Progressively Increased Variation in Tear Osmolarity Mirrors Dry Eye Severity

Sullivan, Benjamin D.; Pepose, Jay S.; Foulks, Gary N.

doi:10.1001/jamaophthalmol.2015.3854

Cited by 10 publications

(5 citation statements)

References 5 publications

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“…Vehof et al investigated the influence of genetic factors on dry eye in female twins and found an estimated heritability of 40% for osmolarity [145]. Variation between normal right and left eyes is 6.9 ± 5.9 mOsm/L [146]. Data on the effect of sex on tear osmolarity remain equivocal, with Lemp et al [128] and Versura et al [126] reporting no significant effect of sex, which is in agreement with a previous review of the literature [54], whilst Fuerst et al [140] show significantly higher tear film osmolarity in men (311.8 vs. 302.3 mOsm/L).…”

Section: Biophysical Measurements Of the Tear Filmmentioning

confidence: 99%

“…The instability of osmolarity readings has been attributed to compromised homeostasis of the dry eye tear film. Differences between readings can be considered a marker for tear film instability [128,133,146]. Such interpretation may be supported by studies showing higher variability between measurements or eyes with higher osmolarity values or more severe dry eye [128,133,137,139,165].…”

Section: Biophysical Measurements Of the Tear Filmmentioning

confidence: 99%

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TFOS DEWS II Tear Film Report

et al. 2017

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The members of the Tear Film Subcommittee reviewed the role of the tear film in dry eye disease (DED). The Subcommittee reviewed biophysical and biochemical aspects of tears and how these change in DED. Clinically, DED is characterized by loss of tear volume, more rapid breakup of the tear film and increased evaporation of tears from the ocular surface. The tear film is composed of many substances including lipids, proteins, mucins and electrolytes. All of these contribute to the integrity of the tear film but exactly how they interact is still an area of active research. Tear film osmolarity increases in DED. Changes to other components such as proteins and mucins can be used as biomarkers for DED. The Subcommittee recommended areas for future research to advance our understanding of the tear film and how this changes with DED. The final report was written after review by all Subcommittee members and the entire TFOS DEWS II membership.

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Section: Biophysical Measurements Of the Tear Filmmentioning

confidence: 99%

Section: Biophysical Measurements Of the Tear Filmmentioning

confidence: 99%

TFOS DEWS II Tear Film Report

et al. 2017

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“…1) [40,51]. This inter-eye difference decreases with effective treatment of DED [5,52,53]. The phenomenon where the variability of one variable (in this case, the interocular difference in tear osmolarity) is unequal and depends upon another variable (in this case, the disease severity) is called heteroscedasticity.…”

Section: Effects Of Bilaterality Of Ded In Design Of Clinical Trials-dry Eye Diseasementioning

confidence: 99%

TFOS DEWS II Clinical Trial Design Report

et al. 2017

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“…1 It also is regarded as a “gold standard” among diagnostic tools for DED. 1–5 Because of these implications in the pathogenesis of DED, there has been a multitude of studies estimating the values of tear osmolarities in normal and dry eye (DE) patients with a variety of techniques. For example, earlier methods using freezing point depression 6–8 and vapor pressure techniques 9 yielded generally a narrow distribution ranging from approximately 284 to 316 mOsm/L in normal individuals compared to a much wider distribution curve ranging from approximately 286 to 364 mOsm/L in DE patients.…”

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confidence: 99%

Estimating the Osmolarities of Tears During Evaporation Through the “Eyes” of the Corneal Nerves

Hirata

Mizerska

Dallacasagrande

et al. 2017

Invest. Ophthalmol. Vis. Sci.

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PurposeA population of corneal neurons in rats preferentially sense and monitor the hyperosmolar conditions of tears when the tears begin to evaporate during corneal dryness. The present study exploited this ability in an effort to estimate tear osmolarities by comparing the responses to corneal dryness to their responses to hyperosmolar stimuli.MethodsExtracellular recordings were performed from single neurons in the trigeminal ganglia innervating the corneas of rats. To determine the extent to which the corneal neurons' responses to drying of the cornea were induced via the activation by hyperosmolar stimuli, we assessed the responses to ocular instillation of 500 and 600 mOsm/L, and a graded series of hyperosmolar stimuli ranging from 350 to 1000 mOsm/L.ResultsThe magnitudes of the responses to drying of the cornea were matched almost exactly to those induced by the ocular instillation of the 600 mOsm/L stimuli but not the 500 mOsm/L solutions. The response magnitudes to a graded series of hyperosmolar solutions were nearly linear from the 350 to the 600 mOsm/L stimuli, but reached a plateau or declined slightly thereafter.ConclusionsOur results demonstrate that the tear osmolarity in rats could reach 600 to 1000 mOsm/L during ocular dryness. Furthermore, a spontaneous eye blink could be generated at a tear osmolarity of approximately 400 mOsm/L if the blink is solely determined by hyperosmolar tears, but ocular surface cooling also can become a major factor if hyperosmolar tears occurring during ocular dryness lower the threshold of activation of the neurons.

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Progressively Increased Variation in Tear Osmolarity Mirrors Dry Eye Severity

Cited by 10 publications

References 5 publications

TFOS DEWS II Tear Film Report

TFOS DEWS II Tear Film Report

TFOS DEWS II Clinical Trial Design Report

Estimating the Osmolarities of Tears During Evaporation Through the “Eyes” of the Corneal Nerves

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