Реферат
ABSTRACT Purpose: To analyze whether inter-eye osmo larity differences were related to dry eye symptomatology. Methods: A total of 135 participants were randomly recruited from those who visited in the Optometry Clinic of the Optometry Faculty (Universidade de Santiago de Compostela). In a single scheduled session after the recruitment, Ocular Surface Disease Index was filled out following the standard instructions and TearLab measurements were made in both the participants' eyes (10-15 min lapse). Osmolarity values were compared between the right and left eyes and the absolute inter-ocular difference (-OD-OS-) correlated with the Ocular Surface Disease Index score for the whole sample. Based on the Ocular Surface Disease Index score, the sample was divided into four symptomatic subgroups, and differences in the -OD-OS- values were calculated. Results: The whole sample showed a statistically significant inter-eye osmolarity difference (p=0.025; -OD-OS- = 9.2 ± 9.3 mOsm/l) and the correlation between Ocular Surface Disease Index and -OD-OS- (r=0.369; p<0.001). A statistically significant difference was found in the -OD-OS- value between symptomatic subgroups (Kruskal-Wallis, p=0.003). Mann-Whitney U test showed a significant difference between asymptomatic vs. moderate (p=0.006) vs. severe symp tomatic patients (p=0.001) and between mild vs. severe symptomatic patients (p=0.045), whereas no difference on -OD-OS- was found between participants with contiguous symptomatic subgroups (all p³0.174). Conclusion: Tear film inter-eye osmolarity differences are significantly higher in severe dry eye disease symptoms.
RESUMO Objetivo: Analisar se as diferenças entre osmolaridade entre os olhos foram relacionadas à sintomatologia do olho seco. Métodos: Um total de 135 participantes foram recrutados aleatoriamente entre os indivíduos da Clínica de Optometria da Faculdade de Optometria (Universidade de Santiago de Compostela). Em uma única sessão agendada após o recrutamento, o Índice de Doenças da Superfície Ocular foi preenchido seguindo as instruções padrão e as mensurações do TearLab foram feitas em ambos os olhos dos participantes (lapso de 10 a 15 min). Os valores de osmolaridade foram com parados entre os olhos direito e o esquerdo e a diferença absoluta ocular (-OD-OS-) correlacionada com a pontuação do Índice de Doença da Superfície Ocular para toda a amostra. Com base na pontuação do Índice de Doença da Superfície Ocular, a amostra foi dividida em quatro subgrupos sintomáticos, e as diferenças nos -OD-OS- os valores foram calcula dos. Resultados: A amostra total mostrou uma diferença de osmolarida de entre os olhos estatisticamente significativa (p=0,025; -OD-OS- = 9,2 ± 9,3 mOsm/l) e a correlação entre o Índice de Doença da Superfície Ocular e -OD-OS- (r=0,369; p<0,001). Diferença estatisticamente significativa foi encontrada no valor -OD-OS- entre os subgrupos sintomáticos (Kruskal-Wallis, p=0,003). O teste U de Mann-Whitney mostrou uma diferença significativa entre pacientes assintomáticos versus moderados (p=0,006) versus sintomáticos graves (p=0,001) e entre pacientes sinto máticos leves e graves (p=0,045), enquanto que nenhuma di ferença de -OD-OS- foi encontrada entre os participantes de subgrupos sintomáticos contíguos (todos p³0,174). Conclusão: As diferenças entre osmolaridade inter-ocular do filme lacrimal são significativamente maiores nos sintomas graves da doença do olho seco.
Тема - темы
Humans , Male , Female , Adult , Middle Aged , Aged , Young Adult , Tears/chemistry , Dry Eye Syndromes/physiopathology , Osmolar Concentration , Reference Values , Severity of Illness Index , Surveys and Questionnaires , Statistics, NonparametricРеферат
ABSTRACT Purpose: To evaluate the effects of suturing 23-gauge pars plana vitrectomies on ocular discomfort and tear film dynamics. Methods: This retrospective chart review involved data from 50 procedures in 50 patients who underwent 23-gauge pars plana vitrectomy from January to November 2016. We divided the eyes into two groups according to the presence or absence of sutures; 35 eyes underwent sutureless vitrectomies (Group 1), and 15 eyes underwent vitrectomy with at least one sclerotomy suture site (Group 2). In each group, we assessed objective variables including tear film break-up time, Schirmer test I, corneal surface grading with Oxford system, and a quantitative method evaluating subjective dry eye symptoms using ocular surface disease index questionnaires preoperatively 1 week, and 1 and 3 months after surgery. Results: The tear film break-up time showed a significant difference at the 3-months follow-up (p=0.026). The Schirmer test I and corneal surface staining score showed no statistically significant differences between two groups at any time after the operations. The ocular surface disease index score was significantly lower in Group 1 than in Group 2 at 1 week (p=0.032), 1 month (p=0.026), and 3 months (p=0.041) after the operation. Conclusion: Sclerotomy suturing caused ocular discomfort and had a negative effect on tear film dynamics during the late postoperative period. Sclerotomies without suturing seem to reduce the ocular surface changes.
RESUMO Objetivo: Avaliar os efeitos da sutura da vitrectomia via pars plana de 23-gauge sobre o desconforto ocular e a dinâmica do filme lacrimal. Métodos: Esta revisão retrospectiva de prontuários envolveu dados de 50 casos em 50 pacientes submetidos à vitrectomia via pars plana de 23-gauge, de janeiro a novembro de 2016. Dividimos os olhos em dois grupos de acordo com a presença ou ausência de suturas; 35 olhos foram submetidos à vitrectomia sem sutura (Grupo 1) e 15 olhos foram submetidos à vitrectomia com pelo menos um ponto de sutura no local da esclerotomia (Grupo 2). Em cada grupo, avaliamos variáveis objetivas incluindo tempo de ruptura do filme lacrimal, teste de Schirmer I, gradação da superfície corneana com o sistema Oxford e um método quantitativo avaliando sintomas subjetivos de olho seco usando questionários de índice de doença da superfície ocular nos períodos: 1 semana do pré-operatório, 1 mês e 3 meses após a cirurgia. Resultados: O tempo de ruptura do filme lacrimal apresentou diferença significativa no seguimento de 3 meses (p=0,026). O teste de Schirmer I e o escore da coloração da superfície da córnea não mostraram diferenças estatisticamente significativas entre os dois grupos em nenhum momento após as operações. O escore do índice de doença da superfície ocular foi significativamente menor no Grupo 1 em relação ao Grupo 2 no período de 1 semana (p=0,032), 1 mês (p=0,026) e 3 meses (p=0,041) após a cirurgia. Conclusão: A sutura da esclerotomia causou desconforto ocular e teve um efeito negativo na dinâmica do filme lacrimal durante o período pós-operatório. Esclerotomias sem sutura parecem reduzir as alterações da superfície ocular.
Тема - темы
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Tears/physiology , Vitrectomy/adverse effects , Sclerostomy/adverse effects , Suture Techniques/adverse effects , Postoperative Complications/etiology , Time Factors , Vitrectomy/methods , Sclerostomy/methods , Dry Eye Syndromes/etiology , Dry Eye Syndromes/physiopathology , Surveys and Questionnaires , Retrospective Studies , Follow-Up Studies , Suture Techniques/instrumentation , Treatment Outcome , Statistics, NonparametricРеферат
ABSTRACT Purpose: The aim of the present study was to compare the severity of ocular and systemic findings among patients with primary Sjögren syndrome. Methods: The study followed a prospective controlled design and comprised two groups; the test group included 58 eyes of 58 patients newly diagnosed with primary Sjögren syndrome with poor dry eye test findings and the control group included 45 right eyes of 45 healthy age- and sex-matched individuals. The ocular surface disease index score, tear osmolarity, Schirmer I test without anesthesia, fluorescein tear breakup time, and cornea-conjunctiva staining with lissamine green (van Bijsterveld scoring) were used to examine tear function in the patients via a complete ophthalmological examination. The results were graded and classified on the basis of a Dry Eye WorkShop report and results of the corneal and conjunctival staining test, Schirmer's test, and fluorescein tear breakup time test. Discomfort, severity and frequency of symptoms, visual symptoms, conjunctival injection, eyelid-meibomian gland findings, and corneal-tear signs were interpreted. Disease activity was scored per the EULAR Sjögren's syndrome disease activity index (ESSDAI) via systemic examination and laboratory evaluations, and the EULAR Sjögren's syndrome patient-reported index (ESSPRI) assessed via a survey of patient responses. Results: Mean patient age was 48.15 ± 16.34 years in the primary Sjögren syndrome group and 44.06 ± 9.15 years in the control group. Mean fluorescein tear breakup time was 4.51 ± 2.89s in the primary Sjögren syndrome group and 10.20 ± 2.39 s in the control group. Mean Schirmer I test result was 3.51 ± 3.18 mm/5 min in the primary Sjögren syndrome group and 9.77±2.30 mm/5 min in the control group. Mean ocular surface disease index score was 18.56 ± 16.09 in the primary Sjögren syndrome group, and 19.92 ± 7.16 in the control group. Mean osmolarity was 306.48 ± 19.35 in the primary Sjögren syndrome group, and 292.54 ± 10.67 in the control group. Mean lissamine green staining score was 2.17 ± 2.76 in the primary Sjögren syndrome group, and 0.00 in the control group. Statistically significant differences were found berween the primary Sjögren syndrome group and control group in terms of fluorescein tear breakup time, Schirmer's test, lissamine green staining, and osmolarity tests (p=0.036, p=0.041, p=0.001, and p=0.001 respectively). The Dry Eye WorkShop score was 2.15 ± 0.98, the EULAR Sjögren's syndrome disease activity index score was 11.18 ± 4.05, and the EULAR Sjögren's syndrome patient-reported index score was 5.20±2.63. When potential associations of the Dry Eye Workshop Study scores and osmolarity scores with the Eular Sjögren's syndrome disease activity index scores were evaluated, the results were found to be statistically significant (p=0.001, p=0.001 respectively). Conclusion: The results showed an association between dry eye severity and systemic activity index in primary Sjögren syndrome patients.
RESUMO Objetivo: O objetivo do presente estudo foi comparar a gravidade dos achados oculares e sistêmicos entre pacientes com síndrome de Sjögren primária. Métodos: O estudo seguiu um delineamento prospectivo controlado e compreendeu dois grupos; o grupo de teste incluiu 58 olhos de 58 pacientes recém-diagnosticados com síndrome de Sjögren primária com resultados deficientes no teste de olho seco e o grupo controle incluiu 45 olhos direitos de 45 indivíduos saudáveis pareados idade e sexo. A contagem do índice de doença da superfície ocular, osmolaridade lacrimal, teste de Schirmer I sem anestesia, tempo de ruptura da fluoresceína e coloração córnea-conjuntiva com verde de lissamina (índice de van Bijsterveld) foram utilizados para examinar a função lacrimal dos pacientes através de exame oftalmológico completo. Os resultados foram classificados com base em um relatório da "Dry Eye Workshop" e resultados do teste de coloração da córnea e conjuntiva, teste de Schirmer e teste do tempo de ruptura da fluoresceína. Desconforto, gravidade e frequência dos sintomas, sintomas visuais, injeção conjuntival, achados das glândulas palpebrais e sinais da córnea foram interpretados. A atividade da doença foi avaliada pelo índice de atividade da doença da síndrome de Sjögren EULAR por meio de exame sistêmico e avaliações laboratoriais, e o índice relatado pelo paciente da síndrome de Sjörgen EULAR avaliado através de uma pesquisa das respostas dos pacientes. Resultados: A média de idade dos pacientes foi de 48,15 ± 16,34 anos no grupo da Síndrome de Sjörgen primária e 44,06 ± 9,15 anos no grupo controle. O tempo médio de ruptura da fluoresceína foi de 4,51 ± 2,89 s no grupo síndrome de Sjögren primária e 10,20 ± 2,39 s no grupo controle. O resultado do teste de Schirmer I médio foi de 3,51 ± 3,18 mm/5 min no grupo síndrome de Sjögren primária e de 9,77 ± 2,30 mm/5 min no grupo controle. O índice médio de doença da superfície ocular foi de 18,56 ± 16,09 no grupo síndrome de Sjögren primária e 19,92 ± 7,16 no grupo controle. A osmolaridade média foi 306,48 ± 19,35 no grupo síndrome de Sjögren primária e 292,54 ± 10,67 no grupo controle. O resultado médio de coloração com lissamina verde foi de 2,17 ± 2,76 no grupo síndrome de Sjögren primária e 0,00 no grupo controle. Diferenças estatisticamente significativas foram encontradas entre o com síndrome de Sjögren primária e o grupo controle em termos de tempo de ruptura da fluoresceína lacrimal, teste de Schirmer I, coloração com lissamina verde e osmolaridade (p=0,036, p=0,041, p=0,001, p=0,001 respectivamente). O índice Estudo do Olho Seco foi de 2,15 ± 0,98, o índice de atividade da doença da síndrome de Sjögren EULAR foi de 11,18 ± 4,05 e a pontuação do índice relatado pelo paciente EULAR Sjögren foi de 5,20 ± 2,63. Quando associações potenciais do Estudo do Olho Seco e o índice da osmolaridade foram comparados a pontuação de índice de atividade da doença da síndrome de Sjögren EULAR, os resultados foram estatisticamente significantes (p=0,001, p=0,001 respectivamente). Conclusão: Os resultados mostraram uma associação entre a gravidade do olho seco e o índice de atividade sistêmica em pacientes com síndrome de Sjögren primária.
Тема - темы
Humans , Male , Female , Adult , Middle Aged , Dry Eye Syndromes/physiopathology , Sjogren's Syndrome/physiopathology , Osmolar Concentration , Reference Values , Staining and Labeling , Tears/physiology , Severity of Illness Index , Dry Eye Syndromes/pathology , Sjogren's Syndrome/pathology , Case-Control Studies , Prospective Studies , Surveys and Questionnaires , Conjunctiva/physiopathology , Conjunctiva/pathology , Cornea/physiopathology , Cornea/pathologyРеферат
El síndrome de disfunción de la película lagrimal mejor conocido como ojo seco, por su variación clínico patológica conlleva a un subregistro en los pacientes, por lo que es necesario la valoración en nuestra consulta, para determinar varios aspectos en torno a la patología y su prevalencia en los pacientes del servicio de reumatología del Hospital Universitario de Caracas. Métodos: fue de tipo observacional descriptivo de corte transversal, evaluando pacientes con patologías reumatológicas que acudieron a la consulta en el servicio de oftalmología, la muestra fue de 59 pacientes con antecedentes reumatológicos, que no presentaron síntomas específicos de ojo seco del servicio de reumatología del Hospital Universitario de Caracas, durante el período junio 2013 diciembre 2013.Se empleó la técnica de encuesta mediante un instrumento de recolección de datos tipo cuestionario que permitió identificar signos, síntomas y se logró medir cuantitativa y cualitativamente la secreción lagrimal y el grado de daño epitelial. Resultados: Se observó una prevalencia de 41,9 % del Síndrome Sjögren siendo más común en el sexo femenino y 44,8 % cursaban con SDPL, siendo más frecuente en el Síndrome de Sjögren. Asimismo 64,3 % de los pacientes con SDPL leve se encontraban sin tratamiento. Por su parte, 71,4 % de los pacientes con SDPL pertenecen al Síndrome de Sjögren. Conclusiones: El síndrome de disfunción de la película lagrimal es una entidad muy frecuente que debe tenerse presente siempre en patologías reumatológicas, y su control es esencial para la calidad visual del paciente(AU)
Syndrome of dysfunction of tear film as all too dry eye, for is relation pathologic clinic that begin to sub register in the patients, for that reason in necessary have a register in consult, for determine some aspects in relation with the illness and prevalence of tear film dysfunction in the patients of the rheumatology service University hospital of Caracas. Methods: The investigation was observation type, descriptive court traversal, evaluating patients on rheumatology pathologic that go to our ophthalmologist service. The total patients was 59 with antecedent rheumatologic, without specific symptoms of dry eye of the rheumatology service University Hospital of Caracas between June to December 2013. Using an assessment through an instrument of recollection information for tis way identify tool signs, symptoms were identified and managed quantitatively and qualitatively measure tear secretion and the degree of epithelial damage Results: The prevalence of 41.9 % of Sjögren 's syndrome is more common in females and 44.8 % were enrolled with SDPL, being more common in Sjögren's syndrome was observed. Also 64.3 % of patients with mild SDPL were untreated. Meanwhile, 71.4 % of patients with SDPL belong to Sjögren's syndrome. Conclusions: The syndrome of the tear film dysfunction is a very common condition that must be always present in rheumatologic diseases, and their control is essential for the patient's visual quality(AU)
Тема - темы
Humans , Dry Eye Syndromes/etiology , Dry Eye Syndromes/physiopathology , Lacrimal Apparatus/physiopathology , Rheumatology , Sjogren's SyndromeРеферат
ABSTRACT Purpose: The aim of this study was to evaluate tear osmolarity, tear film function, and ocular surface changes in patients with psoriasis. Methods: At a single center, 30 eyes of 30 patients with psoriasis (group 1) and 30 eyes of 30 healthy individuals (group 2) were evaluated using the Ocular Surface Disease Index (OSDI) questionnaire, Schirmer I test, tear film break-up time (TBUT) test, scoring of ocular surface fluorescein staining using a modified Oxford scale, and tear osmolarity measurement. Results: Tear osmolarity values, OSDI, and Oxford scale scores were significantly higher in group 1 (309.8 ± 9.4 mOsm, 38.9 ± 1.1, and 0.7 ± 1.1, respectively) than in group 2 (292.7 ± 7.7 mOsm, 4.2 ± 0.3, and 0.1 ± 0.3, respectively; p<0.01 for all). TBUT was significantly lower in group 1 (8.7 ± 3.6 s) than in group 2 (18.1 ± 2.8 s; p<0.001). No significant differences were detected in Schirmer I test values between the groups (16.2 ± 2.5 mm in group 1 and 16.6 ± 2.3 mm in group 2; p=0.629). Conclusions: The results of this study showed that psoriasis may influence tear osmolarity and tear film function. Patients with psoriasis showed tear hyperosmolarity and tear film dysfunction.
RESUMO Objetivo: O objetivo deste estudo foi avaliar a osmolaridade da lágrima, função do filme lacrimal e alterações da superfície ocular em pacientes com psoríase. Método: Em um único centro, 30 olhos de 30 pacientes com psoríase (grupo 1) e 30 olhos de 30 indivíduos saudáveis (grupo 2) foram avaliados pelo questionário do Índice de Doença da Superfície Ocular (OSDI), teste de Schirmer tipo I, tempo de ruptura do filme lacrimal (TBUT), coloração por fluoresceína da superfície ocular utilizando a escala de Oxford modificada e osmolaridade lacrimal. Resultados: Os valores de osmolaridade lacrimal, OSDI e escores da escala de Oxford foram significativamente maiores no grupo 1 (309,8 ± 9,4 mOsm, 38,9 ± 1,1 e 0,7 ± 1,1, respectivamente) em comparação com o grupo 2 (292,7 ± 7,7 mOsm, 4,2 ± 0,3 e 0,1 ± 0,3, respectivamente) (p<0,01 para todos). TBUT no grupo 1 (8,7 ± 3,6 s) foi significativamente menor em comparação com o grupo 2 (18,1 ± 2,8 s) (p<0,001). Não foram detectadas diferenças significativas nos valores de teste de Schirmer (16,2 ± 2,5 mm no grupo 1 e 16,6 ± 2,3 mm no grupo 2, p=0,629). Conclusões: Este estudo mostrou que a psoríase pode influenciar osmolaridade lágrima e função do filme lacrimal. Os pacientes com psoríase apresentaram hiperosmolaridade lágrima e disfunção do filme lacrimal.
Тема - темы
Humans , Male , Female , Adult , Psoriasis/complications , Dry Eye Syndromes/diagnosis , Osmolar Concentration , Psoriasis/physiopathology , Tears/chemistry , Dry Eye Syndromes/etiology , Dry Eye Syndromes/physiopathology , Case-Control Studies , Cross-Sectional Studies , FluoresceinРеферат
ABSTRACTPurpose:To evaluate central corneal thickness (CCT) and peripheral corneal thickness (PCT) in patients with rheumatoid arthritis (RA) and to assess the relationships among the corneal parameters, dry eye disease, and clinical variables of RA.Methods:A total of 58 RA patients and 58 control subjects participated in this study. A detailed ophthalmological examination was performed on each subject. Dry eye evaluation was performed using Schirmer’s test, tear break-up time (TBUT), corneal fluorescein staining, and Ocular Surface Disease Index (OSDI). Corneal thickness at the apex point, the center of the pupil, the thinnest point, and PCT (3 mm from the apex to the superior, inferior, nasal, and temporal locations) were evaluated using Scheimpflug imaging (Pentacam®). Additionally, the relative peripheral index (RPI) was calculated by dividing the PCT by the CCT. The disease severity and quality of life were evaluated with DAS28 and HAQ, respectively. The laboratory evaluation comprised ESR and CRP.Results:The mean corneal thicknesses at the apex point, the center of the pupil, the thinnest point, and the superior, inferior, nasal, and temporal points were significantly thinner in RA patients than controls. Schirmer’s test scores and TBUT were significantly lower, and corneal staining and OSDI scores were significantly higher in RA patients. There were no significant correlations between the corneal parameters and the clinical variables of RA or dry eye tests.Conclusion:The CCT and PCT were thinner in RA patients compared to those in control subjects. However, there were no significant correlations between the corneal parameters and the clinical variables of RA or dry eye tests.
RESUMOObjetivo:Avaliar da espessura central da córnea (CCT) e espessura corneana periférica (PCT) em pacientes com artrite reumatoide (RA). O segundo objetivo foi avaliar as relações entre os parâmetros de córnea, doença do olho seco e variáveis clínicas da RA.Método:Um total de 58 pacientes com RA e 58 indivíduos do grupo controle participaram deste estudo. Exame oftalmológico detalhado foi realizado para cada indivíduo. Avaliação do olho seco foi realizada por meio do teste de Schirmer, tempo de ruptura do filme lacrimal (TBUT), coloração com fluoresceína da córnea e do índice de doença da superfície ocular (OSDI). Espessura da córnea no ápice, centro da pupila e ponto mais fino, assim como PCT (três milímetros do ápice para localização superior, inferior, nasal e temporal) foram avaliadas por meio de imagens Scheimpflug (Pentacam®). Além disso, o índice periférico relativo (RPI) foi calculado dividindo-se a PCT pela CCT. A gravidade da doença e qualidade de vida foram avaliados com DAS28 e HAQ respectivamente. A avaliação laboratorial foi composta por VHS e PCR.Resultados:As espessuras de córnea médias no ápice, centro da pupila, ponto mais fino, assim como nos pontos superior, inferior, nasal e temporal foram significativamente mais finas em pacientes com RA do que nos controles. Os resultados dos testes de Schirmer e TBUT foram significativamente menores e a coloração por fluoresceína e o OSDI foram significativamente maiores em pacientes com RA. Não houve correlações significativas entre os parâmetros da córnea e variáveis clínicas da RA ou testes de olho seco.Conclusões:A espessura corneana central e periférica foram mais finas em pacientes com RA em comparação com indivíduos controle. Não houve correlações significativas entre os parâmetros da córnea e variáveis clínicas da AR ou testes de olho seco.
Тема - темы
Female , Humans , Male , Middle Aged , Arthritis, Rheumatoid/pathology , Cornea/pathology , Corneal Topography/methods , Dry Eye Syndromes/diagnosis , Arthritis, Rheumatoid/physiopathology , Case-Control Studies , Cornea/physiopathology , Diagnostic Techniques, Ophthalmological , Dry Eye Syndromes/physiopathologyРеферат
PURPOSE: To evaluate the changes of higher order aberrations (HOAs) before and after laser subepithelial keratomileusis (LASEK) and to analyze the influence of tear film instability on HOAs of the corneal surface after LASEK. METHODS: In this cross-sectional study, 31 patients who underwent LASEK were divided into dry eye (16 patients, 32 eyes) and non-dry eye groups (15 patients, 30 eyes). Uncorrected distance visual acuity, spherical equivalent refraction, ablation depth, tear film parameters and Ocular Surface Disease Index (OSDI) questionnaire scores were evaluated in both groups. Total HOA root mean square (RMS), third-order coma, third-order trefoil and fourth-order spherical aberration (SA) of the corneal surface immediately and at 10 seconds after blinking were measured before and after surgery. RESULTS: The total HOA RMS, coma, trefoil and SA significantly increased after LASEK compared with preoperative values in both groups. In the dry eye group, total HOA RMS, coma and trefoil significantly increased except for SA at 10 seconds after blinking compared with those measured immediately after blinking. In addition, the changes of total HOA RMS, coma and trefoil were negatively correlated with tear film break-up time (R = -0.420, -0.473 and -0.439, respectively), but positively correlated with OSDI score (R = 0.433, 0.499 and 0.532, respectively). In the non-dry eye group, there were no significant differences between HOAs measured at 10 seconds after blinking and those measured immediately after blinking. CONCLUSIONS: The HOAs including coma, trefoil and SA significantly increased after LASEK. The tear film instability in the dry eye can be associated with more deterioration of the optical quality after LASEK, due to more significant increase of total HOA RMS, coma and trefoil.
Тема - темы
Adult , Female , Humans , Male , Young Adult , Cornea/physiopathology , Corneal Wavefront Aberration/etiology , Cross-Sectional Studies , Dry Eye Syndromes/physiopathology , Keratectomy, Subepithelial, Laser-Assisted/adverse effects , Lasers, Excimer/therapeutic use , Surveys and Questionnaires , Tears/physiology , Visual Acuity/physiologyРеферат
Purpose: To assess the effectiveness and tolerability of GenTeal® gel in post-menopausal patients with moderate to severe dry eye. Methods: This was an open label, multicenter, non-comparative, non-interventional, observational study in post-menopausal women patients of age 39-82 years with moderate to severe dry eye. The patients were treated with GenTeal® gel for 20 weeks and assessed for effectiveness at baseline, 10-12 weeks and at 20 weeks. The primary effectiveness outcomes were changes in ocular symptoms (foreign body sensation, itching, burning, watering, photophobia, feeling of dryness in the eye), tear break up time (TBUT), Schirmer, fluorescein corneal staining score and global assessment for efficacy on dry eye condition. The secondary objective of the study was to evaluate ocular tolerance and systemic safety of the product. Results: A total of 169 out of 170 enrolled patients completed the study. At 20 weeks of treatment, the median composite ocular symptoms scores was reduced by 78% from baseline (median; 2.0 vs 9.0 of baseline, p<0.0001). All ocular symptoms except photophobia were significantly reduced (p<0.05) at 20 weeks of treatment. At 20 weeks, TBUT and schirmer scores were significantly increased by 39.9% and 48.6% respectively (p < 0.0001); while fluorescein staining cumulative score was significantly decreased (100.0%, p < 0.0001) from their baseline. The overall efficacy and ocular tolerability of GenTeal® gel, was ‘good’ to ‘excellent’ for >98.0% of the subjects. Adverse events of mild dyspepsia and frequent micturition of moderate intensity were reported by a subject. Conclusions: The findings of the present study indicate that GenTeal® gel treatment is an effective and tolerable treatment for dry eye in post-menopausal women patients in Indian clinical practice.
Тема - темы
Adult , Aged , Aged, 80 and over , Dry Eye Syndromes/drug therapy , Dry Eye Syndromes/physiopathology , Female , Humans , Middle Aged , Ocular Physiological Phenomena , Ophthalmic Solutions/administration & dosage , Ophthalmic Solutions/pharmacology , Postmenopause , Product Surveillance, Postmarketing , Tears , Treatment OutcomeРеферат
La presente revisión de tema ojo seco está orientada a médicos no oftalmólogos. Se realiza un repaso de la anatomía del sistema lagrimal y fisiología básica de la película lagrimal. Se define el concepto de ojo seco, su importancia epidemiológica y su sintomatología. Se realiza un detallado análisis de la clasificación etiológica definiendo las diferencias entre hipolacrimea asociada o no a síndrome de Sjõgren y ojo seco evaporativo de causa intrínseca y extrínseca, con énfasis en los mecanismos fisiopatológicos subyacentes. Se entrega una visión que da cuenta de la complejidad, envergadura y condición multifactorial de este problema de salud visual y se hace énfasis en la necesidad de identificar de manera integral el tipo de ojo seco para poder instalar un tratamiento basado en la corrección del mecanismo subyacente y no a través de aproximación sintomática de la terapia.
The current review of dry eye disease is directed to non ophthalmologist physicians. We perform an assessment of the anatomy of the lacrimal system and basic physiology of the tear film. The definition of dry eye, its epidemiologic importance and symptoms are explained. A detailed analysis of the etiologic classification is described defining the difference between reduction in tear secretion associated or not to Sjõgren's syndrome and evaporative dry eye of intrinsic or extrinsic origin. We highlight the underlying pathophysiologic mechanisms, conveying the complexity, broadness and multi-factorial conditions related to this visual health problem. We stress the need for identifying in a comprehensive manner the type of dry eye in order to install a treatment based on the underlying mechanism and not through a symptomatic approach to therapy.
Тема - темы
Humans , Dry Eye Syndromes/classification , Dry Eye Syndromes/etiology , Dry Eye Syndromes/physiopathology , Dry Eye Syndromes/epidemiology , Lacrimal Apparatus/anatomy & histology , Lacrimal Apparatus/physiologyРеферат
Os autores descrevem um caso de olho seco pós-transplante de medula óssea associado a lesäo corneana peresistente. Discutem a possibilidade de correlaçäo entre os achados de auto-anticorpos séricos contra constituintes celulares de córnea e conjuntiva presentes neste paciente, e a patogênese da ceratoconjuntivite sicca pós-transplante de medula óssea
Тема - темы
Humans , Male , Adult , Autoantibodies/immunology , Dry Eye Syndromes/etiology , Bone Marrow Transplantation/adverse effects , Graft Rejection , Dry Eye Syndromes/physiopathology , Bone Marrow Transplantation/immunologyРеферат
Os autores descrevem os achados oftalmológicos em pacientes submetidos a transplante de medula óssea, principalmente aqueles portadores de doença enxerto-hospedeiro (GVHD). De 11 pacientes com queixas oculares, nove apresentam alteraçäo da semiologia lacrimal, com aparecimento de síndrome do olho seco. Outras complicaçöes mais graves podem ocorrer, principalmente do tipo hemorrágica ou infecciosa