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Introduction: The purpose of this study was to compare the growth factor concentrations in undiluted autologous platelet-rich plasma (APRP) and autologous serum (AS) eye drops. Methods: This was a single-center, prospective trial conducted in a tertiary university hospital in Bangkok, Thailand. Ninety-six patients with moderate-to-severe dry eye disease, who were randomly assigned to receive either 100% APRP or 100% AS, were enrolled in the study. Primary outcome measures were the concentrations of epitheliotrophic factors, including epithelial growth factor (EGF), basic fibroblast growth factor (bFGF), hepatocyte growth factor (HGF), β-nerve growth factor (β-NGF), platelet-derived growth factor (PDGF)-AA, PDGF-BB, transforming growth factor (TGF)-α, TGF-β1, and vascular endothelial growth factor (VEGF) in 100% APRP and 100% AS. Secondary outcome measures were the correlations between baseline patient characteristics and each growth factor concentration. Results: Undiluted APRP contained more EGF, bFGF, and β-NGF than undiluted AS (P < 0.001, P < 0.001, P = 0.018, respectively). Meanwhile, undiluted AS yielded higher concentrations of HGF, PDGF-AA, PDGF-BB, and VEGF compared with undiluted APRP (P < 0.001 all). There were no significant differences in TGF-α and TGF-β1 concentrations between the two groups. In the 100% APRP group, the platelet concentrations had positive correlations with the concentrations of EGF (P = 0.028) and VEGF (P = 0.020). In the 100% AS group, Sjögren's syndrome negatively correlated with the concentrations of PDGF-BB (P = 0.028) and VEGF (P = 0.023). Diabetes mellitus (DM) showed negative correlations with the concentrations of HGF (P = 0.001), TGF-α (P = 0.001), and VEGF (P = 0.002). Conclusions: With our simple preparation protocols, 100% APRP contains higher concentrations of EGF, bFGF, and β-NGF, whereas 100% AS contains higher concentrations of HGF, PDGF-AA, PDGF-BB, and VEGF. This could allow ophthalmologists to tailor treatments to individual patients by targeting growth factor supply based on their underlying pathophysiology. Trial registration: ClinicalTrials.gov identifier, NCT04683796. [ABSTRACT FROM AUTHOR]

Introduction: This work aimed to evaluate the safety and efficacy of hydroxypropyl guar-hyaluronic acid (HPG-HA) dual-polymer lubricating drops in Indian subjects with dry eye disease (DED). Methods: This prospective, open-label, single-arm, phase IV study was conducted in India. Inclusion criteria: Adults (18–65 years) with an average total ocular surface staining (TOSS) score ≥ 4, best-corrected visual acuity of ≥ 20/40 in each eye, tear break-up time (TBUT) ≤ 10 s, and dry eye questionnaire (DEQ-5) score ≥ 6. Subjects received the first dose of HPG-HA eye drops on day 1 and self-administered 1–2 drops four times daily for 90 ± 5 days. Primary endpoints: Frequency and characteristics of treatment-emergent adverse events (TEAEs) throughout the study and TOSS score at day 90. Secondary/other endpoints: Dry eye symptoms score (through dry eye questionnaire [DEQ-5]) and TBUT. Results: Of 175 subjects, 36 (20.6%) had ≥ 1 TEAE, and 27 (15.4%) of this reported ≥ 1 mild drug-related TEAE (eye irritation [n = 9], eye pruritus [n = 8], blurred vision [n = 6], increased lacrimation [n = 4], ocular hyperemia [n = 3], and ocular discomfort [n = 1]). One subject discontinued due to TEAEs, and none led to drug interruptions. No serious adverse events were reported. The mean TOSS score reduced from day 1 (6.12 ± 1.69, OU [both eyes]) to day 90 (2.40 ± 1.97, OU). The mean DEQ-5 score reduced from day 1 (11.50 ± 2.27) to day 90 (5.50 ± 2.50). TBUT increased from day 1 (right eye [OD], 5.70 ± 1.94; left eye [OS], 5.70 ± 1.96) to day 90 (OD, 9.51 ± 3.08; OS, 9.63 ± 3.01). Conclusions: HPG-HA dual-polymer eye drop was safe and effective in relieving signs and symptoms of DED over 90 days in Indian subjects. Trial Registration: Clinical Trial Registry India, CTRI/2022/03/041175. [ABSTRACT FROM AUTHOR]

Purpose: To assess the clinical efficacy of 0.1% cyclosporine A (CsA) in dry eye patients who have shown inadequate responses to previous treatment with 0.05% CsA. Design: This study was designed as a switching, prospective, multicenter, 12-week, open-label study. Methods: Patients with dry eye disease (DED), who experienced inadequate responses to at least 3 months of treatment with 0.05% cyclosporine, were enrolled in this study. Clinical evaluations included the National Eye Institute (NEI) corneal and conjunctival staining scores, tear film break-up time (TF-BUT), Symptom Assessment in Dry Eye (SANDE), ocular discomfort scale (ODS), and tear volume. These parameters were assessed at baseline, and again at 4, 8, and 12 weeks after switching to 0.1% CsA. Results: Ninety-one patients were enrolled in the study, and 70 patients completed the trial. Statistical analysis was performed on the full analysis set (FAS) using the Markov Chain Monte Carlo (MCMC) method to account for missing data. After switching to 0.1% CsA, subjective symptoms assessed by the Symptom Assessment in Dry Eye (SANDE) and Ocular Discomfort Scale (ODS) showed improvement (p < 0.0001). Objective signs of dry eye, including the National Eye Institute (NEI) score, tear film break-up time (TF-BUT), and tear volume also improved (p < 0.0001). Conclusions: In patients with dry eye disease (DED) who exhibited inadequate responses to 0.05% cyclosporine A (CsA), switching to 0.1% CsA resulted in significant improvements in both subjective symptoms and objective clinical signs. This finding suggests that higher concentrations of CsA may be more effective in treating individuals with moderate to severe 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: Traffic-related air pollution especially in highly socioeconomically developed megacity is usually considered as a severe problem leading to inevitable adverse health outcomes. This study aimed to investigate the associations between traffic-related air pollutants with risk of dry eye disease (DED) outpatient visits in a megacity (Guangzhou) along the subtropical coast in South China. Methods: Daily data on DED outpatient visits and environmental variables from 1 January 2014 to 31 December 2020 in Guangzhou were obtained. A time-series study using a quasi-Poisson generalized linear model (GLM) combined with distributed lag non-linear model (DLNM) was adopted. Subgroup analyses stratified by age, gender, and season were conducted. Results: Totally, 27, 828 DED cases were identified during the study period including 2557 days. Daily number of outpatient visits for DED ranged from 0 to 41. An increase of 10 μg/m3 in PM2.5, NO2 and SO2 concentration was associated with 3.1%, 5.9% and 17.4% increase in the risk of DED outpatient visits, respectively (RRPM2.5 = 1.031, 95%CI: 1.004–1.059, lag 0–11 day; RRNO2 = 1.059, 95% CI: 1.027–1.092, lag0-14 day; RRSO2 = 1.174, 95% CI: 1.036–1.330, lag0-13 day). Subgroup analyses indicated that the effects of PM2.5 exposure on the risk of DED outpatient visits remained significant in aged < 60 years (RR max = 1.008, 95% CI: 1.003–1.013, lag0 day) and the effects of SO2 exposure on the DED outpatient visits risk remained significant in the females (RR max = 1.025, 95% CI: 1.006–1.044, lag0 day). The associations of PM2.5 (RR = 1.010, 95% CI: 1.003–1.016, lag0 day) and SO2 (RR = 1.030, 95% CI: 1.003–1.058, lag14 day) exposure with DED outpatient visits risk remained significant in warm seasons, whereas NO2 (RR = 1.006, 95% CI: 1.002–1.009, lag14 day) exposure was significantly associated with DED outpatient visits in cold seasons. The associations of PM2.5 (first visit, RR = 1.006, 95% CI: 1.001–1.011, lag0 day; re-visit, RR = 1.002, 95% CI: 1.000–1.005, lag6 day), NO2 (first visit, RR = 1.006, 95% CI: 1.001–1.012, lag0 day; re-visit, RR = 1.007, 95% CI: 1.002–1.012, lag0 day), and SO2 (first visit, RR = 1.023, 95% CI: 1.002–1.044, lag0 day; re-visit, RR = 1.023, 95% CI: 1.000–1.045, lag0 day) exposure with risk of DED outpatient visits were significant for both first- and re-visits. Conclusions: Our study revealed that short-term exposure to PM2.5, NO2 and SO2 were positively associated with risk of DED outpatient visits, especially for the youngers, females and during warm seasons, providing evidence for making public health policy to improve life quality in developed megacity. [ABSTRACT FROM AUTHOR]

Significance: Cataract surgery is one of the most performed surgical procedures worldwide. As a potential complication following cataract surgery, dry eye has the potential to impact visual outcomes, lower patient satisfaction, and be detrimental to quality of life. Purpose: To evaluate the effect of cataract surgery on dry eye outcomes postoperatively. Methods: We searched Ovid MEDLINE and Embase from 01/01/2010 to 16/08/2021 and included observational studies of participants ≥ 18 years old undergoing any cataract surgical procedure. We compared postoperative dry eye outcomes with baseline including Ocular Surface Disease Index (OSDI), tear break up time (TBUT), Schirmer's I test (ST1), and corneal fluorescein staining (CFS) at short-term (< 1 week) and medium-term (≥ 1 week to 3 months) follow-up. Results: Our search yielded 11,133 records. After title and abstract, and then full text screening, we included 20 studies with 1,694 eyes. There was some evidence indicating a decrease in the TBUT during the short-term (within 1 week) and medium-term (1 week up to 3 months) periods following cataract surgery. There was a considerable degree of heterogeneity between studies across other outcomes. At medium-term follow-up most studies that reported ST1 and CFS showed deterioration of these outcomes but there was conflicting evidence of the effect of cataract surgery on OSDI. The review is limited by variability in follow-up timeframes which were unable capture potential clinical course like peak occurrence and duration. Conclusion: Dry eye may persist up to three months postoperatively following cataract surgery. Further studies are required to determine if dry eye outcomes return to baseline at longer term follow-up. [ABSTRACT FROM AUTHOR]

Dry eye disease (DED) is a multifactorial, chronic, and often relapsing condition with a significant impact on patient quality of life (QoL). Symptoms such as ocular discomfort and visual disturbances are diverse and frequently misaligned with objective clinical signs, complicating diagnosis and management. DED not only interferes with daily activities like reading, driving, and computer use but also imposes a substantial economic burden due to direct healthcare costs and reduced work productivity. Beyond its ocular manifestations, DED has been associated with higher prevalence rates of depression and anxiety, with a complex bidirectional relationship. Patients with DED may experience psychological distress that exacerbates symptoms, leading to a vicious cycle that further impairs QoL. This underscores the importance of integrating mental health screening into the management of DED, particularly for high-risk populations. Optimizing the care of DED patients requires empathy, effective communication, and the establishment of a therapeutic alliance that acknowledges patient experiences and involves them in personalized treatment plans. Such an approach can improve patient satisfaction, enhance treatment adherence, and address both ocular and psychological dimensions of the disease. This paper highlights current evidence on the impact of DED symptoms and its association with mental health and recommends strategies to improve clinical management through a patient-centered approach. [ABSTRACT FROM AUTHOR]

Introduction: Dry eye disease (DED) is a multifactorial condition of the ocular surface, primarily treated with tear substitutes, which do not fully restore natural tear functions. In this pilot study, we tested the hypothesis that T-Lysyal (T-Lys) improves symptoms and signs in patients with DED. Additionally, we provide a literature overview on the effects of T-Lys in ophthalmology and non-ophthalmology conditions to elucidate its mechanisms of action. Methods: A double-masked, randomized pilot study was conducted in patients with DED treated with T-Lys or hyaluronic acid (HA) 0.2% combined with tamarind seeds polysaccharide (control group) for 2 months. Inclusion criteria were a diagnosis of DED with symptoms lasting ≥ 6 months, Symptom Assessment in Dry Eye (SANDE) score ≥ 30, and at least one of the following: fluorescein staining of the cornea (score ≥ 3, NEI scale), conjunctival staining (Lissamine Green, score ≥ 3), or tear breakup time (T-BUT) ≤ 10 s. Data from the right eye were used for statistical analysis. A PubMed literature search of T-Lys studies was also performed without publication year restrictions. Results: Twelve patients in the T-Lys group and 15 in the control group completed the study (mean age 67 ± 11 years). T-Lys treatment resulted in significant improvements from baseline (V0) to 2 months (V2) in symptoms assessed by visual analogue scale (T-Lys: 4.58 ± 2.57 mm at V0, 2.92 ± 1.38 mm at V2, p < 0.05; control: 5.13 ± 2.29 mm at V0, 5.3 ± 2.4 mm at V2), T-BUT (T-Lys: 2.58 ± 1.31 s at V0, 3.58 ± 1.37 s at V2, p < 0.05; control: 3.07 ± 1.43 s at V0, 3 ± 1.13 s at V2), and corneal staining (T-Lys: 2.16 ± 4.17 at V0, 1.41 ± 3.70 at V2, p < 0.05; control: 1.4 ± 2.19 at V0, 1.4 ± 2.16 at V2). No adverse events were reported. Literature findings supported T-Lys's efficacy in managing both ophthalmology and non-ophthalmology conditions. Conclusion: This study provides the first clinical evidence of T-Lys efficacy in patients with DED, supporting preclinical data and highlighting its potential as a promising ocular surface modulator. Trial Registration: The study was registered in the ISRCTN registry for Clinical Studies with no. 13587929. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to assess in-vitro efficacy of a suffusion of autologous serum withcyclosporine 0.05% (CsA) and sodium hyaluronate 0.1% (SH). Methods: The expression of proinflammatory markers interleukin 6 (IL-6) and TNF-Alpha (TNF-α) in limbal epithelial cells was evaluated. Also, assessment of the stability of epithelial growth factor and transforming growth factor-beta (EGF, TGF-β) in the 50% combinations with autologous serum (AS) was done. The characteristics (pH, density, osmolality) of the two combinations were also evaluated. Additionally, cytotoxicity effect of given test compounds was evaluated on human limbal epithelial cells (LEpiC). Results: The percentage of cells expressing IL-6 subjected to AS + SH and AS + CsA were 6.23% and 5.69% respectively. There was no significant difference in percentage of cells expressing TNF-α between the formulations (5.87%, 5.83% respectively). The growth factors; EGF and TGF-β remained stable forone month duration (on 2 and 4 weeks) at 4 °C without significant difference between the time intervals tested. The results of MTT assay suggested that limbal epithelial cells treated with AS + CsA and AS + SH combinations showed minimal toxicity however it was not significant statistically (p ≤ 0.05). Conclusion: Two test combinations (AS + CsA, AS + SH) showed stable growth factors (EGF, TGF-β) and good anti-inflammatory property against pro-inflammatory markers. Also, the 2 combinations were found safe on cultured limbal epithelial cells. The novel combination of autologous serum in CsA may provide added benefit in dry eye disease (DED) through their combined anti-inflammatory and epitheliotropic effects. [ABSTRACT FROM AUTHOR]

BackgroundPurposeMethodsResultsConclusionsIncreased reactive oxygen species (ROS) are involved in the pathological process of dry eye disease. Our previous results suggested that norepinephrine (NE) has a protective effect on dry eye.This study explored the potential therapeutic role and underlying mechanisms of NE in benzalkonium chloride (BAC)-induced dry eye disease.BAC-pretreated human corneal epithelial cells (HCEpiC) were cultured with various concentrations of NE. A BAC-induced dry eye mice model was established to explore the role of NE. Alterations in mice corneal tissues, ROS levels, mitochondrial function, and mitophagy levels were analyzed.In vitro, our results revealed that BAC-exposed HCEpiC led to mitochondrial malfunction, which involved excessive ROS production, decreased mitochondrial membrane potential (MMP), and promoted mitochondrial fragmentation through increased DRP1 and fission protein 1 (Fis1) expression and reduced mitofusin 2 (Mfn2) expression. Moreover, topical BAC application induced excessive mitophagy. These effects were reversed by NE. Additionally, the increased expression of LC3B, SQSTM1/p62, PINK1, and Parkin, which control mitophagy, in BAC-exposed HCEpiC was suppressed by NE. In BAC-induced C57BL/6J mice, NE resulted in lower fluorescein staining scores, decreased TUNEL-positive cells, and decreased mitochondrial fragmentation.In conclusion, our findings showed that NE therapy prevented HCEpiC following BAC application by regulating mitochondrial quality control, which is controlled by PINK1/Parkin-dependent mitophagy. Our research suggests a potential targeted treatment for dry eye disease. [ABSTRACT FROM AUTHOR]

Dry Eye Disease (DED) is a common condition worldwide, with smoking being recognized as a possible aggravating factor. Although observational studies have indicated a potential correlation, the findings have been inconclusive. In the study, Mendelian randomization (MR) analysis is used to investigate this potential causal relationship. Adhering to STROBE-MR guidelines, a MR analysis was conducted using genetic instrumental variables from Genome-wide association studies (GWAS). The research investigated the impact of various smoking-related exposures (regular smoking, lifetime smoking, smoking intensity, and smoking cessation) on DED as an outcome. Three distinct methodologies were employed: the inverse variance weighted (IVW) method, the MR-Egger method, and the weighted median (WM) method. To ensure the robustness of the MR results, sensitivity analyses were conducted. In MR analyses, it was observed that both lifetime smoking and regular smoking were associated with a significant increase in the risk of DED (IVW method: P < 0.05). The results indicated that the odds ratios (ORs) for lifetime smoking and regular smoking in relation to DED were 1.757 (95% CI 1.021–3.025) and 2.121 (95% CI 1.017–4.423), respectively. However, there was no significant correlation found between smoking intensity, cessation, and the risk of DED. This study presents genetic evidence indicating that long-term smoking could potentially be a causal risk factor for DED. Subsequent research will need to conduct specifically designed randomized controlled trials to further investigate this association. [ABSTRACT FROM AUTHOR]

INTRODUCTION Pterygium is a common disease of the ocular surface characterized by the invasion of fibrovascular tissue from the bulbar conjunctiva onto the cornea. It can cause chronic ocular irritation, tear film disturbances, induced astigmatism, and decreased vision secondary to growth over the visual axis. OBJECTIVES To assess precorneal Tear film before and after pterygium surgery. METHOD This prospective observational study was done on all consecutive patients with pterygium came to ophthalmology OPD at R L Jalappa hospital in kolar from August 2022 to December 2023. A total of 39 eyes were included in each group of which 12 were males and 27 females. All the patients subjected for detail visual acuity (VA) assessment, slit lamp examination, intraocular pressure (IOP) estimation, tear film function tests and underwent Pterygium excision with conjunctival limbal autograft. They were followed post-operatively 1 week, 4 weeks and 6weeks. RESULTS Majority of the patients were females (69.2%), while 30.8% were males with average age (in years) as 51.33 years. Majority had Type 2 (51.3%), followed by Type 3 (26.6%) and Type 1 (23.1%). Schimers test 1 was significantly decreased in the affected eye compared to control eye at pre-op and 1 week following post-op. There was no significant difference in the ST1 at 4 weeks and 6 weeks between the affected and control eyes. Schimers test 2 was significantly decreased in the affected eye compared to control eye at pre-op, one week and four weeks following post-op. There was no significant difference in the ST-2 at 6 weeks between the affected and control eyes. TBUT was significantly decreased in the affected eye compared to control eye at pre-op, and 4 weeks following post-op. There was no significant difference in the TBUT at 1 week and 6 weeks between the affected and control eyes. TMH was significantly lower in the affected eye than the control eye at pre-op, and 1 week following post-op. No significant difference in the TMH at 4 weeks and 6 weeks between the affected and control eyes was noticed. Comparision of schirmers test 1, schirmers 2, TBUT and TMH at 1week, 4 week & 6 weeks between preop and post op in type 1 pterygium, among the affected eye, the tear film function significantly improved. CONCLUSION Our research found that after the pterygium was removed, the measurements, such as Schirmers and Tear Break-up Time (TBUT), showed improvement over time. After a month after the operation in the affected eye, the Schirmers and Tear Break-up Time were almost as close to the control eye's values. This suggests that the dry eye symptoms related to the pterygium got better after the surgery. Nonetheless, our research did not include a long-term check-up to explore if the pterygium would come back and how it might affect the tear film's function. [ABSTRACT FROM AUTHOR]

Introduction: This study investigated the efficacy of pooled human immune globulins (Flebogamma® DIF) to combat the formation of neutrophil extracellular traps (NETs) and NETosis, along with neutrophil adhesion to corneal epithelial cells in response to dry eye disease relevant stimuli. Methods: Human neutrophils were isolated by bead-based immunomagnetic depletion of non-target cells from human whole blood. NETosis was induced using phorbol 12-myristate 13-acetate (PMA) or anti-citrullinated histone 4 R3 antibody (H4R3 ACPA). Extracellular DNA was used as a surrogate biomarker of NETosis, and it was quantified using a 96-well, plate reader-based fluorescent assay and by confocal microscopy in 8-well chambers using the DNA dye, SYTOXTM Green. Neutrophils were labeled with calcein-AM and adhesion to human corneal epithelial cells was measured. The efficacy of a dose-range of pooled human immune globulin (Flebogamma® DIF, 0.01%–5%) was tested in all assays. Results: Pooled human immune globulins (Flebogamma® DIF) dose-dependently inhibited both PMA and H4R3 ACPA induced NETosis, with concentrations ≥2.5% fully preventing release of extracellular DNA over a 2–16 h time period. Similarly, Flebogamma® 5% DIF prevented NETosis against PMA (20 nM) and a dose range (0.1–10 μg/mL) of H4R3 ACPA. Both PMA and H4R3 ACPA increased adhesion of neutrophils to corneal epithelial cells by 20% and 5%, respectively. Flebogamma® DIF treatment resulted in a dose-dependent reduction of neutrophil adhesion, with Flebogamma® 5% DIF reducing adhesion to baseline levels. Discussion: These findings show the dose-dependent efficacy of pooled human immune globulins, specifically Flebogamma® DIF against experimentally and pathologically induced NETosis and neutrophil adhesion to corneal epithelial cells, in vitro. The results from this study support the continued clinical development of Flebogamma® 5% DIF as a novel and efficacious treatment for the signs and symptoms of dry eye disease. [ABSTRACT FROM AUTHOR]

Introduction: Graves' Orbitopathy (GO) is an autoimmune disorder characterized by inflammation of orbital tissues, leading to various ocular manifestations, including ocular surface disease. This cross-sectional study aimed to assess the presence of ocular surface disease using the Ocular Surface Disease Index (OSDI) in patients with Graves' disease (GD) and moderate-to-severe active GO compared to those with GD and mild non-active GO. Additionally, we aimed to investigate the correlation between ocular surface disease and the eye features of GO. Methods: Consecutive GD patients with GO referred to the Ophthalmology and Endocrinology Units of the University Hospital of Pisa between June 2022 and February 2023 were enrolled. OSDI scores were obtained from 79 GD patients, categorized into moderate-to-severe active GO and mild non-active GO groups. Results: OSDI scores were significantly higher in patients with moderate-to-severe active GO compared to those with mild non-active GO (P=0.0006). A cutoff value of 33 for positive tests revealed a higher frequency of pathological OSDI in moderate-to-severe active GO patients compared to mild non-active GO patients (P=0.0221; OR 3.673, CI 1.277-9.531). Within the moderate-to-severe active GO group, a significant positive correlation was found between OSDI and Clinical Activity Score (CAS) (R= 0.3867, 95% CI from 0.1403 to 0.5880; P=0.0030). Using a cutoff value of 55 (the 75th percentile of the study population), patients with CAS ≥ 3 had a significantly higher proportion of pathological OSDI compared to those with CAS <3 (P=0.0039; OR 4.075, CI 1.619-10.39). Proptosis values ≥ 22 mm and the presence of lagophthalmos were identified as significant risk factors for ocular surface disease development (P=0.0406 and P=0.0493, respectively). Discussion: Our study highlights a significantly higher prevalence of ocular surface disease, as measured by OSDI, in patients with moderate-to-severe active GO compared to those with mild non-active disease. The degree of GO activity positively correlates with ocular surface involvement, and proptosis and lagophthalmos increase the risk of its occurrence. These findings emphasise the importance of assessing and managing ocular surface health in GO patients. Early identification and appropriate treatment of ocular surface disease need to be pursued to improve patient management. [ABSTRACT FROM AUTHOR]

Ocular diseases such as cataract, refractive error, age-related macular degeneration, glaucoma, and diabetic retinopathy significantly impact vision and quality of life worldwide. Despite advances in conventional treatments, challenges like limited bioavailability, poor patient compliance, and invasive administration methods hinder their effectiveness. Nanomedicine offers a promising solution by enhancing drug delivery to targeted ocular tissues, enabling sustained release, and improving therapeutic outcomes. This review explores the journey of nanomedicine from bench to bedside, focusing on key nanotechnology platforms, preclinical models, and case studies of successful clinical translation. It addresses critical challenges, including pharmacokinetics, regulatory hurdles, and manufacturing scalability, which must be overcome for successful market entry. Additionally, this review highlights safety considerations, current marketed and FDA-approved nanomedicine products, and emerging trends such as gene therapy and personalized approaches. By providing a comprehensive overview of the current landscape and future directions, this article aims to guide researchers, clinicians, and industry stakeholders in advancing the clinical application of nanomedicine in ophthalmology. [ABSTRACT FROM AUTHOR]

Introduction: Dry eye disease (DED) is a prevalent ocular condition that significantly impacts quality of life. Umbilical cord serum (UCS) has emerged as a promising therapeutic option, but its efficacy requires further investigation. This systemic review and meta-analysis aimed to evaluate the therapeutic effects of UCS eye drops in the treatment of DED. Methods: A comprehensive literature search was conducted across multiple databases, including PubMed, Web of science, Embase, Science Direct, Cochrane Library, and China National Knowledge Network, to identify relevant clinical trials. The efficacy of UCS was assessed based on key outcome measures, such as the ocular surface disease index (OSDI), tear break-up time (TBUT), Schirmer I test, and corneal fluorescein staining scores. Meta-analyses were performed to pool the results, and the findings were presented in a forest plot. Results: Eight studies were included in the meta-analysis, with two relevant randomized controlled trials (RCTs) involving a total of 204 patients. Most of the included studies had a follow-up time of less than 2 months. The pooled results showed that UCS treatment significantly improved the OSDI, with a mean difference (MD) of −9.16 (95% confidence interval [CI], −12.0, −6.36) compared to baseline. Additionally, the TBUT values were higher in the UCS group, with an MD of 2.65 (95% CI, 0.93, 4.36). The Schirmer I test results showed an improvement, with an MD of 1.18 (95% CI, 0.30, 2.06). The fluorescein staining score were also lower in the UCS treatment group, with an MD of −4.71 (95% CI, −5.72, −3.69). Conclusion: This meta-analysis suggested that UCS eye drops had a beneficial therapeutic effect on DED, significantly improving the OSDI, TBUT, Schirmer I test, and corneal fluorescein staining scores. However, larger RCTs with longer follow-up periods were needed to further evaluate the long-term efficacy and safety of UCS in the management of DED. [ABSTRACT FROM AUTHOR]

Background: Objectively compare the changes in ocular surface parameters in myopic patients who have undergone either SMILE or Implantable Collamer Lens (ICL V4c) surgery. Methods: This prospective cohort study enrolled 32 patients (32 eyes) undergoing SMILE surgery and 35 patients (35 eyes) receiving ICL V4c intraocular lenses. Examinations were performed at preoperative, 1-week, 1-month, and 3-month postoperative time points. The assessments included Schirmer's I Test (SIt), First Non-Invasive Break-Up Time (First-NIBUT), Average Non-Invasive Break-Up Time (Average-NIBUT), Tear Meniscus Height (TMH), Ocular Surface Disease Index (OSDI) score, conjunctival congestion score, meibomian gland loss score, lipid layer analysis score, lid margin opening detection score, and corneal fluorescein staining (CFS) score. Results: Repeated measures ANOVA revealed that SIT, TMH, and First-NIBUT initially decreased and then increased. At three months, SIT levels in the SMILE group were significantly lower than those in the ICL group. From the first month onward, TMH levels in the SMILE group remained significantly lower than those in the ICL group (P < 0.05). OSDI scores initially rose and then fell, with the SMILE group consistently showing higher OSDI levels than the ICL group. Conjunctival congestion scores in the SMILE group fluctuated less, while the ICL group exhibited a clear downward trend, with significant differences starting from the first week (P < 0.05). Over time, scores for meibomian gland loss, lipid layer analysis, and lid margin opening detection were all higher in the SMILE group compared to the ICL group. Conclusions: SMILE surgery has a more pronounced and prolonged impact on the ocular surface and meibomian gland function compared to ICL implantation. Objective dry eye parameters in the ICL group recover more quickly than those in the SMILE group one month post-surgery. [ABSTRACT FROM AUTHOR]

Purpose: While substantial research has focused on systemic immunomodulatory therapy for ocular cicatricial pemphigoid (OCP), limited data exist on managing associated ocular surface disease (OSD). This study evaluates treatments for OCP-related OSD at our institution. Methods: We conducted a retrospective analysis of patients diagnosed with cicatrizing conjunctivitis at the University of Colorado Hospital from January 1, 2013, to October 31, 2023. Patients with cicatrizing conjunctivitis due to non-OCP conditions were excluded, and disease severity was classified using the Foster Staging System. Results: Our review included 30 patients with OCP, all with at least six months of follow-up. The mean age of symptom onset (n = 19) was 62.2 years (SD = 16.4), while the mean age at diagnosis (n = 28) was 65.1 years (SD = 12.7). The most common OSD treatments at the last visit were preservative-free artificial tears (87%), topical corticosteroids (43%), autologous serum eye drops (40%), topical antibiotics (30%), and topical immunomodulators (23%). All patients used at least one treatment, with 83.3% on prescription therapies. Patients averaged 3.33 (SD: 1.4) treatments, with 1.7 (SD: 1.2) being prescriptions. Topical immunomodulators had the highest discontinuation rate at 73.1% (n = 19/26). Autologous serum eye drops and topical corticosteroids were the least discontinued treatments. Number of total treatments, prescriptions, and procedures sharply increased at stage three OCP. Conclusions: The number of treatments and procedures increased with OCP severity, indicating that advanced OCP often necessitated more intensive OSD management. [ABSTRACT FROM AUTHOR]

Dry eye disease (DED) is a rapidly growing ocular surface disease with a significant socioeconomic impact that affects the patients' visual function and, thus, their quality of life. It is distinguished by a loss of tear film homeostasis, leading to tear film instability, hyperosmolarity, ocular surface inflammation, and neurosensory abnormalities, with all of these playing etiological roles in the propagation of the vicious DED circle. While current treatments primarily focus on reducing tear film instability and hyperosmolarity, increasingly more attention is being placed on tackling the underlying inflammation that propagates and potentiates these factors. As such, preclinical models are crucial to further elucidate the DED pathophysiology and develop novel therapeutic strategies. This review outlines the role of inflammation in DED, highlighting related signs and diagnostic tools before focusing on relevant preclinical animal models and potential therapeutic strategies to tackle DED-associated inflammation. [ABSTRACT FROM AUTHOR]

Background: Dry eye is a condition of the tear film and ocular surface that causes discomfort, visual disturbance, and tear film instability. The subjective symptoms in dry eye disease (DED) are often nonspecific. More or less common are conjunctival redness and damage to the ocular surface with punctate epithelial erosions. Rheumatoid arthritis (RA) is a systemic autoimmune disease with approximately 25% of patients having ocular manifestations. Methodology: A prospective observational study was carried out in the ophthalmology outpatient department of a tertiary care center. There were 200 RA patients enrolled. Dry eye workup was done using various tests and the Ocular Surface Disease Index questionnaire. RA patients were divided on the basis of duration of illness into two groups. The results of dry eye tests were compared between these two groups. Results: Out of 200 RA patients, 89% were females. The overall prevalence of dry eye was 52.5% according to Schirmer's test without anesthesia. There were 112 patients who were suffering from RA for <5 years and another group of 88 patients who were suffering for ≥5 years. Schirmer's test and corneal fluorescein staining suggested that the patients with longer duration of RA are more prone to DED. Conclusion: The prevalence of dry eyes in patients with RA is high. Chronic ocular surface changes were observed with the longer duration of RA disease activity which affects the quality of life in such patients. [ABSTRACT FROM AUTHOR]

Dry eye disease (DED) is a highly prevalent condition, resulting in reduced quality of life, lower participation in social life and impaired work efficiency. Hydroxypropyl methylcellulose (HPMC) is a cellulose‐based viscosity‐enhancing agent and is one of the most popular therapeutic ingredients in artificial tears. This review aims to evaluate the literature on the efficacy and safety of HPMC used in the treatment of DED. Literature searches were conducted in PubMed and Cochrane CENTRAL. A total of 28 clinical trials from 26 publications are included in this review, including 21 clinical intervention studies evaluating the effect of HPMC treatment over time and seven single instillation studies evaluating the short‐term physical and symptomatic effects of HPMC after drop‐instillation. The duration of clinical intervention studies ranged from 2 weeks to 5.5 months. DED severity ranged from mild to severe. Drop frequency ranged from two to up to 16 drops per day. HPMC concentration in artificial tears ranged from 0.2% to 0.5%. No major complications or adverse events were reported. Artificial tears containing HPMC were effective at improving symptoms and some signs of DED. However, combination drops with HPMC plus other therapeutic ingredients seem more effective than HPMC alone. HPMC appears to be equally effective or inferior to hyaluronic acid (HA). There is no evidence of superiority or inferiority to either carboxymethylcellulose (CMC) or polyethylene glycol 400/propylene glycol (PEG/PG). No single study explained the choice of drop frequency or HPMC concentration. More well‐designed studies are needed to determine an evidence‐based standard for HPMC treatment, including drop frequency, concentration and molecular weight for different DED severity and subgroups. [ABSTRACT FROM AUTHOR]

Background: Organ-on-a-chip models have emerged as transformative tools in ophthalmology, offering physiologically relevant platforms for studying ocular diseases and testing therapeutic interventions. These microfluidic devices replicate human eye tissue architecture, addressing limitations of traditional in vitro and animal models. Methods: A narrative review of recent advancements in organ-on-a-chip technology was conducted, focusing on models simulating ocular structures like the retina and cornea and their applications in studying diseases such as dry eye disease (DED), age-related macular degeneration (AMD), and glaucoma. Results: Advanced organ-on-a-chip models successfully mimic key ocular features, providing insights into disease mechanisms and therapeutic responses. Innovations in microengineering and cellular integration have enhanced these platforms' translational potential, though challenges like scalability and regulatory validation persist. Conclusions: Organ-on-a-chip models are poised to enhance preclinical research and clinical applications in ophthalmology. Addressing scalability and regulatory hurdles will be key to unlocking their full potential in drug discovery and disease modeling. [ABSTRACT FROM AUTHOR]