Efficacy and Safety of 0.2% Hyaluronic Acid in the Management of Dry Eye Disease

Pinto-Fraga, José; Rosa, Alberto López-de la; Arauzo, Francisco Blázquez; Rodríguez, Rubén Urbano; González-García, María J.

doi:10.1097/icl.0000000000000236

Cited by 43 publications

(36 citation statements)

References 32 publications

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“…The anti-inflammatory characteristics that have been attributed to GAGs and PGs, such as high molecular weight HA (HMWHA), makes them even more attractive candidates for use in treating dry eye. The number of studies using HA, chemically modified HA and HA analogs has increased exponentially over the past few years ( Salwowska et al, 2016 ; Ang et al, 2017 ; Pinto-Fraga et al, 2017 ). Lubricin is also emerging as a powerful agent in treating dry eye ( Lambiase et al, 2017 ; Regmi et al, 2017 ).…”

Section: Involvement Of Proteoglycans and Glycosaminoglycans In Cornementioning

confidence: 99%

Distribution and Function of Glycosaminoglycans and Proteoglycans in the Development, Homeostasis and Pathology of the Ocular Surface

Puri

Coulson-Thomas

Gesteira

et al. 2020

Front. Cell Dev. Biol.

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The ocular surface, which forms the interface between the eye and the external environment, includes the cornea, corneoscleral limbus, the conjunctiva and the accessory glands that produce the tear film. Glycosaminoglycans (GAGs) and proteoglycans (PGs) have been shown to play important roles in the development, hemostasis and pathology of the ocular surface. Herein we review the current literature related to the distribution and function of GAGs and PGs within the ocular surface, with focus on the cornea. The unique organization of ECM components within the cornea is essential for the maintenance of corneal transparency and function. Many studies have described the importance of GAGs within the epithelial and stromal compartment, while very few studies have analyzed the ECM of the endothelial layer. Importantly, GAGs have been shown to be essential for maintaining corneal homeostasis, epithelial cell differentiation and wound healing, and, more recently, a role has been suggested for the ECM in regulating limbal stem cells, corneal innervation, corneal inflammation, corneal angiogenesis and lymphangiogenesis. Reports have also associated genetic defects of the ECM to corneal pathologies. Thus, we also highlight the role of different GAGs and PGs in ocular surface homeostasis, as well as in pathology.

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Section: Involvement Of Proteoglycans and Glycosaminoglycans In Cornementioning

confidence: 99%

Distribution and Function of Glycosaminoglycans and Proteoglycans in the Development, Homeostasis and Pathology of the Ocular Surface

Puri

Coulson-Thomas

Gesteira

et al. 2020

Front. Cell Dev. Biol.

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“…However, there is no information on the type of the dye the investigators used. Pinto-Fraga et al14 and Lopez-de la Rosa et al13 describe in double-masked, randomized trials reduced corneal and conjunctival staining after 1 month application of unpreserved 0.2% or 0.3% HA eye drops, respectively, while saline 0.9% alone yielded increased staining values, indicating exacerbation of DED. In another study, 0.4% HA was used and led to a decrease in rose bengal staining after 7 days of treatment, probably due to the higher HA concentration 8.…”

Section: Discussionmentioning

confidence: 99%

Comparison of 0.2% and 0.18% hyaluronate eye drops in patients with moderate to severe dry eye with keratitis or keratoconjunctivitis

Groß¹,

Childs²,

Piaton³

2017

OPTH

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PurposeComparison of efficacy and safety of 0.2% and 0.18% hyaluronic acid (HA) eye drops three times a day (tid) in patients with moderate to severe dry eye disease, related to keratitis or keratoconjunctivitis.Patients and methodsProspective, multicenter, randomized, single-masked, phase IIIb, noninferiority study (0.2% HA vs 0.18% HA) in two parallel groups over a period of 84 days. N=70 patients were evaluated. Primary efficacy outcome was ocular surface (OS) staining change on day 35 (D35), compared to baseline. Fluorescein and lissamine green were used for staining of cornea and conjunctiva. Secondary efficacy outcome included tear film breakup time, OS staining score on day 84 (D84), ocular comfort index, as well as patients’ and doctors’ evaluation.ResultsCompared to day 0 (D0), 0.2% HA achieved a 47.7% reduction in staining score (−3.00±2.81 [standard deviation] points, n=38 patients) at D35; 0.18% HA showed a 41.2% reduction (−2.59±2.20 [standard deviation] points, n=32 patients). Statistical analysis showed noninferiority in efficacy of 0.2% HA compared to 0.18% HA on D35. At D84, the reduction in staining score had further increased to 64.5% for 0.2% HA and to 56.4% for 0.18% HA. Both eye drops improved tear film breakup time and ocular comfort index values. Investigators and patients assessed both treatments with 5 of 7 points (Likert Scale, medians). The rate of adverse events (AE) was 2.3% for 0.2% HA and 7.1% for 0.18% HA with no serious AE.Conclusion0.2% and 0.18% HA eye drops significantly improved signs and symptoms of dry eye disease and were well tolerated with few AEs. Noninferiority of 0.2% HA compared to 0.18% HA was demonstrated for reduction of OS lesions. In some parameters, there was a nonsignificant trend in favor of 0.2% HA concentration.

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“…Previous studies showed that hyaluronic acid has a positive effect on dry eyes. (4,9). It was also observed that combinations with trehalose (10) or vitamin B12 (5) were more protective then simple hyaluronic acid and lead to reduction of in ammatory processes due to synergistic effects.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of protection against desiccation with different artificial tears containing 0.1%-0.3% hyaluronic acid in experimental dry eye model

Ahmed¹,

Tost²,

Großjohann³

et al. 2020

Preprint

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Background: Tear film instability, hyperosmolarity, ocular surface inflammation, apoptosis and neuro-sensory abnormalities are causes of dry eye. Lubricant target tear film instability, the most effective agent for tear film stabilization being Sodium Hyaluronate 0.1 -0.3%. Sodium Hyaluronate is suggested to be protective for epithelium in dry eye. To test this hypothesis, this study was performed in vitro with commercially available solutions containing hyaluronic acid (HA) in concentrations ranging from 0.1 to 0.3%. To evaluate the desiccation protection capability of different Sodium Hyaluronate 0.1 to 0.3%, we employed a reproducible in vitro cell culture system. Methods: Conjunctival (Chang 1-5c-4) and corneal cells (pRSV-T 2.040) were cultivated under standard conditions. Under confluent cell growth cells, conjunctival epithelial cell line Chang 1-5c-4 and the corneal cell line 2.040 pRSV-T were wetted for 20 min with five commercial ophthalmic solutions and one agent in trial phase (sample 1: 0.1% HA; sample 2: 0.3% HA; sample 3: 0.15% HA, 2% dexpanthenol, sodium chloride; sample 4: 0.1% HA; sample 5: 0.2% HA; sample 6: unknown, PBS as negative control, unsupplemented medium as positive control). After 20 minutes cells were exposed to continuous air flow for 0, 15, 30 and 45 minutes. Assessment of viable cells was performed by alamarBlue® assay and LIVE/DEAD® Viability/ Cytotoxicity Kit. Results: It has been shown that both cell lines showed different response to protection by the tested solutions. Greatest protection was observed at 15 minutes with most agents. Best results in protection from desiccation was assessed with sample 2 even at maximum exposure time at 45 minutes. Sample 2 showed an average survival rate of 91% at 45 minutes exposure time, whereas no significant amount of vital cells were detected after application with sample 6. Sample 6 was the only substance that presented with early significant cell loss at 0 and 15 minutes by 35%. Conclusions: Higher concentration of Hyaluronate acid with 0.3% and an ionic composition close to the normal tearfluid seem to provide the best protective effect against desiccation in experimental dry eye.

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Efficacy and Safety of 0.2% Hyaluronic Acid in the Management of Dry Eye Disease

Abstract: This clinical trial demonstrates the safety of Visaid 0.2% and its clear benefit over 0.9% saline solution.

Cited by 43 publications

References 32 publications

Distribution and Function of Glycosaminoglycans and Proteoglycans in the Development, Homeostasis and Pathology of the Ocular Surface

Distribution and Function of Glycosaminoglycans and Proteoglycans in the Development, Homeostasis and Pathology of the Ocular Surface

Comparison of 0.2% and 0.18% hyaluronate eye drops in patients with moderate to severe dry eye with keratitis or keratoconjunctivitis

Evaluation of protection against desiccation with different artificial tears containing 0.1%-0.3% hyaluronic acid in experimental dry eye model

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