ocular surface, both groups were tested with the following: the Schirmer I test, tear breakup time (TBUT), the conjunctival impression cytology (CIC), and the Ocular Surface Disease Index (OSDI). The results were subsequently compared. The average Schirmer I test results were 8.40 ± 2.74mm in group 1 and were significantly lower in patients with endometriosis (P< 0.001). The average TBUT test results were 9.04 ±3.61s in group 1 and were significantly lower in patients with endometriosis (P< 0.001). The average OSDI results were 24.04 ± 9.29 in group 1 and were significantly higher in patients with endometriosis (P< 0.001). The average CIC results were 1.76 ± 0.88 in group 1 and were significantly higher in patients with endometriosis (P< 0.001). Ocular surface changes, including squamous metaplasia, may be observed in the conjunctiva of patients with endometriosis.

Schirmer’s test and tear breakup time in an Egyptian population sample: a hospital-based study

Background Dry eye is a very common disease in Egypt. Tear film stability and tear secretion are important factors in the assessment of dry eye disease. Schirmer’s test (ST) is used to assess tear secretion, whereas tear breakup time test (TBUT) is used to assess tear film stability.Purpose The aim of this study was to identify the normative data of the ST and TBUT in a sample of Egyptians and to highlight the variables that may significantly affect these values.Patients and methods The study included 150 normal healthy participants. They were divided into different groups according to age, sex, residency, and occupation. History was taken from all participants including ocular surface disease index questionnaire. All participants underwent full ophthalmological examination, ST, and TBUT.Results The mean ST for the population sample was 21.9±9.13 mm, whereas the mean TBUT was 16.04±4.99 s. Studying linear regression for ST with age, sex, occupation, and residency showed that ST was mostly affected by age, where it showed a negative correlation. Studying linear regression for TBUT with age, sex, occupation, and residency showed that TBUT was mostly affected by residency.Conclusion The study allowed us to take an idea about the normative data of ST and TBUT in an Egyptian population and the effect of different variables on both tests.

The effect of conjunctivochalasis detected by anterior segment optical coherence tomography on tear function in an elderly population.

Introduction:The aim of this study was to evaluate conjunctivochalasis (CCH) and its relationship with tear meniscus and tear function in an elderly population.Materials and methods:This prospective, observational study included 144 eyes of 144 patients aged >65 years who were referred to our clinic for various reasons. The patients were separated into group 1 including 64 eyes of 64 patients with CCH and group 2 including 80 eyes of 80 patients without CCH. All patients in both groups underwent a full ophthalmological examination, and the presence of CCH, fluorescein tear break-up time (FTBUT) test, Schirmer test, ocular surface staining (Oxford grading score) and OSDI (Ocular Surface Disease Index) test results were recorded. Measurements of the conjunctivochalasis area (CCHA), tear meniscus height (TMH) and tear meniscus area (TMA) were taken using anterior segment optic coherence tomography (AS-OCT).Results:Group 1 comprised 34 females and 30 males with a mean age of 71.15 ± 12.34 years. Group 2 comprised 43 females and 37 males with a mean age of 68.16 ± 6.05 years (p = 0.122). The CCH rate was 44.4% in all of the examined patients. The OSDI score and the ocular surface staining test were significantly higher (p < 0.05), and the FTBUT, TMH and TMA were significantly lower (p < 0.05) in group 1 than in group 2. The Schirmer I test results were not significantly different between the two groups.Conclusion:The prevalence of CCH is quite high in elderly individuals and may disrupt tear function in these patients.

THE RELATION BETWEEN WATER CONTENT IN CONTACT LENS AND DRY EYE SYNDROME (DES) IN STUDENTS OF ATMA JAYA CATHOLIC UNIVERSITY OF INDONESIA SCHOOL OF MEDICINE AND HEALTH SCIENCES

Introduction: Dry Eye Syndrome (DES) is a multifactorial disease of the eye characterized by loss of homeostasis from the tear film and is accompanied by ocular symptoms. One of many factors that can cause DES is the use of contact lenses. This research was conducted to determine the relationship of water content in contact lenses with the occurrence of DES.&#x0D; Methods: This research was conducted in 2019 with a cross-sectional study design with the Tear Break Up Time (TBUT) test, Schirmer test and questionnaire. The research respondents were students of Atma Jaya School of Medicine and Health Sciences (FKIK UAJ) whose eyes were examined as samples (n = 84). The water content of the respondent's contact lenses was obtained using a questionnaire. The inspection methods used to determine DES are TBUT test and Schirmer test. Data analysis using chi-square test with significance level of p &lt;0.05.&#x0D; Results: The prevalence of DES obtained in students with a water content &lt;50% is 25.9%, while the DES in students with a water content &gt;50% is 25.5% .&#x0D; Conclusion: There is no significant relationship between water content in contact lenses with the occurrence of DES in FKIK UAJ students (p=0.963).

Tear and serum interleukin-8 and serum CX3CL1, CCL2 and CCL5 in sulfur mustard eye-exposed patients

BackgroundThe serum and tear levels of four inflammatory chemokines were evaluated in sulfur mustard (SM)-exposed with serious ocular problems. Materials and methodsIn this study, 128 SM-exposed patients and 31 healthy control participants participated. Tear and serum levels of chemokines were assessed by ELISA method. ResultsThere was no significant difference in the serum level of IL-8/CXCL8, CX3CL1/fractalkine, CCL2/MCP-1, and CCL5/RANTES between all SM-exposed subjects and control groups. The tear level of IL-8 in the SM-exposed group was lower than the control group, but the difference was not significant. In the SM-exposed group with the abnormalities in tear breakup time (TBUT) test, fundus and pannus formation were significantly higher than SM-exposed patients without these problems. CX3CL1 levels have significantly increased in SM-exposed group with blepharitis, pterygium, and conjunctival pigmentation as compared with the control group. Besides, significantly higher levels of CX3CL1 were observed in SM-exposed group with or without bulbar conjunctival hyperemia and abnormal vessels a well as with fundus abnormality compared to the control group. Only, SM-exposed group with subconjunctival fibrosis had significantly lower levels of CCL5 than SM-exposed group without this problem. ConclusionThe higher level of CX3CL1 and consistent levels of IL-8/CXCL8, MCP-1/CCL2, and RANTES/CCL5 in SM-exposed individuals may indicate an anti-inflammatory response against the destructive effects of SM gas. High tear level of IL-8/CXCL8 reflects the severity of ocular surface abnormalities, yet significantly low tear level found in mild SM-exposed subgroup compared with the control group. The lower levels of CX3CL1 and RANTES/CCL5 may represent the different pathophysiology which requires further studies.

A Wide Spectrum of Ocular Manifestations Signify Patients with Systemic Sclerosis

ABSTRACT Objectives: Systemic sclerosis (SSc) is a rare, chronic connective tissue disease involving multiple organ systems, including the eye. We evaluated the detailed clinical ocular manifestations of outpatients with SSc. Methods: Demographics, disease duration and subtype, nailfold capillaroscopy (NFC) patterns and laboratory parameters encompassing the autoantibody profile of 51 SSc patients were evaluated, and a general ocular examination was performed for each participant. Results: Twenty-nine patients (56.86%) had eyelid skin alterations, 26 (50.98%) had retinal abnormalities, 26 (50.98%) had cataracts, 8 (15.69%) had conjunctival changes, 7 (13.73%) had iris abnormalities, 33 (64.71%) suffered from dry eye disease (DED), and 11 (21.57%) suffered from glaucoma. Significant positive correlations were found between NFC data and both tear breakup time and Ocular Surface Disease Index test values. Conclusions: Eyelid skin abnormalities, DED and retinal abnormalities are among the most common SSc-related ocular involvements. Diverse ophthalmic findings are attributed to the heterogeneity of SSc.

Efficacy of the Fluorescein Tear Breakup Time Test in Dry Eye.

To examine the effects of volume and method on fluorescein tear breakup time (TBUT) values and to evaluate test efficacy in an independent sample free of selection bias. Subjects were assessed using a battery of dry eye tests (DETs). Efficacy study: Subjects were randomized to the DET, standard strip, and liquid NaFl on separate days. A masked examiner measured TBUTs from video recordings. Verification study: Subjects were investigated for efficacy using volumes of 5.0 and 2.0 μL mL of NaFl for TBUT. Efficacy study: 46 subjects completed the study. Log-transformed TBUTs were significantly different, normal subjects versus dry subjects, for all 3 methods (all P values < 0.001). Area under the curves (AUCs), cut-points, sensitivity, and specificity were 1) DET: 0.873, 4.4 seconds, 0.97, and 0.67, respectively; 2) 2.0 mL: 0.901, 3.22 seconds, 0.90, and 0.87, respectively; and 3) standard strip: 0.912, 3.42 seconds, 0.97, and 0.80, respectively. Verification study: Data splitting analysis for the 2.0 μL data (n = 174 dry subjects and 97 normal subjects) generated an AUC of 0.917 and a cut-point of 6.05 seconds for a sensitivity of 0.87 and a specificity of 0.81. The 5.0 μL sample yielded an AUC of 0.940, with a sensitivity and specificity of 0.92 and 0.83, respectively, at a cut-point of 5.5 seconds. Little difference in TBUT was found using the 3 clinical methods with video recordings. Analysis using liquid NaFl suggests that the TBUT test has excellent diagnostic accuracy and that a cut-point of 5.3 to 6.0 seconds is the optimum to differentiate normals from persons with dry eye.

Assessment of Ocular Tear Film Stability in Subjects with High Total Cholesterol Levels

AbstractBackground: High cholesterol levels are known to cause multiple complications and the correlations between dry eye disease and high cholesterol levels can be used as an indicator of the need for urgent treatment to prevent severe ocular complications.Aim of Study: This study aimed to assess ocular tear film stability in subjects with high total cholesterol levels by using various dry eye diagnostic tests.Subjects and Methods: Twenty male subjects aged 19-43 years (32.5±7.3 years) with a high total cholesterol level (6.2±0.7mmol/L) and an age-matched control group of twenty male subjects (19-40 years; 31.1±4.6 years) with normal total cholesterol levels (3.9±0.6mmol/L) participated in the study. All subjects completed the ocular surface disease index assessment first, followed by the non-invasive tear break-up time (NITBUT) test. After 10 minutes, the tear meniscus time (TMH) test was performed followed by phenol red thread (PRT) and tear ferning (TF) tests, with a 10-minute gap between the tests.Results: The mean scores (p<0.05) in the NITBUT and TMH tests indicated a dry eye condition in the study group [7.5 (3.3) s and 0.15 (0.12) mm, respectively] and a normal eye condition in the control group [15.3 (4.1) s and 0.27 (0.06) mm, respectively]. The average score for the TF grade (p<0.05) showed eye dryness [2.2 (1.8)] in the study group and a normal eye condition in the control group [0.5 (1.5)]. The cholesterol level showed a medium correlation with age (r=0.473; p=0.035), a strong negative correlation with the PRT score (r=-0.524; p=0.018), and a strong correlation with the TF grade (r=0.530; p=0.016).Conclusion: The total cholesterol level significantly influences ocular tear film stability. Both tear quantity and quality decreased in subjects with high total cholesterol levels, which led to meibomian gland dysfunction and disturbances in lipid production and blood and oxygen supply to eye tissues, thereby causing dry eye symptoms.

Effects of chronic smoking on the meibomian glands.

To evaluate the effects of chronic smoking on tear function tests and meibomian glands. This prospective study included 40 volunteers with a long-term (> 5years) cigarette smoking history (study group) and 43 non-smoking healthy individuals (control group). The symptoms of all the participants were scored using the Ocular Surface Disease Index (OSDI) questionnaire, and a detailed ophthalmological examination was performed including the tear breakup time (TBUT) and Schirmer test (with anaesthesia). The upper and lower lid meibomian glands were evaluated with meibography using the Sirius anterior segment analysis system (Sirius, CSO, Florence, Italy). The groups showed homogenous distribution in respect of age and gender (p > 0.05). The patients in the study group were determined with 22.59 ± 17.25 packet/year cigarette usage. The mean OSDI score was 36.67 ± 21.47 in the study group and 31.65 ± 15.60 in the control group (p = 0.64). The TBUT and Schirmer test values were determined as 9.65 ± 6.14s and 8.90 ± 4.95mm, respectively, in the study group and 11.23 ± 5.94s and 13.08 ± 8.61mm in the control group (p > 0.05). In the upper lid meibography, loss of 24.68 ± 16.54% was determined in the study group and 17.87 ± 7.06% in the control group (p = 0.01). No statistically significant difference was determined between the groups in respect of the lower lid meibomian gland loss: study group 14.70 ± 8.49% versus control group 12.48 ± 6.44% (p = 0.20). Smoking results in meibomian gland damage which may be a risk factor for dry eye. In cases of ocular surface disorders related to chronic smoking, meibomian gland damage should be taken into consideration.

Comparison of Schirmer and Tear Break Up Time (TBUT) Diagnostic Test of Dry Eye Following Phacoemulsification Cataract Surgery

Abstract&#x0D; Background: Phacoemulsification is a technique of modern cataract surgery with smaller corneal incision than conventional techniques but uses various effects on springs that cause dry eye syndrome (DES). DES is a multifactorial defect of tears and ocular surfaces characterized by eye discomfort. Examination of DES can be done by examining Schirmer 1 and Tear Break Up Time (TBUT).&#x0D; Purpose: To determine the accuracy, sensitivity and specificity of the Schirmer test dan TBUT in postoperative patients with phacoemulsification techniques at the Rumah Sakit Khusus Mata Province of South Sumatra.&#x0D; Method: Diagnostic test has been done in order to the accuracy, sensitivity and specificity of the Schirmer test dan TBUT on DES in post operative cataract surgery with phacoemulsification techniques. This study has been conduct Schirmer 1 test and TBUT was done periodically from 1 week, 2 weeks and 1 month after cataract surgery. The data analysis has been done with diagnostic research by SPSS version 20.0 (SPSS, Inc Chicago, Illinois).&#x0D; Result: 40 study samples of post operative cataract surgery with phacoemulsification technique obtained by female sex with 22 out of samples were (55%), with an average age of patients between of 60-70 years.The accuracy of Shirmer 1 and TBUT test was 0,425 and the sensitivity value was 39.5% and also the specificity value was 100%.&#x0D; Conclusion: Schirmer 1 test and TBUT in patients of post cataract surgery with phacoemulsification techniques are specific (100%) but less sensitive (39,5%)

Noncontact Meibography in Patients with Keratoconus.

Purpose To examine the morphological changes in the meibomian glands of patients with keratoconus as well as to study the relationship between these changes in the morphology and several tear film parameters. Methods Examination of the meibomian gland (MG) of 300 keratoconus patients presenting to the center using infrared noncontact meibography system (Sirius, CSO, Italy) between January 2017—January 2019. 100 eyes of healthy individuals were also enrolled as a control group. Tear breakup time (TBUT) test and Schirmer test II were evaluated. Subjective symptoms were also assessed using Ocular Surface Disease Index (OSDI). Results Mean age of keratoconus patients was 19 ± 12 years and 21 ± 14 years in control group. Average TBUT was 4.9 ± 2.1 sec. and average Schirmer test was 5.3 ± 2.2 mm which was significantly lower than control group (p=0.05). Meibomian gland dropout in the lower eyelid of the keratoconus group was as follows: grade 0 (no loss of meibomian glands): 100 eyes; grade 1 (gland dropout area <1/3 of the total meibomian glands): 85 eyes; grade 2 (gland dropout area 1/3 to 2/3): 68 eyes; and grade 3 (gland dropout >2/3): 47 eyes. Conclusion Keratoconus shows significant meibomian gland dropout and distortion that can be recorded by noncontact meibography. Sirius meibography is a simple, cost-effective method of evaluating meibomian gland dropout as a part of the routine refractive examination.

Dry eye disease: A longitudinal study among pregnant women in Enugu, south east, Nigeria

ObjectiveThe objective of this study was to determine the course and prevalence of dry eye disease (DED) across different trimesters among pregnant women in Enugu, South East, Nigeria. MethodsA prospective longitudinal study design was used. Pregnant women attending the antenatal clinic of the University of Nigeria Teaching Hospital, Enugu, were consecutively recruited in their second trimester for the study. DED was assessed subjectively using the Ocular Surface Disease Index (OSDI) and objectively using Tear Break-up Time (TBUT) and Schirmer's test. These tests were performed during the second and third trimesters and six weeks post-partum. Data were analyzed using the Statistical Package for Social Sciences version 20 and repeated measures analysis of variance (ANOVA) was used to compare the means of the different parameters. ResultsA total of 134 pregnant women participated in the study. The mean age of the women was 30.8 (±5.5) years. There were significant decreases (p < 0.05) in TBUT and Schirmer's values in the third trimester compared to the second trimester and the post-partum period. The highest score on the OSDI (18.6 ± 6.8) was obtained in the third trimester. The presence of DED was determined using cut-offs for TBUT <10 s or Schirmer's test <10 mm and the OSDI ≥13. Both symptoms of OSDI and prevalence of DED increased significantly (p < 0.05) from the second to the third trimester but returned to their lowest values 6 weeks post-partum. ConclusionThe prevalence of DED was highest in the third trimester and lowest 6 weeks post-partum.

InflammAging at Ocular Surface: Clinical and Biomolecular Analyses in Healthy Volunteers

To assess the ocular surface in volunteers who consider themselves as healthy, in order to evaluate how para-inflammatory mechanisms fail with age, and thus investigate the phenomenon of "InflammAging." In this observational prospective cohort study, volunteers were categorized into three groups according to age: young (19-40 years), middle-aged (41-60 years), and older adults (61-93 years). Clinical assessments included tear breakup time (T-BUT) and Schirmer test type I. Dry eye symptoms were evaluated by the Ocular Surface Disease Index (OSDI) questionnaire. Conjunctival mRNA and protein expression of intercellular adhesion molecule-1 (ICAM-1), MUC5AC, and IL-8 were measured by real-time PCR and immunofluorescence. A total of 82 volunteers (38 males and 44 females) were enrolled. T-BUT decreased significantly with increasing age (young: 11.13 ± 0.18 seconds; middle-aged: 10.83 ± 0.56 seconds; older: 9.00 ± 1.00 seconds, P < 0.05). Schirmer test values decreased significantly with age (young: 20.6 ± 1.0 mm; middle-aged: 19.2 ± 1.2 mm; older: 16.0 ± 1.1 mm, P < 0.05). OSDI scores increased with age in both groups, but they were substantially higher in women. Conjunctival expression of inflammatory markers ICAM-1, IL-8, and MUC5AC increased with age. Clinical signs, symptoms, and biomarkers of chronic inflammation increased with age in a cohort of volunteers who considered themselves healthy, indicating an age-related progressive impairment of ocular surface system function.

Clinical study on microcirculation changes of bulbar conjunctiva after contact lens wear

Objective: To explore the changes of microcirculation of the bulbar conjunctiva after wearing the contact lens and the relationship between contact lens discomfort and bulbar conjunctiva microcirculation. Methods: Prospective cohort study. The postgraduate students from School of Ophthalmology & Optometry and School of Biomedical Engineering of Wenzhou Medical University were included in this prospective cohort study. The subjects wore soft contact lenses, and the right eye was selected as the experimental eye. The ocular surface disease index (OSDI) questionnaire, Schirmer I and tear break-up time tests were completed before and after wearing the contact lens, and the conjunctival blood flow velocity and microvascular network density were also assessed by using functional slit lamp biomicroscopy. The changes of the indicators after wearing the contact lens were observed and the correlation between the subjective feelings of the wearers and the microcirculation parameters of the bulbar conjunctiva and the main factors affecting the subjective feelings of the wearers were analyzed. Results: Twenty-seven subjects were enrolled in the study, including 8 males and 19 females, aged (22.7±1.6) years. The OSDI score was 11.860± 7.783 before wearing the contact lens and 24.017±12.181 after wearing the contact lens. The comparison before and after wearing the contact lens was statistically significant (t=-4.356, P<0.001). The conjunctival blood flow velocity was (0.534±0.132) mm/s before wearing the contact lens and (0.587±0.134) mm/s after wearing the contact lens. The comparison was statistically significant before and after wearing the lens (t=-2.076, P=0.048). OSDI was positively correlated with blood flow velocity at 1 month after wearing the contact lens (correlation coefficient r=0.383, P=0.048). The test results of the independent variables in the generalized estimating equation model showed that time and blood flow velocity were statistically significant (P<0.05). Conclusions: The blood flow velocity of the bulbar conjunctiva was increased after wearing the contact lens, and the contact lens discomfort of the wearers was positively correlated with the blood flow velocity of the bulbar conjunctiva. (Chin J Ophthalmol, 2019, 55: 98-104).

Evaluation of the Ocular Surface in Different Contact Lens Replacement Schedules.

To evaluate the effects of different contact lens (CL) replacement schedules and different CL materials on the ocular surface and tear function. Daily disposable hydrogel CLs were given to group 1 (n = 22), daily disposable silicone hydrogel CLs were given to group 2 (n = 25), and reusable silicone hydrogel CLs were given to group 3 (n = 24). Tear function tests and inflammatory cytokine [interleukin (IL)-6, IL-8, IL-17A, and matrix metalloproteinase (MMP)-9] levels were evaluated before and at 1 and 3 months after CL usage. Impression cytology was evaluated before and at 3 months after CL usage. At the first and third months of CL usage, a statistically significant difference was determined between the groups in the levels of IL-6, IL-8, and IL-17A in tears, with the lowest levels in group 1 and the highest levels in group 3 (all P < 0.05). At the third month of CL usage, the levels of these cytokines (in picograms/milliliter) were 6.06 ± 0.83, 78.18 ± 12.42, 61.69 ± 13.95, and 37.71 ± 5.95 in group 1 and 8.04 ± 0.89, 107.34 ± 14.40, 68.63 ± 13.72, and 46.26 ± 6.50 in group 3, respectively. A statistically significant decrease was determined over time in the Schirmer test in group 1, in only the tear breakup time in group 2, and in the tear breakup time and Schirmer test in group 3 (all P < 0.05). A statistically significant increase was determined over time in the levels of IL-6, IL-8, IL-17A, and MMP-9 in all groups. In the third month, a significant progression was observed in the Nelson grade (P < 0.05) in all groups. The wear of daily disposable CLs can be considered to cause less damage to the ocular surface and less increase in proinflammatory cytokine levels.