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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Assessment of reliability and validity of the 5-scale grading system of the point-of-care immunoassay for tear matrix metalloproteinase-9
Minjeong Kim,Ja Young Oh,Seon Ha Bae,Seung Hyeun Lee,Wonjun Lee,Yeoun Sook Chun,Kyoung Woo Kim +6 more
TL;DR: In this article, the reliability and validity of the 5-scale grading system to interpret the point-of-care immunoassay for tear matrix metalloproteinase (MMP)-9 were evaluated.
Journal ArticleDOI
Ocular surface complications of local anticancer drugs for treatment of ocular tumors.
Jayoon Moon,Se Hyun Choi,Min Joung Lee,Dong Hyun Jo,Un Chul Park,Sun Ok Yoon,Se Joon Woo,Joo Youn Oh,Joo Youn Oh +8 more
TL;DR: Local chemotherapy is increasingly used, either in combination with surgery or as monotherapy, for management of ocular tumors, with an emphasis on their toxicities to the ocular surface, adnexa and lacrimal drainage system.
Journal ArticleDOI
Efficacy and safety of acupuncture at a single BL1 acupoint in the treatment of moderate to severe dry eye disease: Protocol for a randomized, controlled trial.
TL;DR: It is expected to be verified that acupuncture is better than artificial tears toward improving the mean SIT values of patients with moderate to severe DED.
Journal ArticleDOI
Altered Corneal Epithelial Dendritic Cell Morphology and Phenotype Following Acute Exposure to Hyperosmolar Saline.
TL;DR: In this article, the morphological and phenotypic responses of corneal epithelial dendritic cells (DCs) to acute topical hyperosmolar stress, given a pathogenic role for tear hyperosity in dry eye disease (DED), were assessed.
Journal ArticleDOI
Pathophysiology of dry eye disease and novel therapeutic targets.
TL;DR: The pathophysiology of dry eye disease (DED) is complex, and therapy may be a challenge as discussed by the authors , and novel anti-inflammatory treatments may enrich our therapeutic armamentarium in the future.
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