Imaging Biomarkers for Dry Eye Disease

Bonsignore, Francesco; Cantalamessa, Elisa; Serafino, Massimiliano; Nucci, Paolo

doi:10.1097/icl.0000000000000650

Cited by 15 publications

(8 citation statements)

References 57 publications

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“…Several imaging biomarkers are also under study, but require further validation before introduction into a routine clinical setting. 24 Recently, Yang et al reported that lissamine green staining of the conjunctiva correlates with the expression of IFN-γ, IL-6, IL-17, and MMP9 in epithelial cells in patients with dry eye, opening new opportunities in using ocular surface staining to detect inflammation in everyday clinical practice. 25 Such biomarkers may allow identification of patients at greater risk of disease progression, and indicate the most appropriate treatment and management protocol.…”

Section: Discussionmentioning

confidence: 99%

Updated definition and classification of dry eye disease: Renewed proposals using the nominal group and Delphi techniques

Barabino

Aragona

Zazzo

et al. 2020

European Journal of Ophthalmology

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The aim of our research was to obtain expert consensus for updated definition and classification of dry eye disease using formal methodology. The nominal group technique (NGT) involved a steering committee of four ophthalmologists began with collection of ideas followed by group discussion. The ideas were collated, refined, and voted upon. The main characteristics considered, each with different degrees of severity in types I, II, and III, were the ability or not of the ocular surface to re-equilibrate itself, frequency of symptoms, presence of inflammation, epithelial alterations, and possible alterations in the quality of vision. This was followed by three rounds of a “mini-Delphi” involving an expert panel of 13 ophthalmologists, with the last round including all 17 ophthalmologists. Consensus in the final round of voting (⩾75% of votes) was reached on the definition of dry eye disease and on criteria for its classification in three forms. Type I is a transient and reversible form with subclinical inflammation, possible epithelial alterations, and occasional alterations in vision. Type II is a recurrent form characterized by a reduced ability to re-equilibrate the ocular surface, frequent symptoms and alterations in vision with clinically-evident inflammation, and clear evidence of epithelial alterations. Type III is a chronic form with inability to re-equilibrate the ocular surface and accompanied by clinically-evident and chronic inflammation, persistent epithelial alterations, and frequent alterations in quality of vision. The vast majority of patients with dry eye disease can be easily classified into one of these three forms. Dry eye disease definition was updated accordingly.

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Section: Discussionmentioning

confidence: 99%

Updated definition and classification of dry eye disease: Renewed proposals using the nominal group and Delphi techniques

Barabino

Aragona

Zazzo

et al. 2020

European Journal of Ophthalmology

View full text Add to dashboard Cite

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“…Such composite end points in glaucoma have been demonstrated to increase accuracy of prediction of progression, reduce measurement variability and require smaller sample sizes than single end points derived from, for example, perimetry [22,67]. Similarly, the role of surrogate end points as well as composite end points in clinical studies of dry eye disease is growing [68,69]. Specifically, various clinical scores are used as end points, enabling the development of continuous composite end points [68].…”

Section: Discussionmentioning

confidence: 99%

Use of Composite End Points in Early and Intermediate Age-Related Macular Degeneration Clinical Trials: State-of-the-Art and Future Directions

et al. 2020

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The slow progression of early AMD stages to advanced AMD requires the use of surrogate endpoints in clinical trials. The use of combined endpoints may allow for shorter and smaller trials due to increased precision. We performed a literature search for the use of composite endpoints as primary outcome measures in clinical studies of early AMD stages. PubMed was searched for composite endpoints used in early/intermediate AMD studies published during the last 10 years. A total of 673 articles of interest were identified. After reviewing abstracts and applicable full-text articles, 33 articles were eligible and thus included in the qualitative synthesis. The main composite endpoint categories were: Combined structural and functional endpoints, combined structural endpoints, combined functional endpoints and combined multi-categorical endpoints. The majority of the studies included binary composite endpoints. There was a lack of sensitivity analyses of different endpoints against accepted outcomes (i.e. progression) in the literature. Various composite outcome measures have been used but there is a lack of standardization. To date no agreement on the optimal approach to implement combined endpoints in clinical studies of early stages of AMD exists and no surrogate endpoints have been accepted for AMD progression.

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“…IVCM is a non-invasive imaging modality that enables real-time visualization of the ocular surface tissue and changes in the ocular surface microstructures associated with DED [ 82 , 101 ]. However, although the IVCM image is objective, its interpretation may depend on the subjective assessment of the observers.…”

Section: Application Of Ai In Diagnosis and Treatment Of Dedmentioning

confidence: 99%

Integration of Artificial Intelligence into the Approach for Diagnosis and Monitoring of Dry Eye Disease

et al. 2022

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Dry eye disease (DED) is one of the most common diseases worldwide that can lead to a significant impairment of quality of life. The diagnosis and treatment of the disease are often challenging because of the lack of correlation between the signs and symptoms, limited reliability of diagnostic tests, and absence of established consensus on the diagnostic criteria. The advancement of machine learning, particularly deep learning technology, has enabled the application of artificial intelligence (AI) in various anterior segment disorders, including DED. Currently, many studies have reported promising results of AI-based algorithms for the accurate diagnosis of DED and precise and reliable assessment of data obtained by imaging devices for DED. Thus, the integration of AI into clinical approaches for DED can enhance diagnostic and therapeutic performance. In this review, in addition to a brief summary of the application of AI in anterior segment diseases, we will provide an overview of studies regarding the application of AI in DED and discuss the recent advances in the integration of AI into the clinical approach for DED.

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Imaging Biomarkers for Dry Eye Disease

Cited by 15 publications

References 57 publications

Updated definition and classification of dry eye disease: Renewed proposals using the nominal group and Delphi techniques

Updated definition and classification of dry eye disease: Renewed proposals using the nominal group and Delphi techniques

Use of Composite End Points in Early and Intermediate Age-Related Macular Degeneration Clinical Trials: State-of-the-Art and Future Directions

Integration of Artificial Intelligence into the Approach for Diagnosis and Monitoring of Dry Eye Disease

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