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1.
Medicine (Baltimore) ; 99(1): e18459, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31895776

RESUMO

BACKGROUND: The high incidence of Diabetes mellitus (DM) has become a serious challenge for the global epidemic. Increased blood glucose leads to abnormal ocular surface structure and metabolic disorder in patients. DM is a high-risk factor for dry eye disease (DED), with high incidence and increased difficulty in treatment. The disease can cause discomfort, visual impairment, tear film instability and ocular surface damage, and even cause corneal erosion in severe cases, which has a serious impact on people's daily life. Traditional Chinese Medicine (TCM) plays an important role in the evaluation and treatment of DM and its complications. However, whether TCM treatment could improve the treatment efficacy of DM suffering from DED remains poorly understood. OBJECTIVE: To investigate the curative effect of TCM for the alleviation of clinical symptoms in Diabetic patients with DED, and to evaluate its long-term efficacy. METHODS: This trial is a single-case randomized, single-blind, placebo-controlled study. A total of 12 subjects will be recruited in this trial. The trial is divided into three cycles, and one cycle has 2 treatment periods. There is a washout period at each adjacent treatment stage. TCM individualized treatment and placebo will be randomized during the treatment period. The test period will last for 29 weeks, with 4 weeks for each treatment period and 1 week for each washout period to minimize carryover effects. Subjects will be selected by the researcher strictly in accordance with the inclusion and exclusion criteria. The outcomes will evaluate the efficacy of treatment by changes in the various observation indicators. DISCUSSION: This study will realize a patient-centered outcome approach necessary to provide clinical researchers with the evidence that TCM treatment can effectively improve the objective indicators of the eye and systemic symptoms in Diabetic patients with DED. TRIAL REGISTRATION: This study has been registered at the Chinese Clinical Trial Registry (http://www.chictr.org.cn, No. ChiCTR1900024481), (October, 2019).


Assuntos
Complicações do Diabetes/terapia , Síndromes do Olho Seco/terapia , Medicina Tradicional Chinesa/métodos , Feminino , Humanos , Masculino , Assistência Centrada no Paciente/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto , Método Simples-Cego
2.
Invest Ophthalmol Vis Sci ; 61(1): 3, 2020 Jan 23.
Artigo em Inglês | MEDLINE | ID: mdl-31995154

RESUMO

Purpose: The purpose of this study was to investigate the expression of death ligands in the lacrimal glands (LGs), identify upstream factors that regulate their expression, and determine the functional roles of these factors in the pathogenesis of dry eye disease (DED). Methods: For DED experiment, ex vivo coculture system with LG and in vivo murine model using a controlled environment chamber were utilized. C57BL/6 mice and hypoxia-inducible factor (HIF)-1α conditional knockout (CKO) mice were used. Immunohistochemical staining, polymerase chain reaction, and immunoblotting were performed to determine levels of death ligands including tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) in DED-induced LGs. Additionally, acinar cell and CD45+ cell apoptosis was determined with neutralizing TRAIL treatment. Results: Desiccating stress significantly increased HIF-1α expression in LG-acinar cells. Furthermore, HIF-1α deficiency significantly enhanced the infiltration of CD45+ inflammatory cells in LG and induced LG-acinar cell death. Meanwhile, only TRAIL expression was increased in DED-LG, but abrogated in HIF-1α CKO. Interestingly, the main source of TRAIL was the CD45- LG-acinar cells, but not CD45+ immune cells after DED induction. Using ex vivo coculture system, we confirmed LG-induced apoptosis of immune cells via HIF-1α-mediated TRAIL secretion following DED. Consistent with ex vivo, the insufficiency of HIF-1α and TRAIL enhanced recruitment of inflammatory cells to the LG and subsequently exacerbated ocular surface damage in DED mice. Conclusions: Our findings offer novel insight into the regulatory function of acinar cell-derived TRAIL in limiting inflammatory damage and could be implicated in the development of potential therapeutic strategies for DED.


Assuntos
Dacriocistite/metabolismo , Síndromes do Olho Seco/metabolismo , Regulação da Expressão Gênica/fisiologia , Subunidade alfa do Fator 1 Induzível por Hipóxia/fisiologia , Aparelho Lacrimal/metabolismo , Ligante Indutor de Apoptose Relacionado a TNF/genética , Animais , Apoptose , Técnicas de Cocultura , Dacriocistite/patologia , Modelos Animais de Doenças , Síndromes do Olho Seco/patologia , Ensaio de Imunoadsorção Enzimática , Citometria de Fluxo , Immunoblotting , Marcação In Situ das Extremidades Cortadas , Aparelho Lacrimal/patologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Técnicas de Cultura de Órgãos , Reação em Cadeia da Polimerase em Tempo Real
3.
Toxicol Lett ; 319: 74-84, 2020 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-31707104

RESUMO

Benzalkonium chloride (BAK), a quaternary ammonium compound widely used as disinfecting agent as well as preservative in eye drops is known to induce toxic effects on the ocular surface with inflammation and corneal nerve damage leading to dry eye disease (DED) in the medium-to-long term. The aim of this study was to evaluate in vitro the toxicity of a conditioned medium produced by corneal epithelial cells previously exposed to BAK (BAK-CM) on trigeminal neuronal cells. A human corneal epithelial (HCE) cell line was exposed to 5.10-3% BAK (i.e. 0.005% BAK) for 15 min and let recover for 5 h to prepare a BAK-CM. This BAK concentration is the lowest one found in eye drops. After this recovery period, BAK effect on HCE cells displayed cytotoxicity, morphological alteration, apoptosis, oxidative stress, ATP release, CCL2 and IL6 gene induction, as well as an increase in CCL2, IL-6 and MIF release. Next, a mouse trigeminal ganglion primary culture was exposed to the BAK-CM for 2 h, 4 h or 24 h. Whereas BAK-CM did not alter neuronal cell morphology, or induced neuronal cytotoxicity or oxidative stress, BAK-CM induced gene expression of Fos (neuronal activation marker), Atf3 (neuronal injury marker), Ccl2 and Il6 (inflammatory markers). Two and 4 h BAK-CM exposure promoted a neuronal damage (ATF-3, phospho-p38 increases; phospho-Stat3 decreases) while 24 h-BAK-CM exposure initiated a prosurvival pathway activation (phospho-p44/42, phospho-Akt increases; ATF-3, GADD153, active Caspase-3 decreases). In conclusion, this in vitro model, simulating paracrine mechanisms, represents an interesting tool to highlight the indirect toxic effects of BAK or any other xenobiotic on corneal trigeminal neurons and may help to better understand the cellular mechanisms that occur during DED pathophysiology.


Assuntos
Apoptose/efeitos dos fármacos , Compostos de Benzalcônio/toxicidade , Células Epiteliais/efeitos dos fármacos , Epitélio Anterior/efeitos dos fármacos , Inflamação/induzido quimicamente , Neurônios/efeitos dos fármacos , Conservantes Farmacêuticos/toxicidade , Gânglio Trigeminal/efeitos dos fármacos , Fator 3 Ativador da Transcrição/biossíntese , Fator 3 Ativador da Transcrição/efeitos dos fármacos , Animais , Linhagem Celular , Síndromes do Olho Seco/induzido quimicamente , Síndromes do Olho Seco/patologia , Epitélio Anterior/citologia , Expressão Gênica/efeitos dos fármacos , Humanos , Inflamação/patologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Estresse Oxidativo/efeitos dos fármacos , Transdução de Sinais/efeitos dos fármacos , Gânglio Trigeminal/citologia
4.
Ophthalmic Res ; 63(1): 50-58, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31117087

RESUMO

PURPOSE: Ocular graft-versus-host disease (oGvHD) following allogeneic hematopoietic stem cell transplantation develops as severe dry eye disease (DED) and is initially treated with lubricants, although no clinical trials are available using artificial tears in oGvHD. This trial was set up to test perfluorohexyloctane (NovaTears®) as nonpreserved layer-forming agent for the treatment of DED in oGvHD. METHODS: 25 patients with severe DED due to oGvHD received 1 drop perfluorohexyloctane 4 times daily during a prospective, multicenter, observational 12-week study on top of established topical therapy. Clinical parameters included Schirmer test, tear film breakup time, corneal staining, meibum secretion and ocular surface disease index. Adverse events, visual acuity and intraocular pressure were key safety parameters. RESULTS: From 25 patients recruited, 23 presented for the second visit. Perfluorohexyloctane treatment did not lead to any changes in clinical or safety parameters but led to fast relief in symptoms in 57% of the patients. One adverse reaction occurred. CONCLUSIONS: This study showed no change in clinical signs in severe DED due to oGvHD, which was not unexpected due to the underlying pathomechanisms. However, the study showed improvement of symptoms in individual patients allowing application of perfluorohexyloctane as an additional symptomatic therapy in oGvHD.


Assuntos
Síndromes do Olho Seco/tratamento farmacológico , Fluorcarbonetos/uso terapêutico , Doença Enxerto-Hospedeiro/tratamento farmacológico , Soluções Oftálmicas/uso terapêutico , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
5.
Eur J Ophthalmol ; 30(1): 94-103, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30585084

RESUMO

PURPOSE: To evaluate the efficacy and safety of plasma rich in growth factors eye drops for the treatment of corneal and ocular surface disorders in patients with graft versus host disease. METHODS: This retrospective and longitudinal study included graft versus host disease patients with ocular disorders. The resolution of corneal ulcers (area and density staining) was evaluated as primary outcome. Best corrected visual acuity, intraocular pressure, tear film breakup time, Schirmer test, ocular surface disease index, and visual analog score were evaluated as secondary outcomes. All variables were analyzed before and after plasma rich in growth factors treatment. The safety of plasma rich in growth factors treatment was also assessed. RESULTS: Twelve patients (23 eyes) with ocular graft versus host disease were evaluated. Statistically significant improvement in the area (75.7%) and density (73.3%) of the corneal staining, in best corrected visual acuity (74.7%), in ocular surface disease index scale (75.4%), visual analog score frequency (81.4%) and visual analog score severity (81.9%), and an increase of 3.8 s in tear film breakup time and 6 mm in Schirmer test was observed after plasma rich in growth factors treatment (p < 0.001). Some potential modifiers of the therapeutic effect were identified. All patients achieved corneal stability without perforation risk. No adverse events associated with the plasma rich in growth factors were observed. CONCLUSION: Immunosafe plasma rich in growth factors eye drops for the treatment of patients with ocular graft versus host disease could be safe and effective, showing a high rate of corneal ulcer resolution and dry eye disease control. Plasma rich in growth factors eye drops may help to maintain corneal stability and prevent it against higher ocular complications.


Assuntos
Síndromes do Olho Seco/terapia , Doença Enxerto-Hospedeiro/complicações , Peptídeos e Proteínas de Sinalização Intercelular/farmacologia , Plasma Rico em Plaquetas , Adulto , Idoso , Síndromes do Olho Seco/etiologia , Síndromes do Olho Seco/metabolismo , Feminino , Seguimentos , Doença Enxerto-Hospedeiro/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Soluções Oftálmicas/uso terapêutico , Estudos Retrospectivos , Lágrimas/metabolismo
6.
Eur J Ophthalmol ; 30(1): 189-195, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30474390

RESUMO

PURPOSE: To determine the prevalence of symptoms of computer vision syndrome and to identify its associated factors. The secondary objective was to assess knowledge and practices related to preventing computer vision syndrome symptoms. METHODS: The data for this cross-sectional study were collected through a self-administered questionnaire distributed to 713 female undergraduates studying business and medicine in Saudi Arabia. The questionnaire included computer vision syndrome validated symptoms and factors associated with computer vision syndrome development. RESULTS: The most common symptom due to prolonged computer use was neck or shoulder pain, reported by 82.2% of the subjects. Overall, 66.5% of the subjects suffered from headache and 51.5% from dry eyes, in mild, moderate, or severe form. Business students were 1.6 times as likely as medical students to suffer from computer vision syndrome (odds ratio = 1.65; 95% confidence interval: 1.22, 2.24). The use of electronic devices for more than 5 h (odds ratio = 1.52; 95% confidence interval: 1.07, 2.16) was also associated with experiencing computer vision syndrome symptoms. Regarding computer vision syndrome prevention, factors such as hours of use, screen distance, screen brightness, and room illumination showed statistically significant difference between the two groups (p < 0.0001). CONCLUSION: The prevalence of computer vision syndrome symptoms was significantly higher among business students, who reported lower awareness and poor practice measures of computer use recommendations. Relevant awareness campaigns focusing on the appropriate use of computers are highly recommended.


Assuntos
Astenopia/epidemiologia , Computadores , Síndromes do Olho Seco/epidemiologia , Cervicalgia/epidemiologia , Dor de Ombro/epidemiologia , Estudantes/estatística & dados numéricos , Transtornos da Visão/epidemiologia , Adulto , Estudos Transversais , Feminino , Humanos , Prevalência , Fatores de Risco , Arábia Saudita/epidemiologia , Autorrevelação , Inquéritos e Questionários , Síndrome , Universidades
7.
Invest Ophthalmol Vis Sci ; 60(15): 5035-5044, 2019 12 02.
Artigo em Inglês | MEDLINE | ID: mdl-31800960

RESUMO

Purpose: To compare the changes in human tear proteome and clinical effects following topical cyclosporine A (CsA) 0.05% or diquafosol tetrasodium (DQS) 3% treatment of dry eye disease (DED), and to identify biomarkers for determining disease severity and treatment effectiveness in DED. Methods: A total of 18 patients were diagnosed with non-Sjögren DED. Nine patients in each group were treated with topical CsA 0.05% or DQS 3% for 4 weeks. Tear samples were collected after evaluation of tear breakup time, corneal and conjunctival erosion staining, and results of Schirmer's test 1 before and after treatment. Proteomes were characterized using liquid chromatography mass spectrometry, and proteins exhibiting a fold change >1.5 or <0.67 (P < 0.05) were considered differentially expressed (DEP). Results: A total of 794 proteins were identified, with no significant difference observed between pretreatment and posttreatment conditions. Proteomic analysis identified 54 and 106 DEPs between treatment groups (CsA and DQS, respectively), with gene ontology analysis indicating that both treatments enhanced innate and adaptive immune responses and cellular detoxification. Protein-network analysis showed that inflammation associated with the immune response was primarily responsible for the therapeutic process in both groups. Conclusions: These results provide insight into the broad scope of changes at the ocular surface in DED and indicated that although both drugs improved the clinical parameters, the activated tear-specific biomarkers differed significantly between treatments. Our findings suggest that the DEPs identified here and those correlated with the clinical parameters might represent candidate biomarkers for DED.


Assuntos
Ciclosporina/administração & dosagem , Síndromes do Olho Seco/tratamento farmacológico , Polifosfatos/administração & dosagem , Proteoma/metabolismo , Lágrimas/metabolismo , Nucleotídeos de Uracila/administração & dosagem , Administração Tópica , Túnica Conjuntiva/metabolismo , Túnica Conjuntiva/patologia , Córnea/metabolismo , Córnea/patologia , Relação Dose-Resposta a Droga , Síndromes do Olho Seco/metabolismo , Feminino , Seguimentos , Humanos , Imunossupressores/administração & dosagem , Masculino , Pessoa de Meia-Idade , Soluções Oftálmicas/administração & dosagem , Estudos Prospectivos , Método Simples-Cego , Lágrimas/efeitos dos fármacos , Resultado do Tratamento
8.
Nat Commun ; 10(1): 5678, 2019 12 12.
Artigo em Inglês | MEDLINE | ID: mdl-31831729

RESUMO

As a protective mechanism, the cornea is sensitive to noxious stimuli. Here, we show that in mice, a high proportion of corneal TRPM8+ cold-sensing fibers express the heat-sensitive TRPV1 channel. Despite its insensitivity to cold, TRPV1 enhances membrane potential changes and electrical firing of TRPM8+ neurons in response to cold stimulation. This elevated neuronal excitability leads to augmented ocular cold nociception in mice. In a model of dry eye disease, the expression of TRPV1 in TRPM8+ cold-sensing fibers is increased, and results in severe cold allodynia. Overexpression of TRPV1 in TRPM8+ sensory neurons leads to cold allodynia in both corneal and non-corneal tissues without affecting their thermal sensitivity. TRPV1-dependent neuronal sensitization facilitates the release of the neuropeptide substance P from TRPM8+ cold-sensing neurons to signal nociception in response to cold. Our study identifies a mechanism underlying corneal cold nociception and suggests a potential target for the treatment of ocular pain.


Assuntos
Córnea/metabolismo , Nociceptividade/fisiologia , Células Receptoras Sensoriais/metabolismo , Substância P/metabolismo , Canais de Cátion TRPV/metabolismo , Sensação Térmica/fisiologia , Animais , Temperatura Baixa , Síndromes do Olho Seco , Regulação da Expressão Gênica , Hiperalgesia/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Células Receptoras Sensoriais/efeitos dos fármacos , Canais de Cátion TRPV/genética , Tamoxifeno/farmacologia
9.
Zhonghua Yan Ke Za Zhi ; 55(12): 881-884, 2019 Dec 11.
Artigo em Chinês | MEDLINE | ID: mdl-31874501

RESUMO

Dry eye has become a common disease in ophthalmic clinics. With the continuous development and application of examination and treatment equipment, doctors' understanding of dry eye has improved as well as the diagnosis and treatment level of dry eye. However, there are some problems in the diagnosis and treatment of dry eye so far. Doctors rely too much on equipment to help diagnosis and ignore routine eye examinations with the ophthalmic special examinations prescribed usually being lack of definite purposes. The analysis of results is not scientific. The selection of treatment methods is not careful enough. Therefore, standardized diagnosis and reasonable treatment are the goals that dry eye clinics are required to achieve. During the clinical practice, doctors should attach importance to history taking and the analysis of clinical symptoms, strengthen the basic examination of dry eye, gradually expand the scope of examination and make a reasonable and targeted treatment plan. (Chin J Ophthalmol, 2019, 55: 881-884).


Assuntos
Síndromes do Olho Seco , Síndromes do Olho Seco/diagnóstico , Síndromes do Olho Seco/terapia , Humanos , Lágrimas
10.
Zhonghua Yan Ke Za Zhi ; 55(12): 885-890, 2019 Dec 11.
Artigo em Chinês | MEDLINE | ID: mdl-31874502

RESUMO

Dry eye is one of the most common eye diseases characterized by disturbance of tear film homeostasis and a series of ocular discomforts. Discrepancy of ocular subjective symptoms and objective signs, especially unexplained severe symptoms without visible signs has been a long-time confusion for ophthalmologists. Functional disorder is a medical condition that impairs normal functioning of bodily processes due to autonomic nervous dysfunction caused by cerebral cortical dysfunction, but at the exterior, there is no appearance of abnormality. Clinical manifestations are the disease symptoms with a lack of exact physical signs and examination results to confirm the diagnosis. According to the definition and characteristics of functional disorder, we put forward the concept of functional dry eye. We assume that those patients with dry eye symptoms but without detectable signs could be classified into such a functional dry eye subtype. The possible mechanism, clinical manifestations, and treatment strategies are further discussed. (Chin J Ophthalmol, 2019, 55: 885-890).


Assuntos
Síndromes do Olho Seco , Síndromes do Olho Seco/diagnóstico , Síndromes do Olho Seco/fisiopatologia , Olho , Humanos , Lágrimas
11.
Invest Ophthalmol Vis Sci ; 60(14): 4511-4519, 2019 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-31675422

RESUMO

Purpose: The present study was designed to investigate the role of ocular surface glycocalyx and mucins in graft versus host disease (GVHD)-associated dry eye. The ameliorative effect of topical rebamipide, a mucin secretagogue, on GVHD-associated dry eye was also tested. Methods: A mouse model of allogeneic transplantation was used to induce ocular GVHD with C57BL/6 as donors and B6D2F1 as recipient mice. Phenol red thread method and fluorescein staining was used to quantify tear secretion and corneal keratopathy. At 8 weeks after the allogeneic transplantation, corneas were harvested to perform glycocalyx staining and confocal microscopy. Goblet cell staining was performed using periodic acid Schiff's staining. Corneal and tear film levels of Mucin 1, 4, 16, 19, and 5AC were quantified using ELISA and real-time PCR. Rebamipide was applied topically twice daily to mice eyes. Results: Allogeneic transplantation resulted in ocular GVHD-associated dry eye characterized by a significant decrease in tear film volume and the onset of corneal keratopathy. Ocular GVHD caused a significant decrease in the area and thickness of corneal glycocalyx. A significant decrease in the goblet cells was also noted. A significant decrease in mucin 4 and 5AC levels was also observed. Topical treatment with rebamipide partially attenuated ocular GVHD-mediated decrease in tear film volume and significantly reduced the severity of corneal keratopathy. Conclusions: Ocular GVHD has detrimental impact on ocular surface glycocalyx and mucins. Rebamipide, a mucin secretagogue, partially prevents ocular GVHD-associated decrease in tear film and reduces the severity of corneal keratopathy.


Assuntos
Alanina/análogos & derivados , Antioxidantes/uso terapêutico , Síndromes do Olho Seco/metabolismo , Doença Enxerto-Hospedeiro/metabolismo , Mucinas/metabolismo , Quinolonas/uso terapêutico , Administração Oftálmica , Alanina/uso terapêutico , Animais , Transplante de Medula Óssea , Antígeno Ca-125/metabolismo , Modelos Animais de Doenças , Síndromes do Olho Seco/tratamento farmacológico , Ensaio de Imunoadsorção Enzimática , Proteínas do Olho/metabolismo , Feminino , Células Caliciformes/metabolismo , Doença Enxerto-Hospedeiro/tratamento farmacológico , Camundongos , Camundongos Endogâmicos C57BL , Microscopia Confocal , Mucina-5AC/metabolismo , Mucina-1/metabolismo , Mucina-4/metabolismo , Reação do Ácido Periódico de Schiff , Reação em Cadeia da Polimerase em Tempo Real , Lágrimas/metabolismo , Transplante Homólogo
12.
Rom J Ophthalmol ; 63(3): 297-305, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31687635

RESUMO

Introduction: It is acknowledged that leading pharmaceutical companies lately spend more on marketing than they are investing in research and technology development. Romania registers one of the largest market growths in the pharmaceutical industry from Central and Eastern Europe, and it is one of the main investors on the advertising market. The rapid changes in the pharmaceutical landscape have demanded for organizations to re-evaluate their infrastructure and the information delivery methods, as well as cut through the clutter and build competitive advantages by using effective advertising. The dry eye is a commonly disease encountered worldwide, which is treated with the help of over-the-counter (OTC) artificial tear drops. Aim: The aim of this study was twofold: to determine the profile of the Romanian consumer who uses artificial tear drops and to assess the components of experiential marketing used in a TV advertisement, which have the highest influence on the consumer's perception of effective advertising. Material and method: We selected a TV advertisement that used the magical concept of the artificial tear drops in the shape of water in a desert area, suggesting an eye irritation. The instrument for data collection was a self-administered questionnaire based on the watched advertising spot about the OTC artificial tear drops. The sample was made up of 384 participants and the sampling method was the snowball technique. Moreover, a model using Structural Equation was validated in order to assess the established relationships between the experiential marketing components and the effectiveness of the OTC artificial tear drops advertising. Findings: The findings showed that the demographic profile of the OTC artificial tear drops consumer is a female, with the mean age of 39 years, who graduated from university, with an average income of 2500 RON (Romanian currency), single, and with an office job. The mean number of hours spent in front of a computer per day was 10. The structural equation model revealed that the component think experience has the highest direct influence on the consumer's perception of an advertisement about OTC artificial tear drops as being effective. Discussion: The pharmaceutical market is different from other markets in that the decision maker is not the purchaser except for the OTC drugs that do not require a receipt from a physician. Think experience focuses on rational decision-making and problem solving but in a creative way.


Assuntos
/métodos , Síndromes do Olho Seco/tratamento farmacológico , Lubrificantes Oftálmicos/farmacologia , Marketing/métodos , Medicamentos sem Prescrição , Adulto , Feminino , Humanos , Masculino , Estudos Retrospectivos , Romênia
16.
Vestn Oftalmol ; 135(5): 92-98, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31714519

RESUMO

Dry eye syndrome (DES) is a multifactorial disease of the ocular surface characterized by a loss of homeostasis of the tear film, and accompanied by ocular symptoms, in which tear film instability and hyperosmolarity, ocular surface inflammation and damage, and neurosensory abnormalities play etiological roles. The clinical manifestations of DES can be highly variable, so its diagnosing is typically based on a combination of symptoms, signs, and clinical tests. Majority of the techniques involved in the diagnosis of this disease has a large degree of subjectivity. The present article reviews current dry eye diagnostic tests and presents a new tear film stability assessment technique that may potentially become the objective method for establishing DES diagnosis.


Assuntos
Síndromes do Olho Seco , Lágrimas , Olho , Humanos
17.
Vestn Oftalmol ; 135(5. Vyp. 2): 199-203, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31691660

RESUMO

At present, installation of punctal plugs (tear duct occluders) draws attention of ophthalmologists, but this method of treating dry eye syndrome (DES) is not without complications. Considering the rise of DES occurrence - the tendency anticipated to continue - as well as expansion of indications for installation of tear duct occluders, their usage can be expected to rise. The article describes a relatively rare clinical case that involved intracanalicular migration of silicone punctal plug. A female patient of 36 years old sought medical help in Research Institute of Eye Diseases (Moscow) to treat a lump in the area of lower lacrimal punctum in the left eye that was growing in size; the lump had appeared around 2 months prior to the visit. Patient's medical history read that around 2 years ago she had a silicone occluder installed in the lower lacrimal punctum of the left eye. On examination, in the area of lower lacrimal punctum, a body with a nutrient vascular pedicle deriving from lower lacrimal duct could be found. The occluder was absent in the opening of the lacrimal punctum. A revision of lower tear duct cavity was performed to remove its contents. The body filling tear duct opening was removed with forceps. Substance was then sent for histological examination. Tear duct was scraped out, the silicone occluder removed and sent to laboratory for scanning electron microscopy. The patient had no complaints 6 months after the procedure. CONCLUSION: The study showed that the forming body was granuloma resulting from aseptic inflammation. Surface of the silicone occluder in retention of lacrimal pathways remained unchanged. Described surgical tactic is suitable for treating patients with intracanalicular punctal plug migration.


Assuntos
Granuloma , Aparelho Lacrimal , Plug Lacrimal , Adulto , Síndromes do Olho Seco , Feminino , Granuloma/etiologia , Humanos , Implantação de Prótese , Plug Lacrimal/efeitos adversos , Elastômeros de Silicone
18.
Rev Lat Am Enfermagem ; 27: e3201, 2019.
Artigo em Inglês, Português, Espanhol | MEDLINE | ID: mdl-31664409

RESUMO

OBJECTIVE: to verify the extent of impairment of the clinical indicators of the nursing outcome Dry Eye Severity in patients admitted to the Intensive Care Unit. METHOD: cross-sectional, descriptive study developed with 206 patients. Based on the result listed, six indicators of the Classification of Nursing Results were evaluated with a questionnaire containing clinical variables and the Likert scale of the Classification of Nursing Results with constructed definitions, which varies from more impaired to non-impaired. The data were analyzed using descriptive and inferential statistics. RESULTS: the decrease in lacrimal production and the presence of redness in the conjunctiva were more impaired. The other indicators were more frequent for the absence of impairment: incomplete eyelid closure 81% (167), excessive tearing 95.1%(196), excessive mucous secretion 78.7% (162) and decreased blinking mechanism 50.5% (104). The clinical characteristics of hospitalization for neurological disorders, invasive mechanical ventilation, chemosis, use of sedatives, vasoconstrictors, benzodiazepines, antibiotics and corticosteroids interfered in the impairment of the dry eye severity. CONCLUSION: the result indicators show that the clinical characteristics of patients in the intensive care unit interfere in the impairment and in the dry eyes severity. According to these results, the importance of assistance directed to the prevention of eye diseases is emphasized.


Assuntos
Síndromes do Olho Seco/enfermagem , Unidades de Terapia Intensiva/estatística & dados numéricos , Adulto , Idoso , Síndromes do Olho Seco/diagnóstico , Síndromes do Olho Seco/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Índice de Gravidade de Doença
19.
Clin Ter ; 170(5): e357-e363, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31612193

RESUMO

AIM OF THE STUDY: Cilostazol is a phosphodiesterase III inhibitor that has anti-inflammatory and immunomodulatory effects and can act with beneficial effect in Dry Eye Syndrome (DES). This clinical trial evaluates the effects of cilostazol on the tear film. MATERIALS AND METHODS: Following the run-in period, subjects were randomly into two groups: 40 subjects treated with cilostazol and 40 no-treated subjects. The Walking Impairment Questionnaire (WIQ) has been administered to all patients. RESULT: The data obtained from comparison of the two study groups A and B were, respectively, the following: Schirmer I: 10.2±0.2 Vs 13.8±0.4 (p< 0.001); Schirmer II: 3.8±0.1 Vs 4.6±0.2 (p<0.001); Break-up time (BUT) 4.2±0.3 Vs 6.5±0.2 (p<0.001) with disappearing of symptoms. The WIQ showed a significant difference in the walking distance (p<0.05) and calf pain severity (p<0.005) of treated patients. In comparison with the placebo group, treated patients showed an improvement (p<0.03) in calf pain severity. CONCLUSION: The administration of cilostazol was effective, in reducing DES and improve walking distance questionnaire.


Assuntos
Cilostazol/uso terapêutico , Síndromes do Olho Seco/tratamento farmacológico , Claudicação Intermitente/tratamento farmacológico , Doença Arterial Periférica/tratamento farmacológico , Vasodilatadores/uso terapêutico , Caminhada/fisiologia , Idoso , Síndromes do Olho Seco/etiologia , Teste de Esforço , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doença Arterial Periférica/complicações , Inquéritos e Questionários , Resultado do Tratamento
20.
Korean J Ophthalmol ; 33(5): 467-474, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31612658

RESUMO

PURPOSE: To evaluate the protective effect of applying an ophthalmic viscosurgical device (OVD) to the ocular surface during cataract surgery and its ability to prevent dry eye syndrome. METHODS: Twenty-four patients aged 50 to 75 years who underwent cataract surgery at Seoul National University Bundang Hospital and agreed to participate in the study were included and divided into two groups: a study group who underwent cataract surgery after application of an OVD to the ocular surface, and a control group who underwent cataract surgery without application of an OVD. DisCoVisc was used as the OVD in the study group, while other factors including surgical techniques and administration of anesthetic agents were performed in both groups in the same manner. Indicators of dry eye syndrome including ocular staining score, tear break-up time, and tear osmolality were analyzed. Ocular surface disease index and a visual analog scale were analyzed for dry eye symptoms, and the amount of balanced salt solution used during surface irrigation and operation time were also analyzed. RESULTS: Significant improvement in the tear break-up time, corneal ocular staining score, and ocular surface disease index score in the study group compared with the control group one week after operation (by the Mann-Whitney test). Use of OVD was associated with longer operating time. CONCLUSIONS: OVD applied to the ocular surface during cataract surgery had a protective effect on the ocular surface one week after surgery.


Assuntos
Extração de Catarata/instrumentação , Catarata/complicações , Síndromes do Olho Seco/complicações , Ácido Hialurônico/administração & dosagem , Idoso , Síndromes do Olho Seco/tratamento farmacológico , Feminino , Seguimentos , Humanos , Período Intraoperatório , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Lágrimas/metabolismo , Resultado do Tratamento , Viscossuplementos/administração & dosagem
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