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Background: To date, there are no studies on the impact of two distinct environments-one familiar to the horse and another unfamiliar-on intraocular pressure (IOP) and tear production., Objectives: To compare the measured IOP and tear production values in horses between a horse stable and a medical barn., Study Design: Cross-over., Methods: Thirty healthy male Arabian horses, aged 6.88 ± 3.34 years were used. IOP and tear production measurements were assessed in both the horse stable and the medical barn, with a paired Student's t-test and Bland-Altman analysis conducted for comparison and agreement, respectively., Results: A significant increase in IOP was observed in the medical barn (34.2 ± 6.8 mmHg) compared with the horse stable (29.5 ± 7.2 mmHg, p = 0.02). However, no statistically significant difference in tear production was found between horse stable (22.1 ± 2.8 mm/min) and medical barn (23.6 ± 3.4 mm/min) (p = 0.09). The standard error of the slope was 0.36 for the IOP measured in the medical barn, indicating a difference of -4.7 mmHg compared with the IOP measured in the horse stable (p = 0.02). The bias was fitted to y = -7.9350 + 0.1003x. The standard error of the slope was 0.39 for the tear production measured in the medical barn, indicating a difference of -1.5 mm/min compared with the tear production measured in the horse stable (p = 0.09). The bias was fitted to y = 6.1530 + -0.3367x., Main Limitations: The absence of horses with ocular disorders and an assessment of the potential impact of transportation., Conclusions: A notable increase in IOP was observed in the medical barn compared with the horse stable, while tear production exhibited no significant variance between the two environments. The Bland-Altman analysis highlighted a discrepancy in IOP measurements in the horse stable, emphasising the potential influence of the environment on ocular parameters in horses., (© 2024 The Authors. Equine Veterinary Journal published by John Wiley & Sons Ltd on behalf of EVJ Ltd.)

Purpose: This study evaluated the efficacy, safety, and tolerability of a single-dose, preservative-free (PF) Dorzolamide/Timolol combination (Twinzol-SDU). Methods: A 3-month single-arm, multicenter, prospective cohort study was conducted in Egypt between January 2021 and October 2022 on previously diagnosed and controlled patients with ocular hypertension and/or glaucoma. Efficacy was assessed using the change in intraocular pressure (IOP) after 6 and 12 weeks. Safety was identified through the change in the incidence of ocular side effects, ocular surface disease index (OSDI) scores and grades, and Time Break-Up time (TBUT). Results: A total of 382 patients were enrolled in the analysis. After the three-month period of therapy, a significant reduction in IOP was seen (mean change: -1.9, P < 0.001) after switching to PF Dorzolamide/Timolol combination. The rate of ocular abrasion decreased significantly from 30.6% to 1.3% (P < 0.001). The rate of normal aqueous tear production increased from 24.1% to reach 79.4% (P < 0.001). The OSDI scores decreased significantly throughout the study period, with a median score decreased from 41.7 (21.7) to 12.5 (12.5) (P < 0.001). Mild OSDI grades significantly increased from the baseline of 12.6% to reach 24.7%. Moderate OSDI grade decreased at the same rate, from 12.8% to 11.1%. The number of patients with severe OSDI grade substantially decreased from 64.4% to 4.5%, with a P < 0.001. TBUT increased from 9 (3.7) seconds to reach and 12.3 (4) seconds after 12 weeks of treatment (P < 0.001). Conclusion: Generally, the PF dorzolamide/timolol combination was associated with a significant reduction in IOP and tolerability among glaucoma patients. [ABSTRACT FROM AUTHOR]

The Schirmer strip measures tear volume in millimeters. A major limitation of the Schirmer strip is that it does not measure tear volume in a volumetric unit. Furthermore, the linearity range, lower limit of detection (LLOD), and lower limit of quantification (LLOQ) are not established. In this context, we developed a new filter paper based tear volume strip, which measures tear volume in microlitres (a volumetric unit), with a defined linearity range, LLOD, LLOQ, as well as inter-day and intra-day variability. We used standard Whatman filter paper no. 41, measuring 40 × 5 mm. Balanced salt solution (BSS) was used as a tear surrogate. By placing a specific volume of BSS at one marked end of the paper, we measured the distance travelled by the BSS after one minute. Different volumes of BSS (0.5, 1, 2, 4, 8, and 16 μl) were used, and the distance travelled by the BSS drop was recorded. Linearity was evaluated, and the LLOQ and LLOD were determined. Scale data were generated within the linearity range (10 replicates for each). Percentage recovery was calculated, and inter-day and intra-day variation as well as intra examiner and inter examiner coefficients of variation (CV%) were evaluated. High linearity (r2 = 0.976) was observed across all the tested volumes (0.5-16 μl), However, linearity improved within the tested volume range of 1-8 μl (r2 = 0.996). With an LLOD of 0.538 μl and an LLOQ of 1.63 μl, data for the scale were generated from 2-8 μl. Overall, volumetric recovery ranged from 97.34%-104%. The intra-day CV% ranged from 4.576% (for 2 μl) to 1.911% (for 5 μl) and 1.71% (for 7 μl). The inter-day CV% ranged from 1.715 (7 μl) to 4.36% (for 2 μl). The intra examiner CV% ranged from 0.422% (for 7 μl) to 2.66% (for 2 μl). The inter examiner CV% ranged from 1.93% (7 μl) to 3.69% (for 2 μl). This new tear volume measuring tool (named SI tear strip) represents a valuable tool for the measurement of tear volume (in μl) per unit time. This tool may be very helpful for the quantitative evaluation of dry eye patients and functional assessment of lacrimal glands., (Copyright © 2024 Indian Journal of Ophthalmology.)

Perfluorohexyloctane ophthalmic solution (Miebo) and water-free cyclosporine ophthalmic solution 0.1% (Vevye) are recently approved treatments for dry eye disease (DED). Perfluorohexyloctane (PFHO) uses a novel approach to treat evaporative DED, whereas water-free cyclosporine (CsA 0.1%) is formulated to increase ocular delivery of its active ingredient to improve tear production. The two medications utilize the distinctive properties of two different semifluorinated alkanes (SFAs) to elicit their therapeutic effects. PFHO consists of 100% active ingredient and forms a monolayer on the surface of the tear film to inhibit evaporation. CsA 0.1% utilizes a vehicle consisting of perfluorobutylpentane (PFBP) and ethanol to facilitate delivery of cyclosporine to ocular tissues. The structure of these SFAs determines their differing behaviors and functions. The longer chain length of PFHO results in a slower evaporation rate and facilitates formation of a stable monolayer on the ocular surface. In vitro, PFHO demonstrated a substantially lower evaporation rate versus PFBP or human meibum, as well as a significantly longer ocular surface residence time. Ex vivo, PFHO demonstrated a longer ocular surface residence time than PFBP. The shorter chain length of PFBP enables it to better solubilize cyclosporine and improve drug delivery to ocular tissues. Although both of these ophthalmic drops utilize SFAs, their differences—in physicochemical properties and the mechanisms by which they are understood to intervene in the DED cycle—are important considerations in treatment selection for patients with DED. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the changes in meibomian gland (MG) structure in allergic conjunctivitis (AC) patients using an intelligent quantitative analysis algorithm and to explore the relationship between these changes and clinical parameters. Methods: A total of 252 eyes from patients with AC and 200 eyes from normal controls were examined. Infrared meibography was performed using the non-contact mode of the Keratograph 5M. MG images were analyzed using a deep learning-based a quantitative analysis algorithm to evaluate gland length, area, dropout ratio, and deformation. Clinical parameters, including tear meniscus height, tear break up time (TBUT), conjunctival hyperemia, and Ocular Surface Disease Index (OSDI) scores, were assessed and correlated with changes in the structure of MG. Results: The average MG length in AC patients was 4.48 ± 1.04 mm, shorter compared to the control group (4.72 ± 0.94 mm). The average length of the central 5 glands in AC patients was 4.94 ± 1.67 mm, which was also shorter than the control group's central 5 glands (5.38 ± 1.42 mm). Furthermore, the central 5 glands' area in AC patients (1.61 ± 0.64 mm2) was reduced compared to the control group (1.79 ± 0.62 mm2). Tear meniscus height was lower in the allergy group (0.26 ± 0.10 mm) compared to the control group (0.44 ± 0.08 mm) (P < 0.05). The non-invasive first tear film break-up time was shorter in the allergy group (8.65 ± 6.31 s) than in the control group (10.48 ± 2.58 s) (P < 0.05). Conjunctival congestion was higher in the allergy group (1.1 ± 0.52) compared to the control group (0.97 ± 0.30) (P < 0.05). The OSDI score in the allergy group (8.33 ± 7.6) was higher than that in the control group (4.00 ± 0.50) (P < 0.05). Correlation analysis revealed that the gland dropout ratio was positively associated with male gender and negatively associated with age and OSDI scores. Additionally, despite an increased number of MG, tear film stability was not improved. Conclusion: Through the intelligent quantitative algorithm, we found that AC leads to significant changes in MG structure, particularly affecting gland length and central area. [ABSTRACT FROM AUTHOR]

Background: Epiphora and secondary ocular surface damage are increasingly impairing the quality of life of people, particularly elderly women. We aimed to investigate the changes in tear cytokine and lactoferrin levels in postmenopausal women with primary acquired nasolacrimal duct obstruction (PANDO) complicated with obstructed meibomian gland dysfunction (OMGD) and preliminary explore the pathological mechanisms of OMGD in patients with PANDO. Methods: The prospective study involved 43 and 41 postmenopausal women with and without PANDO, respectively. Based on the presence or absence of OMGD, the participants were subdivided. Tear fluid was collected from affected eyes of all participants using Schirmer I test and tested for cytokine concentrations (interleukin (IL)-6, IL-8, IL-1β, interferon-gamma, tumour necrotic factor (TNF)-α, IL-10, epidermal growth factor (EGF)) using the Multiplex Luminex Assay. Tear lactoferrin levels was determined using ELISA. Results: In the PANDO with OMGD group, the IL-8, IL-1α, IL-1β, and macrophage inflammatory protein-1α levels were significantly higher than those in the other groups. The IL-6 and TNF-α levels were significantly higher than those in the controls. The lactoferrin level in the PANDO with OMGD group was lower than that in the Non-PANDO with OMGD group. The IL-10 and EGF levels were not significantly different among the groups. Conclusion: The level of pro-inflammatory factors in the tears of patients with PANDO complicated with OMGD was significantly increased, which is likely to cause further damage to ocular surface. Anti-inflammatory therapy may help protect ocular surface in postmenopausal women with PANDO. [ABSTRACT FROM AUTHOR]

Background: This study investigates the effect of botulinum toxin A on lipid layer thickness (LLT) and blink dynamics in patients with benign essential blepharospasm (BEB) compared to dry eye disease (DED) patients. Methods: We reviewed the medical records of patients with dry eye disease (DED) and BEB treated with botulinum toxin A (BoT A) injections. Data on demographics, lipid layer thickness (LLT), meiboscore, and blink dynamics measured using a LipiView II interferometer before and 2 months after BoT A were collected. Results: Each 28 eyes from 28 patients with BEB and age- and sex-matched patients with DED were included. When comparing blink dynamics, complete blink rate was significantly higher in the pre-injection BEB group compared to the DED group (5.25 ± 4.32 times/20 s vs. 2.43 ± 2.82 times/20 s, p = 0.0055). In tear film lipid profiles analyzed in BEB patients at pre-injection and 2-month follow-up after injection, average LLT significantly increased after injection (72.4 ± 22.7 nm to 83.0 ± 22.2 nm, p = 0.0215). Diabetes and young age were associated factors influencing the LLT increase. Significant increase in LLT was observed post-injection, with specific demographic factors, including diabetes and age, associated with this improvement. Additionally, blink dynamics showed a decrease in complete blink rate post-injection. Conclusions: These findings suggest that BoT-A may alleviate BEB symptoms, but ophthalmologists should carefully interpret LLT and blink patterns in BEB patients due to potential overestimations of blink efficacy by the interferometer. [ABSTRACT FROM AUTHOR]

Background: In secondary Sjogren syndrome (sSS), the presence and extent of hearing and vestibular abnormalities are controversial. Hence, to ascertain if individuals with Rheumatoid arthritis (RA) associated secondary Sjogren syndrome (sSS) had subclinical audio-vestibular impairment as well as to investigate whether serum anticardiolipin and muscarinic receptors type 3 antibodies had a role in its pathogenesis, this cross-sectional study was conducted on 50 RA patients with secondary Sjogren syndrome manifestations and 50 RA patients without such manifestations were included, along with 50 apparently healthy volunteers who were aged, and sex-matched as controls. Full history taking, Otologic examination, Immunologic evaluation, and Audio-vestibular assessment were done for all subjects. Results: Twenty-five percent of our patients experienced subjective audio-vestibular symptoms. In the audiogram, 30 (60%) of the 50 RA patients with sSS and 5 (10%) of RA patients without sSS had abnormal hearing loss compared to only 4 (8%) of the controls (p ≤ 0.001) with a predominance of high-frequency sensorineural hearing loss. Also, 20% of our patients experienced a higher frequency of head-shaking nystagmus than they did (p ≤ 0.001). 30% had a statistically significant increase in the frequency of abnormal caloric test results as compared to either controls (0%) or RA patients without sSS (0%); p ≤ 0.001 Finally, all audio-vestibular symptoms and tests exhibit a strong positive correlation with muscarinic receptors type 3 and anticardiolipin antibodies. Conclusion: The use of muscarinic receptors type 3 and anticardiolipin antibodies are beneficial for early diagnosis of audio-vestibular dysfunction in RA-associated secondary Sjogren syndrome patients. Therefore, this study is important since it justifies rheumatologists' screening for inner ear damage in their RA patients especially if associated with secondary Sjogren. [ABSTRACT FROM AUTHOR]

This prospective cohort study is aimed to investigate circadian variations in corneal parameters, focusing on sleep-deprived subjects. Sixty-four healthy individuals (age range: 21–76 years) actively participated in this study, undergoing examinations at least five times within a 24-hour timeframe. The analysis encompassed keratometric parameters of the cornea's front (F) and back (B) surfaces, refractive power in flattest and steepest axes (K1, K2), astigmatism (Astig) and its axis (Axis), aspheric coefficient (Asph), corneal pachymetry values of thinnest corneal thickness (Pachy Min) and corneal thickness in the center of the pupil (Pachy Pupil), volume relative to the 3 and 10 mm corneal diagonal (Vol D3, Vol D10) and surface variance index (ISV). Circadian changes were assessed using a hierarchical, mixed-effects linear regression adjusted for age and night shift. A total of 1,636 measurements revealed significant circadian changes in various corneal parameters, including K1 F, K2 F/B, Astig F/B, Asph F/B, Pachy Min/Pupil, Vol D3/10, and ISV (p < 0.0001). Moreover, K1 B exhibited a significant circadian change (p = 0.0002), while Axis F/B remained unchanged. Notably, Corneal thickness peaked before 6 o'clock in the morning and reached its minimum after 12 o'clock. Contrary to previous notions linking corneal diurnal changes with eyelid closure during sleep, our study reveals that these changes persist in the absence of sleep. This research contributes valuable insights into the impact of sleep deprivation on corneal properties, warranting further investigations to deepen our understanding of daily variations in visual quality and guide the planning of refractive eye surgery interventions. [ABSTRACT FROM AUTHOR]

This review paper discusses the key aspects of ocular biopharmaceutics, with emphasis on the crucial role played by ocular compartmental modelling and simulation in deciphering physiological conditions related to various eye diseases. It describes eye's intricate structure and function and the need for precise and targeted drug delivery systems to address prevalent eye conditions. The review categorizes and discusses various formulations employed in ocular drug delivery, delineating their respective advantages and limitations. Additionally, it probes the challenges inherent in diverse routes of drug administration for ocular therapies and provides insights into the complexities of achieving optimal drug concentrations at the target site within the eye. The central theme of this work is the ocular compartmental modelling and simulations. Hence, this works discusses on the nuanced understanding of physiological conditions within the eye, drug distribution, drug release kinetics, and key considerations for ocular compartmental modelling and simulations. By combining information from various sources, this review aims to serve as a comprehensive reference for researchers, clinicians, and pharmaceutical developers. It covers the multifaceted landscape of ocular biopharmaceutics and the transformative impact of modelling and simulation in optimizing ocular drug delivery strategies. [ABSTRACT FROM AUTHOR]

Ocular nanoparticles are tiny particles designed to deliver drugs to the eye and have increased drug stability, prolonged drug release, and thereby enhanced bioavailability. Nanoparticles utilized in ocular drug delivery include liposomes, polymeric nanoparticles, solid lipid nanoparticles, nanostructured lipid carriers, dendrimers, and niosomes. Niosomes are non-ionic surfactant-based vesicles that can encapsulate both hydrophilic and lipophilic drugs and are similar to liposomes but are more stable, less toxic, and easier to produce. Niosomes can also be surface-modified with ligands (e.g., antibodies, peptides) to target specific ocular tissues or cells and hence can improve drug penetration through the corneal and conjunctival barriers. Niosomes can bind to the mucin layer of the eye, increasing medication retention time. The encapsulated medicine is released under regulated conditions, allowing therapeutic doses to be maintained for an extended time period. The present study examines niosome-based drug delivery substitutes in ophthalmology, as well as the optimization of nanocarriers for practical use in treating ocular diseases.Article Highlights: Challenges associated with ocular drug delivery due to its unique anatomy, including barriers like the cornea, tear film, and blood-retinal barrier which limit the bioavailability of conventional drug delivery methods. Most studies report that self-assembled nanoparticles are ideal for ocular delivery due to their ability to improve drug stability, solubility, and release profiles. Typically focuses on the advances in nanoparticle technologies for eye-related treatments. [ABSTRACT FROM AUTHOR]

Part 2 explores the transformative potential of artificial intelligence (AI) in addressing the complexities of headache disorders through innovative approaches, including digital twin models, wearable healthcare technologies and biosensors, and AI-driven drug discovery. Digital twins, as dynamic digital representations of patients, offer opportunities for personalized headache management by integrating diverse datasets such as neuroimaging, multiomics, and wearable sensor data to advance headache research, optimize treatment, and enable virtual trials. In addition, AI-driven wearable devices equipped with next-generation biosensors combined with multi-agent chatbots could enable real-time physiological and biochemical monitoring, diagnosing, facilitating early headache attack forecasting and prevention, disease tracking, and personalized interventions. Furthermore, AI-driven advances in drug discovery leverage machine learning and generative AI to accelerate the identification of novel therapeutic targets and optimize treatment strategies for migraine and other headache disorders. Despite these advances, challenges such as data standardization, model explainability, and ethical considerations remain pivotal. Collaborative efforts between clinicians, biomedical and biotechnological engineers, AI scientists, legal representatives and bioethics experts are essential to overcoming these barriers and unlocking AI's full potential in transforming headache research and healthcare. This is a call to action in proposing novel frameworks for integrating AI-based technologies into headache care. [ABSTRACT FROM AUTHOR]

Objective: Researchers have considered medicinal oils to prevent and treat pediatric diseases. In the traditional Persian medicine (TPM) doctrine, anointment is widely used in order to avoid and treat diseases. This study aimed to evaluate and reconcile the uses of anointment in children in TPM and the new studies. Materials and Methods: Accordingly, TPM documents were scrutinized for anointments and their applications in pediatric disorders. Moreover, new studies were reviewed in Google scholar, PubMed, Medline, Scopus, and Web of Science until June 2022. Results: In the health preservation field, TPM scholars have recommended daily anointment with some oils like sweet almonds in the early months after birth to improve growth, strengthen the body, and prevent dry skin, and new studies have confirmed the effectiveness of some oils accordingly. In the treatment field, various oils are recommended, namely sweet almond oil for weight disorders, violet oil for insomnia, olive oil and chamomile oil for functional constipation, infantile colic and enuresis, and olive oil for diaper rash and atopic dermatitis and new studies have shown their effectiveness. Sweet almond, chamomile, violet, olive, and rose oils are among the most widely used oils in Persian medicine for children, which we have discussed in this study. Conclusion: Due to the non-invasive nature of anointment and the observation of minimal adverse effects in studies, it can be given attention for maintaining pediatric health and treating their diseases. [ABSTRACT FROM AUTHOR]

Purpose: To compare the efficacy, safety, and tolerability of lifitegrast 5% versus carboxymethylcellulose (CMC) 0.5% in adult patients with dry eye disease (DED). Methods: A total of 370 eligible patients with DED were randomized equally to receive twice-daily doses of a single drop in each eye of either lifitegrast 5% or CMC 0.5% for 12 weeks. Follow-up at weeks 2, 6, and 12 evaluated changes from baseline in primary [eye dryness score (EDS), ocular discomfort score (ODS), ocular surface disease index (OSDI), and tear film break-up time (TFBUT)] and secondary [Schirmer tear test (STT) score and corneal fluorescein staining (CFS) score] endpoints. Global improvement, safety, and tolerability were also assessed. Results: At week 2, values of ocular discomfort score, OSDI, and conjunctival redness were significantly more favorable in patients treated with lifitegrast compared to CMC. At week 6, values of all study variables were better in patients treated with lifitegrast compared to CMC; differences between the groups were statistically significant for all except photophobia. This trend was also maintained at week 12. Global improvement and tolerability were found to be better with lifitegrast than with CMC. No serious safety concerns were reported in any treatment group. Conclusion: To our knowledge, this is the first active-controlled trial informing on the efficacy, safety, and tolerability of lifitegrast 5%. Significantly more favorable values for EDS (except photophobia), ODS, OSDI, TFBUT, STT score, CFS score, and conjunctival redness score were achieved at week 12 with lifitegrast 5% compared to CMC 0.5%. [ABSTRACT FROM AUTHOR]