A New Perspective on Dry Eye Classification: Proposal by the Asia Dry Eye Society

Ohta, Michio; Yokoi, Norihiko; Watanabe, Hitoshi; Doğru, Murat; Kojima, Takashi; Yamada, Masakazu; Kinoshita, Shigeru; Kim, Hyo-Myung; Tchah, Hungwon; Hyon, Joon Young; Yoon, Kyung Chul; Seo, Kyoung Yul; Sun, Xing‐Guo; Wei, Chen; Liang, Lingyi; Li, Mingwu; Tong, Louis; Hu, Fung‐Rong; Puangsricharern, Vilavun; Lim-Bon-Siong, Ruben; Yong, Then Kong; Liu, Zuguo; Shimazaki, Jun

doi:10.1097/icl.0000000000000643

Cited by 129 publications

(154 citation statements)

References 115 publications

Supporting

Mentioning

146

Contrasting

Unclassified

Order By: Relevance

“…5 Further, the Asian Dry Eye Society (ADES) emphasized the role of tear film (TF) instability in DED and of TF-oriented therapy (TFOT) approaches for the management of DE patients. 6,7 In DED, the stable state of equilibrium (i.e., homeostasis) of the ocular surface and the TF is impaired. For homeostasis to be restored, it is necessary to alleviate the signs and symptoms of DE and concomitantly improve the different, interdependent elements constituting the ocular surface environment.…”

Section: Introductionmentioning

confidence: 99%

Cationic Emulsion-Based Artificial Tears as a Mimic of Functional Healthy Tear Film for Restoration of Ocular Surface Homeostasis in Dry Eye Disease

Daull

Amrane

Ismail

et al. 2020

Journal of Ocular Pharmacology and Therapeutics

View full text Add to dashboard Cite

Dry eye disease (DED) is a complex multifactorial disease that affects an increasing number of patients worldwide. Close to 30% of the population has experienced dry eye (DE) symptoms and presented with some signs of the disease during their lifetime. The significant heterogeneity in the medical background of patients with DEs and in their sensitivity to symptoms renders a clear understanding of DED complicated. It has become evident over the past few years that DED results from an impairment of the ocular surface homeostasis. Hence, a holistic treatment approach that concomitantly addresses the different mechanisms that result in the destabilization of the tear film (TF) and the ocular surface would be appropriate. The goal of the present review is to compile the different types of scientific evidence (from in silico modeling to clinical trials) that help explain the mechanism of action of cationic emulsion (CE)-based eye drop technology for the treatment of both the signs and the symptoms of DED. These CEbased artificial tear (AT) eye drops designed to mimic, from a functional point of view, a healthy TF contribute to the restoration of a healthy ocular surface environment and TF that leads to a better management of DE patients. The CE-based AT eye drops help restore the ocular surface homeostasis in patients who have unstable TF or no tears.

show abstract

Section: Introductionmentioning

confidence: 99%

Cationic Emulsion-Based Artificial Tears as a Mimic of Functional Healthy Tear Film for Restoration of Ocular Surface Homeostasis in Dry Eye Disease

Daull

Amrane

Ismail

et al. 2020

Journal of Ocular Pharmacology and Therapeutics

View full text Add to dashboard Cite

show abstract

“…Each pattern is considered to reflect the underlying DED pathophysiology. DED was classified into three categories based on the underlying pathophysiology responsible for tear film instability: aqueous-deficient (area or line break), decreased surface wettability (spot or dimple breaks), or excessive evaporation (random break) [ 14 ].…”

Section: Methodsmentioning

confidence: 99%

Tear Film Osmolarity Measurement in Japanese Dry Eye Patients Using a Handheld Osmolarity System

Shimazaki

Sakata²,

Den

et al. 2020

Diagnostics

Self Cite

View full text Add to dashboard Cite

We studied the efficacy and safety of a handheld osmolarity measurement system (I-PEN) in Japanese patients with dry eye disease (DED) and non-DED subjects. In this prospective, multicenter study, tear osmolarity was examined using the I-PEN in a total of 122 eyes divided into DED (n = 71) and non-DED (n = 51) groups. Subjective symptoms were assessed using the Dry Eye-Related Quality-of-Life Score (DEQS) questionnaire. Ocular surface condition was evaluated in terms of fluorescein tear breakup time (FBUT) and tear breakup pattern (TBUP), and by fluorescein staining and Schirmer’s test. The I-PEN measurements were performed safely in the majority of cases. There was no statistically significant difference in mean tear film osmolarity between the DED and non-DED groups (294.76 ± 16.39 vs. 297.76 ± 16.72 mOsms/L, respectively, p = 0.32). No significant correlations were observed between osmolarity values and DEQS score, FBUT, or the Schirmer score. Osmolarity did not differ among TBUP subgroups. This prospective clinical study found no correlations between the tear film osmolarity values obtained with the I-PEN system and any subjective or objective parameters of DED. Further studies are required to determine the utility of the I-PEN system in other settings.

show abstract

“…is very important. Deficits in ocular surface lubrication which cause an increase in attrition are further enhanced by local imperfections at the surface, leading to premature break up [47], possibly identifying disease groups of its own [26,48], most recently summarized as "decreased wettability dry eye" [49]. It is at these locations that the first signs of ocular discomfort, as an equivalent of neurogenic irritation, may be perceived.…”

Section: Characterizing Attritionmentioning

confidence: 99%

Impact of Attrition, Intercellular Shear in Dry Eye Disease: When Cells are Challenged and Neurons are Triggered

Setten

2020

IJMS

View full text Add to dashboard Cite

The mechanical component in the pathophysiology of dry eye disease (DED) deserves attention as an important factor. The lubrication deficit induced impaired mechano-transduction of lid pressure to the ocular surfaces may lead to the dysregulation of homeostasis in the epithelium, with sensations of pain and secondary inflammation. Ocular pain is possibly the first sign of attrition and may occur in the absence of visible epithelial damage. Attrition is a process which involves the constant or repeated challenge of ocular surface tissues by mechanical shear forces; it is enhanced by the thinning of corneal epithelium in severe DED. As a highly dynamic process leading to pain and neurogenic inflammation, the identification of the impact of attrition and its potential pathogenic role could add a new perspective to the current more tear film-oriented models of ocular surface disease. Treatment of DED addressing lubrication deficiencies and inflammation should also consider the decrease of attrition in order to stimulate epithelial recovery and neural regeneration. The importance of hyaluronic acid, its molecular characteristics, the extracellular matrix and autoregulative mechanisms in this process is outlined. The identification of the attrition and recognition of its impact in dry eye pathophysiology could contribute to a better understanding of the disease and optimized treatment regimens.

show abstract

A New Perspective on Dry Eye Classification: Proposal by the Asia Dry Eye Society

Cited by 129 publications

References 115 publications

Cationic Emulsion-Based Artificial Tears as a Mimic of Functional Healthy Tear Film for Restoration of Ocular Surface Homeostasis in Dry Eye Disease

Cationic Emulsion-Based Artificial Tears as a Mimic of Functional Healthy Tear Film for Restoration of Ocular Surface Homeostasis in Dry Eye Disease

Tear Film Osmolarity Measurement in Japanese Dry Eye Patients Using a Handheld Osmolarity System

Impact of Attrition, Intercellular Shear in Dry Eye Disease: When Cells are Challenged and Neurons are Triggered

Contact Info

Product

Resources

About