The mission of the Tear Film & Ocular Surface Society (TFOS) is to advance the research, literacy, and educational aspects of the scientific field of the tear film and ocular surface. Fundamental to fulfilling this mission is the TFOS Global Ambassador program. TFOS Ambassadors are dynamic and proactive experts, who help promote TFOS initiatives, such as presenting the conclusions and recommendations of the recent TFOS DEWS II™, throughout the world. They also identify unmet needs, and propose future clinical and scientific solutions, for management of ocular surface diseases in their countries. This meeting report addresses such needs and solutions for 25 European countries, as detailed in the
Background: Despite the fact that keratoconus has been tipically defined as a noninflammatory condition, recent research has promoted the role of inflammatory factors and protein changes of tear film in disease progression.Aims: to determine the level of serum albumin, lactoferrin and lyzozyme in tears of keratoconic patients and their correlations with corneal biomechanical properties.Subjects and methods: 16 eyes of keratoconus patients and 14 eyes of control cases were enrolled in an observational prospective study. We performed a complete ophthalmological examination on all participants. In order to determine the concentration of tear film proteins, a minimum of 20 microlitres of tears from the lower conjunctival fornix were collected from each subject and measured by enzyme-linked immunosorbent assay (ELISA) analysis.Results: The level of lactoferrin measured in the tear film was significantly decreased in the keratoconus group compared to the normal subjects in all cases (p<0.05). We also found an increased level of lyzozyme and albumin in the keratoconus patients when compared to the controls, only the lyzozyme beeing statistically significant. In the keratoconus group, the correlations between proteins and important parameters such as keratometry, pachymetry and corneal biomechanics were statistically relevant in our study.Conclusions: We can state that the protein composition of tears is modified in keratoconus by increased levels of protein with inflammatory properties such as albumin or by decreased levels of protein with anti-inflammatory properties such as lactoferrin.
Neovascular Glaucoma (NVG) is a severe form of glaucoma characterized by neovascularization and the proliferation of fibrovascular tissue in the anterior chamber angle. Patients with NVG generally present with elevated intraocular pressure (IOP) and may experience severe pain. Ocular surface is affected by high IOP and can lead from moderated to marked conjunctival congestion that is frequently associated with edematous cornea. The aim of the study is to show how the high IOP can affect the ocular surface of the NVG patients and how we can treat and prevent the suffering. Materials and methods: We took in the study a number of 38 eyes from 35 patients with NVG in stage 3 with angle closure glaucoma, that presented high IOP and impaired ocular surface. Results and discussions: The ocular surface was damaged in patients that presented IOP between a minimum of 38 mmHg and maximum of 89 mmHg. The symptoms that patients presented were: conjunctival congestion in particular perikeratic, epithelial and stromal corneal edema, epithelial bubble, corneal ulcerations. Treatment followed rapid drop in IOP and the restoration and protection of ocular surface. The management of neovascular eye with high IOP was medical, laser and surgical. The restoration of ocular surface was made with lubricating hyperosmotic ophthalmic solutions, regenerative and protective agents. In all cases after the treatment was performed the ocular surface was restored. Conclusions: NVG is a very difficult pathology and is very hard to manage. The uncontrolled IOP in NVG patients affect the ocular surface and leads to complications. Long-term maintenance of normal intraocular pressure is important in NVG management but also in protecting the ocular surface.
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