Investigational drugs in dry eye disease

Abstract

The dry eye disease (DED) is a chronic multifactorial disorder of the tears that also involves the ocular surface, the lacrimal glands, and meibomian dysfunction. Furthermore, DED is often associated with Sjögren's syndrome (SS) and other autoimmune disorders. Sometimes, this chronic or subclinical condition is difficult to diagnose and treat, due to its heterogeneity. Areas covered: A literature search of relevant publications about treatment of DED was performed. All relevant articles published between 2011 and 2016 were identified through a computerized search for reviews and clinical trials using the Pub Med database. In particular, investigational treatments have been reported in this peer-reviewed publication. Relevant articles identified were manually searched and reviewed, then data concerning with novel treatment for DED were included into the manuscript. Expert opinion: The treatment of dry eye patients evolves continuously because DED seriously impacts the quality of life of older adults. Indeed, as a chronic disease, DED prevalence is expected to worsen with the aging population. For this reason, current efforts focus on combined pharmacological strategies targeted towards multiple systems. Probably this is the correct way to reach a long lasting symptoms relief treatment that may allow an actual improvement of patients' quality of life.

Analysis of the Pathogenic Factors and Management of Dry Eye in Ocular Surface Disorders

“…Subsequently, punctate 6 keratopathy and superficial vascularization of peripheral cornea are also common findings [12,13].…”

“…It has been found a decreased basal epithelium cell density, reduced acinar unit diameters, higher glandular orifice diameters, greater secretion reactivity, and greater inhomogeneity of the periglandular interstices were the main observed findings. Morphologic changes in the MGs shown by contact lens wearers were interpreted by the authors as signs of MGs dropout, duct obstruction, and glandular infiammation caused by chronic mechanical contact lens irritation [12,19,20,30]. In such cases, therefore it is recommend the use of low or medium lenses hydration that would release liquid retaining its geometry, high permeability of oxygen, and the use of monodose artificial tears viscous.…”

“…It is characterized by erythema, telangiectasia, facial rash, inflammatory papules, occasionally hypertrophy of connective tissue [11]. It is more common among 50-60 years [11,12] and ocular manifestations may accompany those skin or appear independently. Although the etiology is uncertain, the latest findings show that microbial pathogenesis and mechanisms associated with chronic inflammation and autoimmune dysregulation may be involved.…”

“…Although several therapeutic approaches for DE are available, therapeutic strategies, like the use of artificial eye lubricants, focus on the treatment of symptoms guaranteeing just a temporary relief to the patient without having an effect on the implicit causes of DE [12]. DEWS report suggests to choose specifich treatments based on the severity of disease according to patients' clinical history and experience [2].…”

Methods of Screening for Meibomian Gland Dysfunction

“…В первую очередь, это связано с тем, что в настоя-щее время изменились представления о распространен-ности данной патологии, которая по разным данным составляет от 40 до 71% населения в различных воз-растных группах [1,2,3]. Кроме того, данные научных исследований, направленных на изучение дисфункции мейбомиевых желез, свидетельствуют о том, что на их функциональное состояние оказывают влияние не толь-ко системные факторы, такие как дефицит андрогенов, менопауза, старение, синдром Шегрена, повышенное со-держание холестерина, псориаз, атопия, розовые угри, гипертония и доброкачественная гиперплазия простаты.…”