Dry Eye Assessment and Management (DREAM©) Study: Study design and baseline characteristics

Asbell, Penny A.; Maguire, Maureen G.; Peskin, Ellen; Bunya, Vatinee Y.; Kuklinski, Eric; Assessment, Dry Eye

doi:10.1016/j.cct.2018.06.002

Cited by 55 publications

(53 citation statements)

References 67 publications

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“…After the exclusion of 294 duplicate articles, 552 articles were assessed for eligibility. Finally, 15 records from 13 RCTs met the eligibility criteria [13,14,15,16,17,18,19,21,22,23,24,25,26,28]. The process of evidence selection is shown in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

“…For instance, DED was caused by a specific disease, surgery, or patients’ behavior. As we know, the PUFA effects upon the DED were various in etiology [27], and non-specific DED was most similar to real world populations [22,26]. The effect of PUFA on specific DED should be separated from this synthesis in the future.…”

Section: Methodsmentioning

confidence: 99%

“…The DREAM trial results mentioned that the patient selection, other treatments restriction, and duration of treatment may contribute to heterogeneities and controversies [22,26]. These factors possibly cause the heterogeneity in the outcomes among the previous RCTs.…”

Section: Introductionmentioning

confidence: 99%

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Effects of Polyunsaturated Fatty Acids on Nonspecific Typical Dry Eye Disease: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

2019

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To investigate the effects of polyunsaturated fatty acids (PUFAs) in patients with dry eye disease (DED), a multifactorial inflammatory disorder, we searched Cochrane Library, EMBASE, PubMed, and Web of Science for randomized clinical trials (RCTs) investigating the effect of PUFAs in patients with DED before March 2019. Two reviewers independently abstracted data of tear breakup time (TBUT), Schirmer’s test, osmolarity, and ocular surface disease index (OSDI). We conducted pairwise meta-analysis using means and standard deviations (SDs) in a random-effects model for continuous outcomes. Thirteen eligible RCTs with 1782 patients with nonspecific typical DED were included. Patients who received PUFA treatment without other eye medications exhibited greater improvements in TBUT (MD = 1.80; p = 0.001), Schirmer test scores (MD = 0.50; p < 0.001), osmolarity (MD = −15.95; p < 0.001), and OSDI scores (MD = −10.19; p < 0.001) than those who received placebo treatment. However, the effects of PUFAs on TBUT (p < 0.001) and OSDI scores (p = 0.03) weakened with treatment duration. PUFAs are effective in treating nonspecific typical DED, particularly as a short-term treatment, with relatively few adverse events. Therefore, in real-world clinical practice, PUFA supplements are worth being suggested to patients with nonspecific typical DED who are not concurrently using other topical or systematic eye medications.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Effects of Polyunsaturated Fatty Acids on Nonspecific Typical Dry Eye Disease: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

2019

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“…Prior to study conduct, DED clinicians completed a certification program on the standardized procedures for assessing signs of DED. 21 Instillation of 2% fluorescein dye and 1% lissamine green dye was standardized by the use of an Eppendorf micropipette to instill 5 µL of dye into the inferior cul-de-sac. Measurements of TBUT began approximately 30 seconds after the addition of fluorescein dye.…”

Section: Methodsmentioning

confidence: 99%

Climatic and Environmental Correlates of Dry Eye Disease Severity: A Report From the Dry Eye Assessment and Management (DREAM) Study

Berg

Ying

Maguire

et al. 2020

Trans. Vis. Sci. Tech.

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Correlate climate, weather parameters, and environmental exposures with the severity of symptoms and signs of dry eye disease (DED) in Dry Eye Assessment and Management (DREAM) study participants. Methods: Participants from five distinct climates completed the Ocular Surface Disease Index (OSDI) and were examined for corneal and conjunctival staining, tear breakup time (TBUT), and Schirmer's testing at baseline, 3, 6, and 12 months. Climate, weather parameters, and pollutants including ozone (O 3), carbon monoxide (CO), nitrous oxides (NO 2 , NO x , NO y), sulfur dioxide (SO 2), particulate matter, and optical depth were obtained from governmental databases. Multivariate analysis and partial correlation coefficients (ρ) were used to assess associations, adjusted for age, sex, and the presence of Sjögren disease. Results: Among 535 participants, 81% were female and mean age was 58 years. Participants from the Mediterranean climate demonstrated better corneal fluorescein staining, better TBUT, and higher Schirmer's test scores throughout the calendar year (each P < 0.0001). Greater corneal fluorescein staining was associated with lower humidity (P < 0.0038). TBUT measurements positively correlated with temperature, humidity, and dewpoint and inversely correlated with NO 2 levels (P < 0.0038). Paradoxically, some airborne pollutants were associated with less severe signs of dry eye (P < 0.0038). Windspeed was not correlated with signs of DED, and OSDI scores did not correlate with individual environmental exposures. Conclusions: Dry eye signs differed between climates and local humidity levels. With the exception of NO 2 , airborne pollutants were not associated with detrimental dry eye features. Translational Relevance: These results support limiting dry air exposure for patients with DED.

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“…A detailed description of the DREAM study design has previously been described. 9 Briefly, subjects needed to be ≥18 years with ocular symptoms related to DED for at least 6 months with the use of or a desire to use artificial tears. The patient's average score from the two visits on the OSDI needed to be between 22 and 80.…”

Section: Study Populationmentioning

confidence: 99%

Grading and baseline characteristics of meibomian glands in meibography images and their clinical associations in the Dry Eye Assessment and Management (DREAM) study

et al. 2019

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Purpose: To describe and evaluate a comprehensive grading system for meibomian gland (MG) digital infrared images developed by for the Dry Eye Assessment and Management (DREAM) Study. Methods: Cross-sectional study. Reading Center (RC) certified readers independently evaluated MG features of both lids from meibographs of dry eye disease subjects. Dropout areas were measured using planimetry software. Inter-reader and grade-regrade agreement and comparison of meiboscale scores (Meiboscale©; Pult) from clinical centers to RC percent dropout and of MG features with clinical parameters were evaluated. Results: Among 551 eyes of 277 patients at baseline, 62 (11%) upper lid and 5 (1%) lower lid images were missing. Lid eversion was poor in 63 (13%) of upper lids compared to 15 (3%) of lower lids. Intraclass correlation for inter-reader and grade-regrade agreement was moderate to substantial for most MG features. MG features were more frequent in the upper lid (p<0.001), except for dropout glands, gaps, fluffy gland areas and dropout areas. Clinic meiboscale score was associated with RC percent dropout (p<0.001), a clinic score of 0% having a mean RC score of 19%, and a clinic score of >75% having a mean RC score of 66%. MG plugging was associated

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Dry Eye Assessment and Management (DREAM©) Study: Study design and baseline characteristics

Abstract: ClinicalTrials.gov number NCT02128763.

Cited by 55 publications

References 67 publications

Effects of Polyunsaturated Fatty Acids on Nonspecific Typical Dry Eye Disease: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

Effects of Polyunsaturated Fatty Acids on Nonspecific Typical Dry Eye Disease: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

Climatic and Environmental Correlates of Dry Eye Disease Severity: A Report From the Dry Eye Assessment and Management (DREAM) Study

Grading and baseline characteristics of meibomian glands in meibography images and their clinical associations in the Dry Eye Assessment and Management (DREAM) study

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