Types Of Dry Eye Research Articles

Correlation Between the Severity of Dry Eye Disease and Fluorescein Break-Up Patterns (FBUP)

Dry eye disease is a disorder of the eye surface characterized by instability of the tear film. The FBUP examination is one of the examinations used to determine the stability of the tear film. The various symptoms that occur in each type of dry eye indicate differences in break-up patterns (BUP). This study aims to determine the correlation between the severity of dry eye disease and the appearance of FBUP at RSUP dr. Mohammad Hoesin Palembang. A correlative analytical cross-sectional study was undertaken at the Eye Polyclinic, Infection- Immunology Subdivision, Dr. Mohammad Hoesin General Hospital Palembang from January to June 2022. There were 32 patient samples with 60 dry eye samples that met the inclusion criteria. The correlation between the Schirmer Test, TBUT and the severity of dry eye disease with the appearance FBUP was analyzed using the Spearman Rho's test. All data were analyzed with SPPS version 23.0. In this study, the results showed that there was a moderate and significant positive correlation between the degree of the Schirmer test and the appearance FBUP (r = 0.482; p = 0.000) and a moderate and significant positive correlation between the TBUT degree and the appearance FBUP (r = 0.435; p = 0.001) . In addition, the results showed that there was a moderate and significant positive correlation between the severity of dry eye disease and the appearance of FBUP (r = 0.478; p = 0.000). Using the multivariate test, it was concluded that the degree of dry eye was statistically significantly related to age (p = 0.001) and gender (p = 0.001). There is a correlation between the severity of the disease and the appearance FBUP of patients with dry eye disease.

A Comprehensive Assessment of Tear-Film-Oriented Diagnosis (TFOD) in a Dacryoadenectomy Dry Eye Model.

Tear film instability is a major cause of dry eye disease. In order to treat patients with short tear film breakup time (TBUT)-type dry eye, the development of tear film stabilizing agents is essential. However, the lack of an appropriate animal model of tear film instability has made drug development difficult. Although rabbit dry eye models have been reported in the past, there are only a few reports that focus on tear film instability. Herein, we assessed the tear film stability of a rabbit dry eye model induced by dacryoadenectomy. A clinical evaluation of the ocular surface, interferometry, and histological assessments of the cornea and conjunctiva were performed. Following the removal of the lacrimal glands, TBUT was shortened significantly, with dimple and random breakup patterns prominently observed. Furthermore, the blink rate in this model increased after dacryoadenectomy, suggesting that this model partially captured the phenotypes of human short TBUT-type dry eye and may be useful as an animal model for investigating potential drug candidates.

Analysis of postoperative ocular surface changes and intervention effect after pars plana vitrectomy in meibomian gland dysfunction dry eye patients.

To observe ocular surface changes after phacovitrectomy in patients with mild to moderate meibomian gland dysfunction (MGD)-type dry eye and track clinical treatment response using a Keratograph 5M and a LipiView interferometer. Forty cases were randomized into control group A and treatment group B; the latter received meibomian gland treatment 3d before phacovitrectomy and sodium hyaluronate before and after surgery. The average non-invasive tear film break-up time (NITBUTav), first non-invasive tear film break-up time (NITBUTf), non-invasive measured tear meniscus height (NTMH), meibomian gland loss (MGL), lipid layer thickness (LLT) and partial blink rate (PBR) were measured preoperatively and 1wk, 1 and 3mo postoperatively. The NITBUTav values of group A at 1wk (4.38±0.47), 1mo (6.76±0.70), and 3mo (7.25±0.68) were significantly lower than those of group B (7.45±0.78, 10.46±0.97, and 11.31±0.89; P=0.002, 0.004, and 0.001, respectively). The NTMH values of group B at 1wk (0.20±0.01) and 1mo (0.22±0.01) were markedly higher than those of group A (0.15±0.01 and 0.15±0.01; P=0.008 and P<0.001, respectively); however, there was no difference at 3mo. The LLT of group B at 3mo [91.5 (76.25-100.00)] significantly exceeded that of group A [65.00 (54.50-91.25), P=0.017]. No obvious intergroup difference was found in MGL or PBR (P>0.05). Mild to moderate MGD dry eye worsens in the short term after phacovitrectomy. Preoperative cleaning, hot compresses, and meibomian gland massage as well as preoperative and postoperative sodium hyaluronate promote the rapid recovery of tear film stability.

Association of Dry Eye with Vernal Keratoconjunctivitis: A Hospital-based Cross-sectional Study

Introduction: Vernal Keratoconjunctivitis (VKC) is a common allergic disease seen in children. The allergic component is caused by Immunoglobulin E (IgE) and mast cell-mediated pathway. It is proposed to be a combination of immune system, genetic, and environmental factors. Secondary dry eye develops secondary to inflammatory disease namely vascular, allergic, environmental conditions like allergens, cigarette smoke, hormonal changes, systemic disorders, such as diabetes mellitus, eye surgeries such as refractive surgery and systemic medications, such as diuretics and antihistamines. Co-existence of dry eye and VKC can worsen the symptoms of the patient and may also lead to prolonged and unnecessary treatment of the disease. Aim: To study the association of dry eye with VKC by Schirmer’s test and Tear Film Breakup Time (TBUT). Materials and Methods: A hospital-based cross-sectional study was conducted in the Department of Opthalmology, Sri Siddhartha Medical College and Research Centre, Tumkur, Karnataka, India, from December 2020 to June 2022. Thirtythree patients of age group between 5-20 years with symptoms of VKC were evaluated for dry eye using Schirmer’s test and TBUT, respectively. Each patient was subjected to detailed history taking, followed by ocular examination as per the predesigned proforma. The patients were subjected to the tear film analysis using Schirmer’s test and TBUT. A total of 33 patients were evaluated and the data was compiled. The association between categorical variables were analysed by using Chi-square test. The data was analysed by using Statistical Package fot the Social Sciences (SPSS) software version 21.0. The parameters compared were the type of dry eye with the type of VKC. Results: The mean±Standard Deviation (SD) age of the study group was found to be 11±1.5 years. Out of 33 patients, 69.69% of all the cases were seen in the 5-12 years age group. There was male preponderance in the present study with 63.63% of patients being male child. VKC was most commonly seen as mixed accounting for 57.57% of cases. In the current study, it was discovered that 60.6% of cases showed no sign of dry eye, whereas 39.82% of cases had dry eye. The dry eye was more commonly seen in mixed type of VKC. The p-value was statistically significant (p-value&lt;0.001) for association of dry eye with mixed type of VKC. Conclusion: The present study highlighted the co-existence of dry eye with VKC. There was a significant association of dry eye with VKC and type of VKC as well, which might have long-term effects on the ocular surface. These ocular surface alterations exist during active and the quiet phase of VKC. The patients of VKC may need a long-term follow-up and treatment for this ocular surface alteration.

Analysis of diagnostic tests in patients with dry eye and hypothyroidism: an observational study

PurposeColombia is a country with a high prevalence of hypothyroidism, approximately 18.5% compared to the rest of Latin American countries, which is estimated at 10%. That is why in the ophthalmology consultation we find a large proportion of patients with this disease and who also present symptoms of dry eye. When conducting a search in the medical literature, most publications refer to the clinical presentation of dry eye in hyperthyroidism, which is why the main objective of this study is to evaluate tear function tests in the diagnosis of dry eye in patients with hypothyroidism. MethodsThis is an observational, cross-sectional study carried out in the period between May and December 2019 in the ocular surface unit of the Ophthalmic Technology Center (CTO) in Bogotá. The tests of: OSDI test (Ocular Surface Disease Index), Schirmer type I, tear meniscus height, NiBUT, Osmolarity, Ferning test, Lisamine Green test of 59 patients with Dry Eye Disease (DED) and history of hypothyroidism. ResultsSchirmer type I and NiBUT tests were the parameters that presented the highest percentage of severity, while lissamine green staining and meniscometry showed a tendency to normality. ConclusionsThe population of this study presents a mixed type dry eye without epithelial cell damage.

Análisis de pruebas diagnósticas de pacientes con ojo seco e hipotiroidismo: un estudio observacional

PurposeColombia is a country with a high prevalence of hypothyroidism, approximately 18.5% compared to the rest of Latin American countries, which is estimated at 10%. That is why in the ophthalmology consultation we find a large proportion of patients with this disease and who also present symptoms of dry eye. When conducting a search in the medical literature, most publications refer to the clinical presentation of dry eye in hyperthyroidism, which is why the main objective of this study is to evaluate tear function tests in the diagnosis of dry eye in patients with hypothyroidism. MethodsThis is an observational, cross-sectional study carried out in the period between May and December 2019 in the ocular surface unit of the Ophthalmic Technology Center (CTO) in Bogotá. The tests of: OSDI test (Ocular Surface Disease Index), Schirmer type I, tear meniscus height, NiBUT, Osmolarity, Ferning test, Lisamine Green test of 59 patients with Dry Eye Disease and history of hypothyroidism. ResultsSchirmer type I and NiBUT tests were the parameters that presented the highest percentage of severity, while lissamine green staining and meniscometry showed a tendency to normality. ConclusionsThe population of this study presents a mixed type dry eye without epithelial cell damage.

Correlation between tear film lipid layer thickness and transepidermal water loss from the ocular area in patients with dry eye disease and in healthy controls.

PurposeThis study aimed to evaluate the correlation between tear film lipid layer thickness and transepidermal water loss (TEWL) from the ocular area in patients with short tear break-up time (TBUT)-type dry eye and healthy controls.MethodsThis prospective study included 25 eyes of patients with short TBUT-type dry eye disease and 25 eyes of healthy controls.ResultsTear film lipid layer thickness was measured using an interferometer, and TEWL from the ocular area was measured using a Tewameter TM300 with custom-made goggles. The correlation between tear film lipid layer thickness and TEWL was evaluated. Additionally, other parameters such as TBUT, Schirmer I score, ocular surface staining, the presence and type of meibomian gland dysfunction (MGD), ocular surface disease index (OSDI), and visual analog scale (VAS) scores were evaluated. Tear film lipid layer thickness did not show a significant correlation with TEWL from the ocular area measured using a Tewameter TM300. However, tear film lipid layer thickness was significantly correlated with tear break-up time (p = 0.004) and ocular surface staining by NEI (National Eye Institute) scheme (p = 0.03). TEWL showed positive correlation with the Schirmer I score (p = 0.004).ConclusionsThe tear film lipid layer affected the stability of the tear film more than the amount of TEWL in patients with short TBUT dry eye and healthy controls.

In Vivo Confocal Microscopy in Different Types of Dry Eye and Meibomian Gland Dysfunction.

In vivo confocal microscopy (IVCM) imaging is increasingly popular in ocular surface disease diagnosis and management. We conducted a systematic review to update the use of IVCM in the diagnosis and treatment of dry eye and meibomian gland dysfunction (MGD). A literature review was conducted on IVCM studies in MGD, dry eye disease, systemic disease causing dry eye, dry eye in glaucoma patients, contact lens-associated ocular conditions, graft-versus-host disease, and Sjogren’s syndrome-related dry eye. The articles were identified through PubMed and a total number of 63 eligible publications were analyzed in detail. All primary research studies on confocal microscopy on dry eye and related conditions from 2017 onwards were included. The reports were reviewed for their contribution to the existing literature as well as potential biases and drawbacks. Despite limitations such as small field of view, lack of population-based norms, and lack of standardization of image acquisition, interpretation, and quantification, IVCM is useful as a complementary technique for clinical diagnosis in various ocular surface disorders related to dry eye. With advances in hardware and software in the near future, it has the potential for further practical impact.

Chinese expert consensus on dry eye: dry eye related to drugs (2021)

Ocular local or systemic medication may cause drug-related dry eye, which has become one of the important types of dry eye. A missed diagnosis or misdiagnosis of this type of dry eye is easy to occur clinically. To arouse the attention of ophthalmologists, experts from the Chinese Branch of the Asian Dry Eye Society and other related academic organizations have combined the new research progress and clinical practice associated with this specific disease, in terms of its definition, classification, risk factors, related drug types, pathogenesis, diagnosis, differential diagnosis, treatment principles and preventive measures, to form expert consensus opinions, hoping to promote the standardized diagnosis and treatment of drug-related dry eye in China. (Chin J Ophthalmol, 2021, 57: 734-742).

Evaluation of Ocular Surface and Meibomian Glands in Patients With Scleroderma.

To evaluate the prevalence of dry eye and meibomian gland dysfunction in patients with scleroderma. A total of 32 patients with scleroderma (study group) and 31 healthy subjects (control group) were enrolled. Besides routine ophthalmologic evaluation, Schirmer 1 test, tear break-up time, tear osmolarity, ocular surface staining with fluorescein (Oxford score), and Ocular Surface Disease Index (OSDI) score, meibomian gland dysfunction evaluation (foamy tears, telangiectasia of the eyelid, eyelid contour abnormalities, and meibomian plugs), and meibography were performed. Sixty-four eyes of 32 patients with scleroderma and 62 eyes of 31 healthy individuals were evaluated. Mean ages of the study group was 48.34 ± 9.73 years (21-62 years) and of the control group was 45.84 ± 4.42 years (38-54 years) (P = 0.067). Mean duration of systemic sclerosis or scleroderma in study group was 9.78 ± 7.40 years (1-30 years). Mean tear break-up time was shorter in study group than that in the control group (P < 0.0005). No statistical differences were detected for osmolarity, OSDI score, and Schirmer 1 values between groups (P = 0.051, P = 0.053, and P = 0.358, respectively). The prevalence of grade 1 and higher Oxford score was higher in the study group (P < 0.0005). Upper meiboscores of grade 1 and higher were found to be more common in the study group than those in the control group (P = 0.036). The presence of foamy tears and telangiectasia of the eyelids were significantly higher in the study group (P = 0.002 and P = 0.002, respectively). OSDI score was the only significantly correlated data with disease duration (Spearman ρ coefficient = 0.396, P = 0.001). Evaporative type dry eye is more common in patients with scleroderma than the healthy population.

Evaluation of the Prevalence and Risk Factors of Dry Eye in Young Population

Methods: It was a prospective observational study, conducted in 500 patients (1000 eyes), who visited at outpatient department of pediatric ophthalmology of our tertiary eye care center. All patients were screened for ocular surface disease index. Of those, having score >13 were further evaluated for the dry eye tests. The 60 eyes of 30 patients were selected and studied for the causes, types of dry eye.

A New Perspective on Dry Eye Classification: Proposal by the Asia Dry Eye Society.

:The 2017 consensus report of the Asia Dry Eye Society (ADES) on the definition and diagnosis of dry eyes described dry eye disease as “Dry eye is a multifactorial disease characterized by unstable tear film causing a variety of symptoms and/or visual impairment, potentially accompanied by ocular surface damage.” The report emphasized the instability of tear film and the importance of visual dysfunction in association with dry eyes, highlighting the importance of the evaluation of tear film stability. This report also discussed the concept of tear film–oriented therapy, which stemmed from the definition, and which is centered on provision of insufficient components in each tear film layer and ocular surface epithelium. The current ADES report proposes a simple classification of dry eyes based on the concept of tear film–oriented diagnosis and suggests that there are three types of dry eye: aqueous-deficient, decreased wettability, and increased evaporation. It is suggested that these three types respectively coincide with the problems of each layer: aqueous, membrane-associated mucins, and lipid/secretory mucin. Although each component cannot be quantitatively evaluated with the current technology, a practical diagnosis based on the patterns of fluorescein breakup is recommended. The Asia Dry Eye Society classification report suggests that for a practical use of the definition, diagnostic criteria and classification system should be integrated and be simple to use. The classification system proposed by ADES is a straightforward tool and simple to use, only through use of fluorescein, which is available even to non-dry eye specialists, and which is believed to contribute to an effective diagnosis and treatment of dry eyes.

Ocular surface assessment and morphological alterations in meibomian glands with meibography in obstructive sleep apnea Syndrome

PurposeTo evaluate ocular surface and Meibomian glands morphology of patients with obstructive sleep apnea syndrome (OSAS). Materials and methodsBased on polysomnography, 36 eyes of 36 patients with severe OSAS (Group 1, apnea-hypopnea index (AHI) ≥30/h) and 24 eyes of 24 patients with primary snoring or mild OSAS (Group 2, AHI<15/h) were enrolled. Detailed eye examination along with ocular surface staining (fluorescein, 2%) according to Oxford scale, tear film break-up time (t-BUT), Schirmer 1 test, ocular surface disease index (OSDI) scoring, and evaluation of upper and lower eyelid Meibomian glands using infrared filter of slit-lamp biomicroscope were performed. In addition to grading Meibomian gland drop-out, the presence morphologic alterations such as Meibomian gland duct distortion, thinning and dilatation were also assessed. ResultsThe mean ages were 50.8 ± 8.3 (range, 35–68) and 47.9 ± 10.5 (range, 27–69) in Group 1 and Group 2, respectively (p = 0.616). Best-corrected visual acuity, Schirmer 1 test, Oxford scale and OSDI scores, and lower meiboscores did not differ significantly between groups. In Group 1, average t-BUT was lower (p = 0.003), upper and total (upper + lower) meiboscores were higher as compared to Group 2 (p < 0.05). The frequency of Meibomian gland duct distortion, thinning and dilatation were also significantly greater in Group 1 (p < 0.05). ConclusionMorphological changes, in addition to Meibomian glands dropout were significant in severe OSAS patients as demonstrated objectively with meibography. Schirmer 1 and t-BUT tests were in favor of evaporative type dry eye syndrome, which also support Meibomian gland alterations in severe OSAS patients.

Short Tear Film Breakup Time-Type Dry Eye.

Measurement of tear film breakup time (TBUT) has become a standard diagnostic procedure in the dry eye clinic. Short TBUT-type dry eye is characterized by TBUT of less than 5 seconds and dry eye symptoms such as ocular fatigue or dryness; the importance of this type has recently been gaining prominence. Patients with this condition show no reduction in tear production and no staining of the ocular surface. The severity of symptoms is almost the same as in dry eye in which the ocular surface is stained with rose bengal or fluorescein. In addition to discomfort, patients suffer from decreased vision due to the unstable tear film, which can be attributed to the relative abnormality of the lipid layer, aqueous layer, and/or mucin layer. The diagnosis should be performed carefully on the basis of the patient's symptoms and the TBUT test, because the ocular surface appears normal and remains unstained.

Therapeutic effects of 3% diquafosol ophthalmic solution in patients with short tear film break-up time-type dry eye disease

BackgroundTo investigate therapeutic effects of topical diquafosol tetrasodium 3% ophthalmic solution in patients with short tear film break-up time (TFBUT)-type dry eye (DE).MethodsThe prospective study was performed in 70 eyes of 70 patients with short TFBUT-type DE. Diagnosis of short TFBUT-type DE was made based on the presence of DE symptoms, TFBUT value ≤5 s, corneoconjunctival staining score ≤ 2 (on a scale of 0 to 4), and Schirmer I value > 5 mm. Patients with systemic immunologic disorders or ocular graft-versus-host disease were excluded. Before and after instillation of 3% diquafosol ophthalmic solution six times per day for 4 weeks, subjective DE symptoms, TFBUT, corneoconjunctival staining score, and Schirmer I value were examined and compared. Also, demographic factors were compared between patients who showed improvement in each DE parameter by treatment and those who did not.ResultsFour-week treatment with 3% diquafosol ophthalmic solution significantly improved DE symptoms (p < 0.0001), increased TFBUT (p < 0.0001), and reduced corneoconjunctival staining scores (p < 0.0001). Schirmer I values were not changed by treatment. The age of patients who showed improvement in subjective DE symptoms after treatment was significantly lower than that of patients who did not (53.4 ± 27.5 vs. 63.3 ± 13.9 years, p = 0.012). Ocular side effects developed in 3 patients (4.3%), including conjunctival chemosis (n = 1) and persistent stinging sensation (n = 2).ConclusionsDiquafosol tetrasodium 3% ophthalmic solution is effective in improving subjective symptoms and tear film stability in short TFBUT-type DE patients.Trial registrationThe study was retrospectively registered on Clinical Research Information Service (CRiS), Republic of Korea.Trial registration number: KCT0003134.Date of registration: 2018-08-15.

The proportion of ocular surface diseases in untreated patients with epiphora.

PurposeVarious ocular surface disorders, such as dry eye, infectious and non-infectious inflammation, anatomical anomalies in lid structure, and/or obstruction of the tear outflow tract, can cause epiphora. However, few reports have described the proportions of causative diseases in patients with epiphora. Therefore, we investigated the frequent causes of epiphora in older adult patients.Materials and methodsWe enrolled 220 patients (70 men, 150 women) who visited a primary eye care clinic from January 2016 to August 2017 with lacrimation as a chief complaint. The mean age of the patients was 61.3±10.9 years. The causes of epiphora were assessed by slit-lamp examinations, dry eye tests, fluorescein disappearance tests, and lacrimal pathway washing.ResultsThe causes of epiphora were dry eye in 96, conjunctivochalasis in 56, lacrimal obstruction in 30, conjunctivitis in 20, trichiasis in 16, and facial palsy in 2 patients. Ocular surface diseases were identified in 187 of the 220 (85%) patients who complained of epiphora. Conjunctivochalasis was observed in 36 of the 96 (38%) patients with dry eye. Among the patients with dry eye, 99% had short break-up time type dry eye, with the random break type being the most frequent type (61/96; 64%) in patients with epiphora.ConclusionAmong older adult patients whose main complaint was epiphora, 85% had ocular surface diseases. In contrast, only 15% of patients had lacrimal diseases. Short break-up time dry eye, especially the random break type, was the most frequently observed form of dry eye in our cohort.

A new dry eye mouse model produced by exorbital and intraorbital lacrimal gland excision

Chronic dry eye is an increasingly prevalent condition worldwide, with resulting loss of visual function and quality of life. Relevant, repeatable, and stable animal models of dry eye are still needed. We have developed an improved surgical mouse model for dry eye based on severe aqueous fluid deficiency, by excising both the exorbital and intraorbital lacrimal glands (ELG and ILG, respectively) of mice. After ELG plus ILG excision, dry eye symptoms were evaluated using fluorescein infiltration observation, tear production measurement, and histological evaluation of ocular surface. Tear production in the model mice was significantly decreased compared with the controls. The corneal fluorescein infiltration score of the model mice was also significantly increased compared with the controls. Histological examination revealed significant severe inflammatory changes in the cornea, conjunctiva or meibomian glands of the model mice after surgery. In the observation of LysM-eGFP(+/−) mice tissues, postsurgical infiltration of green fluorescent neutrophils was observed in the ocular surface tissues. We theorize that the inflammatory changes on the ocular surface of this model were induced secondarily by persistent severe tear reduction. The mouse model will be useful for investigations of both pathophysiology as well as new therapies for tear-volume-reduction type dry eye.

Relation of accommodative microfluctuation with dry eye symptoms in short tear break-up time dry eye.

PurposeTo investigate accommodative microfluctuations (AMFs) and visual function in short tear break-up time (BUT)-type dry eye (DE) and non-DE subjects.MethodsThis prospective comparative study included 48 volunteers with DE symptoms (mean age 34.8 ± 5.5 years, age range 25–42 years) and 73 without DE symptoms (mean age 30.6 ± 4.7 years, age range 25–42 years). The eyes were divided into two groups: (1) DE group with DE symptoms and BUT ≤ 5 s and (2) non-DE group without DE symptoms and BUT > 5 s. We excluded eyes with Schirmer score ≤ 5 mm and positive keratoconjunctival epithelial damage. Tear evaluation, AMF, and functional visual acuity (VA) examinations were performed. AMF parameters included total high-frequency component (HFC), HFC with low accommodation for the task of staring into the distance (HFC1), and HFC with high accommodation for deskwork (HFC2). Functional VA parameters included starting VA, functional VA, visual maintenance ratio, and blink frequency.ResultsA total of 33 and 34 eyes were categorized in the DE and non-DE groups, respectively. Mean blink frequency and HFC1 values were significantly higher in the DE group than they were in the non-DE group.ConclusionsDEs with symptoms showed abnormal AMF and visual function, which may be associated with DE symptoms.

Dry eye and Meibomian gland dysfunction with meibography in patients with lamellar ichthyosis.

To evaluate the dry eye findings and Meibomian gland dysfunction as demonstrated with meibography in patients with lamellar ichthyosis. Twenty-four eyes of 12 patients with lamellar ichthyosis (Group 1) and twenty-four eyes of 12 healthy individuals (Group 2) were enrolled. Comprehensive eye examination along with corneal and conjunctival fluorescein staining with Oxford scoring, tear film break-up time, Schirmer 1 test, ocular surface disease index (OSDI) score assessment, and evaluation of upper and lower eyelid Meibomian glands using infrared filter of slit-lamp biomicroscope (SL-D701, TOPCON, Tokyo, Japan) were performed. The Meibomian glands were graded from grade 0 (no loss of Meibomian glands) to grade 3 (gland dropout >2/3 of the total Meibomian glands). The mean ages of Group 1 and Group 2 were 25.3±15.6years (range, 9-61 years) and 25.3±13.3years (range, 9-52 years), respectively (p=0.997). No significant difference in terms of best-corrected visual acuity, Schirmer 1 test and Oxford scores were detected in between groups. Mean tear film break-up time was lower (p=0.013), and OSDI score, lower, upper and total (upper+lower) meiboscores were significantly higher in Group 1 as compared with Group 2 (p<0.001, p=0.001, p=0.001, p=0.001, respectively). Lamellar ichthyosis is associated with evaporative type dry eye disease with decreased tear film break-up time, normal Schirmer 1 values and Meibomian gland dysfunction that can objectively be demonstrated with meibography. For this reason, in order to prevent undesired complications, these patients should be examined and treated for dry eye disease especially targeting Meibomian gland dysfunction.

Tear Fluid Protein Changes in Dry Eye Syndrome Associated with Rheumatoid Arthritis: A Proteomic Approach

PurposeSjögren syndrome (SS) secondary to rheumatoid arthritis (RA) affects lacrimal and salivary glands, and therefore dry eye syndrome (DES) is more prevalent in patients with RA. This study used a proteomic approach to identify potential biomarkers in tear of DES secondary to RA (DES-RA). MethodsTear specimens were collected with Schirmer strips from patients with DES with RA, patients with other types of dry eye (namely, primary Sjögrens and non-Sjögrens [NSS]), and age-matched controls. Tear proteins were subjected to 2D-differential gel electrophoresis (2D-DIGE), and the differentially expressed proteins were identified using nano ESI-LC-MS/MS analysis. ResultsAmong the differentially regulated proteins of DES-RA that were identified, lactotransferrin isoform 1 precursor was found to be d own-regulated in 100% cases and SHC transforming 1 isoform in 63% of the cases, while proteins such as ribonuclease p protein subunit 20, protocadherin, and heterogeneous nuclear ribonucleoprotein Q isoform 6 were down-regulated in over 80% of the cases. Proteins such as Ecto-ADP ribosyltransferase 5 precursor, Rho-related GTP-binding protein, and RhoJ precursor were up-regulated in 80% of the cases. ConclusionFunctional annotation revealed that these proteins have roles in regulation, antimicrobial activity, immune, metabolic, and cellular processes. The study observed characteristic marker proteins differentially expressed in DES-RA that are previously unreported. Further validation is needed.