Report of the TFOS/ARVO Symposium on Global Treatments for Dry Eye Disease: An Unmet Need

Sullivan, David A.; Hammitt, Katherine M.; Schaumberg, Debra A.; Sullivan, Benjamin D.; Begley, Carolyn G.; Gjörstrup, P.; Garrigue, Jean-Sébastien; Nakamura, Masatsugu; Quentric, Yann; Barabino, Stefano; Dalton, Michelle; Novack, Gary D.

doi:10.1016/j.jtos.2012.02.001

Cited by 48 publications

(36 citation statements)

References 43 publications

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“…There are relatively few effective treatments for DED, especially for severe disease 7. Clinical development of new DED treatments is slow, partly because of problematic diagnosis and classification 8.…”

Section: Introductionmentioning

confidence: 99%

Diagnosing the severity of dry eye: a clear and practical algorithm

et al. 2014

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Dry eye disease (DED) is a distressing ocular condition. Due to its multifactorial nature, clinical and biological signs of DED can be inconsistent and sometimes discordant with symptomatology. Consequently, no gold-standard model for determining DED severity exists. This can impact treatment decisions and complicate evaluation of disease progression, particularly within the stringent context of clinical trials. The multinational ODISSEY European Consensus Group is comprised of ophthalmologists who contend with ocular surface disease issues on a daily basis. This group convened to establish a clear and practical algorithm for evaluation and diagnosis of severe DED. Using a consensus-based approach, they assessed 14 commonly used DED severity criteria. The panel agreed that following confirmed DED diagnosis, just two criteria, symptom-based assessment and corneal fluorescein staining were sufficient to diagnose the presence of severe DED in the majority of patients. In the event of discordance between signs and symptoms, further evaluation using additional determinant criteria was recommended. This report presents the ODISSEY European Consensus Group recommended algorithm for DED evaluation, which facilitates diagnosis of severe disease even in the event of discordance between signs and symptoms. It is intended that this algorithm will be useful in a clinical and developmental setting.

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Section: Introductionmentioning

confidence: 99%

Diagnosing the severity of dry eye: a clear and practical algorithm

et al. 2014

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“…DED, a serious public health problem that affects more than 100 million people worldwide, degrades the quality of life seriously [2,3]. However, therapies for DED remain elusive for two reasons: there is no quantitative, highly repeatable, objective diagnosis method, and there is little or no correlation between signs and symptoms [4]. In this work, we hypothesize that tear film instability is a key indicator of DED and can be quantified by tear film dynamics, specifically the thinning rate of the tear film across the cornea.…”

Section: Introductionmentioning

confidence: 99%

Maximum-likelihood estimation in Optical Coherence Tomography in the context of the tear film dynamics

Huang¹,

Clarkson²,

Kupinski³

et al. 2013

Biomed. Opt. Express

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Understanding tear film dynamics is a prerequisite for advancing the management of Dry Eye Disease (DED). In this paper, we discuss the use of optical coherence tomography (OCT) and statistical decision theory to analyze the tear film dynamics of a digital phantom. We implement a maximum-likelihood (ML) estimator to interpret OCT data based on mathematical models of Fourier-Domain OCT and the tear film. With the methodology of task-based assessment, we quantify the tradeoffs among key imaging system parameters. We find, on the assumption that the broadband light source is characterized by circular Gaussian statistics, ML estimates of 40 nm +/− 4 nm for an axial resolution of 1 μm and an integration time of 5 μs. Finally, the estimator is validated with a digital phantom of tear film dynamics, which reveals estimates of nanometer precision. Ferris, "Task-based optimization and performance assessment in optical coherence imaging," J. Opt. Soc. Am. A 22(6), 1132-1142 (2005). 7. A. C. Akcay, E. Clarkson, and J. P. Rolland, "Effect of source spectral shape on task-based assessment of detection and resolution in optical coherence tomography," Appl. Opt. 44(35), 7573-7580 (2005). 8.

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“…An UTF resulting from increases in tear film osmolarity is considered to be part of the vicious cycle of dry eye. 15 Our results suggest that DQS showed therapeutic value by disrupting this cycle, possibly through an effect on tear osmolarity. The major limitations of this study are its small sample size and nonblinded nature.…”

Section: Discussionmentioning

confidence: 63%

“…BUT, a marker of tear film stability, is influenced by both qualitative and quantitative changes in tears. 15 In the clinical setting, we encounter many patients with UTF DED. Although this type of dry eye has not been regarded as classical dry eye, our group has demonstrated that subjects have positive subjective symptoms and visual disturbances similar to those of conventional AD dry eye (data under submission).…”

Section: Discussionmentioning

confidence: 99%