DRY EYE PUBLICATION MARCH 10th 2015

1.	Invest Ophthalmol Vis Sci. 2015 Mar 5. pii: IOVS-14-15890. doi: 10.1167/iovs.14-15890. [Epub ahead of print] Corneoscleral limbus in glaucoma patients: in vivo confocal microscopy and immunocytological study. Mastropasqua R1, Agnifili L2, Fasanella V3, Curcio C 4, Brescia L5, Lanzini M6, Fresina M7, Mastropasqua L3, Marchini G8. Author information:  1Department of Neurological, Neuropsychological, Morphological and Movement Sciences, University of Verona, Ophthalmology Unit, University of Verona, Verona, 37126, Italy. 2Department of Medicine and Ageing Science, University G. d'Annunzio of Chieti-Pescara, Ophthalmic Clinic, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy, Via dei Vestini, Chieti, 66100, Italy l.agnifili@unich.it. 3Department of Medicine and Ageing Sciences, Ophthalmic Clinic, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy, Chieti, 66100, Italy. 4Department of Medicine and Ageing Sciences, Excellence Eye Research Center, CeSI, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy, via dei vestini, Chieti, 66100, Italy. 5Medicine and Ageing Science, Ophthalmic Clinic, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy, Chieti, 66100, Italy. 6Departement of Medicine and Ageing Sciences Ophthalmology Clinic. University, via dei vestini, Chieti, 66100, Italy. 7Department of Specialist, Diagnostics and Experimental Medicine (DIMES), Ophthalmology Service, University of Bologna, Italy, Ophthalmology Service, University of Bologna, Italy, Bologna, 40138, Italy. 8Ospedale di Borgo Trento, Clinica Oculistica dell'Universita, P.le A. Stefani, 1, Verona, 37126, Italy. Abstract Purpose: To investigate morphological changes of the corneoscleral limbus in glaucoma patients using laser scanning confocal microscopy (LSCM) and impression cytology (IC). Methods: Eighty patients with glaucoma and twenty with dry eye were enrolled; twenty healthy subjects served as controls. Patients underwent the Ocular Surface Disease Index (OSDI) questionnaire, tear film break-up time, corneal staining, Schirmer test I, and LSCM of the limbus. LSCM evaluated the limbal transition epithelium (LTE) regularity, dendritic cell (DC) density, and palisades of Vogt (POV). IC was performed and samples stained with HLA-DR and IL6. Results: Glaucomatous patients were divided into three groups: Group 1 (40 eyes): one drug; Group 2 (20): two drugs; and Group 3 (20): ≥ three drugs. LTE regularity was worse, and DC density higher in Groups 2, 3, and dry eyes compared to Group 1 and controls (p<0.01). Preserved drugs worsened LTE regularity and induced higher DC density compared to preservative-free (PF) drugs (p=0.041; p=0.004). Despite typical POV architecture was preserved, signs of inflammation were found in glaucoma groups. HLA-DR and IL-6 positivity were higher in Groups 2, 3 and dry eye compared to controls (p<0.001), and in preserved vs PF drugs (p<0.05; p<0.001). DC density and LTE regularity correlated with HLA-DR, IL-6, and OSDI score in glaucoma groups and dry eyes (p<0.001). Conclusions: LSCM and IC documented anti-glaucoma therapy induced morphologic alterations of limbus, which may play a role in the glaucoma related ocular surface disease. Further studies are required to determine if limbal changes affect stem cell viability. Copyright © 2015 by Association for Research in Vision and Ophthalmology.
	PMID: 25744981 [PubMed - as supplied by publisher]
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2.	Cont Lens Anterior Eye. 2015 Feb 27. pii: S1367-0484(15)00007-7. doi: 10.1016/j.clae.2015.01.005. [Epub ahead of print] Ex vivo heat retention of different eyelid warming masks. Lacroix Z1, Léger S1, Bitton E2. Author information:  1École d'optométrie, Université de Montréal, Montreal, Quebec, Canada. 2École d'optométrie, Université de Montréal, Montreal, Quebec, Canada. Electronic address: etty.bitton@umontreal.ca. Abstract PURPOSE:  Meibomian gland dysfunction (MGD) appears to be the most common cause of evaporative dry eye, in which the meibum has an altered chemical structure that increases its melting point. Eyelid warming masks slowly transfer heat, preferably between 40 and 45°C to the inner meibomian glands, in an attempt to melt or soften the stagnant meibum. This ex vivo study evaluates the heat retention properties of commercially available masks over a 12-min interval. METHODS:  Five eyelid-warming masks (MGDRx EyeBag®, EyeDoctor®, Bruder®, Tranquileyes™, Thera°Pearl ®) were heated following manufacturer's instructions and heat retention was assessed at 1-min interval for 12min on a non-conductive surface. A facecloth warmed with hot tap water was used as comparison. RESULTS:  All masks reached above 40°C within the first 2min after heating and remained so for 5min, with the exception of the facecloth, which lasted only 3min and quickly degraded to 30°C within 10min. The Bruder® and Tranquileyes™ reached >50°C, after heating and the Bruder® maintained >50°C for nearly 6min. The MGDRx EyeBag®, and Thera°Pearl® had the most stable heat retention between 2 and 9min, remaining between the targeted temperature. CONCLUSIONS:  Heat retention profiles are different for commercially available eyelid warming masks. This ex vivo study highlights that despite the popularity of the time-honored facecloth, it is poor at retaining the desired heat over a 5-10min interval. Clinical studies need to corroborate these results, remembering that ocular tissue parameters may be factors to consider. Copyright © 2015 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.
	PMID: 25735560 [PubMed - as supplied by publisher]
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3.	Int Forum Allergy Rhinol. 2015 Mar 2. doi: 10.1002/alr.21462. [Epub ahead of print] Endoscopic vidian neurectomy: a prospective case series. Zhang H1, Micomonaco DC, Dziegielewski PT, Sowerby LJ, Weis E, Wright ED. Author information:  1Division of Otolaryngology-Head and Neck Surgery, University of Alberta, Edmonton, Alberta, Canada. Abstract BACKGROUND:  Chronic refractory vasomotor rhinitis (VMR) is a debilitating condition that causes significant impairment of quality of life. The purpose of this study is to investigate the efficacy and potential side effects of endoscopic vidian neurectomy as treatment for patients with VMR. METHODS:  This study was a prospective, intent-to-follow case series. Inclusion criteria were as follows: (1) patients with debilitating VMR refractory to medical therapy and with significant impact on quality of life; (2) negative allergy history and skin testing; and (3) negative computed tomography (CT) scan to rule out skull-base defect or cerebrospinal fluid (CSF) fistula. Patients underwent bilateral vidian neurectomy via a pterygomaxillary approach. Prior to surgery all patients underwent formal ophthalmologic testing to quantify preoperative ocular and lacrimal function. Ophthalmologic testing was repeated postoperatively at approximately 3 months. Patients also completed surveys regarding rhinologic outcomes including the Sinusitis Symptom Questionnaire (SSQ) and the 22-item Sino-Nasal Outcome Test (SNOT-22) at the following time points: preoperatively, and 1 week, 4 weeks, 12 weeks, 6 months, 1 year, and 2 years postsurgery. Descriptive statistics and analysis of variance (ANOVA) were undertaken. RESULTS:  Eleven patients (22 sides) underwent bilateral vidian neurectomy with pathologic confirmation of nerve section in all cases. Average follow-up was 19.4 months. Statistically and clinically significant improvement was measured for both the SSQ and the SNOT-22 and compared with the patients' baseline scores (p < 0.0001). Subscores for rhinorrhea and nasal congestions were also statistically significantly improved (p < 0.05). No incidence of permanent or measureable dry eye has been reported. CONCLUSION:  The data suggests that vidian neurectomy is an effective, safe, and definitive treatment for most patients with VMR refractory to medical treatment. © 2015 ARS-AAOA, LLC.
	PMID: 25732231 [PubMed - as supplied by publisher]
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