Efficacy of Carboxymethylcellulose and Hyaluronate in Dry Eye Disease: A Systematic Review and Meta-Analysis

Song, Jae Kyeong; Lee, Kiheon; Park, Hwa Yeon; Hyon, Joon Young; Oh, Seung Won; Bae, Woo Kyung; Han, Junhee; Jung, Sung Il; Um, Yoo Jin; Lee, Ga Hye; Yang, Ji Hye

doi:10.4082/kjfm.2017.38.1.2

Cited by 25 publications

(24 citation statements)

References 16 publications

(44 reference statements)

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“…We also reviewed the latest published meta-analysis that focused on DED therapy. In summary, in comparison to AT or placebo, 0.05% cyclosporine group and omega-3 group had lower OSDI (MD = 4.10 and MD = 0.968), but carboxymethylcellulose group and sodium hyaluronate group had no statistical significance [20][21][22][23]. In consideration of the fact that AS group had significant lower OSDI (MD = 10.75) than AT group, AS might had powerful effectiveness in comforting DED patients.…”

Section: Discussionmentioning

confidence: 89%

Autologous Serum Eye Drops versus Artificial Tear Drops for Dry Eye Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

et al. 2019

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Objective: To compare the efficacy of autologous serum (AS) eye drops and artificial tears (AT) in dry eye disease (DED). Methods: Five databases (PubMed, Science Direct, the Cochrane Library, the Chinese National Knowledge Infrastructure, and the Wanfang Database) were searched for randomized controlled trials (RCTs). Efficacy was evaluated in terms of the Ocular Surface Disease Index (OSDI), Schirmer I test, tear break-up time (TBUT), and fluorescein and rose bengal staining of ocular surface. The estimated effects of AS or AT were expressed as a proportion with the 95% confidence interval and plotted on a forest plot. Results: Seven RCTs with 267 subjects were included in the meta-analysis. For most of the studies, subjects' age was around 50 years old, and the mostly treatment duration was within 8 weeks. The followup results showed that the OSDI after AS treatment was lower than that after the AT treatment: the mean difference (MD) was-10.75 (95% CI,-18.12;-3.39) points. There was no difference on the Schirmer I test after treatment between the two groups: the MD was 1.68 (95% CI,-0.65; 4.00) mm. The TBUT of the AS group was longer than that of the AT group, with an MD of 4.53 (95% CI, 2.02; 7.05) s. There was no statistically significant difference on fluorescein staining score of the ocular surface between the AS group and the AT group, the MD was-2.53 (95% CI,-6.08; 1.03) points. The rose bengal staining score of the AS group was slightly lower than that of the AT group after treatment: the MD was-0.78 (95% CI,-1.34;-0.22) points. Conclusion: AS could be an effective treatment for DED, improving OSDI, TBUT, and rose bengal staining score. Further RCTs with large samples and longterm follow-up are still needed to determine the exact role of AS in the management of DED.

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Section: Discussionmentioning

confidence: 89%

Autologous Serum Eye Drops versus Artificial Tear Drops for Dry Eye Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

et al. 2019

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“…In a recent review, Song et al carried out a meta-analysis of five original studies comparing CMC and HA eye drops. 13 The authors concluded that CMC was more efficacious than HA in treating DED. These conclusions, however, are obviously limited, since they were based on nonsignificant results and only TBUT test results were analyzed.…”

Section: Discussionmentioning

confidence: 99%

Comparative study of 0.1% hyaluronic acid versus 0.5% carboxymethylcellulose in patients with dry eye associated with moderate keratitis or keratoconjunctivitis

Groß¹,

Childs²,

Piaton³

2018

OPTH

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BackgroundEye drops containing 0.1% hyaluronic acid (HA) and 0.5% carboxymethylcellulose (CMC) applied one drop three times a day per affected eye were compared in patients with moderate keratitis or keratoconjunctivitis related to dry eye disease (DED).Patients and methodsThis was a prospective, randomized, multicenter, Phase IIIB noninferiority study, with a single-masked phase in parallel mode with two groups over 84 days. The primary efficacy outcome was change in ocular surface (OS) staining between day 0 (D0) and day 35 (D35). The conjunctiva and cornea were stained with lissamine green and fluorescein. Secondary efficacy measures at day 84 (D84) were OS-staining score (SS), ocular comfort index, tear-film breakup time and how patients and investigators rated treatment efficacy and safety.ResultsAt D35, 0.1% HA achieved a 46.6% reduction in OS-SS (−2.03±1.35 points, n=39 patients) and 0.5% CMC treatment, followed by a 34.9% reduction (−1.61±1.69 points, n=38 patients) compared to D0. At D84, the SS difference to D0 improved by −2.58±1.45 points (−59.2%) for 0.1% HA and −2.59±2.27 points (−54.4%) for 0.5% CMC. Ocular comfort-index scores improved, with significantly lower (better) values for stinging and itching on D84 for 0.1% HA. Patients assessed treatment with 0.1% HA as significantly better than 0.5% CMC (Likert scale, 4.82 vs 3.97; P=0.018). Four adverse events (AEs) occurred in four of 41 patients (9.8%) treated with 0.1% HA, and three AEs in two of 39 patients (5.1%) treated with 0.5% CMC. No serious AEs were noted.ConclusionDED signs and symptoms of DED significantly improved with both eye drops. OS staining improved >54% at D84. Treatment was well tolerated, with only minor AEs <10%. 0.1% HA and 0.5% CMC were equally safe and effective. Significant and nonsignificant results were constantly in favor of 0.1% HA.

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“…Its etiologies include causes secondary to systemic autoimmune disorders such as Sjogren's syndrome, rheumatoid arthritis, systemic lupus erythematous, and so on that are bothersome to doctors and patients [6][7][8][9][10]. In conventional treatment, arti cial tear eye drops are mainly used to moisturize the ocular surface and offer additional lubrication [11]. To address symptoms of chronic in ammation, antiin ammation and topical immunosuppression agents could be considered [12].…”

Section: Introductionmentioning

confidence: 99%

Establishment of Functional Epithelial Organoid From Human Lacrimal Glands

Jeong

Choi

Lee

et al. 2020

Preprint

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Background: Tear deficiency due to dysfunction of the lacrimal gland is one of the major causes of dry eye disease (DED). Artificial tears as conventional medicine often alleviate symptoms, however, they insufficient to prevent the progression of severe DED. Lacrimal gland stem cell-based therapies have been extensively reported to regenerate injured lacrimal tissue, but the number of stem cells in the lacrimal gland is pretty low, and 2D long-term cultivation results in the reduction of the differentiation capacity of stem cells. Therefore, 3D lacrimal gland organoids could be an alternative for a DED therapeutic method, which is capable of prolonged growth while maintaining the characteristics of the lacrimal gland tissue.Method: Digested cells from human lacrimal gland tissue were mixed with Matrigel and cultured in five different media modified from human prostate/salivary organoid culture media. After organoid formation, the growth, expression of specific markers and histological characters were analyzed to prove the lacrimal gland organoids. And then, the secretory function of lacrimal gland organoids was confirmed by calcium influx or proteomics after pilocarpine treatment.Result: Human lacrimal gland organoids were formed and cultured under a modified salivary organoid culture medium, and their histological features and gene expression pattern were similar to normal lacrimal gland tissue. After pilocarpine treatment, their secretory function was confirmed and the secretomes were analyzed by proteomics. More than 70% of the identified proteins were proven to exosome through GO analysis. Additionally, to explore the curability of developed organoids, mouse-derived lacrimal gland organoids were fabricated and transplanted into mouse lacrimal tissue with DED, and we confirmed that organoids were well engrafted in the lacrimal tissue.Conclusion: These results demonstrate that our established lacrimal gland organoids resemble characteristics of normal lacrimal gland tissue and could be used as cell therapy for patients with dry eye syndrome.

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Efficacy of Carboxymethylcellulose and Hyaluronate in Dry Eye Disease: A Systematic Review and Meta-Analysis

Cited by 25 publications

References 16 publications

Autologous Serum Eye Drops versus Artificial Tear Drops for Dry Eye Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Autologous Serum Eye Drops versus Artificial Tear Drops for Dry Eye Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Comparative study of 0.1% hyaluronic acid versus 0.5% carboxymethylcellulose in patients with dry eye associated with moderate keratitis or keratoconjunctivitis

Establishment of Functional Epithelial Organoid From Human Lacrimal Glands

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