Topical rebamipide improves lid wiper epitheliopathy

Itakura, Hirotaka; Kashima, Tomoyuki; Itakura, Mariko; Akiyama, Hideo; Kishi, Shoji

doi:10.2147/opth.s54511

Cited by 27 publications

(12 citation statements)

References 30 publications

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“…Treatment of severe LWE would likely necessitate the targeting of a different disease pathway in LWE, such as the use of topical mucin secretagogues to increase mucin production in the ocular surface. 55,56 Although greater tear film instability is noted with contact lens wear, it only plays a minor role in why a higher prevalence of LWE was observed in contact lens wearers; this conjecture is supported by the small effect size of LWE by FTBUT observed in our statistical model. Instead, it is the higher coefficient of friction (CoF) in contact lens compared to an ocular surface without contact lens that may be a major contributor for the difference in LWE.…”

Section: 13supporting

confidence: 58%

The Relationship of Lid Wiper Epitheliopathy to Ocular Surface Signs and Symptoms

Yeh

Leung

et al. 2018

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. There has been interest in determining whether lid wiper epitheliopathy (LWE) plays a key role in causing ocular discomfort. Conflicting reports have made it difficult to discern whether LWE is more prevalent in certain populations, what characteristics are associated with its severity, and what its role is in symptomology. This cross-sectional study on a large and diverse population attempts to answer these questions.METHODS. Subjects were asked to complete questionnaires related to dry eye and to ocular discomfort. A comprehensive set of ocular surface parameters were assessed, including LWE length and width, tear-film lipid layer thickness, fluorescein tear breakup time (FTBUT), lidparallel conjunctival folds (LIPCOF), and corneal staining. RESULTS.A total of 287 subjects participated in the study. LWE was observed in 45% of the study cohort and was twice as prevalent in Asians than non-Asians (P < 0.005). LWE was more likely to present in contact lens wearers than non-contact lens wearers (P ¼ 0.03). Decreased FTBUT was associated with increased LWE length and width (P < 0.005 and P ¼ 0.01, respectively), although only a small effect size was noted. Presence of LIPCOF was linked with a 0.25-grade increase in LWE width (P ¼ 0.01). Only LWE width was associated with greater symptoms in contact lens wearers.CONCLUSIONS. LWE was associated with decreased tear-film stability, contact lens wear, lid anatomy, and LIPCOF. LWE was not associated with symptoms in non-contact lens wearers. LWE width was associated with greater symptoms in contact lens wearers but was only clinically significant with moderate to severe LWE width.

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Section: 13supporting

confidence: 58%

The Relationship of Lid Wiper Epitheliopathy to Ocular Surface Signs and Symptoms

Yeh

Leung

et al. 2018

Invest. Ophthalmol. Vis. Sci.

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“…Goblet cells contribute to the maintenance of the normal precorneal tear film (3) and also the internal lubrication system for reduction of friction between the lid margin and the globe (2). Clinically, goblet cell damage in the lid wiper may induce deterioration in mucin secretion and friction, which lead to several ocular surface disorders such as dry eye and lid wiper epitheliopathy (4,5).…”

Section: Introductionmentioning

confidence: 99%

“…It has previously been demonstrated that topical administration of rebamipide, an antiulcer agent, increases the mucin level of the tear film and improves the conditions of the ocular surface in dry eyes (6) and lid wiper epitheliopathy (4). Previous studies have reported that rebamipide facilitates the secretion of mucin.…”

Section: Introductionmentioning

confidence: 99%

Effect of topical rebamipide on goblet cells in the lid wiper of human conjunctiva

Kase

Shinohara

Kase

et al. 2017

Experimental and Therapeutic Medicine

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Abstract. It has been demonstrated that topical administration of rebamipide, which is an antiulcer agent, increases the mucin level of the tear film and ameliorates ocular surface conditions such as lid wiper epitheliopathy. The aim of the present study was to analyze the changes in goblet cell number, cell proliferation, and epidermal growth factor receptor (EGFR) induced by topical rebamipide addition to the lid wiper of humans. A total of 30 eyelid tissue samples were obtained during involutional entropion surgeries, fixed in paraformaldehyde, embedded in paraffin and divided into two groups: Rebamipide or non-rebamipide. The tissues in the rebamipide group were obtained from patients who had a medical history of topical rebamipide use prior to surgery. The number of goblet cells was counted under light microscopy. A total of 22 eyelid tissue samples were further examined using immunohistochemistry with anti-Ki-67 and anti-EGFR antibodies to evaluate cell proliferation and EGFR expression, respectively. Histologically, the lid wiper and palpebral conjunctiva were clearly identified in the tissues. The number of goblet cells was significantly higher in the rebamipide group compared with the non-rebamipide group (P= 0.0367). There was no significant difference in lid wiper cell proliferation between the rebamipide and non-rebamipide groups. Immunohistochemistry revealed that EGFR levels in the lid wiper epithelial cells were significantly higher in the rebamipide group compared with the non-rebamipide group (P=0.0237). These results suggest that topical rebamipide application increases the number of goblet cells in the lid wiper, which in turn upregulates the expression of EGFR. These findings may be clinically relevant and provide a therapeutic basis for the treatment of ocular disease such as dry eye and lid wiper epitheliopathy.

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“…No specific study was found for rebamipide use in thyroid eye disease with dry eye disease after search of Google scholar and Pubmed. But studies were done on the effects of rebamipide ophthalmic suspension on superior limbic keratopathy (SLK), 33 lagophthalmos, 34 lid wiper epitheliopathy 35 and persistent corneal erosion. 36 Takahashi et al reported that thyroid eye disease patients with SLK after using topical rebamipide showed an improvement and complete disappearance of SLK in 84.8% of patients after treatment.…”

Section: Discussionmentioning

confidence: 99%

Topical Rebamipide Treatment for Dry Eye Syndrome in Thyroid Ophthalmopathy

Nanda¹,

Rath²,

Meher³

2019

jebmh

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A BS T R A C T BACKGROUNDThyroid eye disease (TED) is prevalent in patients with thyroid abnormality and usually in hyperthyroid state. Dry eye disease in TED is multifactorial with a significant component being the inflammatory processes due to involvement of the lacrimal gland, goblet cells in the conjunctival microvilli etc. The effect of Rebamipide tablet on the gastric mucosa for healing of gastric ulcer has already been proved by many studies. Rebamipide acts on the goblet cells, microvilli functions and decrease the inflammatory process. METHODS42 eyes of 33 patients having thyroid eye disease were included in the study. They were evaluated with TBUT and Schirmer test using Whatman-41 stripes and using dry eye scoring system. They were diagnosed as dry eye if TBUT < 10 secs and Schirmer <5 mm/ 5 mins and dry eye score >6. These eyes were treated with eye drop Rebamipide 2% and reassessed at 8 wks. and 16 wks. RESULTS38 and 39 eyes showed significant improvement of dry eye state as evaluated by means of TBUT (>10 secs) and Schirmer's test (> 5 mm/ 5 mins) and decrease in the dry eye score at 8 weeks and 16 weeks of follow up respectively. No serious adverse events were reported during follow up. CONCLUSIONSTopical Rebamipide significantly improved the dry eye condition in patients of thyroid eye disease.

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Topical rebamipide improves lid wiper epitheliopathy

Cited by 27 publications

References 30 publications

The Relationship of Lid Wiper Epitheliopathy to Ocular Surface Signs and Symptoms

The Relationship of Lid Wiper Epitheliopathy to Ocular Surface Signs and Symptoms

Effect of topical rebamipide on goblet cells in the lid wiper of human conjunctiva

Topical Rebamipide Treatment for Dry Eye Syndrome in Thyroid Ophthalmopathy

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