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Purpose: To investigate the efficacy, safety and tolerability of topical omega-3 polyunsaturated fatty acids (PUFA) as an innovative treatment of dry eye disease (DED). Patients and Methods: In a pilot, multicenter, masked-observer, randomized, active-controlled, non-inferiority study in Germany, patients self-treated their eyes with daily instillations of eye drops containing either omega-3 PUFA or povidone as major components for three months. At four and twelve weeks, efficacy was among others evaluated based on Ocular Surface Disease Index (OSDI), ocular surface symptoms intensity, general clinical impression, tear break-up time (TBUT), corneal fluorescein staining using the Oxford grading scale, tear volume, and matrix metalloproteinase-9 (MMP-9) concentration in the tear film. Safety evaluation included visual acuity, intraocular pressure, and the incidence of adverse events. Co-primary endpoints were the mean percent changes from baseline of TBUT and OSDI after four weeks. Results: In total 80 patients were included, of whom 37 in the PUFA group and 39 in the povidone group were evaluable for the co-primary endpoints. Patients had a mean age of 52 years and > 80% were women. Both co-primary endpoints (TBUT and OSDI) significantly improved from baseline in both treatment groups, at Week 4 and Week 12 and the statistical analysis demonstrated topical omega-3 PUFA to be non-inferior to 2% povidone for these two parameters. Both treatments resulted in a significant improvement of most secondary efficacy endpoints as well, often with a slight difference in favor of PUFA, not reaching statistical significance though. One non-severe, treatment-related local AE was reported in each group. Conclusion: Omega-3 PUFA-based eye drops proved to be non-inferior to povidone-containing eye drops in the treatment of signs and symptoms of dry eye. This treatment may thus be an additional tool for the management of DED. [ABSTRACT FROM AUTHOR]

Background: To determine the repeatability of corneal topography measurements in severe dry eye disease (DED). A comparison of corneal topography parameters between severe DED and healthy subjects was a secondary goal of this study.Methods: Sixty-nine patients with severe DED and 46 healthy subjects were enrolled in the study. All participants underwent repeated corneal topography measurements with Pentacam (Oculus, Germany) within a half hour time. Both eyes of the participants were used in statistical analysis. A further subcategorization of severe DED patients was performed according to Ocular Surface Disease Index (OSDI) scores: 32-50, 51-70 and 71-100. The repeatability of corneal parameters was assessed with correlation coefficients (CC).Results: The mean age of dry eye patients and healthy subjects were 40.8 ± 13.2 (17-66) and 39.8 ± 8.2 (18-61) years (p:0.604) respectively. No significant differences were found between severe DED and control groups according to analysed corneal parameters in both eyes (p:>0.05). All CCs were greater than 0.9 in severe DED group (p:<0.001). All CCs were also greater than 0.9 in severe DED patients among different OSDI groups (p:<0.001).Conclusions: Corneal topography measurements are highly repeatable in severe DED with Pentacam. This is the first report about this topic. Nonetheless, further studies are needed with different topography devices for validation. [ABSTRACT FROM AUTHOR]

Dry eye disease (DED) is a multifactorial disease of the ocular surface characterized by loss of homeostasis of the tear film. Epidemiological studies suggest it occurs more frequently in women than men. The aim of this retrospective analysis was to determine whether patients with DED show gender-specific differences in symptoms and signs. A retrospective analysis of 107 patients was conducted at the Department of Ophthalmology of the University of Düsseldorf – Germany. After completing the OSDI questionnaire, the patients underwent objective refraction and were asked about the following symptoms: burning, itching, foreign body sensation, epiphora, sticky eyes, pain, red eyes and swollen eyelids. Furthermore, they underwent an evaluation of the following signs: lipid layer thickness, non-invasive break-up-time (NI-BUT), conjunctival hyperemia, lid parallel conjunctival folds, meibography, Schirmer test and tear meniscus height, ocular surface staining, expressibility of meibomian glands. Of the 107 patients (56.2 ± 17.3 years) 75 were women and 32 men. Women reported significantly more often eyelid swelling (p =.03) and showed a tendency to complain more about red eyes (p =.051), while men tended to complain more often about epiphora (p =.053). In an age-matched sample taken from the cohort, significant differences were found for OSDI-scores (p =.025) showing women reporting more symptoms compared to men, while men showed more conjunctival hyperaemia (p =.004) than women. Women showed a significant thicker lipid layer (p =.0009) in the full cohort, but not in the age-matched sample (p =.43). Although the majority of the investigated parameters did not show gender-specific differences, women reported higher OSDI scores. These findings could be explained by an increased frequency of neuropathic symptoms or ocular surface sensitivity in women or higher resilience of men to consult an ophthalmologist. Sex may have an effect on the clinical characteristics of DED, but further studies are needed to confirm these findings. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the clinical and economic burden of dry eye disease (DED) among affected patients in Germany. Methods: Adult patients (≥18 years) with ≥1 confirmed diagnosis of DED during the study period (2008–2015) were identified from the medical claims of ~3.6 million insured patients from Betriebskrankenkassen, a German statutory health insurance database. Prevalence (per 1000 patients) and incidence (per 1000 person‐years at risk) were estimated, and demographic and clinical characteristics, treatment history (excluding over‐the‐counter tear supplements), healthcare resource use (HCRU) and costs were assessed. Results: In this population, the prevalence of DED increased from 20.24 in 2008 to 23.13 per 1000 patients in 2014. Overall incidence was 6.24 per 1000 person‐years at risk (2008–2015). Prevalence and incidence increased with age and were higher in women. Mean age at index was 63.4 years (incident cohort, n = 35 026). The most common ocular comorbidity was cataract (48.5%), and ~36% of patients were dispensed a reimbursed DED‐specific medication during the postindex period – most commonly, corticosteroids alone (13.2%) or in combination with anti‐infectives (21.8%). HCRU was high in patients with DED, mostly due to comorbidities. HCRU and associated costs were highest in patients ≥60 years. Total costs during the postindex period were higher in the DED cohort than among matched controls (€117 million versus €107 million; p < 0.001). Conclusion: This retrospective database analysis provides a better understanding of the epidemiology, clinical characteristics, real‐world treatment patterns, HCRU and costs associated with DED in patients living in Germany. [ABSTRACT FROM AUTHOR]

Purpose: The first aim of this study was to compare inferior tear meniscus height (TMH) measured by keratography and swept-source optical coherence tomography (OCT). Effect of locations of fluorescein instillation and subjects' subjective sensation, and the TMH results were also investigated. Methods: Forty-one eyes from 41 healthy adults had TMH randomly measured by keratography (K5M, Oculus, Germany) and swept-source OCT (Casia SS-1000, Tomey Corp, Japan) at baseline, followed by touching either the inferior bulbar or inferior palpebral conjunctiva, randomly assigned, with a moistened fluorescein strip. Two-way analysis of variance (ANOVA) was used to compare TMH obtained from the two devices and three measurement conditions. Subjective sensation of conjunctival touch was obtained through a 4-point scale with zero representing no sensation, and one to three representing ocular sensation in an ascending order. Results: Two-way ANOVA revealed no significant difference in TMH between keratography and swept-source OCT (Factor (devices): F = 0.579, p =.451) while there was a significant difference among fluorescein instillations (Factor (conditions): F = 10.146, p <.001). Baseline TMH was around 0.25 mm, and increased to around 0.28 mm after instillation of fluorescein sodium. Ocular sensation was similar between the two conjunctival touch, and TMH was not significantly associated with ocular sensation. Conclusions: Keratography and swept-source OCT provided similar TMH results. Applying fluorescein sodium through moistened fluorescein strip could over-estimate TMH by around 0.03 mm. Applying moistened fluorescein strip at bulbar or palpebral conjunctival led to similar subjective sensations and did not affect TMH measurement. [ABSTRACT FROM AUTHOR]