Evaluation of the Clinical Course of Dry Eye Syndrome

Horwath‐Winter, Jutta; Berghold, Andrea; Schmut, O.; Floegel, Ingrid; Solhdju, Verena; Bodner, E.; Schwantzer, Gerold; Haller-Schober, Eva Maria

doi:10.1001/archopht.121.10.1364

Cited by 96 publications

(51 citation statements)

References 21 publications

(14 reference statements)

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“…Researchers have reported that subjects with SS have decreased meibum expressibility and quality [38], as well as increased meibomian gland dropout [39, 40] and dysfunction [38, 40, 41]. Further, SS patients have a reduced volume [1, 42], stability [39], lipid layer [39], and surface activity [43] of tears, heightened tear film evaporation [44, 45], ocular surface damage [1, 42], and increased DED symptoms [1, 41]. In effect, as indicated by Akpek et al [46], SS patients have combined aqueous and evaporative DED.…”

Section: Discussionmentioning

confidence: 99%

Meibomian Gland Dysfunction in Primary and Secondary Sjögren Syndrome

et al. 2018

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Purpose: We hypothesized that women with primary (pSS) and secondary Sjögren syndrome (sSS; with systemic lupus erythematosus [SLE] or rheumatoid arthritis [RA]) have meibomian gland dysfunction (MGD). We sought to test our hypothesis. Methods: Subjects with pSS, sSS + SLE, sSS + RA, and non-SS-related MGD were recruited from the Sjögren’s Syndrome Foundation or outpatient clinics at Tufts University School of Dental Medicine or Brigham and Women’s Hospital. The control population was recruited from the Greater Boston area. After providing written informed consent, the subjects underwent an eye examination and/or completed two questionnaires that assess symptoms of dry eye disease (DED). Results: Our results demonstrate that pSS and sSS patients have MGD. These subjects had meibomian gland orifice metaplasia, an increased number of occluded meibomian gland orifices, and a reduced quality of meibomian gland secretions. Further, patients with pSS, sSS + SLE, sSS + RA, and MGD had significant alterations in their tear film, lid margin, cornea, and conjunctiva. Symptoms of DED were increased ∼10-fold in all pSS, sSS, and MGD groups relative to controls. Conclusions: Our findings support our hypothesis and show that individuals with pSS, sSS + SLE, and sSS + RA have MGD. In addition, our study indicates that patients with pSS and sSS have both aqueous-deficient and evaporative DED.

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Section: Discussionmentioning

confidence: 99%

Meibomian Gland Dysfunction in Primary and Secondary Sjögren Syndrome

et al. 2018

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“…17 In brief, tear film BUT was measured by touching the inferotemporal bulbar conjunctiva with a fluorescein sodium strip, wetted with a preservative-free isotonic sodium chloride solution. The mean value of a total of three measurements was recorded.…”

Section: Patients' Datamentioning

confidence: 99%

“…15 The IC score was designed for observing the course of dry eye patients over a long period, and for the statistical evaluation of morphological changes. 16,17 The aim of this study was to evaluate the IC score on impression cytological specimens of 398 patients with dry eye syndrome as a diagnostic tool in relation to the type and severity of disease. The IC scores and the score points for each morphological parameter (IC subscores) of patients with simple dry eye (S-DE), patients with Sjö gren's syndrome and dry eye (SS-DE), and patients with dry eye and connective tissue disease (CTD-DE) were calculated and compared.…”

Section: Introductionmentioning

confidence: 99%

Evaluating an impression cytology grading system (IC score) in patients with dry eye syndrome

Schwantzer

Berghold

et al. 2005

Eye

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Purpose To evaluate the IC score, a newly developed grading system for the morphological alterations of the ocular surface as a diagnostic tool in relation to type and severity of dry eye disease. Methods Impression cytological specimens of 309 patients with simple dry eye (S-DE), 50 patients with Sjö gren's syndrome and dry eye (SS-DE), and 39 patients with connective tissue disease and dry eye (CTD-DE) were examined. In all, 10 different morphological parameters were judged with points (IC subscores) and summarized to the IC score. IC score and subscores were correlated to tear function test results and with each other. Results SS-DE patients had the highest IC scores and IC subscores. IC scores and IC subscores correlated significantly with the fluorescein staining of the cornea in all three patient groups. They were correlated to the rose bengal score in SS-DE and S-DE patients. The analysis of the IC subscores showed that there are significant correlations between most of the morphological alterations investigated. This underlines the importance of each parameter for the summarized IC score. Conclusion The IC score provides detailed information about the morphological alterations of the bulbar conjunctiva. It has proven to be useful for the differentiation of dry eye diseases and might help in the investigation of the pathogenesis of these diseases as well as for follow-up and therapy control.

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“…DES is even a symptom of many systemic diseases. In particular, people affected by Sjögren syndrome often experience DES as a common complication [16,17]. Diagnostic tests comprising a grading of the disease are generally clinical [18,19].…”

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confidence: 99%

A Highly Soluble Matrix Metalloproteinase‐9 Inhibitor for Potential Treatment of Dry Eye Syndrome

Mori

Lorenzo

Torre

et al. 2012

Basic Clin Pharma Tox

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Dry eye syndrome (DES) or keratoconjunctivitis sicca is an eye disease caused by the chronic lack of lubrication and moisture of the eye. The pathogenesis of DES involves the over-expression and over-activity of corneal Matrix Metalloproteinase 9 (MMP-9). We propose herein a new, non-symptomatic approach for the treatment of DES based on the inhibition of MMP-9 by a new highly soluble molecule, designed as PES_103 that has been shown to inhibit MMP-9 both in vitro and in vivo. The efficacy of PES_103 in vivo and the potential benefits of this treatment in restoring tear production were studied in this work using an animal model of reduced lacrimation. PES_103 did not show any significant corneal toxicity.Matrix metalloproteinases (MMPs) are a family of zinc containing hydrolases with a broad proteolytic specificity and large structural similarity [1]. These enzymes are involved in the degradation of several extracellular proteins including extracellular matrix components (ECM) and play a crucial role in tissue remodelling and in the regulation of different cellular activities [2]. An aberrant MMPs activity often promotes an excessive degradation of the ECM and could be responsible for the genesis of diseases such as inflammation, angiogenesis and cancer [3]. Recently, relevant ocular disorders such as proliferative diabetic retinopathy and dry eye syndrome (DES), or keratoconjunctivis sicca, have been associated with a significant increase in the concentration and activity of MMPs in the tear fluid [4-6]. In particular, DES has been associated with the over-expression and increased activity of corneal Matrix Metalloproteinase-9 (MMP-9 or Gelatinase B) [7], which has been shown to be both a marker and a promoter of eye dryness [8]. According to the work of Pflugfelder et al. [9], MMP-9 knockout mice do not develop DES, whereas the topical administration of active MMP-9 to such mice significantly increased corneal epithelial permeability.The 2007 Report of the Dry Eye WorkShop (DEWS) defined dry eye as an eye disease that results mostly in symptoms of discomfort, visual disturbance and tear film instability, with potential damage to the ocular surface that affects about 20% of the American population and 75% of the over-65-year population [10,11]. DES can be caused by a decrease in tear production or an increase in tear film evaporation, hence being represented by reduced lacrimation models. Persistent dryness, burning and a sandy-gritty eye irritation are the most common symptoms associated with DES and, in general, get worse as the day goes on [12]. Generally, both eyes are affected by DES and the physical damage occurs mainly at the corneal level. The aetiology of this syndrome is manifold, from the normal ageing process, to the effects of different drugs [13], to climatic factors together with daily routines and working-related features, such as standing in front of a computer screen, the use of air conditioning or of contact lenses [14,15]. DES is even a symptom of many systemic diseases. In particu...

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Evaluation of the Clinical Course of Dry Eye Syndrome

Abstract: To assess subjective symptoms, tear function factors, and ocular surface morphology in the clinical course of patients with dry eye syndrome under treatment within an observation period of up to 8 years.

Cited by 96 publications

References 21 publications

Meibomian Gland Dysfunction in Primary and Secondary Sjögren Syndrome

Meibomian Gland Dysfunction in Primary and Secondary Sjögren Syndrome

Evaluating an impression cytology grading system (IC score) in patients with dry eye syndrome

A Highly Soluble Matrix Metalloproteinase‐9 Inhibitor for Potential Treatment of Dry Eye Syndrome

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