Journal ArticleDOI
TFOS DEWS II pathophysiology report
Anthony J. Bron,Anthony J. Bron,Cintia S. de Paiva,Sunil K. Chauhan,Stefano Bonini,Eric E. Gabison,Sandeep Jain,Erich Knop,Maria Markoulli,Yoko Ogawa,Victor L. Perez,Yuichi Uchino,Norihiko Yokoi,Driss Zoukhri,David A. Sullivan +14 more
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TLDR
The TFOS DEWS II Pathophysiology Subcommittee reviewed the mechanisms involved in the initiation and perpetuation of dry eye disease, finding the targeting of the terminal duct in meibomian gland disease and the influence of gaze dynamics and the closed eye state on tear stability and ocular surface inflammation to be important.Abstract:
The TFOS DEWS II Pathophysiology Subcommittee reviewed the mechanisms involved in the initiation and perpetuation of dry eye disease. Its central mechanism is evaporative water loss leading to hyperosmolar tissue damage. Research in human disease and in animal models has shown that this, either directly or by inducing inflammation, causes a loss of both epithelial and goblet cells. The consequent decrease in surface wettability leads to early tear film breakup and amplifies hyperosmolarity via a Vicious Circle. Pain in dry eye is caused by tear hyperosmolarity, loss of lubrication, inflammatory mediators and neurosensory factors, while visual symptoms arise from tear and ocular surface irregularity. Increased friction targets damage to the lids and ocular surface, resulting in characteristic punctate epithelial keratitis, superior limbic keratoconjunctivitis, filamentary keratitis, lid parallel conjunctival folds, and lid wiper epitheliopathy. Hybrid dry eye disease, with features of both aqueous deficiency and increased evaporation, is common and efforts should be made to determine the relative contribution of each form to the total picture. To this end, practical methods are needed to measure tear evaporation in the clinic, and similarly, methods are needed to measure osmolarity at the tissue level across the ocular surface, to better determine the severity of dry eye. Areas for future research include the role of genetic mechanisms in non-Sjogren syndrome dry eye, the targeting of the terminal duct in meibomian gland disease and the influence of gaze dynamics and the closed eye state on tear stability and ocular surface inflammation.read more
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Analysis of Globular Cells in Corneal Nerve Vortex
TL;DR: Globular cells had characteristic distribution patterns and biological features different from LCs and were associated with long-term irritation of the meibomian gland dysfunction.
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Comparison of Efficacy and Sensation of Instillation between 0.05% Cyclosporine Nanoemulsion and Microemulsion Type
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The red eye.
TL;DR: The role of the general physician is crucial in the decision making to judge the severity of the ocular condition as discussed by the authors, and managing a red eye often requires the support of other specialists.
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Impact of Improper Approach to Identify Lid Wiper Epitheliopathy (LWE).
TL;DR: It was demonstrated that using a double instillation of dye was statistically different from a single-dose, even with extended wait time for clinical observation, and an optimal methodology for LWE identification was used.
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Lipidomics Analysis of the Tears in the Patients Receiving LASIK, FS-LASIK, or SBK Surgery.
TL;DR: In this paper, a rapid direct injection shotgun lipidomics workflow, MS/MSALL, was applied to examine the tear lipidome of patients undergoing laser-assisted in situ in situ keratomileusis (LASIK), femtosecond LASIK (FS-LASik), or sub-Bowman's keratomiliusis(SBK) surgery preoperatively and post-operatively.
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