Tear Film Rupture Research Articles

Linarine inhibits inflammatory responses in dry eye disease mice by modulating purinergic receptors.

Linarine is a natural chemical component widely found in Buddleja officinalis Maxim., Chrysanthemum indicum L., Mentha canadensis L., and other medicinal plants. Modern pharmacological studies have shown that linarine with good anti-inflammatory and antioxidant activities can inhibit the proliferation and induce apoptosis of many kinds of tumor cells. Moreover, linarine showed protective effect on the liver, kidneys, and other organs. Inflammation model of human corneal epithelial cell (HCEC) was constructed using NaCl induction, and cytotoxicity was detected by the CCK8 assay. The levels of inflammatory factors tumor necrosis factor-α (TNF-α) and interleukin 1β (IL-1β) were measured using Enzyme-linked immunoassay (ELISA). Chronic painful stimulation (tail clamping) in combination with Benzalkonium Chloride Solution drops in a desiccator established a mouse model of dry eye disease (DED). The following parameters were recorded: body mass, anal temperature, tear secretion, tear film rupture time, and corneal fluorescein staining. The levels of inflammatory factors mitogen activated protein kinase (MAPK), nuclear factor kappa-B (NF-kB), c-Jun N-terminal kinase (JNK), IL-1β, Interleukin 18(IL-18), A2A, A3, P2X4, P2X7, P2Y1 were measured by using immunofluorescence (IF) staining. Linarine can inhibit the secreation of TNF-α, and IL-1β in HCECs. Linarine prolonged tear film rupture time, promoted tear secretion, repaired corneal damage, and reduced the levels of inflammatory factors of MAPK, NF-kB, JNK, IL-1β, IL-18, and modulated the levels of the purinergic receptor. Linarine is effective in treating dry eye in mice by inhibiting purinergic receptors-mediated inflammatory response.

Efficacy and safety of 0.01% atropine combined with orthokeratology lens in delaying juvenile myopia: An observational study.

It aims to study the efficacy and safety of low-concentration Atropine combined with orthokeratology (OK) lens in delaying juvenile myopia. This is a prospective study, 172 adolescents aged 8 to 12 years who were admitted to the diopter department of Hengshui People Hospital from April 2021 to May 2022 were selected. According to the equivalent spherical diopter measured at the time of initial diagnosis, myopic patients were randomly divided into low myopia group (group A) and moderate myopia group (group B). At the same time, according to the different treatment methods, the patients were divided into the group wearing frame glasses alone (group c), the group wearing frame glasses with low-concentration Atropine (group d), the group wearing corneal shaping glasses alone at night (group e), and the group wearing corneal shaping glasses at night with low-concentration Atropine (group f). The control effect of myopia development and axial elongation in group f was better than that in groups d and e (P < .05). The effect of controlling myopia development and axial elongation in group f is with P > .05. The probability of postoperative adverse reactions in group f was lower and lower than that in the other groups. Low-concentration atropine combined with OK lens could effectively delay the development of juvenile myopia, and had a high safety. Low-concentration of Atropine would not have a significant impact on the basic tear secretion and tear film stability. Nightwear of OK lens also had no significant impact, but it would significantly reduce the tear film rupture time in the first 3 months, and at the same time, the tear film rupture time would be the same after 6 months as before treatment.

Evaluation of the Effect and Efficiency of Ear Tip Bloodletting Combined with Xianfang Huoming Yin in the Treatment of Early-Stage Wheals

Objective: To evaluate the effect and efficiency of ear tip bloodletting combined with Xianfang Huoming Yin (XFH) in the treatment of early-stage wheals. Methods: 70 patients with early-stage wheals admitted from September 2020 to September 2022 were divided into two groups by randomized numerical table method, with 35 cases/group. Both groups received conventional treatment, the control group combined with XFH, and the observation group combined with ear tip bloodletting therapy and XFH. Conscious symptom scores, ocular indexes, therapeutic effects, and sleep quality between the two groups were compared. Results: After the treatment, the patients in the observation group had lower self- awareness symptom scores and sleep quality scores as compared to those in the control group; the diameter of the mass in the observation group was smaller than that of the control group after treatment; the average tear film rupture time and the time taken for the first non-contact tear film to rupture were longer in the observation group than those in the control group; the total effective rate of the treatment in the observation group was higher than that of the control group (P &lt; 0.05). Conclusion: Ear tip bloodletting combined with XFH was ideal for the treatment of early-stage wheals and has a high effective rate.

Efficacy and safety of the initial hypotensive treatment with an optimized latanoprost composition

Purpose: a comparative study of the efficacy and safety of Latanoprost-Optic, a new composition of excipients and the original latanoprost, in the initial therapy of primary open-angle glaucoma (POAG)Material and methods. We performed a prospective, randomized, comparative study of 60 previously untreated patients (71 eyes) with early and advanced POAG stages. During the screening visit, patients were randomly divided into the main (Latanoprost-Optic) and the control (original latanoprost) groups. The target points included intraocular pressure (IOP), visual acuity, MD and PSD perimetry indices, RNFL thickness, MRW, NFL, GCL, IPL, tear film break time, OSDI, and adverse events. The observation period was 12 weeks. IOP was measured 4 and 12 weeks from observation start.Results. The average decrease in IOP in the study group by the end of the observation was 32% and did not show any statistically significant differences from the original drug at any control point. A positive unreliable dynamic of the values of most functional parameters was noted, which may indicate the presence of an indirect neuroprotective effect. In the study group, there was a positive trend in tear film rupture time and OSDI. According to corneal confocal microscopy, no negative changes in dynamics were noted, in contrast to the control group. Reversible discomfort and mild redness of the bulbar conjunctiva were recorded in both groups. No serious or systemic adverse events were noted.Conclusion. Latanoprost-Optic has a hypotensive efficacy, comparable to the original latanoprost, and a high favorable safety profile.

Dry Eye Syndrome in Refractive Patients. Literature Review

Dry eye syndrome is a multifactorial disease of the ocular surface, which is based on the development of hyperosmolarity, inflammation and sensorineural disorders in the imbalance of the structural components of the tear film. The main complaints of refractive patients after keratorefractive surgery are a feeling of dryness in the eyes, a foreign body, redness, blurring of the image, which is due to the clinical manifestations of post-refractive dry eye syndrome. There are factors that contribute to the development of postrefractive dry eye syndrome, such as: neurotrophic epitheliopathy, postoperative inflammation, damage to goblet cells, toxic corneal epitheliopathy caused by preservatives contained in eye drops, leading to inadequate restoration of the tear film. In clinical practice, to assess the stability of the tear film, a method is used to determine the tear film rupture time using invasive and non-invasive methods. Invasive methods include: staining of the ocular surface with a solution of fluorescein during the Norn test. To date, laboratory diagnostics expands the understanding of the pathogenesis, etiology and mechanisms underlying the xerosis of the ocular surface at the molecular level, and also facilitates the diagnosis and prognosis of dry eye syndrome. Laboratory methods of the ocular surface include the study of biomarkers of lacrimal fluid, conducting impression cytology with an assessment of the condition of goblet cells. In this regard, it is necessary to have a deep understanding of the main etiopathogenetic links of dry eye syndrome, a wide range of diagnostics of the condition of the ocular surface before and after the surgical stage of patient management, which will determine the success of keratorefractive surgery and a stable course of the postoperative period.

Modified Danzhi Xiaoyao Powder (MDXP) improves the corneal damage in dry eye disease (DED) mice through phagocytosis

Ethnopharmacological relevanceModified Danzhi Xiaoyao Powder (MDXP) is a traditional Chinese medicine formula remedy for treating Dry Eye Disease (DED). It showed the function of dispersing stagnated liver Qi for relieving Qi stagnation and clearing heat, which can be effective in treating conditions such as Dry Eye Disease (DED) and irregular menstruation due to liver depression and fire transformation. Aim of the studyThis study investigated the mechanism of the effect of MDXP in mice with DED. Materials and methodsA DED model was induced in mice using chronic painful stimulation (tail clamping) in combination with Benzalkonium Chloride Solution drops administered in a dry box for 28 days. After modeling, the MDXP groups were given Chinese medicine with different dosages by gavage for 14 days. The following parameters were recorded in each group: body mass, anal temperature, tear secretion, tear film rupture time, and corneal fluorescein staining. Behavioral changes were evaluated by elevating cross-maze and open-field experiments. The levels of inflammatory factors serum tumor necrosis factor-α (TNF-α), interleukin 1β (IL-1β), fcγR-mediated phagocytosis pathway cell division control protein 42 homolog (CDC42), actin-related protein 2/3 complex subunit 2 (ARPC2), and actin-related protein 3 (ACTR3) were measured by using Enzyme-linked immunoassay (ELISA), immunohistochemical staining, and real-time fluorescent qualitative polymerase chain reaction (RT-qPCR). ResultsMDXP increased body mass and lowered body temperature, prolonged tear film break-up time, promoted tear secretion, repaired corneal damage, decreased horizontal and vertical scores, elevated percentage of open arm times and boom opening time percentage, and reduced the expression levels of inflammatory factors of TNF-α, IL-1β and pathway-related proteins CDC42, ARPC2, and ACTR3 in mice. MDXP also reduced the expression levels of inflammatory factors of TNF-α and IL-1β in human corneal endothelial cells (HCECs), mouse mononuclear macrophage cells (RAW264.7), and human myeloid leukemia mononuclear cells (THP-1). ConclusionsMDXP can relieve tension and anxiety, inhibit apoptosis, reduce phagocytosis, reduce the expression of pro-inflammatory factors, repair corneal damage, and improve the symptoms in DED mice. The mechanism of action may be through the fcγR-mediated phagocytosis pathway.

Проявления синдрома сухого глаза у детей с сахарным диабетом 1-го типа в зависимости от уровня гликированного гемоглобина

Introduction. Diabetes mellitus is one of the serious diseases that leads not only to restrictions on physical activity, but also changes the social and psychological spheres of life of patients. The purpose of the studyis to evaluate the results of functional methods for studying tear production function in children with type 1 diabetes mellitus. Materials and methods of research. The study included 240 children registered at the Children's City Endocrinology Center in Almaty. There were 133 boys (55.42 %), 107 girls (44.58 %). The examined children were divided into 6 groups depending on the level of glycated hemoglobin (HbA1c). The control group consisted of 52 people. All patients were assessed for the severity of blockage of the breast ducts, the state of total tear production (Schirmer test 1), the state of the tear meniscus (biometry of the tear meniscus), the time of tear film rupture, and the state of the conjunctiva. Patients with dry eye syndrome were prescribed softdrops and the dynamics of the process were monitored. Research results. In patients with type 1 diabetes mellitus, in 69.6 % of cases there were manifestations of breast dysfunction of varying severity. From 17 % to 39.8 % of patients in the main groups had manifestations of hyperemia and 28 % mild conjunctival edema, which is clinically a sign of the presence of an irritating factor, possibly due to an increase in tear hyperosmolarity. The Schirmer test showed a decrease in tear secretion function, a decrease in tear film rupture and a decrease in the level of menisci in comparison with the control. The use of softdrops eye drops helps to stabilize the tear film, increase tear secretion and tear production functions in children with signs of dry eye syndrome due to type 1 diabetes mellitus. These studies should be taken into account when prescribing pathogenetic therapy for the correction of dry eye syndrome in these groups of patients. Keywords: diabetes mellitus, ophthalmological manifestations of diabetes mellitus, dry eye syndrome, dry eye disease

Клинико-функциональные результаты комплексного лечения синдрома сухого глаза на фоне хронического периферического увеита

Relevance. Inflammation and impaired stability of the pre-corneal tear film are central to the pathogenesis of dry eye disease (DED). Signs of ocular surface irritation and symptoms characteristic of DED accompany intermediate uveitis in 28–57 % of cases. Purpose. To evaluate clinical and functional results of treatment of DED and intermediate uveitis, including tear replacement and anti-inflammatory therapy in combination with laser retinal coagulation at the extreme periphery of the ocular fundus. Materials and methods. The results of treatment of 78 patients with DED and intermediate uveitis were analyzed. The effectiveness of the developed method of treatment of combined pathology was evaluated after 3, 6, 12, 18 months based on the dynamics of OSDI index, hyperemia of bulbar conjunctiva, LIPCOF test, Schirmer I test and Norn's test. Results. Application of complex treatment of DED in patients with intermediate uveitis promotes statistically significant (p≤ 0.05) decrease of discomfort signs according to OSDI results up to 34.7 %, decrease of bulbar conjunctiva hyperemia index up to 50 %, decrease of LIPCOF test index up to 27.2 %, increase of tear film rupture time up to 31.6 % and total tear production up to 89.7 % with stable cure of intermediate uveitis during 18 months of observation. Conclusions. Tear replacement and anti-inflammatory therapy in combination with laser retinal coagulation at the extreme periphery of the ocular fundus is an effective method of treatment of DED and intermediate uveitis, providing stable clinical and functional results for a long time. Keywords: dry eye disease, intermediate uveitis, laser coagulation of the extreme periphery of the retina

Modern diagnosis of dry eye syndrome on MEDI WORKS S390L slit lamp

In recent years, in conditions of increased work with gadgets and computers, the prevalence of dry eye syndrome has increased dramatically. The presented article is devoted to the modern diagnosis of dry eye syndrome.25 patients (50 eyes) participated in the study, which was conducted at the ophthalmological center of Astana Vision Pavlodar LLP in Pavlodar. Of these, 7 patients after laser vision correction, 4 patients suffering from myopia, wore contact lenses, locally applied medications for the treatment of dry eye syndrome. The examination included a Schirmer test, a tear film rupture time test (NIBUT, VRSP), filling out the questionnaire «Ocular Surface Disease Index» (OSDI) and determining the height of the lacrimal meniscus.The author of the article concluded that noninvasive research methods used for the diagnosis of SSG are more acceptable, since they do not violate the integrity of the tear film.

Клиническая эффективность селективной IPL-терапии пациентов с синдромом сухого глаза, сочетанным с дисфункцией мейбомиевых желез

Purpose. To evaluate functional and clinical parameters characterizing dry eye syndrome (dES) before and after selective IPL therapy. Material and methods. The study involved 19 patients (38 eyes). Inclusion criteria: dry eye syndrome associated with meibomian gland dysfunction (mgd). The age of the study participants ranged from 23 to 75 years, on average 53.2 ± 14.5; women - 68 %, men - 32 %. the evaluation of the data was carried out at the initial visit, after each session of treatment and in the long-term period - after 3 months. Evaluated features: norn tear film stability scores (time to first tear film break, mean tear film break time), tear meniscus height, tear film lipid layer thickness. The assessment of the patients’ conditions according to biomicroscopy data, the condition of the meibomian glands, the eyelid margin, redness of the eye was performed at the initial visit and after each session of hardware treatment. The treatment included: 3 sessions of selective IPL therapy on the lumenis m22 optima IPL device with an interval of 1 time in 3 weeks. Results and discussion. The mean time to first tear film (tF) rupture in study participants before selective IPL therapy was 0.2 (0.1–0.5) seconds, after treatment it increased to 1.6 (0.3–5.4) seconds. The average value of the average tear film rupture time in patients before treatment was 4.7 (1.5–7.8) seconds, and after treatment it increased to 8.6 (4.4–12.0) seconds. Conclusion. The time of the first tF rupture and the average time of tF rupture in patients after the treatment increased. After the treatment, the following statements were reliably established: an increase in the proportion of patients with a lacrimal meniscus height of more than 0.2 mm; increase in the thickness of the lipid layer of the tear film; improvement in the proportion of patients with eyelid border disorders; reduction in the proportion of patients with eye redness. Keywords: selective IPL therapy, dry eye syndrome, meibomian gland dysfunction

Prevention and Treatment of Epitheliopathy as a Result of Acute Inflammatory Diseases of the Ocular Surface

Acute inflammatory diseases of the ocular surface occur in case of epitheliopathy. As a result, most patients complain of discomfort and persistence of residual inflammation after the infection has been stopped.The purpose: to assess the degree of damage to the ocular surface as a result of bacterial conjunctivitis and keratitis, as well as the regenerative effect of dexpanthenol 5 % eye gel on the healing and restoration of the functional activity of the ocular surface epithelium.Methods. A non-randomized case-control study was performed in patients with a bacterial infection of the conjunctiva and cornea. Under supervision there were 23 patients (46 eyes) diagnosed with bacterial conjunctivitis and 31 patients (31 eyes) with bacterial keratitis. According to the study design, patients were divided into two groups. After stopping the acute process, dexpanthenol 5 % eye gel was prescribed. To control the effectiveness, the tear film rupture time, the degree of damage to the mucin coating and surface epithelial cells were evaluated. Diagnostic tests with vital dyes (fluorescein (FA) and lyssamine green (LG)) were performed before the appointment of the gel, then seven and thirty days after the appointment of the drug.Results. After the relief of bacterial inflammation, 86.9 % patients with conjunctivitis and in all cases of keratitis had complaints (unpleasant sensations and redness of the eyes, blurred vision). There was a decrease in tear break-up time (TBUT) test, a significant accumulation of dye in the conjunctiva in both study groups and a partial accumulation of FA in the cornea, more intense in keratitis. After 7 days Corneregel use, there was an increase in TBUT compared to the baseline level, with a further increase in this indicator after a 1 month, a decrease in the manifestation of conjunctival epitheliopathy and the degree of corneal staining.Conclusions. The appointment of dexpanthenol 5 % eye gel after stopping a bacterial infection helps to relieve discomfort, accelerates the restoration of regeneration of the epithelial cells of the ocular surface, and increases the strength of the tear film.

Evaluating the Efficacy of Polyglycolic Acid-Loading Tetrandrine Nanoparticles in the Treatment of Dry Eye

Introduction: Dry eye disease (DED) is a multifactor-induced disease accompanied by increased osmolarity of the tear film and inflammation of the ocular surface. Traditional anti-inflammation agent corticosteroids applied in DED treatment could result in high intraocular pressure, especially in long-term treatment. Therefore, we explored a nano drug that aimed to block the formation pathway of DED which had anti-inflammatory, sustained release, and good biocompatibility characteristics in this study. Methods: We prepared a novel nanomedicine (Tet-ATS@PLGA) by the thin film dispersion-hydration ultrasonic method and detected its nanostructure, particle size, and zeta potential. Flow cytometry was used to detect the cell survival rate of each group after 24 h of drug treatment on inflammed Statens Seruminstitut Rabbit Corneal (SIRC) cells. Observed and recorded corneal epithelial staining, tear film rupture time, and Schirmer test to detect tear secretion on the ocular surface of rabbits. The corneal epithelial thickness, morphology, and number of bulbar conjunctival goblet cells were recorded by H&E staining. Finally, we detected the expression of VEGF, IL-1β, PGE2, and TNF-α by cellular immunofluorescence staining and enzyme-linked immunosorbent assay (ELISA). Results: The encapsulation efficiency and drug loading of Tet-ATS@PLGA were 79.85% and 32.47%, respectively. At eye surface temperature, Tet can easily release from Tet-ATS@PLGA while that it was difficult to release at storage temperature and room temperature. After 2 weeks medication, Tet-ATS@PLGA can effectively improve the tear film rupture time and tear secretion time in a DED model (p <0.05). Compared with the normal group (62.34 ± 4.86 mm), the thickness of corneal epithelium in ATS (29.47 ± 3.21 mm), Tet-ATS (46.23 ± 2.87 mm), and Tet-ATS@PLGA (55.76 ± 3.95 mm) gradually increased. Furthermore, the flow cytometry indicated that Tet-ATS@PLGA can effectively promote the apoptosis of inflammatory SIRC cells, and the cellular immunofluorescence and ELISA experiments showed that the expression intensity of inflammatory factors such as VEGF, IL-1β, PGE2, and TNF-α decreased in this process. Interestingly, Tet also had the effect of reducing intraocular pressure. Conclusion: Tet-ATS@PLGA can effectively promote the apoptosis of inflammatory corneal epithelial cells, thus inhibiting the expression of inflammatory factors to block the formation of DED and improve the secretion of tear on the ocular surface.

Tear film stability in dry eye syndrome: Time and break‐up patterns

AbstractPurpose: Comparison between traditional invasive methodologies and modern non‐invasive high‐tech methodologies for qualitative and quantitative evaluation in 3 groups of patients with dry eye disease.Methods: Cross sectional study of 111 participants recruited consecutively at the eye clinic of San Giuseppe Hospital in Milan in 3 groups: healthy (n = 30), aqueous deficient dry eye ADDE) (n = 32) and evaporative dry eye (EDE) (n = 49) underwent osmolarity assessment, OSDI questionnaire, tear meniscus height measurement (TMH), Non‐invasive (NIKBUT‐first and NIKBUT‐average) and invasive (FBUT with fluorescein) tear film break up time, Meiboscore, corneal staining and Schirmer test.Results: FBUT, Schirmer test, f‐NIKBUT and a‐NIKBUT were significantly different between the three groups (p &lt; 0.001). FBUT and also f‐NIKBUT were lower in EDE group (4.46 ± 2.24) than other groups; In healthy and ADDE subjects, tear film break‐up time was located in the lower sector between the periphery average and the extreme. NiKBUT pattern was significantly different between the upper and lower peripheral, nasal and temporal periphery and the central temporal into the different groups (p &lt; 0.05). Correlation analysis showed an inverse association between age and f‐NIKBUT (r = −0.358) between all patients. Corneal staining was more severe in ADDE patients.Conclusions: In ADDE group the f‐NIKBUT was higher, almost at normal values, compared to FBUT. In a previous study, NIKBUT was found to be higher than FBUT due to non‐installation of dyes in the eye. In healthy and EDE subjects the tear film rupture was located in the lower sector between the average periphery and the extreme, probably due to a longer exposure time than in other areas. In EDE subjects, however, f‐NIKBUT was found in the central temporal and nasal sectors in according with previous studies. Average and f‐NIKBUT were negatively related with the age and also positively related to each other. FBUT and f‐NIKBUT were related to each other differently in 3 groups of patients; they could study different aspects of the same phenomenon, further studies are ongoing.

Acupuncture Alleviates Corneal Inflammation in New Zealand White Rabbits with Dry Eye Diseases by Regulating α7nAChR and NF-κB Signaling Pathway.

The purpose of this study is to determine the mechanism of improvement in dry eye diseases (DEDs) treated by acupuncture. The inflammatory molecules and related pathways will be analyzed in our study. In order to establish the animal model for DEDs, healthy New Zealand white rabbits were treated with scopolamine (Scop) hydrobromide for 21 consecutive days. After 21 days, acupuncture, fluorometholone (Flu), and α7nAChR antagonist (α-BGT) treatments were performed, and the Scop injections were continued until day 35. The therapeutic effect of acupuncture on DED inflammation was evaluated by corneal fluorescence staining, tear film rupture time, tear flow measurement, in vivo confocal microscopy (IVCM), corneal histopathology, and cytokine protein chip technology. The influence of acupuncture on the corneal pathology and inflammatory factors ACh, α7nAChR, and NF-κB was detected by enzyme-linked immunosorbent assay (ELISA) and western blot. Compared with the group Scop, acupuncture can significantly reduce corneal staining and increase the tear film rupture time and tear flow, which are accompanied by a decrease in corneal epithelial detachment and lymphocyte infiltration. Acupuncture can relieve the inflammation of corneal stroma and mitigate the expression of proinflammatory factors and chemokines. Acupuncture can upregulate the expression of ACh and α7nAChR and downregulate the expression of NF-κB. Our findings demonstrate that acupuncture can alleviate corneal inflammation in New Zealand white rabbits with DEDs via α7nAChR and NF-κB signaling pathway regulation. The expression indicates that α7nAChR/NF-κB signaling pathway may be active and that acupuncture is a potential therapeutic target for dry eye.

Особенности лечения синдрома «сухого глаза» у пациентов с хроническим периферическим увеитом

Introduction. The development of inflammation and violations of the homeostasis of the tear film are of fundamental importance for the occurrence of dry eye disease (DED). In 28–57 % of cases, intermediate uveitis (IU) is accompanied by signs of irritation of the ocular surface and symptoms characteristic of DED. Purpose. Analysis of the effectiveness of complex treatment of DED and IU, including tear replacement and anti-inflammatory therapy in combination with laser retinal coagulation at the extreme periphery of the fundus. Material and methods. The results of treatment of 98 patients were analyzed: the main group – 78 patients – were prescribed complex treatment of DED, the comparison group – 20 patients – only local tear replacement and anti-inflammatory therapy. Evaluation of the effectiveness of the developed method of treatment of combined pathology was carried out after 3 and 6 months. based on the dynamics of OSDI indices, hyperemia of the bulbar conjunctiva, LIPCOF test and Norn test. Results. The use of complex treatment of DED in patients with IU contributes to a statistically significant (p &lt; 0.05) decrease in signs of discomfort according to the results of OSDI to 34.8 %, a decrease in the bulbar conjunctiva hyperemia index to 51.4 %, a decrease in the LIPCOF test index to 22.2 %, an increase in tear film rupture time to 23.3 % with stable CP relief for 6 months observations. Conclusions. Thus, the results obtained clearly demonstrate the effectiveness of the use of complex treatment of DED in patients with IU. The developed method contributes not only to increasing the stability of the tear film, but also to reducing subjective feelings of discomfort and ensuring relief of inflammation at the extreme periphery, which allows us to recommend its wide application. Keywords: dry eye disease, intermediate uveitis, laser coagulation of the extreme periphery of the retina

Comparison of the stability of different concentrations of fluorescein sodium on the detection of tear film rupture time

Comparison of the stability of different concentrations of fluorescein sodium on the detection of tear film rupture time

Предоперационная оценка риска развития синдрома сухого глаза путем сравнительной эффективности методов корнеотопографии и пробы норна перед фоторефракционной хирургией у пациентов с миопией

Purpose. To conduct a comparative analysis of the effectiveness of assessing the stability of the tear film using corneotopography and the classic Norn test in patients with myopia and myopic astigmatism before keratorefractive surgery. Material and methods. The study included 26 patients planned for keratorefractive surgery for myopia and myopic astigmatism, aged 18 to 47 years. 7 people there was a mild degree of myopia, in 14 people – medium degree, in 5 people – high degree. The average degree of corneal astigmatism was 2.25 diopters. The stability of the pre-corneal tear film was assessed using computed keratotopography and Norn's test – the tear film rupture time (TFRT) was determined. A standard questionnaire was also used to assess the severity of symptoms of dry eye syndrome. A comparison was made of the indicators of the stability of the tear film obtained by the methods of corneotopography and the Norn's test, with their subsequent comparison with the data of the questionnaire. Results. In 17 patients (65.4 %), the TFRT index corresponded to the age norm. In the remaining 9 people (34.6 %), indicators of stability of the tear film were reduced both by corneotopography (12 ± 4 sec) and by Norn's test (13.5 ± 4.5 sec), and there were also subjective signs of dry eye syndrome according to data questionnaire. The data turned out to be comparable. Conclusions. 1. Among the total population of patients, 34.6 % were persons with impaired tear film stability and subjective manifestations of dry eye syndrome. 2. Assessment of the stability of the tear film, determined using the method of corneal topography, showed a high degree of comparability with the results of Norn's test. A significant advantage of the keratotopography method is its non-invasiveness. 3. It is necessary to pay attention to the condition of the ocular surface and identify risk groups to avoid chronicity or aggravation of existing disorders. Keywords: dry eye syndrome, tear film, keratotopography, Norn's test.

Effectiveness and safety of hypotensive therapy of primary glaucoma with a Russian generic fixed combination of dorzolamide and timolol

Purpose: a comparative study of the efficacy and safety of the generic drug Dorzial Plus, an analogue of the original reference drug Cosopt®, in patients with primary open-angle glaucoma (POAG).Material and methods. The study involved 80 patients of both sexes aged 55–75 with newly diagnosed POAG of the initial and advanced stages with uncompensated intraocular pressure (IOP), of which 40 patients (study group) received Dorzial Plus and 40 patients (comparison group) received the reference drug (Cosopt®). Hypotensive efficacy of the drugs in both groups was assessed using a portable ophthalmic tonometer Icare PRO (Finland) by reducing IOP from the initial level after 1 week, 1 month and 3 months of treatment.Results. In both groups, the screening showed comparable average IOP values: 26.7 ± 3.2 mm Hg in the reference drug group and 27.4 ± 2.8 mm Hg in the Dorzial Plus group. After 1 week of therapy with Cosopt, IOP showed a significant decrease of 33% (reduction to 17.9 ± 3.2 mm Hg), while the group receiving Dorzial Plus demonstrated a 31% decrease (reduction to 18.9 ± 1.7 mm Hg). After 1 month of the instillation regimen, a slight increase in P0 (of about 3%) was recorded in both groups (increase to 18.7 ± 2.3 and 19.7 ± 2.0 mm Hg, respectively). By the end of the 3 months’ follow-up period, IOP decrease level with respect to the baseline remained practically the same, amounting to 30 and 29% (up to 18.6 ± 1.8 and 19.5 ± 2.3 mm Hg), respectively. The state of the ocular surface showed a slightly negative dynamics of tear film rupture time and OSDI index in the reference drug group, which could be observed throughout 3 months of therapy. In the study group, therapy with preservative-free drug containing a moisturizing agent (sodium hyaluronate) revealed a significantly changed OSDI index, manifesting itself in restructured severity of the evaluated features.Conclusion. Dorzial Plus reduces IOP in POAG patients by an average of 30% of the baseline, so that its hypotensive efficacy is comparable to the original fixed combination Cosopt. The tolerability analysis of the study drug demonstrates a significant positive dynamic of the state of the ocular surface as soon as 3 months after therapy start.

Expression of TNF-α and IL-1β in Peripheral Blood of Patients with T2DM Retinopathy.

Aims The expression and clinical significance of tumor necrosis factor-α (INF-α) and interleukin 1-β (IL-1β) in retinal cells of patients with type 2 diabetes (T2DM) retinopathy were detected by flow cytometry. Materials and Methods Fifty patients with T2DM who attended our ophthalmology clinic between May 2021 and May 2022 were selected as the observation group. Another 50 healthy individuals who were examined at our hospital during the same period were selected as the comparison group. Tear film rupture time (BUT), fluorescein staining (FL), basal tear secretion (Schirmer I) test, and conjunctival impression cytology (CIC) were detected in both groups, and the expression of TNF-α and IL-1β in retinal cells was observed by immunohistochemical staining. Results The levels of IL13 and TNF-α in the two groups were not exactly the same. The serum levels of IL13 and TNF-α in the observation group were significantly higher than those in the control group, and there was a statistically significant difference (P < 0.05). TNF-α and IL-1B expressions in the observation group were positively correlated with the fluorescence staining, and the expression of TNF-α and IL-1β in the observation group was significantly negatively correlated with the BUT test and Schirmer I test. Conclusion Serums TNF-α and IL-1β are significantly elevated in patients with T2DM retinopathy and gradually increase with disease progression. Combined detection of serums TNF-α and IL-1β can help determine the severity of the disease and assess the prognosis.

DETERMINATION OF SCREEN TIME FOR USING DIGITAL DEVICES WITHOUT DAMAGING EFFECT ON LACRIMAL FILM

Introduction. The changes in the thickness of lipid layer of lacrimal film, the height of the lacrimal meniscus, and non-invasive time of the lacrimal film rupture under the exposure to digital devices up to 60 minutes are requiring in-depth investigation. This justifies the needs for extensive research to determine the safe continuous time spent in front of the screen of digital devices. The aim of this study is to determine the safe time for work with digital devices that does not result in significant changes in the tear film indices. Materials and methods. We examined 335 people (670 eyes) aged from 18 to 48 years, an average age is 28 ± 0.74 years. The study was conducted in two stages: during I stage we analyzed the tear film without the exposure to digital devices; during II stage we analyzed changes in the tear film after the work with digital devices. The analysis of the tear film composition after the exposure to digital devices for 20; 30; 40 and 60 minutes was carried out. Results. Following 20 minute exposure, the thickness of the lipid layer did not differ from the initial data obtained in the subjects (p&gt;0.05); NIBUT also did not change and was similar to the initial indicators (p&gt;0.05); the frequency of blinking began to decrease by 3% of subjects compared with the initial data, however, the difference was not reliable (p&gt;0.05). After 30 minute exposure, there was no significant change in the lipid layer of the tear film, the height of the lacrimal meniscus and the tear film rupture (p&gt; 0.05). Only the frequency of blinking decreased down by 12% of all participants compared with the initial data (p &lt;0.05). After 40 minute exposure, the number of subjects with moderate lipid layer thinning went up to 13% (p&lt;0.05); the number of subjects with pathological indices of tear meniscus increased by 11% (p&lt;0.05); there was no significant change in tear film rupture found (p&gt; 0.05); the blinking frequency decreased by 26% of all participants compared to the initial data (p &lt;0.01). After 60 minute exposure, the number of those examined with a thinning of the lipid layer increased to 16% (p &lt;0.01), of which 3% had a significant thinning of the lipid layer; the number of examined patients with pathological indices of the lacrimal meniscus increased by 16% (p &lt;0.01); the number of patients with NIBUT changes increased by 14% (p &lt;0.01); the frequency of blinking decreased in 50% of all subjects compared to the initial data (p &lt;0.01). Conclusion. The influence of computer devices for 20 minutes does not significantly affect the qualitative composition of the tear film.