Effectiveness of Combined Tear Film Therapy in Patients with Evaporative Dry Eye with Short Tear Film Breakup Time

Kim, Yung Hui; Kang, Yeon Soo; Lee, Hyo Seok; Choi, Won Suk; You, In Cheon

doi:10.1089/jop.2017.0019

Cited by 19 publications

(14 citation statements)

References 57 publications

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“…Thus far, only a few studies, mostly in Japan and some in Korea, have been performed on this condition. [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27]…”

Section: Recent Progress Around the Worldmentioning

confidence: 99%

“…Since the first report in 1995, many more papers have been added to the literature describing short TBUT-type dry eye, and this number is expected to increase, especially in Asia. [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27]36 Although this type of dry eye has been considered relatively mild to moderate because of the limited abnormality of ocular surface, recently Kim et al reported that the prevalence of depression among dry eye patients is higher in the mild type of dry eye, which overlaps with the short TBUT-type dry eye. 37,38 The precise prevalence of short TBUT-type dry eye is unclear, but TBUT is expected to be high according to a study among office workers in Osaka.…”

Section: History Of the Short Tbut-type Dry Eyementioning

confidence: 99%

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Short Tear Film Breakup Time–Type Dry Eye

Ohta

2018

Invest. Ophthalmol. Vis. Sci.

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Measurement of tear film breakup time (TBUT) has become a standard diagnostic procedure in the dry eye clinic. Short TBUT-type dry eye is characterized by TBUT of less than 5 seconds and dry eye symptoms such as ocular fatigue or dryness; the importance of this type has recently been gaining prominence. Patients with this condition show no reduction in tear production and no staining of the ocular surface. The severity of symptoms is almost the same as in dry eye in which the ocular surface is stained with rose bengal or fluorescein. In addition to discomfort, patients suffer from decreased vision due to the unstable tear film, which can be attributed to the relative abnormality of the lipid layer, aqueous layer, and/or mucin layer. The diagnosis should be performed carefully on the basis of the patient's symptoms and the TBUT test, because the ocular surface appears normal and remains unstained.

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“…Thus far, only a few studies, mostly in Japan and some in Korea, have been performed on this condition. [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27]…”

Section: Recent Progress Around the Worldmentioning

confidence: 99%

Section: History Of the Short Tbut-type Dry Eyementioning

confidence: 99%

Short Tear Film Breakup Time–Type Dry Eye

Ohta

2018

Invest. Ophthalmol. Vis. Sci.

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“…The mean reduction in the OSDI sum score was À23% in 10 days and À53% in 30 days, clearly reflecting time dependence. Improvements by 25 OSDI units have usually not been achieved in randomized clinical trials within similar time frames (Essa et al 2018;Fariselli et al 2018;Kim et al 2017). The observed change of 2.6 times the MCID (Miller et al 2010;Wolffsohn et al 2017) demonstrates the SIME and control formulations capable of reducing symptoms to a clinically meaningful extent that can be noticed by the patient.…”

Section: Discussionmentioning

confidence: 96%

Disease aetiology‐based design of multifunctional microemulsion eye drops for moderate or severe dry eye: a randomized, quadruple‐masked and active‐controlled clinical trial

Laihia¹,

Järvinen²,

Wylęgała

2019

Acta Ophthalmologica

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Purpose: To assess the safety and efficacy of multi-ingredient sacha inchi microemulsion (SIME) eye drops designed to target (1) tear film instability, (2) tear hyperosmolarity, and (3) ocular surface damage and inflammation in moderate or severe dry eye. Methods: This randomized, quadruple-masked, active-controlled parallel study in 64 adult patients comprised three parts. Part 1 (n = 3): one eye was treated with SIME for one day. Part 2 (n = 9): randomized eyes were treated with SIME and 0.2% hyaluronic acid (HA) control eye drops 3 times a day for 10 days. Part 3 (n = 26 + 26): randomized treatment was applied on both eyes 3 times a day for 30 days. OSDI change was tested for superiority of SIME over HA. Ocular assessments were performed at baseline and after the last dose. Results: Both treatments were well tolerated without adverse device effects. Tear film break-up time (p = 0.0025) and ocular protection index (p = 0.0026; change vs. HA, p = 0.047) increased significantly with SIME after 30 days. Tear osmolarity decreased more in SIME than in the HA group and significantly with both eye drops in hyperosmolar subgroups. Corneal (p = 0.014) and nasal conjunctival staining (p = 0.043) were reduced with SIME in per-protocol patients (n = 24). Conjunctival (p = 0.001) and lid redness (p = 0.012) decreased with SIME in all patients (n = 26). Symptoms decreased by about 25 OSDI units with both treatments (p < 0.0001) and with nonsignificant difference between treatments. Conclusions: Sacha inchi microemulsion (SIME) proved safe and efficacious in improving each aetiologic factor for dry eye as revealed through objective tests. Hyperosmolar stress dominating blink cycles must be disrupted by biophysical protection of the ocular surface to facilitate resolution of cellular damage and inflammation, and relief of ocular symptoms.

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“…There were several treatments to improve the quality of the Meibomian gland in the past, including warm compresses and improved eyelid hygiene, as well as antibiotic and anti-inflammatory agents. To overcome the shortcomings of the above, there are more options for the treatment of dysfunction of Meibomian gland currently, such as intraductal Meibomian gland probing, emulsion eye drops containing lipids, thermal pulsation system, and intense pulsed light therapy [74][75][76][77][78]. One systemic review also confirmed that a single 12-min vectored thermal pulsation was more efficient than traditional warm compression for DED in both objective or subjective measurements.…”

Section: Lipid Anomaly Dry Eye (Lade)mentioning

confidence: 99%

Dry Eye Disease: A Review of Epidemiology in Taiwan, and its Clinical Treatment and Merits

Kuo

Lin

Chien

et al. 2019

JCM

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Dry eye disease (DED) has become common on a global scale in recent years. There is a wide prevalence of DED in different countries based on various ethnicities and environment. DED is a multifactorial ocular disorder. In addition to advanced age and gender, such factors as living at high altitude, smoking, pterygium, prolonged use of consumer electronics or overingesting of caffeine or multivitamins are considered to be the major risk factors of DED. We report the DED epidemiology in Taiwan firstly in this article. According to the pathophysiological factors and changes inthe composition of the tear film in DED, it can be categorized into several subtypes, including lipid anomaly dry eye, aqueous tear deficiency, allergic and toxic dry eye among others. Each subtype has its own cause and disease management; therefore, it is important for ophthalmologists to identify the type through literature review and investigation. The management of DED, relies not only on traditional medications such as artificial tears, gels and ointments, but also newer treatment options such as acupuncture, SYL1001, and nanomedicine therapy. We also conducted a comprehensive literature review including common subtypes and treatment of DED. Clearly, more clinical trials are needed to assess the efficacy and safety of the various treatments and common subtypes of DED.

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Effectiveness of Combined Tear Film Therapy in Patients with Evaporative Dry Eye with Short Tear Film Breakup Time

Abstract: Mucin or lipid-targeting agents combined with aqueous supplements in patients with refractory EDE with short TBUT might improve subjective symptoms and TBUT. Of this, targeting whole tear film layers was most effective in improving ocular symptoms and tear film quality.

Cited by 19 publications

References 57 publications

Short Tear Film Breakup Time–Type Dry Eye

Short Tear Film Breakup Time–Type Dry Eye

Disease aetiology‐based design of multifunctional microemulsion eye drops for moderate or severe dry eye: a randomized, quadruple‐masked and active‐controlled clinical trial

Dry Eye Disease: A Review of Epidemiology in Taiwan, and its Clinical Treatment and Merits

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