Age-related Defects in Ocular and Nasal Mucosal Immune System and the Immunopathology of Dry Eye Disease

Abstract

Dry eye disease (DED) is a prevalent public health concern that affects up to 30% of adults and is particularly chronic and severe in the elderly. Two interconnected mechanisms cause DED: (1) an age-related dysfunction of lacrimal and meibomian glands, which leads to decreased tear production and/or an increase in tear evaporation; and (2) an age-related uncontrolled inflammation of the surface of the eye triggered by yet-to-be-determined internal immunopathological mechanisms, independent of tear deficiency and evaporation. In this review we summarize current knowledge on animal models that mimic both the severity and chronicity of inflammatory DED and that have been reliably used to provide insights into the immunopathological mechanisms of DED, and we provide an overview of the opportunities and limitations of the rabbit model in investigating the role of both ocular and nasal mucosal immune systems in the immunopathology of inflammatory DED and in testing novel immunotherapies aimed at delaying or reversing the uncontrolled age-related inflammatory DED.

The improvement of dry eye after cataract surgery by intraoperative using ophthalmic viscosurgical devices on the surface of cornea

“…Therefore, in recent years, a large number of basic and applied researches have been conducted to further investigate the sex differences. Women were found to have distinctly higher incidence and degree of severity of dry eye, [ 3 , 15 ] and the reduction in estrogen is related to the occurrence of dry eye. [ 16 , 17 ] Sex-based differences exist in the lacrimal glands and Moll glands in terms of anatomy, physiology, and pathophysiology, and this kind of difference is also reflected in conjunctival goblet cells.…”

“…[ 1 ] According to the current epidemiological studies, the incidence of dry eye in China reached up to about 21% to 30%, which was similar to that in other Asian countries and higher than that in the United States and Europe. [ 2 , 3 ] Many factors, including ocular surgery, could induce or aggravate symptoms of dry eye. In recent years, phacoemulsification with intraocular lens implantation has been the main surgical treatment for cataract.…”

Ocular Surface Changes in Treatment-Naive Thyroid Eye Disease

“…We think that the TED MGD might be seborrheic MGD [40], with excessive secretion of cloudy meibomian lipids. Moreover, the inflammation of eye contents also affects the meibomian gland and the poor secretion quality of the meibum [41]. Lagophthalmos is incomplete eyelid closure, which results in exposure keratitis [42,43].…”

The Case for a More Holistic Approach to Dry Eye Disease: Is It Time to Move beyond Antibiotics?

“…As such, more promising DED agents are those directed towards reducing inflammation and restoring normal tear film though currently there is no specific immunotherapy for DED [29]. A 2017 review of cyclosporin A (CsA) for the treatment of chronic dry eye [30] indicated strong evidence of efficacy in treating signs but not symptoms.…”