The Anatomical Dry Eye &amp;lt;br/&amp;gt;—A Different Form of Ocular Surface Disease Deserves Focus

Setten, Gysbert van

doi:10.4236/ojoph.2017.73025

Cited by 11 publications

(10 citation statements)

References 19 publications

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“…On the side of the bleb towards the fornices the staining was usually less and had mostly a sandbank epitheliopathy [11,12] like appearance. Such staining occurred mainly when tear fluid insufficiency was simultaneously present.…”

Section: Resultsmentioning

confidence: 99%

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Epitheliopathy of the bleb (EoB) - identifying attrition: A new model for failure of glaucoma surgery

Setten¹

2018

New Front Ophthalmol

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Introduction: Fluorescein staining of the ocular surface is used to detect anomalies and damage of the ocular surface. The intensity of staining and its pattern does reflect underlying pathology and severity. We have recently reported on the presence of sandbank epitheliopathy and its specific staining of the conjunctival surface. As glaucoma surgery is known to alter ocular tissues structures we investigated if it might cause a characteristic footpint at the ocular surface.

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Section: Resultsmentioning

confidence: 99%

“…Slitlamp photography was conducted using a cobalt blue filter and a yellow filter within 30 seconds after application of a standardized amount of fluorescein. The results were compared to the recently described features of anatomical dry eye and sandbank epitheliopathy [11,12]. …”

Section: Methodsmentioning

confidence: 99%

Epitheliopathy of the bleb (EoB) - identifying attrition: A new model for failure of glaucoma surgery

Setten¹

2018

New Front Ophthalmol

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“…In the presence of local surface elevations, otherwise normal moving forces of the lid create enhanced attrition, summarizing all the effects of pressure and friction [1]. Moreover, minor, local protrusions of the ocular surface decreasing viscoelastic separation between lid to and ocular surface, leading to enhanced friction, such as in the anatomical dry eye [26], can lead to very specific and localized pain sensations. Therefore, such pain can be perceived as far more disturbing and alerting, as it generally occurs in a no-pain condition and herein gains full attention of the body and mind [27].…”

Section: Characterizing Attritionmentioning

confidence: 99%

“…In the presence of dry eye enhanced shear forces, attrition is augmented by surface imperfections and irregularities, maximizing the lubrication requirements. Even minor irregularities, such as after the use of laser or cataract surgery, can expose the insufficiency of lubrication, even in only borderline dry eyes [26]. In any dry eye condition, the therapeutic rheological optimization is mandatory for treatment success.…”

Section: Epithelial Lesions-the Effect Of Attritionmentioning

confidence: 99%

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

Setten

2020

IJMS

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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.

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“…It is worthwhile noting that MUC16 plays not only an important role for the cellular epithelial barrier function, but also contributes to the tight junctions between epithelial cells and thus for the paracellular barrier function [51]. Topographical irregularities of the ocular surface have recently drawn attention as an additional source of ocular surface friction [57]. The concentration and chain length of MUC5AC in the mucoaqueous layer may either be too high, causing mucous strands, blurring and high friction during blinking or too low resulting in insufficient lubrication and instable tear film [45].…”

Section: Ocular Surface Homeostasismentioning

confidence: 99%

Why Chain Length of Hyaluronan in Eye Drops Matters

Müller-Lierheim¹

2020

Diagnostics

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The chain length of hyaluronan (HA) determines its physical as well as its physiological properties. Results of clinical research on HA eye drops are not comparable without this parameter. In this article methods for the assessment of the average molecular weight of HA in eye drops and a terminology for molecular weight ranges are proposed. The classification of HA eye drops according to their zero shear viscosity and viscosity at 1000 s−1 shear rate is presented. Based on the gradient of mucin MUC5AC concentration within the mucoaqueous layer of the tear film a hypothesis on the consequences of this gradient on the rheological properties of the tear film is provided. The mucoadhesive properties of HA and their dependence on chain length are explained. The ability of HA to bind to receptors on the ocular epithelial cells, and in particular the potential consequences of the interaction between HA and the receptor HARE, responsible for HA endocytosis by corneal epithelial cells is discussed. The physiological function of HA in the framework of ocular surface homeostasis and wound healing are outlined, and the influence of the chain length of HA on the clinical performance of HA eye drops is illustrated. The use of very high molecular weight HA (hylan A) eye drops as drug vehicle for the next generation of ophthalmic drugs with minimized side effects is proposed and its advantages elucidated. Consequences of the diagnosis and treatment of ocular surface disease are discussed.

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The Anatomical Dry Eye <br/>—A Different Form of Ocular Surface Disease Deserves Focus

Cited by 11 publications

References 19 publications

Epitheliopathy of the bleb (EoB) - identifying attrition: A new model for failure of glaucoma surgery

Epitheliopathy of the bleb (EoB) - identifying attrition: A new model for failure of glaucoma surgery

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

Why Chain Length of Hyaluronan in Eye Drops Matters

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