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Presence or absence of ocular surface inflammation directs clinical and therapeutic management of dry eye
BACKGROUND: The presence of clinically significant inflammation has been confirmed in the tears of 40%–65% of patients with symptoms of dry eye. Ocular surface inflammation may lead to tear film instability, epithelial cell irregularities, and permeability, resulting in chronic symptomatic pain and...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Dove Medical Press
2016
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5127432/ https://www.ncbi.nlm.nih.gov/pubmed/27920494 http://dx.doi.org/10.2147/OPTH.S121256 |
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author | Sambursky, Robert |
author_facet | Sambursky, Robert |
author_sort | Sambursky, Robert |
collection | PubMed |
description | BACKGROUND: The presence of clinically significant inflammation has been confirmed in the tears of 40%–65% of patients with symptoms of dry eye. Ocular surface inflammation may lead to tear film instability, epithelial cell irregularities, and permeability, resulting in chronic symptomatic pain and fluctuating vision as well as negative surgical outcomes. PATIENTS AND METHODS: A retrospective single center medical chart review of 100 patients was conducted. All patients were tested with the InflammaDry test to determine if patients exhibited elevated levels of matrix metalloproteinase 9 (MMP-9). InflammaDry-positive patients were started on a combination of cyclosporine 0.05% twice daily, 2,000–4,000 mg oral omega-3 fatty acids, and frequent artificial tear replacement. InflammaDry-negative patients were started on 2,000–4,000 mg of oral omega-3 fatty acids and frequent artificial tear replacement. Each patient was retested at ~90 days. A symptom questionnaire was performed at the initial visit and at 90 days. RESULTS: 60% of the patients with dry eye symptoms tested positive for elevated MMP-9 at the initial visit. 78% of all patients returned for follow-up at ~90 days including 80% (48/60) of the previously InflammaDry-positive patients and 75% (30/40) of the previously InflammaDry-negative patients. A follow-up symptom questionnaire reported at least 75% symptomatic improvement in 65% (31/48) of the originally InflammaDry-positive patients and in 70% (21/30) of the initially InflammaDry-negative patients. Symptomatic improvement of at least 50% was reported in 85% (41/48) of previously InflammaDry-positive patients and 86% (26/30) of previously InflammaDry-negative patients. Following treatment, 54% (26/48) of previously InflammaDry-positive patients converted to a negative InflammaDry result. CONCLUSION: Identifying which symptomatic dry eye patients have underlying inflammation may predict patient responses to treatment and influence clinical management strategies. |
format | Online Article Text |
id | pubmed-5127432 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Dove Medical Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-51274322016-12-05 Presence or absence of ocular surface inflammation directs clinical and therapeutic management of dry eye Sambursky, Robert Clin Ophthalmol Original Research BACKGROUND: The presence of clinically significant inflammation has been confirmed in the tears of 40%–65% of patients with symptoms of dry eye. Ocular surface inflammation may lead to tear film instability, epithelial cell irregularities, and permeability, resulting in chronic symptomatic pain and fluctuating vision as well as negative surgical outcomes. PATIENTS AND METHODS: A retrospective single center medical chart review of 100 patients was conducted. All patients were tested with the InflammaDry test to determine if patients exhibited elevated levels of matrix metalloproteinase 9 (MMP-9). InflammaDry-positive patients were started on a combination of cyclosporine 0.05% twice daily, 2,000–4,000 mg oral omega-3 fatty acids, and frequent artificial tear replacement. InflammaDry-negative patients were started on 2,000–4,000 mg of oral omega-3 fatty acids and frequent artificial tear replacement. Each patient was retested at ~90 days. A symptom questionnaire was performed at the initial visit and at 90 days. RESULTS: 60% of the patients with dry eye symptoms tested positive for elevated MMP-9 at the initial visit. 78% of all patients returned for follow-up at ~90 days including 80% (48/60) of the previously InflammaDry-positive patients and 75% (30/40) of the previously InflammaDry-negative patients. A follow-up symptom questionnaire reported at least 75% symptomatic improvement in 65% (31/48) of the originally InflammaDry-positive patients and in 70% (21/30) of the initially InflammaDry-negative patients. Symptomatic improvement of at least 50% was reported in 85% (41/48) of previously InflammaDry-positive patients and 86% (26/30) of previously InflammaDry-negative patients. Following treatment, 54% (26/48) of previously InflammaDry-positive patients converted to a negative InflammaDry result. CONCLUSION: Identifying which symptomatic dry eye patients have underlying inflammation may predict patient responses to treatment and influence clinical management strategies. Dove Medical Press 2016-11-24 /pmc/articles/PMC5127432/ /pubmed/27920494 http://dx.doi.org/10.2147/OPTH.S121256 Text en © 2016 Sambursky. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. |
spellingShingle | Original Research Sambursky, Robert Presence or absence of ocular surface inflammation directs clinical and therapeutic management of dry eye |
title | Presence or absence of ocular surface inflammation directs clinical and therapeutic management of dry eye |
title_full | Presence or absence of ocular surface inflammation directs clinical and therapeutic management of dry eye |
title_fullStr | Presence or absence of ocular surface inflammation directs clinical and therapeutic management of dry eye |
title_full_unstemmed | Presence or absence of ocular surface inflammation directs clinical and therapeutic management of dry eye |
title_short | Presence or absence of ocular surface inflammation directs clinical and therapeutic management of dry eye |
title_sort | presence or absence of ocular surface inflammation directs clinical and therapeutic management of dry eye |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5127432/ https://www.ncbi.nlm.nih.gov/pubmed/27920494 http://dx.doi.org/10.2147/OPTH.S121256 |
work_keys_str_mv | AT samburskyrobert presenceorabsenceofocularsurfaceinflammationdirectsclinicalandtherapeuticmanagementofdryeye |