High Molecular Weight Hyaluronan Promotes Corneal Nerve Growth in Severe Dry Eyes

The purpose of this study was to investigate the effect of high molecular weight hyaluronan (HMWHA) eye drops on subbasal corneal nerves in patients suffering from severe dry eye disease (DED) and to evaluate the damage of subbasal corneal nerves associated with severe DED. Designed as an international, multicenter study, 16 patients with symptoms of at least an Ocular Surface Disease Index (OSDI) score of 33, and corneal fluorescein staining (CFS) of at least Oxford grade 3, were included and randomized into two study arms. The control group continued to use their individual optimum artificial tears over the study period of eight weeks; in the verum group, the artificial tears were substituted by eye drops containing 0.15% HMWHA. At the baseline visit, and after eight weeks, the subbasal nerve plexus of 16 patients were assessed by confocal laser scanning microscopy (CSLM). The images were submitted to a masked reading center for evaluation. Results showed a significant increase of total nerve fiber lengths (CNFL) in the HMWHA group (p = 0.030) when compared to the control group, where the total subbasal CNFL did not significantly change from baseline to week 8. We concluded that in severe DED patients, HMWHA from topically applied eye drops could cross the epithelial barrier and reach the subbasal nerve plexus, where it exercised a trophic effect

The HYLAN M Study: Efficacy of 0.15% High Molecular Weight Hyaluronan Fluid in the Treatment of Severe Dry Eye Disease in a Multicenter Randomized Trial

The aim of the HYLAN M study was to investigate if symptoms and/or signs of patients suffering from severe dry eye disease (DED) can be improved by substituting individually optimized artificial tear therapy by high molecular weight hyaluronan (HMWHA) eye drops. In this international, multicenter study, patients with symptoms of at least ocular surface disease index (OSDI) 33 and corneal fluorescein staining (CFS) of at least Oxford grade 3 were included. A total of 84 per-protocol patients were randomized in two study arms. The control group continued to use their individual optimum artificial tears over the study period of eight weeks; in the verum group, the artificial tears were substituted by eye drops containing 0.15% HMWHA. At the week 8 visit, the average OSDI of the verum group had improved by 13.5 as compared to the control group (p = 0.001). The best corrected visual acuity (BCVA) had improved by 0.04 logMAR (p = 0.033). CFS, tear film break-up time (TBUT), Schirmer I, lid wiper epitheliopathy (LWE), mucocutaneous junction (Yamaguchi score), and tear osmolarity were not significantly different between the verum and control groups (p > 0.050). We conclude that for most patients with severe DED, 0.15% HMWHA eye drops provide excellent improvement of symptoms without impairment of dry eye signs

TFOS European ambassador meeting:Unmet needs and future scientific and clinical solutions for ocular surface diseases

The mission of the Tear Film & Ocular Surface Society (TFOS) is to advance the research, literacy, and educational aspects of the scientific field of the tear film and ocular surface. Fundamental to fulfilling this mission is the TFOS Global Ambassador program. TFOS Ambassadors are dynamic and proactive experts, who help promote TFOS initiatives, such as presenting the conclusions and recommendations of the recent TFOS DEWS II™, throughout the world. They also identify unmet needs, and propose future clinical and scientific solutions, for management of ocular surface diseases in their countries. This meeting report addresses such needs and solutions for 25 European countries, as detailed in the TFOS European Ambassador meeting in Rome, Italy, in September 2019

C L I N I C A L I N V E S T I G AT I O N Iodide protection from UVB irradiation-induced degradation of hyaluronate and against UVB-damage of human conjunctival fibroblasts

Abstract Background: To determine whether iodide protects from UVB irradiation-induced destruction of hyaluronate and against UVB injury of cultured human conjunctival fibroblasts. Methods: Hyaluronate and primary cultured human conjunctival fibroblasts were incubated with various concentrations of iodide and then exposed to UV light irradiation of 312 nm. Hyaluronate destruction was determined by viscosity measurements. Cell viability was assessed with MTT assay. Results: Iodide protects hyaluronate from UVB lightinduced degradation of this macromolecule in a concentration-dependent manner. Incubation of human conjunctival fibroblasts with iodide inhibited cells from damage by UVB light. Conclusion: Iodide protects hyaluronate, a component of tear fluid and tissues of the anterior part of the eye, against UVB light-induced degradation. Also, injury of human conjunctival cells can be prevented by incubation with iodide before UVB irradiation. The mechanism of protection is likely to include an antioxidative reaction. To support the natural defence mechanisms of the eyes, the administration of an antioxidant such as iodide to artificial tears, for example, may help to prevent the damage of the eye provoked by oxidative stress

Arbeitsablauf zur Behandlung des Trockenen Auges, ein Versuch der Zuordnung von Diagnose zur Therapie

Hintergrund Das Trockene Auge ist eine sehr komplexe Erkrankung der Augenoberfläche. Zur Behandlung bieten sich eine Vielzahl von Tränenersatzmitteln mit unterschiedlichen Inhaltsstoffen an sowie diverse Methoden. Diese Arbeit entwickelt ein Schema zur Anwendung der in Österreich erhältlichen Produkte. Material und Methode Aus der Literatur werden verschiedene diagnostische Verfahren, ätiologische/pathogenetische Mechanismen sowie Beschreibungen der Schweregrade den therapeutischen Möglichkeiten für das Trockene Auge gegenübergestellt. Daraus entsteht eine Arbeitstabelle, welche als Grundlage zur erleichterten Behandlung dieser Erkrankung dienen soll. Resultate Es werden 149 Tränenersatzmittel/Therapeutika für das Trockene Auge in der Arbeitstabelle erfasst, welche je nach Diagnose und dem Schweregrad zu den Therapiemöglichkeiten in 9 Untergruppen zugeordnet werden. Schlussfolgerung Der Arbeitsablauf zur Behandlung dieser Erkrankung beinhaltet die Schritte von der Symptomatik, Diagnostik und Einordnung der subjektiven und objektiven Parameter bis zur optimierten Therapie mit den in Österreich erhältlichen Produkten.Background Dry eye is a complex disease of the ocular surface. Many artificial tear medications are available with different components and modes of application. This paper develops a schematic chart of the medications and application modes available in Austria. Material and methods A comparative literature search of the causes, diagnostic procedures and severity of dry eye syndrome to create a workflow chart for facilitating dry eye management. Results 149 artificial tear medications and application methods were entered in the workflow sheet, subdivided into 9 management groups according to diagnosis and severity level. Conclusion This work process includes hints and steps based on patient complaints,classified into subjective and objective factors, to optimize management of dry eye(VLID)347210

Reflections on the ocular surface: Summary of the presentations at the 4th Coronis Foundation Ophthalmic Symposium Debate: “A multifactorial approach to ocular surface disorders” (August 31 2021)

The author (van Setten) thanks the Karin Sandqvists Foundation (Karin Sandqvists Stiftelse) Stockholm, Sweden, the Eye Foundation (Ögonfonden), Stockholm, Sweden and the Crown Princess Margaretas Foundation Working committee for the visually impaired KMA (Stiftelsen Kronprinsessan Margaretas Arbetsnämnd för synskadade KMA) Stockholm, Sweden, for the funding received forming the base for the presented model of dry eye disease.Peer reviewe

High Molecular Weight Hyaluronan Promotes Corneal Nerve Growth in Severe Dry Eyes

The purpose of this study was to investigate the effect of high molecular weight hyaluronan (HMWHA) eye drops on subbasal corneal nerves in patients suffering from severe dry eye disease (DED) and to evaluate the damage of subbasal corneal nerves associated with severe DED. Designed as an international, multicenter study, 16 patients with symptoms of at least an Ocular Surface Disease Index (OSDI) score of 33, and corneal fluorescein staining (CFS) of at least Oxford grade 3, were included and randomized into two study arms. The control group continued to use their individual optimum artificial tears over the study period of eight weeks; in the verum group, the artificial tears were substituted by eye drops containing 0.15% HMWHA. At the baseline visit, and after eight weeks, the subbasal nerve plexus of 16 patients were assessed by confocal laser scanning microscopy (CSLM). The images were submitted to a masked reading center for evaluation. Results showed a significant increase of total nerve fiber lengths (CNFL) in the HMWHA group (p = 0.030) when compared to the control group, where the total subbasal CNFL did not significantly change from baseline to week 8. We concluded that in severe DED patients, HMWHA from topically applied eye drops could cross the epithelial barrier and reach the subbasal nerve plexus, where it exercised a trophic effect

The Impact of Visual Guided Order Picking on Ocular Comfort, Ocular Surface and Tear Function

<div><p>Purpose</p><p>We investigated the effects of a visual picking system on ocular comfort, the ocular surface and tear function compared to those of a voice guided picking solution.</p><p>Design</p><p>Prospective, observational, cohort study.</p><p>Method</p><p><i>Setting</i>: Institutional. <i>Study Population</i>: A total of 25 young asymptomatic volunteers performed commissioning over 10 hours on two consecutive days. <i>Main Outcome Measures</i>: The operators were guided in the picking process by two different picking solutions, either visually or by voice while their subjective symptoms and ocular surface and tear function parameters were recorded.</p><p>Results</p><p>The visual analogue scale (VAS) values, according to subjective dry eye symptoms, in the visual condition were significantly higher at the end of the commissioning than the baseline measurements. In the voice condition, the VAS values remained stable during the commissioning. The tear break-up time (BUT) values declined significantly in the visual condition (pre-task: 16.6 sec and post-task: 9.6 sec) in the right eyes, that were exposed to the displays, the left eyes in the visual condition showed only a minor decline, whereas the BUT values in the voice condition remained constant (right eyes) or even increased (left eyes) over the time. No significant differences in the tear meniscus height values before and after the commissioning were observed in either condition.</p><p>Conclusion</p><p>In our study, the use of visually guided picking solutions was correlated with post-task subjective symptoms and tear film instability.</p></div

Subjective Values.

<p>Subjective Values.</p

Voice guided system.

<p>Voice guided system.</p