New publications on dry eye
| 1. | Eur J Pharm Biopharm. 2015 Feb 25. pii: S0939-6411(15)00101-0. doi: 10.1016/j.ejpb.2015.02.019. [Epub ahead of print]
Reimondez-Troitiño S 1, Csaba N 2, Alonso MJ 2, de la Fuente M 3.
Author information:
Abstract
The topical route is the most frequent and preferred way to deliver drugs to the eye. Unfortunately, the very low ocular drug bioavailability (less than 5%) associated with this modality of administration, makes the efficient treatment of several ocular diseases a significant challenge. In the last decades, it has been shown that specific nanocarriers can interact with the ocular mucosa, thereby increasing the retention time of the associated drug onto the eye, as well as its permeability across the corneal and conjunctival epithelium. In this review, we comparatively analyze the mechanism of action and specific potential of the most studied nano-drug delivery carriers. In addition, we present the success achieved until now using a number of nanotherapies for the treatment of the most prevalent ocular pathologies, such as infections, inflammation, dry eye, glaucoma, and retinopathies. Copyright © 2015 Elsevier B.V. All rights reserved. |
| PMID: 25725262 [PubMed - as supplied by publisher] | |
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| 2. | Cornea. 2015 Feb 18. [Epub ahead of print]
Bhargava R 1, Kumar P.
Author information:
Abstract
PURPOSE::
The aim of this study was to evaluate the effect of dietary omega-3 fatty acid (O3FA) supplementation on dry eye symptoms, tear film tests, and conjunctival impression cytology in patients with contact lens wear-associated dry eye. METHODS::
In this randomized, double-blind, multicentric trial, contact lens wearers (n = 496) were randomized to receive either O3FAs or placebo capsules (corn oil) twice daily for 6 months. Subjects underwent examinations at baseline, 3 months, and 6 months. At each visit, a questionnaire of dry eye symptoms and lens wear comfort was administered. Subjects further underwent measurement of tear film break-up time (TBUT) and a Schirmer test. Conjunctival impression cytology was performed by the transfer method. Improvement in symptoms and lens wear comfort were primary outcome measures. Changes from baseline in TBUT, Schirmer, and Nelson grade at 6 months were secondary outcome measures. RESULTS::
The mean improvement in symptom score in the O3FA group was 4.7 ± 2 (2.0) as compared with 0.5 ± 2 (0.9) in the placebo group (P < 0.0001). Lens wear comfort levels improved significantly (P < 0.0001) from baseline. There was a significant increase in TBUT [3.3 ± 2 (1.5)] and Nelson grade [0.7 ± 2 (0.6)] in the O3FA group (P < 0.0001) as compared with 0.3 ± 2 (0.6) and 0.1 ± 2 (0.4) in the placebo group (P = 0.164 and 0.094, respectively). However, the magnitude of increase in Schirmer score [2.0 ± 2 (1.5)] was relatively small (P = 0.08). CONCLUSIONS::
The results of this study point toward benefits of orally administered O3FAs in alleviating dry eye symptoms, improving lens wear comfort, and cytological changes in contact lens wearers. |
| PMID: 25719253 [PubMed - as supplied by publisher] | |
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| 3. | J Pharm Sci. 2015 Feb 25. doi: 10.1002/jps.24385. [Epub ahead of print]
Pehlivan SB 1, Yavuz B, Çalamak S, Ulubayram K, Kaffashi A, Vural İ, Çakmak HB, Durgun ME, Denkbaş EB, Ünlü N.
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Abstract
In terms of ocular drug delivery, biodegradable implant systems have several advantages including the ability to provide constant drug concentration at the target site, no necessity for surgical removal, and minimum systemic side effects. Cyclosporin A (CsA) is a neutral, hydrophobic, cyclic peptide of amino acids that frequently used for dry eye disease treatment. The aim of this study was to develop a nanoparticle-loaded implant system for sustained-release CsA delivery following subconjunctival implantation. Poly(lactide-co-glycolide) (85:15) or poly-ε-caprolactone (PCL) were used to prepare two different nanoparticle formulations. These nanoparticles loaded into PCL or poly(lactide-co-caprolactone) implant formulations were prepared by two different methods, which were molding and electrospinning. Size and zeta potential of nanoparticles were determined and the morphology of the formulations were investigated by scanning electron microscopy. CsA-loading efficiencies were calculated and the in vitro degradation and in vitro release studies were performed. MTT test was also performed using L929 fibroblast cells to evaluate the cytotoxicity of the formulations. PCL-PCL-NP-I formulation was implanted to Swiss Albino mice with induced dry eye syndrome to evaluate the efficacy. In vitro release studies showed that the release from the formulations continues between 30 and 60 days, and the cell viability was found to be 77.4%-99.0%. In vivo studies showed that healing is significantly faster in the presence of the selected implant formulation. Results indicated that nanodecorated implants are promising ocular carriers for controlled-release CsA application. © 2015 Wiley Periodicals, Inc. and the American Pharmacists Association J Pharm Sci. © 2015 Wiley Periodicals, Inc. and the American Pharmacists Association. |
| PMID: 25716582 [PubMed - as supplied by publisher] | |
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| 4. | Vestn Oftalmol. 2014 Sep-Oct;130(5):78, 80-4.
[Article in Russian]
[No authors listed]
Abstract
OBJECTIVE:
to evaluate the effectiveness of therapeutic eyelid hygiene in the treatment of chronic, or perennial, allergic blepharoconjunctivitis (ABC). MATERIAL AND METHODS:
A total of 30 patients with chronic ABC (11 men, 19 women aged 25-41 years; disease duration 2-4 years) were examined before and after a treatment course which included instillations of olopatodine hydrochloride instillations (1 mg/ml, 2 times daily) and hyaluronic acid (2 mg/ml, 3-4 times daily). Patients from the main group (18 patients, 36 eyes) additionally practiced therapeutic eyelid hygiene using Blepharoshampoo, Blepharolotion or Blepharosalfetka, and Blepharogel-1 (2 times daily). The control group was given only anti-allergic therapy and tear substitutes. Conventional ophthalmological examination, allergy testing, ABC signs and symptoms evaluation, Schirmer's 1 and Norn's tests, tear film break-up time evaluation, assessment of meibomian gland function, optical coherence tomography (OCT) for tear meniscus, xerosis index evaluation and lissamine green staining for lid wiper epitheliopathy, and anterior segment photography with further computer morphometry were performed in all patients. RESULTS:
Dry eye signs and symptoms, including combined lipid, water, and mucus tear deficiency, were found in all patients with chronic ABC. Patients from the main group demonstrated a significantly greater decrease of integral indices of subjective ocular discomfort, reduction of chronic ABC signs as well as more pronounced improvement of the meibomian gland function, appearance of the lid wiper region, tear film break-up time, results of the OCT-meniscometry, and xerosis index. CONCLUSION:
Introduction of therapeutic eyelid hygiene to the complex treatment of chronic allergic blepharoconjunctivitis with the aim of resolving secondary dry eye symptoms enhances the effectiveness of the treatment. |
| PMID: 25711068 [PubMed - in process] | |
| 5. | Int J Ophthalmol. 2015 Feb 18;8(1):174-81. doi: 10.3980/j.issn.2222-3959.2015.01.31. eCollection 2015.
Bhatnagar KR 1, Pote S 1, Pujari S 1, Deka D 1.
Author information:
Abstract
AIM:
To determine the role of subjective assessment using McMonnies dry eye questionnaire in diagnosing dry eye disease and its association with clinical tests. METHODS:
There were 500 patients screened for dry eye using McMonnies dry eye questionnaire between May to October 2013 at the outpatient Department of Ophthalmology of a medical college hospital. All 500 patients were subjected to clinical tests. Dry eye was defined as having one or more symptoms often or all the time. Positive signs were if one or both eyes revealed tear film breakup time (TBUT) of ≤10s, a Schirmer test score of ≤10 mm, a Rose Bengal staining score of ≥1, a Lissamine green staining score of ≥1 or existence of meibomian gland disease (≥grade 1). Statistical analysis was performed to describe the distribution of symptoms and signs, to assess the correlations between McMonnies score (MS) and variable clinical signs of dry eye, and to explore the association between dry eye symptoms and variable clinical signs. Analysis was performed using software package Epi info. A Probability (P) value using Chi-square test of RESULTS:
Dry eye prevalence with symptoms (questionnaire), Schirmer test, TBUT, Rose Bengal staining and Lissamine green staining was 25.6%, 15.20%, 20.80%, 23.60%, and 22.60% respectively. Among those with severe symptoms (MS>20), 75.86% had a low TBUT (<10s), 58.62% had a low Schirmer's I test (≤10 mm), 86.20% had Rose Bengal staining score of ≥1, 79.31% had Lissamine green staining score of ≥1. We found statistically significant associations between positive Schirmer test and arthritis (P<0.002), dryness elsewhere (P<0.001), contact lens use (P<0.002), systemic medication (P<0.0001), sleeping with eyes partly open (P<0.002), history of dry eyes treatment (P<0.0001), environmental factors (P<0.001), swimming (P<0.001). CONCLUSION:
Subjective assessment plays an important role in diagnosing dry eye disease. There is strong correlation between MS and Schirmer test, TBUT, Rose Bengal staining and Lissamine green staining in normal as well as marginal and pathological dry eye. |
| PMID: 25709929 [PubMed] | |
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| 6. | J Ophthalmic Vis Res. 2014 Oct-Dec;9(4):487-93. doi: 10.4103/2008-322X.150829.
Hobbs RP 1, Bernstein PS 1.
Author information:
Abstract
There have been enormous advances in the past decade for the treatment of age-related macular degeneration (AMD); however, these treatments are expensive and require frequent follow-up and injections which place a tremendous burden on both the healthcare system and patients. Consequently, there remains considerable interest in preventing or slowing the progression of AMD requiring treatment. Epidemiological studies have shown that diet is a modifiable AMD risk factor, and nutrient modification is a particularly appealing treatment for AMD due to the perceived universal benefit and relatively low expense. Recently, the age-related eye disease study part two (AREDS2) was concluded and demonstrated further benefit with the addition of lutein and zeaxanthin as a replacement for the β-carotene of the previous generation formulation. The addition of omega-3 essential fatty acids did not show an added benefit. This review aims to highlight some of the evidenced based body of knowledge that has been accumulated from recent studies regarding the use of nutritional supplements and their effect on AMD, cataracts, and dry eyes. |
| PMID: 25709776 [PubMed] | |
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| 7. | J Ophthalmic Vis Res. 2014 Oct-Dec;9(4):417-22. doi: 10.4103/2008-322X.150803.
Jadidi K 1, Panahi Y 2, Ebrahimi A 3, Mafi M 4, Nejat F 2, Sahebkar A 5.
Author information:
Abstract
PURPOSE:
To evaluate the efficacy of topical cyclosporine A (tCsA) for treatment of dry eye disease in patients suffering from chronic ocular complications of mustard gas (MG) injury. METHODS:
This interventional case series included patients with MG injury suffering from severe dry eye despite receiving artificial tears and punctal plugs. Patients were administered tCsA 0.05% twice daily for 3 months. Severity of the condition was evaluated by measuring tear osmolarity, ocular surface disease index (OSDI), tear break-up time (TBUT), and Schirmer's test at baseline and at the end of study. RESULTS:
A total of 34 patients with chronic MG injury and mean age of 47.1 ± 6.5 years were studied. Compared to baseline values, tear osmolarity (301.7 ± 11.5 vs. 286.3 ± 7.9 mOsmol/L, P < 0.001) and OSDI (47.5 ± 7.2 vs. 42.7 ± 7.1, P < 0.001) were significantly improved. Likewise, Schirmer's test (4.6 ± 1.3 vs. 5 ± 1.3 mm, P < 0.001) and TBUT (1.9 ± 1.4 vs. 2.7 ± 1.5 s, P < 0.001) also significantly recovered at the end of the study. CONCLUSION:
TCsA 0.05% reduces tear osmolarity and improves dry eye symptoms and can serve as an efficacious treatment for ocular complications in patients with chronic MG injury. |
| PMID: 25709764 [PubMed] | |
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| 8. | Clin Transl Allergy. 2014 Oct 30;4:40. doi: 10.1186/2045-7022-4-40. eCollection 2014.
Ueta M 1, Shoji J 2, Sotozono C 3, Kinoshita S 3.
Author information:
Abstract
Rebamipide eyedrops are approved in Japan for the treatment of dry eye disease. Some patients with allergic conjunctival diseases also manifest dry eye. Earlier we reported that rebamipide suppressed polyI:C-induced inflammatory cytokines in human conjunctival epithelial cells. In the current study we examined the effect of rebamipide eyedrops on the level of interleukin-8 (IL-8), eosinophil cationic protein (ECP), and total IgE on the ocular surface. We prescribed rebamipide eyedrops to patients with atopic keratoconjunctivitis (AKC) who presented with dry eye (6 eyes in 4 AKC patients) and measured the IL-8, ECP, and total IgE levels in their tears before- and 2, and 4-6 weeks after the start of rebamipide treatment. To measure the IL-8 and total IgE levels in their tears we used BD™ CBA Flex sets; ECP measurements were with ELISA. The level of IL-8, ECP, and total IgE in the tears of AKC patients was reduced significantly 4-6 weeks after the start of rebamipide treatment. We also recorded subjective symptoms associated with AKC, e.g. itching, foreign body sensation, and eye mucus discharge, by using a patient questionnaire. Their subjective symptoms associated with AKC were also significantly ameliorated at 2 and 4-6 weeks. Our observations suggest that the anti-inflammatory effects of rebamipide eyedrops help to combat human ocular surface inflammation and that they may be a new effective therapy in patients with AKC. |
| PMID: 25705372 [PubMed] | |
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| 9. | Cont Lens Anterior Eye. 2015 Feb 16. pii: S1367-0484(15)00009-0. doi: 10.1016/j.clae.2015.01.007. [Epub ahead of print]
Bhargava R 1, Kumar P 2, Phogat H 3, Kaur A 3, Kumar M 4.
Author information:
Abstract
PURPOSE:
To assess the efficacy of dietary consumption of omega-3 fatty acids (O3FAs) on dry eye symptoms, Schirmer test, tear film break up time (TBUT) and conjunctival impression cytology (CIC) in patients with computer vision syndrome. SETTING AND DESIGN:
Interventional, randomized, double blind, multi-centric study. METHODS:
Four hundred and seventy eight symptomatic patients using computers for more than 3h per day for minimum 1 year were randomized into two groups: 220 patients received two capsules of omega-3 fatty acids each containing 180mg eicosapentaenoic acid (EPA) and 120mg docosahexaenoic acid (DHA) daily (O3FA group) and 236 patients received two capsules of a placebo containing olive oil daily for 3 months (placebo group). The primary outcome measure was improvement in dry eye symptoms and secondary outcome measures were improvement in Nelson grade and an increase in Schirmer and TBUT scores at 3 months. RESULTS:
In the placebo group, before dietary intervention, the mean symptom score, Schirmer, TBUT and CIC scores were 7.5±2, 19.9±4.7mm, 11.5±2s and 1±0.9 respectively, and 3 months later were 6.8±2.2, 20.5±4.7mm, 12±2.2s and 0.9±0.9 respectively. In the O3FA group, these values were 8.0±2.6, 20.1±4.2mm, 11.7±1.6s and 1.2±0.8 before dietary intervention and 3.9±2.2, 21.4±4mm, 15±1.7s, 0.5±0.6 after 3 months of intervention, respectively. CONCLUSION:
This study demonstrates the beneficial effect of orally administered O3FAs in alleviating dry eye symptoms, decreasing tear evaporation rate and improving Nelson grade in patients suffering from computer vision syndrome related dry eye. Copyright © 2015 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved. |
| PMID: 25697893 [PubMed - as supplied by publisher] | |
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| 10. | Clin Immunol. 2015 Jan;156(1):1-8. doi: 10.1016/j.clim.2014.10.004. Epub 2014 Oct 24.
Young NA 1, Wu LC 1, Bruss M 1, Kaffenberger BH 1, Hampton J 1, Bolon B 2, Jarjour WN 3.
Author information:
Abstract
Despite recent advances in the understanding of Sjögren's Syndrome (SjS), the pathogenic mechanisms remain elusive and an ideal model for early drug discovery is not yet available. To establish a humanized mouse model of SjS, peripheral blood mononuclear cells (PBMCs) from healthy volunteers or patients with SjS were transferred into immunodeficient NOD-scid IL-2rγ(null) mouse recipients to produce chimeric mice. While no difference was observed in the distribution of cells, chimeric mice transferred with PBMCs from SjS patients produced enhanced cytokine levels, most significantly IFN-γ and IL-10. Histological examination revealed enhanced inflammatory responses in the lacrimal and salivary glands of SjS chimeras, as measured by digital image analysis and blinded histopathological scoring. Infiltrates were primarily CD4+, with minimal detection of CD8+ T-cells and B-cells. These results demonstrate a novel chimeric mouse model of human SjS that provides a unique in vivo environment to test experimental therapeutics and investigate T-cell disease pathology. Copyright © 2014. Published by Elsevier Inc. |
| PMID: 25451161 [PubMed - indexed for MEDLINE] | |
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| 11. | J Steroid Biochem Mol Biol. 2015 Jan;145:237-44. doi: 10.1016/j.jsbmb.2014.08.014. Epub 2014 Aug 23.
Konttinen YT 1, Stegajev V 2, Al-Samadi A 2, Porola P 2, Hietanen J 3, Ainola M 2.
Author information:
Abstract
Sjögren's syndrome (SS) is an autoimmune disease characterized by lymphoplasmacytoid focal adenitis leading to mucosal dryness, with 9:1 female dominance and peak incidence at menopause. Due to autoimmune adenitis it can be speculated that the normal epithelial cell renewal has failed, possibly as a result of local intracrine failure to process dehydroepiandrosterone (DHEA) to dihydrotestosterone (DHT). Local intracrine/-cellular DHT deficiency seems to predispose to SS if estrogens are low, in menopausal women and in men. This intracrine failure could be the initial noxious stimulus, factor X, initiating the development of SS. Abnormal release and presentation of exocrine gland-derived antigens (Ag-epitopes), in a complex with major histocompatibility complex class II (MHC II), by migratory dendritic cells (DC) activates T-cells in the regional lymph nodes. B-cells with the same specificity capture and present self-Ag to Th-cells which provide T-cell help. B-cells transform to plasma cells and start to produce autoantibodies (Ab) against these T-cell-dependent Ag. Ab against SS-A/Ro and SS-B/La ribonucleoproteins occur only in HLA-DQw2.1/DQw6 heterozygous individuals, but hY-RNA and RNA polymerase III transcripts in these Ag may in all SS patients stimulate toll-like receptors (TLR) 7 and 9 of the plasmacytoid DCs, because IFN-α and IFN-signature are produced. CD8+αEβ7+cytotoxic T-cells activated via cross-presentation recirculate to attack intracrine-deficient, apoptotic epithelial cells expressing self-Ag on their surface. Exocrine glands fall into the sphere of mucosal/gut-associated lymphatic tissue. This together with immune complexes spreads the immunological memory/aggression to extra-glandular sites explaining the systemic nature of the syndrome. Secondary SS could be explained by disturbed lymphocyte recirculation. There is no conclusive evidence that SS in those few men affected is more severe than in women, suggesting that sex steroid endo-/intracrinology has its major impact on the target tissue, not on immune modulation. This article is part of a Special Issue entitled 'Essential role of DHEA'. Copyright © 2014 Elsevier Ltd. All rights reserved. |
| PMID: 25158020 [PubMed - indexed for MEDLINE] | |
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| 12. | Curr Eye Res. 2014 Sep;39(9):879-84. doi: 10.3109/02713683.2013.859273. Epub 2014 Jul 11.
Author information:
Abstract
PURPOSE/AIM:
Wink glass (WG), an invention to stimulate blinking at interval of 5 s was designed to reduce dry eye symptoms during visual display unit (VDU) use. The objective of this study is to investigate the effect of WG on visual functions that include blink rate, ocular surface symptoms (OSS) and tear stability during VDU use. MATERIALS AND METHODS:
A total of 26 young and asymptomatic subjects were instructed to read articles in Malay language with a computer for 20 min with WG whereby their blink rate, pre- and post-task tear break-up time, and OSS were recorded. The results were compared to another reading session of the subjects wearing a transparent plastic sheet as a control. RESULTS:
Non-invasive tear break-up time was reduced after reading session with transparent plastic sheet (pre-task = 5.97 s, post-task = 5.14 s, z = -2.426, p = 0.015, Wilcoxon), but remained stable (pre-task = 5.62 s, post-task = 5.35 s, z = -0.67, p = 0.501) during the reading session with WG. The blink rate recorded during reading session with plastic sheet was 9 blinks/min (median) and this increased to 15 blinks/min (z = -3.315, p = 0.001) with WG. The reading task caused OSS (maximum scores = 20) with median score of 1 (0-8) reduced to median score of 0 (0-3) after wearing WG (z = -2.417, p = 0.016). CONCLUSION:
WG was found to increase post-task tear stability, increased blinking rate and reduced OSS during video display unit use among young and healthy adults. Although it may be considered as an option to improve dry eye symptoms among VDU users, further studies are warranted to establish its stability and its effect on subjects with dry eyes. |
| PMID: 25014251 [PubMed - indexed for MEDLINE] | |
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| 13. | Int J Clin Exp Pathol. 2014 Apr 15;7(5):1988-96. eCollection 2014.
Author information:
Abstract
OBJECTIVE:
To examine amount of CD4+CXCR5+Tfh cells and B cells subsets in salivary gland and peripheral blood from patients with primary Sjogren's syndrome (pSS) and to analyze whether the frequency of CD4+CXCR5+Tfh cells is associated with pSS pathologic process. METHODS:
The percentages of CD4+CXCR5+Tfh cells and B cell subsets were examined by flow cytometry. B-lymphocyte chemoattraetant (BLC; also called CXCL13), IL-21, IL-6 from the serum of pSS patients was assessed by polymerase chain reaction-enzyme-linked immunosorbent assay (ELISA). RESULTS:
The percentages of CD4+CXCR5+Tfh cells in peripheral blood were increased in pSS patients, but decreased after treatment with glucocorticoid and/or immunosuppressive drugs. Abnormal B cell subsets appeared in salivary and peripheral blood of pSS patients. The frequency of salivary CD4+CXCR5+Tfh cells was positively correlated with CD19+CD27+ memory B cells and CD19+CD27high plasma cells. Also increase of salivary CD19+CD27high plasma cells was positively associated with serum ANA titer of pSS patients. CONCLUSIONS:
CD4+CXCR5+Tfh cells are significantly increased in salivary and peripheral blood in pSS patients with aberrant CD19+CD27+ memory B cells and CD19+CD27high plasma cells, suggesting that CD4+CXCR5+Tfh cells may contribute to the pathogenesis of pSS by promoting the maturation of B cells. |
| PMID: 24966908 [PubMed - indexed for MEDLINE] | |
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| 14. | Clin Rheumatol. 2014 Jul;33(7):931-7. doi: 10.1007/s10067-014-2573-7. Epub 2014 Mar 21.
Chiang CH 1, Liu CJ, Chen PJ, Huang CC, Hsu CY, Chan WL, Huang PH, Chen TJ, Lin SJ, Chen JW, Leu HB.
Author information:
Abstract
Few studies are available on the risk of ischemic stroke after a diagnosis of primary Sjögren's syndrome (PSS). This study investigated whether PSS increased the risk of ischemic stroke in a large, nationwide cohort. Data for 4,276 patients who were newly diagnosed with PSS from 2000 to 2006 and who did not have a stroke prior to diagnosis of PSS were obtained from the Registry of Catastrophic Illness in Taiwan. For each PSS patient, data for ten controls (matched by age, gender, comorbidities, and enrollment date) without systemic autoimmune disease or previous stroke were obtained from the Longitudinal Health Insurance 2000 database. All study subjects were followed up from the date of enrollment until they developed ischemic stroke, died, or until the end of 2006, whichever was earliest. To investigate if PSS was an independent factor in determining the risk of developing ischemic stroke, a Cox regression model was used with adjustment for age, gender, and comorbid disorders. Among 4,276 PSS patients and 42,760 controls, 669 subjects (51 PSS patients and 618 controls) developed ischemic stroke during the mean 3.7-year follow-up period (interquartile range 2.2-5.2 years). Patients with PSS and controls had a similar incidence of ischemic stroke occurrence (3.17/1,000 vs. 3.90/1,000 person years). Multivariate analysis adjusted for baseline covariates indicated that PSS did not increase the risk of ischemic stroke (adjusted hazard ratio: 0.84, 95 % confidence interval: 0.63-1.12, P = 0.244). PSS is not associated with an increased risk of ischemic stroke subsequent to diagnosis. |
| PMID: 24651915 [PubMed - indexed for MEDLINE] | |
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| 15. | Clin Rheumatol. 2014 Jul;33(7):925-30. doi: 10.1007/s10067-014-2548-8. Epub 2014 Mar 20.
Author information:
Abstract
The aim of this work was to clarify the effect of leflunomide (LEF) on the eye dryness in patients with secondary Sjögren's syndrome associated with rheumatoid arthritis (RA-sSS) and in patients with rheumatoid arthritis (RA). Seventy-five female patients, 45 with RA-sSS (group A) and 30 with RA (group B), taking methotrexate at a dose of 20 mg/week for more than 6 months were enrolled in this study. They all had a loading dose of leflunomide then were maintained at a dose of 20 mg/day in addition to methotrexate for another 3 months. The modified disease activity score (DAS28) was calculated and modified Schirmer's-I test was performed. Assessment of disease parameters was done to all patients before and after 3 months of taking LEF. The mean modified Schirmer's-I test showed a significant decrease after 3 months of taking LEF in group A (3 ± 1.6 before versus 1.9 ± 1.6 after 3 months, P < 0.001), while this difference was non-significant in group B (21.3 ± 10 versus 19.9 ± 11). One patient (group A) developed peripheral ulcerative keratitis (PUK) with exacerbation of disease activity (DAS-28 = 6.9) that improved by taking corticosteroids. Three patients (group A) had aggravation of punctate keratocojunctivitis sicca with punctate erosions without PUK. The condition improved dramatically by stopping LEF and using topical lubricants. We report in this study a significant deterioration of the eye dryness in patients with sSS-RA after 3 months of receiving LEF inspite of the significant improvement of their DAS28. This finding was not clearly detected in RA patients. Close monitoring of eye dryness changes by special tests in patients using LEF is recommended, especially in cases with sSS-RA having very low baseline values. |
| PMID: 24647977 [PubMed - indexed for MEDLINE] | |
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| 16. | Acta Ophthalmol. 2014 Sep;92(6):e429-36. doi: 10.1111/aos.12174. Epub 2013 Jun 7.
Malet F 1, Le Goff M, Colin J, Schweitzer C, Delyfer MN, Korobelnik JF, Rougier MB, Radeau T, Dartigues JF, Delcourt C.
Author information:
Abstract
PURPOSE:
To describe dry eye disease in French elderly subjects. METHODS:
The Alienor Study is a population-based study on age-related eye disease in 963 residents of Bordeaux (France), aged 73 years or more. Self-reported dry eye disease and use of artificial tears were documented through face-to-face interview. Dry eye symptoms were assessed using the Ocular Surface Disease Index (OSDI) questionnaire and tear film stability by tear break-up time measurements (TBUT). Definite dry eye disease was defined as self-reported dry eye, confirmed by use of artificial tears and/or OSDI greater or equal to 22. RESULTS:
Nine hundred and fifteen subjects, with mean age of 80 ± 4 years, returned the OSDI questionnaire. Of these, 271 (29.6%) subjects reported a dry eye disease and 135 (14.7%) were using artificial tears. An OSDI score > 22 was found in 359 (39.2%) subjects and a TBUT < 5 seconds in 335/746 (44.9%) subjects. Overall, definite dry eye affected 21.9% of subjects and was more frequent in women (27.1%) than in men (13.6%). After multivariate adjustment, dry eye disease was also significantly less frequent in subjects with high educational level (odds ratio (OR) = 0.49, 95% confidence interval (CI): 0.31-0.78 for long secondary school) and more frequent in subjects with ocular hypertension (OR = 1.61, 95% CI: 1.02-2.57) and those using anxiolytics (OR = 1.53, 95% CI: 1.02-2.29). CONCLUSIONS:
This large observational study confirmed the high prevalence of dry eye symptoms among elderly subjects and confirmed some of the previously identified risk factors (in particular female gender and use of anxiolytics). © 2013 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd. |
| PMID: 23742664 [PubMed - indexed for MEDLINE] | |
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