The mission of the Tear Film & Ocular Surface Society (TFOS) is to advance the research, literacy, and educational aspects of the scientific field of the tear film and ocular surface. Fundamental to fulfilling this mission is the TFOS Global Ambassador program. TFOS Ambassadors are dynamic and proactive experts, who help promote TFOS initiatives, such as presenting the conclusions and recommendations of the recent TFOS DEWS II™, throughout the world. They also identify unmet needs, and propose future clinical and scientific solutions, for management of ocular surface diseases in their countries. This meeting report addresses such needs and solutions for 25 European countries, as detailed in the
The artificial tears on the basis hyaluronic acid is primary importance today in dry eye syndrome (DES) treatment. In recent years, they have been supplemented Optinol® Express Moisture (0.21 %) and Optinol® Deep Moisture (0.4 %) differing concentrations of sodium hyaluronate and viscosity. The study is devoted to assessing the effectiveness of these drugs in the treatment of patients with dry eye syndrome (DES) of various etiology and severities.There were 73 volunteers with DES of various etiology: 21 — Sjogren’s syndrome, 24 — meibomian blepharitis, and 28 — perimenopause in the study. All patients were divided into 2 groups: 36 patients of the first group received instillations into conjunctival cavity of the Optinol® Express Moisture (0.21 %) and 37 patients of the second group — Optinol® Deep moistening (0.4 %).Starting from the first days of therapy, all patients had a decrease in the severity of subjective signs of DES, estimated by the value of the ocular surface disease index (OSDI). At the same time, tendency to stop of the degenerative changes in the epithelium of the ocular surface was established. It is characterized by a decrease in the degree of staining. The increasement of the tear film stability and an index of the tear meniscus was found in all patients. The dynamics of the controlled parameters increased, as the instillation of the drugs took place and by the 30th day of therapy. There were significant differences from the baseline values. At the same time, the Optinol® Express Moisture (0.21 %) was more effective (mainly in terms of subjective discomfort and the severity of degenerative changes in the epithelium of the ocular surface) in patients with mild and extremely severe form of the xerosis process.The drug Optinol® Deep Moisture (0.4 %) was more effective in patients with xerosis of moderate severity and severe by the same parameters. In the course of research, we have not observed any side effects of both drugs. It allows us to recommend the drugs Optinol® Express Moisture (0.21 %) and Optinol® Deep Moisture (0.4 %) to widespread clinical use in treating patients with DES of various etiology.
Of the large number of polymers used in artificial tear formulations, natural polysaccharides - hydroxypropyl guar, sodium hyaluronate, chondroitin sulfate, dextran, etc., are gaining more and more popularity. Hydroxypropyl guar stands out through its ability to form a long-lasting structured matrix adhered to the damaged ocular surface and ensuring good wettability of the latter and regeneration of epithelial cells. At that, the viscosity of hydroxypropyl guar increases with increasing tear pH (which, in turn, correlates with the severity of xerosis) and further prolongs the moisturizing effect. According to experimental studies, the in vitro protective activity of hydroxypropyl guar surpasses that of sodium hyaluronate, which is widely used. Thus, corneal epithelial cell cultures were more tolerant to drying and pericardial leaflets showed lower friction coefficient, if pretreated with hydroxypropyl guar and not hyaluronic acid. Subsequent clinical studies showed that Systane Ultra was more effective in patients with dry eye syndrome than a carboxymethylcellulose and glycerol-containing drug. It has been also proved that Systane Balance provides a greater increase in thickness of the tear film lipid layer and in overall stability of the tear film as compared to SootheXP, which has a similar lipid composition. The present review also covers potential utility of other artificial tear formulations that, besides the moisturizing effect, are able to reduce the tear film osmolarity, prevent further oxidative stress, and abate the inflammatory process.
It is considered, that one of the main directions of treatment of adenovirus conjunctivitis is the appointment of interferon alpha-2b in combination with diphenhydramine, which until recently was provided by the only original drug. In 2020, the first generic drug, Interferon-Oftalmo, would be registered in Russia.The purpose: to evaluate and compare the efficacy, safety and tolerability of treatment of patients with keratopathy against the background of adenovirus keratoconjunctivitis with Interferon-Oftalmo and Oftalmoferon.Material and methods. The comparative analysis included completed cases of treatment of 51 patients (102 eyes) aged 18–75 years with clinical signs of keratopathy against the background of epidemic adenoviral keratoconjunctivitis. Patients of the first group (n = 27, 54 eyes) on the background of tear replacement therapy received eight instillations of the drug Interferon-Ophthalmo, the second (n = 24, 48 eyes) received Oftalmoferon. The observation period was 15 days. Treatment efficacy was assessed based on a quantitative analysis of the dynamics of clinical symptoms of inflammation and the state of the cornea, the severity of subjective manifestations of ocular surface xerosis using the ocular surface damage index (OSDI), as well as the stability of the tear film. Safety and tolerability were also evaluated.Results. Against the background of complex therapy, which included the instillation of Interferon-Ophthalmo or Oftalmoferon, all patients showed comparable dynamics in the relief of the inflammatory process and keratopathy. This was expressed in a statistically significant decrease in the severity of foreign body sensation, lacrimation, itching, eyelid edema, conjunctival edema and hyperemia, follicular reaction, conjunctival hemorrhages, punctate keratopathy, subepithelial infiltrates in the cornea. In both groups, there was a steady downward trend in OSDI against the background of an increase in the stability of the tear film and an increase in maximally corrected visual acuity. The safety and tolerability profile of the drugs was assessed as comparably favorable.Conclusion. The inclusion of the drug Interferon-Oftalmo in the complex therapy of adenoviral epidemic keratoconjunctivitis allows us to expect a comparable effect on the course of the disease compared to the original drug Oftalmoferon.
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