Assessment and management of dry eye disease

Buckley, Roger

doi:10.1038/eye.2017.289

Cited by 52 publications

(35 citation statements)

References 25 publications

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“…DED is often treated with artificial tears which provide temporary relief, or with cyclosporine or lifitegrast, both of which suppress ocular inflammation. None of the available treatments for DED are optimal, necessitating the development of new agents 8,9 .…”

Section: Introductionmentioning

confidence: 99%

A Rabbit Model of Aqueous-Deficient Dry Eye Disease Induced by Concanavalin A Injection into the Lacrimal Glands: Application to Drug Efficacy Studies

Honkanen

Huang

Rigas

2020

JoVE

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Dry eye disease (DED), a multifactorial inflammatory disease of the ocular surface, affects 1 in 6 humans worldwide with staggering implications for quality of life and health care costs. The lack of informative animal models that recapitulate its key features impedes the search for new therapeutic agents for DED. Available DED animal models have limited reproducibility and efficacy. A model is presented here in which DED is induced by injecting the mitogen concanavalin A (Con A) into the orbital lacrimal glands of rabbits. Innovative aspects of this model are the use of ultrasound (US) guidance to ensure optimal and reproducible injection of Con A into the inferior lacrimal gland; injection of Con A into all orbital lacrimal glands that limits compensatory production of tears; and use of periodic repeat injections of Con A that prolong the state of DED at will. DED and its response to test agents are monitored with a panel of parameters that assess tear production, the stability of the tear film, and the status of the corneal and conjunctival mucosa. They include tear osmolarity, tear break-up time, Schirmer's tear test, rose bengal staining, and tear lactoferrin levels. The induction of DED and the monitoring of its parameters are described in detail. This model is simple, robust, reproducible, and informative. This animal model is suitable for the study of tear physiology and of the pathophysiology of DED as well as for the assessment of the efficacy and safety of candidate agents for the treatment of DED. Video Link The video component of this article can be found at https://www.jove.com/video/59631/ 10,11. Most of the more than 12 rabbit DED models reported to date attempt to reduce tear production by either removing LGs or by impeding their function 12,13,14,15,16. Such approaches include the surgical resection of the ILG; closure of its excretory duct; and impairing LG function by irradiation or injection of one of the following: activated lymphocytes, mitogens, botulinum toxin, atropine, or benzalklonium. Major limitations of these methods are their inconsistency and the frequent partial suppression of tear production. Concanavalin A (Con A), a lectin of plant origin, is a potent stimulator T-cell subsets and has been used in experimental models of hepatitis 17 and DED 18. The original Con A-based model was reported to offer significant advantages, including its relative simplicity; inflammatory cell influx in the LGs, mimicking diseases such as Sjogren's; stimulation of the proinflammatory cytokines IL-1β, IL-8, and TGF-β1; reduced tear function

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Section: Introductionmentioning

confidence: 99%

A Rabbit Model of Aqueous-Deficient Dry Eye Disease Induced by Concanavalin A Injection into the Lacrimal Glands: Application to Drug Efficacy Studies

Honkanen

Huang

Rigas

2020

JoVE

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“…Topical corticosteroids have been used for years to treat the inflammation associated with dry eye. 44 Topical cyclosporine A is a common second line therapy for those that have had little success with the first line more conservative measures. 22 In July 2016, lifitegrast 5% became the second FDA approved topical ocular anti-inflammatory drug for the treatment of DED.…”

Section: Discussionmentioning

confidence: 99%

“…Although there has been a link between low dietary intake of omega-3 essential fatty acids and DED, there are only a limited number of random controlled trials confirming supplementation improves tear break up times and Schirmer scores. 44 …”

Section: Discussionmentioning

confidence: 99%

Trends in Dry Eye Disease Management Worldwide

Hantera¹

2021

OPTH

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“…19 Although the use of multiple tests can determine the multifactorial etiology of dry eye disease, the consensus among eye care practitioners is that tear osmolarity is best used as a disease severity marker. [20][21][22] Using the tear-film oriented diagnosis approach, a range of clinical examinations can be used to ascertain the reason for the clinical signs and symptoms. 19 The aqueous tear film layer quantity can be evaluated using the Schirmer test, the strip meniscometry, or anterior segment optical coherence tomography.…”

Section: Dry Eye Disease Diagnosis Functional and Subjective Testsmentioning

confidence: 99%

Tear Film Biomarkers in Dry Eye Disease

Hantera¹

2020

US Ophthalmic Review

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Assessment and management of dry eye disease

Cited by 52 publications

References 25 publications

A Rabbit Model of Aqueous-Deficient Dry Eye Disease Induced by Concanavalin A Injection into the Lacrimal Glands: Application to Drug Efficacy Studies

A Rabbit Model of Aqueous-Deficient Dry Eye Disease Induced by Concanavalin A Injection into the Lacrimal Glands: Application to Drug Efficacy Studies

Trends in Dry Eye Disease Management Worldwide

Tear Film Biomarkers in Dry Eye Disease

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