Therapeutic effect of Keap1-Nrf2-ARE pathway-related drugs on age-related eye diseases through anti-oxidative stress

Age-related eye diseases,including cataract,glaucoma,diabetic retinopathy(DR),and age-related macular degeneration(AMD),are the leading causes of vision loss in the world.Several studies have shown that the occurrence and development of these diseases have an important relationship with oxidative stress in the eye.The Keap1-Nrf2-ARE pathway is a classical pathway that resists oxidative stress and inflammation in the body.This pathway is also active in the development of age-related eye diseases.A variety of drugs have been shown to treat agerelated eye diseases through the Keap1-Nrf2-ARE(Kelch-like ECH-Associating protein 1-nuclear factor erythroid 2 related factor 2-antioxidant response element)pathway.This review describes the role of oxidative stress in the development of age-related eye diseases,the function and regulation of the Keap1-Nrf2-ARE pathway,and the therapeutic effects of drugs associated with this pathway on age-related eye diseases.

Potential therapeutic applications of mesenchymal stem cells for the treatment of eye diseases

Stem cell-based treatments have been extensively explored in the last few decades to develop therapeutic strategies aimed at providing effective alternatives for those human pathologies in which surgical or pharmacological therapies produce limited effects.Among stem cells of different sources,mesenchymal stem cells(MSCs)offer several advantages,such as the absence of ethical concerns,easy harvesting,low immunogenicity and reduced tumorigenesis risks.Other than a multipotent differentiation ability,MSCs can release extracellular vesicles conveying proteins,mRNA and microRNA.Thanks to these properties,new therapeutic approaches have been designed for the treatment of various pathologies,including ocular diseases.In this review,the use of different MSCs and different administration strategies are described for the treatment of diabetic retinopathy,glaucoma,and retinitis pigmentosa.In a large number of investigations,positive results have been obtained by in vitro experiments and by MSC administration in animal models.Most authors agree that beneficial effects are likely related to MSC paracrine activity.Based on these considerations,many clinical trials have already been carried out.Overall,although some adverse effects have been described,promising outcomes are reported.It can be assumed that in the near future,safer and more effective protocols will be developed for more numerous clinical applications to improve the quality of life of patients affected by eye diseases.

Pattern of Eye Diseases among Tea Workers

Background: Bangladesh’s tea industry is essential to the country’s economic expansion. Since tea workers in Bangladesh are marginalized within our community, they have limited access to comprehensive eye care services. Productivity and well-being are cornerstones of comprehensive health care strategy. Ocular disorders are influenced by life expectancy, sociodemographic status, and the epidemiological transition. In this context, the state of ocular health and the many eye illnesses remain to be significantly addressed. Purpose: To evaluate the pattern of eye diseases among tea workers in a tea estate of Bangladesh. Methods: This cross-sectional observational study was carried out in Halda Valley Tea Estate, Nazirhat, Fatickchari, Chattogram, Bangladesh, under the supervision of the Department of Community Ophthalmology, BSMMU, following ethical clearance and approval by the IRB board of BSMMU. With informed written consent and approval from the authority of the tea estate, a total of 110 tea workers were recruited. Socio-demographic characteristics, ocular findings, and patterns of eye diseases were determined and recorded. Results: The mean age of the study participants was 39.60 ± 11.63 years. The maximum (58.1%) study participants were 31 - 50 years old, female (64.5%), illiterate (82.7%), and tribal (71.8%) indigenes. Eye diseases were found in 94.5% of workers. Presbyopia (28.2%), cataracts (27.3%), and refractive error (26.4%) were the most common. Tea workers with eye diseases were significantly older than those who did not have any eye diseases (40.20 ± 11.57 vs. 29.17 ± 7.31 years, p Conclusion: A significant number of tea workers had eye diseases, of which presbyopia, cataracts, and refractive error were the most common.

The essential role of N6-methyladenosine RNA methylation in complex eye diseases

There are many complex eye diseases which are the leading causes of blindness,however,the pathogenesis of the complex eye diseases is not fully understood,especially the underlying molecular mechanisms of N6-methyladenosine(m6A)RNA methylation in the eye diseases have not been extensive clarified.Our review summarizes the latest advances in the studies of m6A modification in the pathogenesis of the complex eye diseases,including cornea disease,cataract,diabetic retinopathy,age-related macular degeneration,proliferative vitreoretinopathy,Graves’disease,uveal melanoma,retinoblastoma,and traumatic optic neuropathy.We further discuss the possibility of developing m6A modification signatures as biomarkers for the diagnosis of the eye diseases,as well as potential therapeutic approaches.

Dual‑Atom Nanozyme Eye Drops Attenuate Inflammation and Break the Vicious Cycle in Dry Eye Disease

Dry eye disease(DED)is a major ocular pathology worldwide,causing serious ocular discomfort and even visual impairment.The incidence of DED is gradually increasing with the highfrequency use of electronic products.Although inflammation is core cause of the DED vicious cycle,reactive oxygen species(ROS)play a pivotal role in the vicious cycle by regulating inflammation from upstream.Therefore,current therapies merely targeting inflammation show the failure of DED treatment.Here,a novel dual-atom nanozymes(DAN)-based eye drops are developed.The antioxidative DAN is successfully prepared by embedding Fe and Mn bimetallic single-atoms in N-doped carbon material and modifying it with a hydrophilic polymer.The in vitro and in vivo results demonstrate the DAN is endowed with superior biological activity in scavenging excessive ROS,inhibiting NLRP3 inflammasome activation,decreasing proinflammatory cytokines expression,and suppressing cell apoptosis.Consequently,the DAN effectively alleviate ocular inflammation,promote corneal epithelial repair,recover goblet cell density and tear secretion,thus breaking the DED vicious cycle.Our findings open an avenue to make the DAN as an intervention form to DED and ROSmediated inflammatory diseases.

Global trends in diabetic eye disease research from 2012 to 2021

Diabetic eye disease refers to a group of eye complications that occur in diabetic patients and include diabetic retinopathy, diabetic macular edema, diabetic cataracts, and diabetic glaucoma. However, the global epidemiology of these conditions has not been well characterized. In this study, we collected information on diabetic eye disease-related research grants from seven representative countries––the United States, China, Japan, the United Kingdom, Spain, Germany, and France––by searching for all global diabetic eye disease journal articles in the Web of Science and Pub Med databases, all global registered clinical trials in the Clinical Trials database, and new drugs approved by the United States, China, Japan, and EU agencies from 2012 to 2021. During this time period, diabetic retinopathy accounted for the vast majority(89.53%) of the 2288 government research grants that were funded to investigate diabetic eye disease, followed by diabetic macular edema(9.27%). The United States granted the most research funding for diabetic eye disease out of the seven countries assessed. The research objectives of grants focusing on diabetic retinopathy and diabetic macular edema differed by country. Additionally, the United States was dominant in terms of research output, publishing 17.53% of global papers about diabetic eye disease and receiving 22.58% of total citations. The United States and the United Kingdom led international collaborations in research into diabetic eye disease. Of the 415 clinical trials that we identified, diabetic macular edema was the major disease that was targeted for drug development(58.19%). Approximately half of the trials(49.13%) pertained to angiogenesis. However, few drugs were approved for ophthalmic(40 out of 1830;2.19%) and diabetic eye disease(3 out of 1830;0.02%) applications. Our findings show that basic and translational research related to diabetic eye disease in the past decade has not been highly active, and has yielded few new treatment methods and newly approved drugs.

Knowledge, Attitude, and Practices Regarding Diabetic Eye Disease among General Population in Medina City, Saudi Arabia

Background: Diabetic eye disease is known as a group of eye problems that diabetic patients may develop as a complication of diabetes and can lead to blindness. They may include Diabetic retinopathy (DR), Cataracts, and Glaucoma. Objectives: This study aims to assess the knowledge, attitude, and practices (KAP) around diabetic eye disease in the general population including patients with DM and non-diabetic people in Medina City, Saudi Arabia. Methods: This is a cross-sectional study involving 385 participants via a self-administered online Questionnaire started in January 2023 in Medina, Saudi Arabia. Results: In total, 339 participants with ages ranged from 18 to more than 60 years with a mean age of 26.8 ± 12.6 years old completed the questionnaire. The majority were females (74.6%), singles (67.8%), and had a university level of education (54.6%). Most of the study participants were found to have poor knowledge levels (67%) in comparison to 33% who had an overall good knowledge of diabetic eye diseases. Knowledge level was found to be higher among old-aged participants and those with a family history of DM (P = 0.001, P = 0.049) respectively. Regarding participants’ attitudes and practices, the study showed good attitudes toward eye care practice for diabetics with half of the participants (50%) reporting self-awareness as a reason that made them undergo the first eye screening. Conclusion: Participants in the present study have poor knowledge and awareness level of diabetic eye disease. Furthermore, positive attitudes and perceptions have been revealed by the participants toward the practice of providing eye care for diabetics. .

Mechanisms of electrical stimulation in eye diseases:A narrative review

Background:In the last two decades,electrical stimulation(ES)has been tested in patients with various eye diseases and shows great treatment potential in retinitis pigmentosa and optic neuropathy.However,the clinical application of ES in ophthalmology is currently limited.On the one hand,optimization and standardization of ES protocols is still an unmet need.On the other hand,poor understanding of the underlying mechanisms has hindered clinical exploitation.Main Text:Numerous experimental studies have been conducted to identify the treatment potential of ES in eye diseases and to explore the related cellular and molecular mechanisms.In this review,we summarized the in vitro and in vivo evidence related to cellular and tissue response to ES in eye diseases.We highlighted several pathways that may be utilized by ES to impose its effects on the diseased retina.Conclusions:Therapeutic effect of ES in retinal degenerative diseases might through preventing neuronal apoptosis,promoting neuronal regeneration,increasing neurotrophic factors production in Müller cells,inhibiting microglial activation,enhancing retinal blood flow,and modulating brain plasticity.Future studies are suggested to analyse changes in specific retinal cells for optimizing the treatment parameters and choosing the best fit ES delivery method in target diseases.

Rabbit models of dry eye disease: comparative analysis

AIM:To report ocular changes in rabbits after the implementation of three different induction methods to create dry eye(DE)conditions and provides evidence of DErelated disease evolution.METHODS:Experimental methods were divided into 3 models.The first model used involved triple injection of complete Freund’s adjuvant,50µL each,also called the meibomian gland dysfunction(MGD)model.In the second model,DE conditions were created by the resection of nictitating membranes(NM),Harderian glands(HG),and main lacrimal glands(LG),also called the LGR model.The third model involved the topical administration of benzalkonium chloride(BAK)0.1%solution.The Schirmer test,ocular surface staining with fluorescein,and tear breakup time tests were implemented before and after excision.After euthanasia,the ocular tissues were dissected.Cornea,conjunctiva,and meibomian glands were treated with periodic acid–Schiff(PAS)staining and haematoxylin–eosin staining.RESULTS:The MGD model triggered inflammation of meibomian glands.It detected changes in the lipid layer of the tear film.The bilateral resection of NM,HG,and LG reduced the watering layer of the tear film.The topical administration of BAK of 0.1%solution impacted the mucosal layer of the tear film.CONCLUSION:Different changes are observed with different DE syndrome models.The composition of the tear film differ depending on which part of the eye is targeted.More studies need to be done to confirm whether an increased thickness of the cornea has any impact on the DE disease.

Optimizing Fully Convolutional Encoder-Decoder Network for Segmentation of Diabetic Eye Disease

In the emerging field of image segmentation,Fully Convolutional Networks(FCNs)have recently become prominent.However,their effectiveness is intimately linked with the correct selection and fine-tuning of hyperparameters,which can often be a cumbersome manual task.The main aim of this study is to propose a more efficient,less labour-intensive approach to hyperparameter optimization in FCNs for segmenting fundus images.To this end,our research introduces a hyperparameter-optimized Fully Convolutional Encoder-Decoder Network(FCEDN).The optimization is handled by a novel Genetic Grey Wolf Optimization(G-GWO)algorithm.This algorithm employs the Genetic Algorithm(GA)to generate a diverse set of initial positions.It leverages Grey Wolf Optimization(GWO)to fine-tune these positions within the discrete search space.Testing on the Indian Diabetic Retinopathy Image Dataset(IDRiD),Diabetic Retinopathy,Hypertension,Age-related macular degeneration and Glacuoma ImageS(DR-HAGIS),and Ocular Disease Intelligent Recognition(ODIR)datasets showed that the G-GWO method outperformed four other variants of GWO,GA,and PSO-based hyperparameter optimization techniques.The proposed model achieved impressive segmentation results,with accuracy rates of 98.5%for IDRiD,98.7%for DR-HAGIS,and 98.4%,98.8%,and 98.5%for different sub-datasets within ODIR.These results suggest that the proposed hyperparameter-optimized FCEDN model,driven by the G-GWO algorithm,is more efficient than recent deep-learning models for image segmentation tasks.It thereby presents the potential for increased automation and accuracy in the segmentation of fundus images,mitigating the need for extensive manual hyperparameter adjustments.

Spatial Correlation Module for Classification of Multi-Label Ocular Diseases Using Color Fundus Images

To prevent irreversible damage to one’s eyesight,ocular diseases(ODs)need to be recognized and treated immediately.Color fundus imaging(CFI)is a screening technology that is both effective and economical.According to CFIs,the early stages of the disease are characterized by a paucity of observable symptoms,which necessitates the prompt creation of automated and robust diagnostic algorithms.The traditional research focuses on image-level diagnostics that attend to the left and right eyes in isolation without making use of pertinent correlation data between the two sets of eyes.In addition,they usually only target one or a few different kinds of eye diseases at the same time.In this study,we design a patient-level multi-label OD(PLML_ODs)classification model that is based on a spatial correlation network(SCNet).This model takes into consideration the relevance of patient-level diagnosis combining bilateral eyes and multi-label ODs classification.PLML_ODs is made up of three parts:a backbone convolutional neural network(CNN)for feature extraction i.e.,DenseNet-169,a SCNet for feature correlation,and a classifier for the development of classification scores.The DenseNet-169 is responsible for retrieving two separate sets of attributes,one from each of the left and right CFI.After then,the SCNet will record the correlations between the two feature sets on a pixel-by-pixel basis.After the attributes have been analyzed,they are integrated to provide a representation at the patient level.Throughout the whole process of ODs categorization,the patient-level representation will be used.The efficacy of the PLML_ODs is examined using a soft margin loss on a dataset that is readily accessible to the public,and the results reveal that the classification performance is significantly improved when compared to several baseline approaches.

Role of lymphotoxin alpha as a new molecular biomarker in revolutionizing tear diagnostic testing for dry eye disease

Dry eye disease(DED),primarily classified as multifactorial ocular surface disorder,afflicts tens of millions of individuals worldwide,adversely impacting their quality of life.Extensive research has been conducted on tear film analysis over the past decades,offering a range of tests to evaluate its volume,health,and integrity.Yet,early diagnosis and effective treatment for DED continue to pose significant challenges in clinical settings.Nevertheless,by recognizing key phenomena in DED such as ocular surface inflammation,hyperosmolarity,and tear film instability,this article provides a comprehensive overview of both traditional and recently developed methods for diagnosing and monitoring DED.The information serves as a valuable resource not only for clinical diagnosis but also for further research into DED.

Evaluation of macular choroidal and microvascular network changes by activity scores and serum antibodies in thyroid eye patients and healthy subjects

AIM:To investigate the choroidal thickness and the microvascular network changes around the macula in thyroid eye disease(TED)patients at different stages and the relationship of those changes with risk factors,serum antibodies and the severity of TED.METHODS:A total of 85 participants were enrolled.All participants underwent ophthalmology and endocrinology examinations.Subfoveal choroidal thickness(SFCT),superficial(s)and deep(d)foveal avascular zone(FAZ)area,mean(m)and central(c)superficial vascular density(SVD),deep vascular density(DVD)measurements of the enrolled cases were performed with Topcon swept source optical coherence tomography(OCT)/OCT angiography(OCTA)DRI OCT Triton.Multiple linear regression analysis was used to explore the associations between SFCT,FAZ area,SVD,DVD and the relevant factors of TED.RESULTS:Those with active TED patients had higher c-DVD and m-DVD levels(P<0.05),however there is no statistically significant difference in SFCT between active and stable TED patients.Among the serum antibodies,it was observed that s-FAZ and d-FAZ increased,c-SVD and m-SVD decreased in patients with high thyroid stimulating hormone-receptor autoantibodies(TRAB)level,whereas SFCT thickened in patients with high levels of both TRAB and human thyroglobulin(hTG).There was no significant difference in SFCT,FAZ,SVD and DVD measurement at gender,between hyperthyroid and euthyroid patients and among those with or without thyroid papillary carcinoma.CONCLUSION:The results show that both disease activation and serum antibodies differentially affect both superficial and deep retinal vascular density.It has also been shown that high serum antibody levels affect choroidal thickness independent of clinical activity.

Dry eye disease among patients infected with the SARSCoV-2 Omicron variant:a cross-sectional study

AIM:To investigate the incidence of dry eye disease(DED)and relevant risk factors among patients infected with the severe acute respiratory syndrome coronavirus 2(SARSCoV-2)Omicron variant.METHODS:This cross-sectional,observational analysis included 993 patients with corona virus disease 2019(COVID-19)treated at the National Exhibition and Convention Center(Shanghai)Fangcang Shelter Hospital,from April 10 to May 26,2022.Totally 944 uninfected control participants were recruited.All participants completed ocular surface disease index(OSDI)questionnaires,and DED symptoms were determined using OSDI scores.The demographic characteristics,length of hospital stay and in nasopharyngeal swabs were performed using questionnaires.SARS-CoV-2 Omicron variant infection was confirmed by nucleic acid-based detection in nasopharyngeal swabs using a 2019-nCoV nucleic acid detection kit.The risk factors for DED symptoms among patients with COVID-19 and control participants were determined by logistic regression analysis.RESULTS:Patients with COVID-19 showed a higher incidence of DED than controls(64.9%vs 55.1%,P<0.001).SARS-CoV-2 infection[odds ratios(ORs)(95%CI):1.271(1.038,1.556)],use of contact lenses[ORs(95%CI):9.350(3.676,23.783)],history of corneal refractive surgery[ORs(95%CI):2.047(1.494,2.804)],poor sleep quality[ORs(95%CI):2.657(2.029,3.480)],and video display terminal(VDT)use for more than 8h per day[ORs(95%CI):6.348(4.720,8.538)]were found to be risk factors for DED symptoms in patients with COVID-19 as well as controls.For patients with COVID-19,the length of hospital stay[ORs(95%CI):1.196(1.134,1.262)],use of contact lenses[ORs(95%CI):20.423(2.680,155.632)],history of corneal refractive surgery[ORs(95%CI):2.166(1.321,3.553)],poor sleep quality[ORs(95%CI):3.650(2.381,5.597)],and VDT use for more than 8h per day[ORs(95%CI):7.740(4.918,12.180)]were significant risk factors for DED symptoms.CONCLUSION:Patients with COVID-19 are more prone to develop symptomatic DED.SARS-CoV-2 infection and length of hospital stay are important risk factors for DED symptoms.

Recent advance in natural plant products for treatment of dry eye disease

Dry eye disease(DED),a chronic multifactorial illness of the ocular surface with itching,burning,irritation,eye fatigue and ocular inflammation,may result in potential damage,such as cornea and conjunctiva,and even decreased vision.With the global prevalence of DED on the rise,it is crucial to find treatment options with minimal side effects.Natural plant products have shown promise in alleviating DED symptoms and may serve as a potential approach for its treatment.However,their application as instilled drugs is limited by solubility,stability and biological barriers.This review summarizes recent studies(published in the last 5 years)on natural plant products and their derivatives for the treatment of DED,focusing on efficacy,mechanism,drug delivery systems.Meanwhile,their shortcomings are also discussed.By exploring these aspects,we find polyphenol,flavonoid and others natural plant products can effectively improve or treat DED by different mechanisms,and suitable delivery system and structural modification can enhance their therapeutic effect,suggesting they are likely to become candidates for the treatment of DED.

Pro-inflammatory cytokines levels in tears and dry eye disease in Parkinson’s disease

Background:Neuroinflammation is an essential event in Parkinson’s disease(PD).Identifying affordable and less invasive biomarkers to make an early diagnosis and monitor therapeutic strategies should be a priority among researchers.The study’s objective was to measure tear levels of cytokines in subjects with PD and their association with motor features and the presence of dry eye symptoms.Methods:A total of 16 subjects with PD and 16 age-and sex-matched controls were included.Movement Disorders Society-Unified Parkinson’s Disease Rating Scale(MDS-UPDRS),Hoehn and Yahr(HY)stage scale,Montreal Cognitive Assessment(MoCA),tear break-up time(TBUT),blink rate(BR),Dry Eye Questionnaire 5(DEQ-5)were examined,and pro-inflammatory cytokines[interleukin(IL)-1β,IL-6,IL-8,IL-10,IL-12p70 and tumor necrosis factor-alpha(TNF-α)]were quantified in tears using the BD Cytometric Bead Array Human Inflammatory Cytokine Kit.Results:Higher tear TNF-αwere quantified in PD compared to controls(2.94±3.95 vs.0.33±0.49 pg/mL,P=0.008).According to DEQ-5,50.0%(n=8)of PD subjects and 12.5%(n=2)controls had dry eye disease(DED).No differences were found in cytokines concentrations between PD patients with DED compared to those without DED.IL-8 was associated with the HY stage,TBUT,DEQ-5,and a better MoCA score.A higher BR correlated moderately with a lower HY stage(r=−0.645,P=0.007),and DED patients have lower BR in PD(12.14±2.54 vs.9.0±2.06 blinks/minute,P=0.031).Conclusions:PD patients have higher levels of TNF-αin tears than age-and sex-matched HC.IL-8 in tears may be both involved in the severity of the disease and in the development of DED in PD.In addition,our findings suggest that as HY stage increases,indicating a more advanced stage,BR decreases,indicating greater motor impairment.Conversely,the presence of DED is associated with higher levels of bradykinesia in PD patients,suggesting a potential relationship between DED and motor impairment severity.

Artificial intelligence,machine learning and deep learning for eye care specialists

Artificial intelligence(AI)methods have become a focus of intense interest within the eye care community.This parallels a wider interest in AI,which has started impacting many facets of society.However,understanding across the community has not kept pace with technical developments.What is AI,and how does it relate to other terms like machine learning or deep learning?How is AI currently used within eye care,and how might it be used in the future?This review paper provides an overview of these concepts for eye care specialists.We explain core concepts in AI,describe how these methods have been applied in ophthalmology,and consider future directions and challenges.We walk through the steps needed to develop an AI system for eye disease,and discuss the challenges in validating and deploying such technology.We argue that among medical fields,ophthalmology may be uniquely positioned to benefit from the thoughtful deployment of AI to improve patient care.

Evaluation of patients with dry eye disease for conjunctival Chlamydia trachomatis and Ureaplasma urealyticum

AIM:To determine the possibility of the development of dry eye disease(DED) as a result of persistent infection with Chlamydia trachomatis and Ureaplasma urealyticum in the conjunctiva of patients.METHODS: This study was conducted on 58 patients of age range 20-50 y,diagnosed with DED confirmed by Schirmer I test and tear breakup time.The non-dry eye control group included 27 subjects of the same age.Ocular specimens were collected as conjunctival scrapings and swabs divided into three groups: the first used for bacterial culture,the second and third taken to detect Chlamydia trachomatis and Ureaplasma urealyticum by direct fluorescent antibody(DFA) assay and polymerase chain reaction(PCR) method. RESULTS: Chlamydia trachomatis was detected in 65.5% and 76% of DED patients by DFA and PCR methods respectively.Ureaplasma urealyticum was found in 44.8% of DED infected patients using the PCR method.Both organisms were identified in only 37.9% of DED patients found to be infected.Control subjects had a 22%detection rate of Chlamydia trachomatis by DFA assay versus a 7% detection rate by PCR; while Ureaplasma urealyticum was detected in 3.7% of the controls by PCR method.The conjunctival culture revealed that gram positive microorganisms represented 75% of isolates with coagulase negative Staphylococci the most common(50%) followed by Staphylococcus aureus(20%),whereas gram negative microorganisms occurred in 25% of cases,isolating Moraxella spp.as the most frequent organism. CONCLUSION: Our results tend to point out that Chlamydia trachomatis and Ureaplasma urealyticum were detected in a moderate percentage of patients with DED,and could be a fair possibility for its development.PCR is more reliable in detecting Chlamydia trachomatis than DFA technique.The presence of isolated conjunctival bacterial microflora can be of some potential value.

Inflammation and dry eye disease——where are we?

The presence of inflammation in dry eye disease(DED)results in increased patient symptomatology,ocular surface damage and worsening tear dysfunction.It also affects the health of meibomian glands and their secretions which further aggravates ocular surface disease.This article reviews current knowledge regarding ocular surface inflammation in DED and explores the relationships between the vicious cycles of DED,inflammation and meibomian gland dysfunction(MGD).The clinical evaluation of eyes with such changes,markers that identify the presence of inflammation on the ocular surface and current treatment options are discussed.

Effects of dietary high dose DHA omega-3 supplement in dry eye with meibomian gland dysfunction

AIM:To evaluate the clinical efficacy of dietary supplement of high dose DHA omega-3 in dry eye with meibomian gland dysfunction(MGD).METHODS:Prospective randomized double-masked,placebo-controlled clinical trial was conducted in mild to moderate dry eye patients with MGD.Patients have no history of taking any dietary omega-3 supplements before 3 mo.Patients were divided into two groups:24 patients in the omega-3 group and 26 patients in the placebo group.The omega-3 group received two capsules of Easyeye Dry?,total containing 600 mg of EPA and 1640 mg of DHA,while the placebo group received two capsules containing 3000 mg of olive oil.All patients take two pills once a day.The examination of MGD scores,tear break-up time(TBUT),corneal staining test(NEI),strip meniscometry(SM tube),and ocular surface disease index(OSDI)scores were performed at baseline,after 4 and 8 wk.RESULTS:A total of 50 patients were included.There were no differences in baseline characteristics between the two groups,such as age,sex,and other ocular examination findings.The TBUT,NEI,and OSDI scores significantly improved after 4 and 8 wk in both groups.While after 8 wk TBUT(6.00±1.62 s vs 5.08±1.28 s,P=0.034)and MGD score(7.2±1.8 vs 8.1±2.6,P=0.033)in the omega-3 group was more significantly improved than that of the placebo group.CONCLUSION:Dry eye with the MGD patient,a high dose of DHA omega-3 dietary supplement can improve TBUT and MGD score after 8 wk,effective in stabilizing the tear film.