Objective Imaging Diagnostics for Dry Eye Disease

Han, Sang Beom; Liu, Yu‐Chi; Mohamed-Noriega, Karim; Tong, Louis; Mehta, Jodhbir S.

doi:10.1155/2020/3509064

Cited by 26 publications

(35 citation statements)

References 124 publications

(206 reference statements)

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“…More reproducible and reliable tests, such as tear osmolarity, tear cytokine level, impression cytology, and in vivo confocal microscopy have been introduced for assessment of DED, which may be helpful for more accurate evaluation of the influence of PUFAs on DED [24,54,56,64,65]. Newly developed objective test methods for DED, such as anterior segment optical coherence tomography, non-invasive tear breakup time, interferometry, tear film imager, meibography, and thermometry are shown to allow more reproducible and accurate measurement of biomarkers of DED, such as tear volume, thickness, height and stability, meibomian gland function, thickness of tear muco-aqueous and lipid layers, and ocular surface temperature [101].Therefore, application of these devices is expected to enable the evaluation of the real efficacy of various PUFAs on DED [101].…”

Section: Current Perspectivesmentioning

confidence: 99%

The Protective Effect of Polyunsaturated Fatty Acids against Dry Eye Disease: A Literature Review

Hyon

Han

2021

Applied Sciences

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Dry eye disease (DED) is a common disease, and have an adverse effect the physical, functional, and psychological quality of life. It is a multifactorial disorder characterized by the loss of tear film homeostasis, in which self-perpetuating vicious cycle leads to deterioration of function and inflammation of the lacrimal functional unit. Hence, treatment strategies should be aimed at the interruption of the vicious inflammatory cycle and alleviation of ocular surface inflammation. Anti-inflammatory therapies have been shown to improve the signs and symptoms of the disease. Evidence indicates that polyunsaturated fatty acids (PUFAs) may contribute to reinforcement of innate anti-inflammatory mechanisms, and systemic and topical administration of PUFAs may help modulate ocular surface inflammation. In the present review, the authors will introduce the results of clinical and experimental studies to elucidate the mechanism, efficacy, and safety of systemic and topical supplementation with PUFAs as an alternative therapeutic strategy for DED. This review will also include discussion regarding current perspectives, including evidence-based recommendations and possible side effects of PUFAs supplementation. The review of the literature suggests that PUFAs supplementation can be a viable option for the treatment of DED, although further studies are needed for establishment of treatment guidelines.

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Section: Current Perspectivesmentioning

confidence: 99%

The Protective Effect of Polyunsaturated Fatty Acids against Dry Eye Disease: A Literature Review

Hyon

Han

2021

Applied Sciences

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“…Best corrected visual acuity (BCVA) was used as an indicator of visual stability. CFS, TBUT, and the Schirmer test without topical anesthesia (Schirmer I) were used to assess the lubricating properties, stability, and quantity of the tear film [43][44][45][46][47]. Tear film osmolarity in the lower tear meniscus was additionally measured using the TearLab osmolarity system (TearLab Corporation, San Diego, CA, USA).…”

Section: Efficacy Assessmentmentioning

confidence: 99%

The HYLAN M Study: Efficacy of 0.15% High Molecular Weight Hyaluronan Fluid in the Treatment of Severe Dry Eye Disease in a Multicenter Randomized Trial

Setten

Baudouin

Horwath‐Winter

et al. 2020

JCM

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The aim of the HYLAN M study was to investigate if symptoms and/or signs of patients suffering from severe dry eye disease (DED) can be improved by substituting individually optimized artificial tear therapy by high molecular weight hyaluronan (HMWHA) eye drops. In this international, multicenter study, patients with symptoms of at least ocular surface disease index (OSDI) 33 and corneal fluorescein staining (CFS) of at least Oxford grade 3 were included. A total of 84 per-protocol patients were randomized in two study arms. The control group continued to use their individual optimum artificial tears over the study period of eight weeks; in the verum group, the artificial tears were substituted by eye drops containing 0.15% HMWHA. At the week 8 visit, the average OSDI of the verum group had improved by 13.5 as compared to the control group (p = 0.001). The best corrected visual acuity (BCVA) had improved by 0.04 logMAR (p = 0.033). CFS, tear film break-up time (TBUT), Schirmer I, lid wiper epitheliopathy (LWE), mucocutaneous junction (Yamaguchi score), and tear osmolarity were not significantly different between the verum and control groups (p > 0.050). We conclude that for most patients with severe DED, 0.15% HMWHA eye drops provide excellent improvement of symptoms without impairment of dry eye signs.

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“…Infrared thermography (IRT) in the medical setting has been used to noninvasively assess the surface temperature of various body parts, organs, tissues, and cells for indication of abnormality [ 16 – 19 ]. It has gained popularity in medical diagnostics and research since the 1960s due to its nonionizing and noninvasive nature [ 20 , 21 ]. To date, studies have successfully reported the capability of IRT in screening breast cancer, diabetic neuropathy, mass fever screening, and meibomian gland dysfunction [ 22 – 25 ].…”

Section: Introductionmentioning

confidence: 99%

Screening Evaporative Dry Eyes Severity Using an Infrared Image

Zhang

Song

et al. 2021

Journal of Ophthalmology

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Background. Dry eye disease (DED) is a multifactorial and one of the most common problems treated in an ophthalmic outpatient clinic. Due to the variability in presentation, diagnosis of DED consists of a combination of subjective and objective clinical tests. The purpose of this study was to assess the effectiveness of a handheld smartphone-based infrared thermal (IRT) camera for screening symptomatic evaporative DED. Methods. This observational sex-matched control study assessed IRT images of 184 right eyes (46 normal and 138 DED) of 184 participants. Evaporative DED was assessed using noninvasive tear breakup time, fluorescein staining, and the Chinese version of the ocular surface disease index (C-OSDI) questionnaire and categorized into their respective dry eye symptomology group (none, mild, moderate, or severe). The ocular surface temperature (OST) at 8 anatomical regions of interest (ROI) (nasal conjunctiva, nasal limbus, nasal cornea, central cornea, inferior cornea, temporal limbus, temporal cornea, and temporal conjunctiva) were measured and compared using a handheld smartphone-based IRT camera. The effectiveness of these 8 ROIs OST in detecting varying severity of DED was evaluated in terms of correlations with severity of DED and their area under the curve (AUC). Results. OST at the 8 anatomical ROI was significantly higher in DED participants than in the non-DED group ( p < 0.05 ) except for inferior cornea, temporal limbus, and temporal conjunctival regions (>0.05). Analyzing 8 anatomical ROIs revealed that the nasal limbus had the highest Pearson correlation with the severity of DED (0.64, p < 0.001 ). Additionally, the nasal limbus ROI achieved the highest AUC of 0.79 (CI: 0.73–0.85; p < 0.05 ), sensitivity, and specificity (0.96 and 0.91) when comparing its ability to discriminated DED vs. non-DED eyes. Conclusions. Rather than a diagnostic tool, handheld smartphone-based IRT images can be considered as a rapid, noninvasive, and hygienic screening tool in discriminating DED and non-DED and potentially alleviating inconvenience experienced during conventional tests.

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Objective Imaging Diagnostics for Dry Eye Disease

Cited by 26 publications

References 124 publications

The Protective Effect of Polyunsaturated Fatty Acids against Dry Eye Disease: A Literature Review

The Protective Effect of Polyunsaturated Fatty Acids against Dry Eye Disease: A Literature Review

The HYLAN M Study: Efficacy of 0.15% High Molecular Weight Hyaluronan Fluid in the Treatment of Severe Dry Eye Disease in a Multicenter Randomized Trial

Screening Evaporative Dry Eyes Severity Using an Infrared Image

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