Efecto de unas gotas a base de ácido hialurónico, Aloe vera y Centella asiática en la calidad de vida de pacientes con ojo seco / Effect of eye drops based on hyaluronic acid, Aloe vera and Centella asiatica on quality of life of patients with dry eye

Introducción: la enfermedad de ojo seco (EOS) es una patología común y un motivo de consulta frecuente en farmacia comunitaria. Esta tiene un gran impacto en la calidad de vida (QoL) de los pacientes; por ello, un tratamiento adecuado debería mejorarla. Las lágrimas artificiales constituyen la base para el manejo de la EOS y el principal tratamiento de indicación farmacéutica.Objetivo: estudiar el efecto de unas gotas oculares a base de ácido hialurónico, Centella asiática y Aloe vera en la QoL de pacientes con EOS. Paralelamente, la adherencia al tratamiento, la tolerancia y seguridad del producto, fueron evaluados.Metodología: estudio clínico posautorización, abierto, prospectivo y multicéntrico. Los pacientes recibieron el tratamiento durante 60 días. Para estudiar el efecto sobre la QoL, los pacientes cumplimentaron el cuestionario OSDI© antes de iniciar el tratamiento y a los 30 y 60 días de tratamiento. La adherencia se evaluó mediante la reconciliación de los envases y la seguridad mediante un seguimiento de los eventos adversos. Resultados: los pacientes tratados con las gotas oculares, población por intención de tratar (ITT, n=44), obtuvieron mejoras clínicamente importantes en la QoL, sintomatología y función visual, pues la puntuación OSDI© disminuyó de 32,80 (DE=23,00) (basal, EOS severo) a 12.64 (DE=15,32) (estado normal, p<0,001), y a 9.22 (DE=10,37) (estado normal, p<0,001), a los 30 y 60 días, respectivamente. Más del 70 % de los pacientes se adhirieron al tratamiento. El perfil de seguridad fue favorable. Se observaron 4 efectos adversos oculares de intensidad leve. No se plantearon problemas de seguridad. Conclusiones: Las gotas oculares objeto de estudio podrían ser una opción de tratamiento efectiva y segura para mejorar la QoL de pacientes con EOS.

Association between anticholinergic activity and xerostomia and/ or xerophthalmia in the elderly: systematic review.

PURPOSE: The aim of this work was to investigate the association between anticholinergic burden or anticholinergic drug use and xerostomia and/or xerophtalmia in elderly through a systematic review of the published literature. METHODS: A search was carried out in 3 databases (CINAHL, Embase and Pubmed). Studies conducted in people ≥65 years of age, who took anticholinergic medications, and measured the association between the anticholinergic burden or the use of these medications with the prevalence of xerostomia and / or xerophthalmia, published up to August 2022, were selected. Studies published in languages other than Spanish and/or English were excluded. RESULTS: One thousand two hundred eleven articles were identified, 10 were selected for this review: six cross-sectional studies, two cohorts, one case-control and one randomized controlled clinical trial. A total of 3535 patients included in the different studies were studied. The most used scales were the Anticholinergic Drug Scale (ADS) and the Anticholinergic Risk Scale (ARS). Four articles studied the relationship between the use of anticholinergic medication and the prevalence of xerostomia and / or xerophthalmia, finding a positive relationship with xerostomia in all of them. Another 6 measured the relationship between anticholinergic burden and xerostomia and / or xerophthalmia. Four found a positive relationship between anticholinergic burden and xerostomia and/or xerophthalmia. CONCLUSIONS: Our findings suggest a clear relationship between the use of anticholinergic drugs or anticholinergic burden and the presence of xerostomia. This relationship was less conclusive in the case of xerophthalmia.

Sodium hyaluronate combined with rhEGF contributes to alleviate clinical symptoms and Inflammation in patients with Xerophthalmia after cataract surgery.

BACKGROUND: To determine the effect of sodium hyaluronate combined with recombinant human epidermal growth factor (rhEGF) on clinical symptoms and inflammation in patients with newly diagnosed xerophthalmia after cataract surgery. METHODS: A total of 106 patients who underwent cataract surgery and were newly diagnosed with xerophthalmia in our hospital between June 2018 and August 2019 were enrolled. Of these, 50 patients who were treated with sodium hyaluronate (0.1%) were assigned to the monotherapy group (MG) and the remaining 56 patients who were treated with sodium hyaluronate (0.1%) combined with rhEGF (20 µg/ml) were assigned to the combination group (CG). The 2 groups were compared based on ocular surface disease index (OSDI) score, break-up time (BUT), fluorescein corneal staining level, Schirmer I test (SI) level, clinical efficacy (disappearance of typical symptoms, including eyes drying, burning sensation, foreign body sensation, etc), and interleukin (IL)-1, IL-6, and tumor necrosis factor-α (TNF-α) levels. Spearman correlation analysis was conducted to analyze the relationship between IL-1, IL-6, TNF-α and clinical efficacy. In addition, receiver operating characteristic curves were drawn to analyze the predictive value of IL-1, IL-6, and TNF-α in efficacy on xerophthalmia. RESULTS: After treatment, the CG showed reduced OSDI score compared with the MG. The CG showed increased BUT (s) and SI (mm) levels compared with MG. After treatment, the CG exhibited decreased levels of IL-1(ng/mL), IL-6 (ng/mL), and TNF-α (ng/mL) compared with the MG. Spearman correlation analysis revealed that IL-1, IL-6, and TNF-α were negatively correlated with clinical efficacy. The areas under the curves of IL-1, IL-6, and TNF-α were 0.801, 0.800, and 0.736 respectively. CONCLUSIONS: Sodium hyaluronate combined with rhEGF is helpful to alleviate clinical symptoms and inflammation in patients with xerophthalmia undergoing cataract surgery.

[Xerophthalmia in a 7-year-old autistic child]. / Xeroftalmi ­ tidig diagnos kan hindra irreversibla ögonskador.

Vitamin A deficiency and xerophthalmia is a rare finding in developed countries. We report a severe case of xerophthalmia in a 7-year-old autistic child with restricted diet. Both eyes had Bitot's spots and ulceration. The right cornea had a perforation at admission. After treatment with high doses of vitamin A the right cornea epithelialized with formation of the anterior chamber and the left eye healed completely. This case adds to the increasing number of reports on cases of xerophthalmia particularly in autistic children and highlights the importance of considering vitamin A deficiency in patients with risk of malnutrition also in developed countries.

[Lingnan fire needling combined with 0.1% sodium hyaluronate eye drops in the treatment of xerophthalmia: a randomized controlled trial].

OBJECTIVE: To observe the effect of Lingnan fire needling combined with artificial tears in the treatment of xerophthalmia. METHODS: A total of 86 xerophthalmia patients were equally and randomly divided into treatment group and control group. The patients of both groups were received treatment with 0.1% sodium hyaluronate eye drops in their eyes 3 times a day, one drop in each eye. In addition, the patients of treatment group also treated by Lingnan fire needling on bilateral Shaoze (SI1), Neichengqi and beside lacrimal puncta once a week. The treatment was conducted for 4 consecutive weeks. Before and after 4 weeks of treatment, the clinical efficacy, visual acuity, intraocular pressure, ocular symptom score, OSDI score, fluorescence staining （FL） score, schemer I, tear menisci height, tear film break-up time (BUT) and eye redness index were recorded and evaluated. RESULTS: After the treatment, self-comparison showed that the symptom score, OSDI score, FL score and eye redness index were significantly decreased (P<0.05), and BUT was notably increased in both groups (P<0.05) in comparison with their own pre-treatment. The tear menisci height in the treatment group was higher than that before the treatment (P<0.05). Comparison between the two groups showed that the symptom score, OSDI score and eye redness index were obviously lower in the treatment group than in the control group (P<0.05), whereas the BUT and tear menisci height were evidently higher (P<0.05). The total effective rate of the treatment group was 84.88% (73/86), better than 76.74% (66/86) of the control group (P<0.05). CONCLUSION: Lingnan fire needling combined with 0.1% sodium hyaluronate eye drops is more effective than simple sodium hyaluronate eye drops for xerophthalmia patients, with significant curative effect and no adverse reactions.

The clinical effects of sodium hyaluronate, polyethylene glycol, and dextran-70 eye drops in relieving dry eye after phacoemulsification.

ABSTRACT: To compare the clinical efficacy of sodium hyaluronate eye drops, polyethylene glycol eye drops, and compound dextran eye drops in the treatment of dry eye after phacoemulsification of cataract.A total of 99 patients with dry eye after cataract phacoemulsification combined with intraocular lens implantation were treated in our hospital. Patients were divided into group A (sodium hyaluronate eye drops), group B (polyethylene glycol eye drops), and group C (dextran-70 eye drops). The clinical effect, tear film breakup time, basic tear secretion, corneal staining score, dry eye symptom score, and the incidence of ocular irritation were assessed.On the 3rd, 15th, 30th, and 60th day after operation, the tear film breakup time, corneal staining score, Schirmer I test, and dry eye symptom score in group A and group B were better than those in group C (P < .05). In addition, there were no significant differences in tear breakdown time, corneal staining score, Schirmer I test, and dry eye symptom score between group A and group B (P > .05). At 3 days to 60 days after operation, the incidence of dry eye in group A (12.12%) and group B (18.18%) was lower than that in group C (39.39%), and the incidence of dry eye in group A was significantly lower than that in group B (P < .05).The effect of sodium hyaluronate eye drops elicited a greater beneficial impact as compared to polyethylene glycol eye drops and dextran-70 eye drops.

Servicio profesional farmacéutico de indicación farmacéutica en sequedad ocular utilizando el programa 'I-VALOR' / Minor ailment service for dry eye syndromes: I-VALOR programme

INTRODUCCIÓN: la labor del farmacéutico comunitario en el Servicio de Indicación Farmacéutica (SIF) es muy importante como primera línea de asistencia a la población, aunque no está suficientemente documentada. OBJETIVOS: evaluar la intervención del farmacéutico comunitario en el SIF ante una consulta sobre enfermedad de ojo seco (EOS) con el uso de protocolos. MATERIAL Y MÉTODOS: estudio descriptivo, observacional realizado dentro del programa I-VALOR (enero-junio 2015). Los participantes fueron farmacéuticos voluntarios y pacientes que solicitaron algún remedio para aliviar la EOS. Se utilizó el protocolo del SIF del Foro de Atención Farmacéutica en Farmacia Comunitaria, un consenso para EOS realizado entre sociedades científicas, una hoja de derivación, un informe para el paciente y una hoja de recomendaciones. RESULTADOS: participaron 6.350 pacientes. 62,7 % consultas fueron realizadas por mujeres (24,3 % 46-65 años). El 60 % de los pacientes no presentaba ningún criterio de derivación. Se detectaron 3.887 criterios de derivación en 2.537 pacientes. Se decidió no derivar al 15,4 %, y del resto, 87,3 % aceptó la derivación. La dispensación de algún tratamiento tuvo lugar en el 80 % de los pacientes: 3.157 con tratamiento farmacológico (89,2 % un único medicamento) y 2.403 con tratamiento no farmacológico. El 35 % recibió consejos higiénico-dietéticos y consejo farmacéutico. Se detectaron 25 reacciones adversas a medicamentos (0,4 %). El 70,5 % de todas las consultas realizadas fueron resueltas sin necesidad de derivar al médico. CONCLUSIONES: el programa I-VALOR para EOS ha permitido evaluar la intervención protocolizada del farmacéutico en EOS mediante el registro de las actuaciones farmacéuticas para demostrar la labor desarrollada desde la farmacia comunitaria

BACKGROUND: Minor ailment service offered in community pharmacist is a key element in patient care. Thought in Spain the service is not properly documented. AIMS: The main objective was to evaluate community pharmacists' interventions through an agreed minor ailment service for dry eye syndromes (DES). METHOD: Descriptive study undertaken alongside I-VALOR programme (January-June 2015). Participants were pharmacists from SEFAC who voluntarily decided to do, and patients were those who consulted about DES in community pharmacy. Pharmacists used the Pharmaceutical Care Forum guideline for the Minor Ailment Service and an agreed consensus between pharmaceutical and medical societies. A patient's form and a referral's form were designed. RESULTS: There were 6,350 patients involved. 62.7% consultations were made by women 24.3% of 46-65 years old). No referral criteria were detected in 60% of patients. The pharmacist detected 3,887 referral criteria in 2,537 patients. Pharmacists decided not to refer 15.4% of those patients. 87.3% of the patients referred accepted the referral. Treatments were dispensed in 80% of patients: 3,157 pharmacological treatment (89.2% a single medication) and 2,403 non-pharmacological treatment (medical device, food supplement or eye cleaning product). 35% received hygienic-dietary advice and pharmaceutical advice. Twenty-five adverse drug reactions were detected (0.4%). 70.5% of all consultations made were managed with no referral to a general practitioner (GP). CONCLUSIONS: I-VALOR programme allowed to evaluate an agreed intervention for DES in community pharmacy through the record of MAS to demonstrate CP contribution to manage minor ailments

Meta-Analysis of Treatment for Primary Sjögren's Syndrome.

OBJECTIVE: The current focus of treatment in primary Sjögren's syndrome (SS) is symptom management. Since SS is an autoimmune disease with multisystem involvement, systemic immunosuppression may have a role in improving signs and symptoms and preventing progression. We undertook this review to assess the efficacy and safety of immunomodulation on primary SS from randomized clinical trials (RCTs). METHODS: Five electronic databases (Medline, Embase, Central, ClinicalTrials.gov, and the World Health Organization International Clinical Trials Registry Platform) were searched to include RCTs for the treatment of SS. Primary outcome measures included ocular dryness, oral dryness, tear production, and salivary function. Serious adverse events (AEs) and withdrawals due to AEs were also assessed. RESULTS: The search yielded 32 trials evaluating 19 different medications. The average duration of diagnosis was long (up to 9.2 years). Twenty-two trials examined ocular and oral dryness, for which only 2 and 4 trials showed statistically significant improvements, respectively. No studies found a benefit for tear production; few studies found improvements for unstimulated salivary flow (3 of 16 RCTs) and stimulated salivary flow (2 of 14 RCTs). Meta-analysis at 6 months found improvements as compared to placebo for unstimulated salivary flow (P = 0.003) and a decrease in the erythrocyte sedimentation rate (P = 0.007). No differences were seen for serious AEs, but there were increased withdrawals from AEs (risk ratio 2.33; P = 0.03). CONCLUSION: Reducing inflammation potentially improves salivary gland function. No individual immunomodulatory drug demonstrated a consistent benefit in xerostomia and xerophthalmia. Further work is needed to identify SS patients with an ability to improve and with outcomes that are valid and sensitive to change within clinical trials. Tradeoffs in the future between benefit and safety may also be important, because more withdrawals occurred with active treatment.

Chronic eyelid edema and xerophthalmia secondary to periorbital hyaluronic acid filler injection.

BACKGROUND: Hyaluronic acid (HA) is a popular, nonsurgical, temporary technique that is commonly used in the periocular region to restore volume in areas that have undergone volume loss, as well as adjusting the height and contour of the eyebrow. AIMS: Due to the location of glands, nerves, and vasculature, the facial anatomy should be well understood to avoid injections into areas that may result in complications. PATIENT/METHODS: A 54-year-old woman presented for a cosmetic consultation to address "puffy eyelids". She states she had HA filler injected along the orbital ridge inferior to the eyebrow and medially at the glabellar crease two years prior. Two months after her injection, she began to notice upper eyelid edema, xerophthalmia, and dryness of her nasal mucous membranes. Extensive evaluation and imaging were done by physicians of different specialties with a negative workup. RESULTS: A total of 60 units of hyaluronidase were injected into the areas of previous filler placement over a three-week period. This resulted in complete resolution of the patient's presenting symptoms. CONCLUSION: Familiarity with potential adverse events is arguably the most important aspect of treating patients with HA filler. The anatomy of the orbit and lacrimal system are important to keep in mind when evaluating symptoms related to possible long-term complications of retained filler injections. Reporting this case should raise awareness about this potential adverse event and further explain the delicate anatomy of the periorbital area.

Aplicación de toxina botulínica en el músculo de Horner para el tratamiento de ojo seco / Application of botulinum toxin in Horner's muscle for the treatment of dry eye

OBJETIVO/MÉTODOS: Describir el uso de toxina botulínica tipo A para aumentar la retención lagrimal en pacientes con ojo seco mediante el reporte de 2 casos. RESULTADOS: Pacientes con ojo seco moderado a severo, a quienes se les inyectaron 5 UI de toxina botulínica tipo A en el músculo de Horner. Se describen los resultados al mes y 3 meses. Se evaluó la percepción subjetiva del paciente en cuanto a la mejoría, además, del Ocular Surface Disease Index, la queratitis punteada superficial, el tiempo de rotura de la lágrima y el menisco lagrimal, los cuales también fueron tenidos en cuenta. Se evidenció una importante mejoría de la percepción subjetiva del paciente, el Ocular Surface Disease Index, la queratitis punteada superficial, el tiempo de rotura de la lágrima y el menisco lagrimal al mes de la aplicación, manteniéndose aún con buenos resultados al tercer mes. No se presentaron eventos adversos. DISCUSIÓN: El uso de toxina botulínica tipo A puede ser considerado una alternativa para aumentar la retención de la lágrima en pacientes con ojo seco moderado a severo con una buena respuesta durante el primer mes, manteniendo una respuesta aceptable incluso al tercer mes. Dado el efecto temporal del medicamento, podría precisar retratamientos

OBJECTIVE/METHODS: The aim of this study is to describe the use of botulinum toxin to increase tear retention in patients with dry eye, using the description of 2 cases. RESULTS: Patients with moderate to severe dry eye that were given an injection of type A botulinum toxin in the Horner's muscle. The results at one month and 3 months are reported. An assessment was made of the subjective perception of the patient as regards any improvement, as well as taking into account, the Ocular Surface Disease Index, superficial punctate keratitis, and the time of the tear rupture and tear meniscus. A significant improvement was observed in the subjective perception of the patient, the Ocular Surface Disease Index, superficial punctate keratitis, and the time of the tear rupture and tear meniscus at one month after treatment, and the good results still being maintained at the third month. There were no adverse events. DISCUSSION: The use of type A botulinum toxin can be considered as an alternative to increase tear retention in moderate to severe dry eye, with a good response during the first month, with an acceptable response still being maintained at the third month. Given the temporary effect of the drug, further treatments would be required

Aucuba japonica Extract and Aucubin Prevent Desiccating Stress-Induced Corneal Epithelial Cell Injury and Improve Tear Secretion in a Mouse Model of Dry Eye Disease.

Dry eye disease is affected by a broad range of causes such as age, lifestyle, environment, medication and autoimmune diseases. These causes induce tear instability that activates immune cells and promotes expression of inflammatory molecules. In this study, we investigated the therapeutic effects of an ethanolic extract of Aucuba japonica (AJE) and its bioactive compound, aucubin, on dry eye disease. The human corneal cells were exposed to desiccation stress induced by exposing cells to air, so that viability was decreased. On the other hand, pre-treatment of AJE and aucubin restored cell survival rate depending on the dose under the dry condition. This result was confirmed again by terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining. The mRNA expression of inflammatory molecules was reduced by the pretreatment of AJE and aucubin under the dry state. The therapeutic effects of AJE and aucubin were examined in the animal model for dry eye induced by unilateral excision of the exorbital lacrimal gland. Declined tear volumes and corneal irregularity in the dry eye group were fully recovered by the administration of AJE and aucubin. The apoptotic cells on the cornea were also decreased by AJE and aucubin. Therefore, this study suggests that administration of AJE can be a novel therapeutic for dry eye disease and that the pharmacological activities of AJE may be in part due to its bioactive compound, aucubin.

Pilocarpine and artificial saliva for the treatment of xerostomia and xerophthalmia in Sjögren syndrome: a double-blind randomized controlled trial.

BACKGROUND: Sjögren syndrome (SS) is associated with xerostomia and xerophthalmia. Pilocarpine has been shown to stimulate the secretion of saliva. OBJECTIVES: To investigate and compare the efficacy of pilocarpine and artificial saliva as symptomatic treatments for xerostomia and xerophthalmia in patients with SS. METHODS: A double-blind randomized controlled study was performed. A total of 72 patients with SS were assigned randomly to receive 10 drops of pilocarpine (5 mg) or 10 drops of artificial saliva orally, three times daily for 12 weeks. Whole saliva and tear flow were evaluated at baseline and periodically throughout the study to provide a global assessment of dryness and to report any adverse effects. RESULTS: Patients receiving pilocarpine had a statistically significant improvement in their salivary flow (P < 0·001), lacrimal flow (P < 0·001) and their subjective global assessment (P < 0·001), compared with patients who received artificial saliva. The most common side-effects were sialorrhoea and nausea. CONCLUSIONS: Pilocarpine is more effective than artificial saliva for enhancing salivary and lacrimal secretion in patients with SS. This is the first study to compare the efficacy of pilocarpine and artificial saliva for the treatment of xerostomia and xerophthalmia in SS.

A Comparison of the Effects of Benzalkonium Chloride on Ocular Surfaces between C57BL/6 and BALB/c Mice.

Models of benzalkonium chloride (BAC)-induced ocular disruption have been created and are widely used in various animals. This study aimed to compare the effects of BAC on the ocular surfaces of C57BL/6 and BALB/c mice. C57BL/6 and BALB/c mice were treated separately with BAC eye-drops at different concentrations. Eyes were evaluated by scoring epithelial disruption, corneal opacity and neovascularization in vivo, and by histological assays with hematoxylin/eosin (H/E) and periodic acid-Schiff stainings and by determining the expression of inflammatory factors in vitro on Days 7 and 14. The in vivo corneal epithelial disruption, corneal edema/opacity and neovascularization, which were in accordance with the results of the H/E staining and peaked at Day 7, were observed in a dose-dependent manner in the BAC-treated mice, with more severe signs in the C57BL/6 mice than the BALB/c mice. The loss of conjunctival goblet cells in the conjunctivas and the increasing expression of monocyte chemoattractant protein 1 (MCP-1), growth-regulated protein alpha (GROa) and macrophage inflammatory protein-1 alpha (MIP-1a) in the corneas were found in a dose-dependent manner in both strains of mice. Topical application of BAC can dramatically disrupt the ocular surfaces of C57BL/6 and BALB/c mice, and the disruptions were much more severe in the C57BL/6 mice that received high doses of BAC.

Topical Application of Apricot Kernel Extract Improves Dry Eye Symptoms in a Unilateral Exorbital Lacrimal Gland Excision Mouse.

The purpose of this study was to investigate the therapeutic effects of topical application of apricot kernel extract (AKE) in a unilateral exorbital lacrimal gland excision mouse model of experimental dry eye. Dry eye was induced by surgical removal of the lacrimal gland. Eye drops containing 0.5 or 1 mg/mL AKE were administered twice a day from day 3 to day 7 after surgery. Tear fluid volume and corneal irregularity scores were determined. In addition, we examined the immunohistochemical expression level of Muc4. The topical administration of AKE dose-dependently improved all clinical dry eye symptoms by promoting the secretion of tear fluid and mucin. Thus, the results of this study indicate that AKE may be an efficacious topical agent for treating dry eye disease.

Combined effect of traditional Chinese and Western medicine on inflammatory factors in patients with diabetes-induced xerophthalmia.

Diabetes-induced xerophthalmia is a general metabolic disorder with high incidence and increased treatment difficulty. Our study aimed to explore the combined effect of traditional Chinese and Western medicines on diabetes-associated xerophthalmia. We recruited 60 diabetic xerophthalmia patients, and randomly assigned them to either the control (Western medicine treatment) or the experimental (combined treatment of traditional Chinese medicine and Western medicine) groups. Pre-treatment and post-treatment analyses were performed to assess the combined therapeutic effect of traditional Chinese and Western medicine on xerophthalmia-associated indicators. We found that the experimental group expressed reduced levels of IL-1, IL-8, and TNF-α (P < 0.05) as compared to the control group. Furthermore, the experimental group showed higher treatment efficacy as compared to the control group (85.00 vs 51.67% Z = 22.244, P < 0.05). In addition, break-up time (t = 20.582, P < 0.05) and tear section (t = 23.082, P < 0.05) was increased in the experimental group as compared to the controls. Lastly, it was found that the combined treatment of traditional Chinese and Western medicine effectively reduced corneal injuries, as indicated by reduced fluorescein staining. This study suggested that a combination treatment consisting of both traditional Chinese and Western medicines may be effective against xerophthalmia in diabetes, and that inflammatory factors are potential biomarkers to examine the treatment efficacy.

Therapeutic Efficacy of Topically Applied Antioxidant Medicinal Plant Extracts in a Mouse Model of Experimental Dry Eye.

Purpose. To investigate the therapeutic effects of topical administration of antioxidant medicinal plant extracts in a mouse model of experimental dry eye (EDE). Methods. Eye drops containing balanced salt solution (BSS) or 0.001%, 0.01%, and 0.1% extracts were applied for the treatment of EDE. Tear volume, tear film break-up time (BUT), and corneal fluorescein staining scores were measured 10 days after desiccating stress. In addition, we evaluated the levels of interleukin- (IL-) 1ß, tumor necrosis factor- (TNF-) α, IL-6, interferon- (IFN-) γ, and IFN-γ associated chemokines, percentage of CD4+C-X-C chemokine receptor type 3 positive (CXCR3+) T cells, goblet cell density, number of 4-hydroxy-2-nonenal (4-HNE) positive cells, and extracellular reactive oxygen species (ROS) production. Results. Compared to the EDE and BSS control groups, the mice treated with topical application of the 0.1% extract showed significant improvements in all clinical parameters, IL-1ß, IL-6, TNF-α, and IFN-γ levels, percentage of CD4+CXCR3+ T cells, goblet cell density, number of 4-HNE-positive cells, and extracellular ROS production (P < 0.05). Conclusions. Topical application of 0.1% medicinal plant extracts improved clinical signs, decreased inflammation, and ameliorated oxidative stress marker and ROS production on the ocular surface of the EDE model mice.

Sodium hyaluronate's effect on xerophthalmia: a meta-analysis of randomized controlled trials.

BACKGROUND AND AIMS: Several studies in the past have attempted to demonstrate the efficacy of sodium hyaluronate in the treatment of xerophthalmia. However, results have been conflicting and a definite conclusion has not yet been reached. In order to provide integrated evidence for the effectiveness of sodium hyaluronate and to judge the methodological value of relevant randomized controlled trials (RCTs) in nearly thirty years, we conducted this meta-analysis. METHODS: A range of electronic databases were searched: MEDLINE, the Cochrane Library Database, EMBASE, CINAHL, Web of Science and the Chinese Biomedical Database (CBM) without language restrictions. Two independent reviewers assessed trials for eligibility and quality, and meta-analysis was performed using the STATA 12.0 software. An integrated odds ratio (OR) with its corresponding 95% confidence interval (95% CI) was calculated. RESULTS: Six RCTs were included with a total of 839 xerophthalmia patients. The meta-analysis results revealed that patients with xerophthalmia who received the intervention of sodium hyaluronate eye drops didn't have significantly higher remission rate of dry eye symptoms than those in controlled groups (OR = 1.811, 95% CI = 0.741-4.429, p = 0.193). Sensitivity analysis suggested that the statistical results were robust. No publication bias was detected in this meta-analysis (p > 0.05). CONCLUSION: Although sodium hyaluronate can be used to help relieve the symptoms of dry eyes, present evidence cannot show in unequivocal terms that patients with xerophthalmia can benefit more from the clinical application of sodium hyaluronate than other eye drops or therapies.

[Experimental study on efficiency of Spanishneedles Herb eye drops in treating perimenopausal xerophthalmia in rabbits].

OBJECTIVE: To investigate the efficiency of Spanishneedles Herb eye drops in treating perimenopausal xerophthalmia in rabbits. METHOD: Totally 36 rabbits (36 right eyes) were ovariectomized, and 2 months later divided into three groups: the experimental group (group A, n = 12) given Spanishneedles Herb eye drops, the control group (group B, n = 12) given PBS and the model group (group C, n = 12) given no drug. The Schirmer I test (SIT), fluorescent (FL), total tear protein, diastase activity, lactoferrin and lysozyme contents and confocal scanning microscopy were performed at before the treatment and at 1 w, 2 w, 1 mo, 2 mo after the treatment. RESULT: Before the treatment, There was no significant difference in SIT, FL, total tear protein, lysozyme, lactoferrin and amylase activity between two groups. Two months later after the treatment, both the group B and the group A showed differences degrees of changes in SIT, FL, total tear protein, lysozyme, lactoferrin and amylase activity compared with that before the treatment, with statistical differences (P < 0.05); At each time point, both groups revealed statistical differences in SIT, FL, total tear protein, lysozyme, lactoferrin and amylase activity (1 < 0.05). Two months later alter the treatment, densities of basal epithelial cells and inflammatory cells in the group A were (4 122 ±416) cells/mm2 and (339 ± 131) cells/mm2, while that in the group B were (3 343 ± 424) cells/mm2 and (49 ± 17) cells/mm2, with statistical differences between them (P < 0.05). CONCLUSION: Spanishneedles Herb eye drops could effectively treat perimenopausal xerophthalmia in rabbit caused by sex hormones decline.