Contact Lens & Anterior Eye最新文献

Purpose: To develop a Chinese version of the 8-item Contact Lens Dry Eye Questionnaire (CLDEQ-8) with cross-cultural adaption and clinical validation among soft contact lens wearers (SCL) in China.

Methods: The translation and adaptation of the Chinese CLDEQ-8 (C-CLDEQ-8) followed a rigorous methodological process based on cross-cultural research guidelines consisting of three main phases: 1) forward and backward translation of original CLDEQ-8 into Chinese, 2) cross-cultural adaptation performed by medical advising committee, and 3) clinical validation and repeatability test of the translated questionnaire on Chinese SCL wearers. Rasch analysis was also performed to investigate the psychometric properties of C-CLDEQ-8.

Results: 134 experienced SCL wearers aged 18-45 completed the C-CLDEQ-8. C-CLDEQ-8 score was linearly related to the overall opinion of SCLs (beta = 2.16, p = 0.002), gestalt eye dryness response (beta = 2.90, p < 0.001), and sensitivity response (beta = 1.83, p = 0.001). The questionnaire showed excellent test-retest repeatability with an intra-class correlation coefficient (ICC) of 0.95 and great internal consistency with a Cronbach's alpha of 0.83. The corrected index of homogeneity for each item was more significant than 0.5. In Rasch analysis, the infit and outfit values for eight items were all within 0.6-1.4, suggesting a good fit for the Rasch model. Martin-Löf test result indicated that the Rasch model was unidimensional (p = 1.0). Item characteristics curves suggested combining categories 3-4 and 5-6 in item 5 of C-CLDEQ-8.

Conclusions: This study produced a Chinese version of CLDEQ-8 with great validity and reliability and proved capable of evaluating SCL-related symptoms.

The eye is a highly sensitive and vital component that significantly affects human quality of life. Diseases that affect the eye are major contributors to visual impairment and blindness and can have a profound effect on an individual's well-being. Ocular drug delivery is challenging because of physiological and anatomical barriers. Invasive Intravitreal administration is primarily used for the treatment and management of posterior segmental disease. However, frequent intravitreal administration is associated with adverse effects. Furthermore, topical administration results in less than 5% ocular bioavailability, leading to a void in the safe and efficacious management of posterior segment diseases. Nanocarrier-based systems have been well explored as ocular therapeutics to overcome the sub-therapeutic management attributed to conventional eye drops and physiological and anatomical barriers. Since the first report of nanoparticles to date, the nanocarrier system has come a long way with the simplicity and versatility offered by the system. Significant progress has been made in the development of noninvasive nanocarrier systems and their interactions with the ocular surface. The nanocarrier system enhances precorneal retention, limits nontherapeutic absorption, and offers controlled drug release. This review aims to provide an overview of the recent advancements in noninvasive nanocarrier-based topical ocular drug delivery systems, including their interaction with the ocular surface, the barriers to their translation to clinical settings, and the associated scale-up challenges.

Purpose: To characterize the ocular surface microbiota in regular contact lens wearers with dry eyes and assess the effectiveness of reducing bacterial load using a liposomal ozonated oil solution.

Methods: This prospective, longitudinal, controlled study randomized subjects into two groups. Group A (45 subjects) received hydroxypropylmethylcellulose (HPMC, Artific®), while Group B (41 subjects) received ozonated sunflower seed oil with soybean phospholipids (OSSO, Ozonest®). Microbial communities were analyzed via DNA metabarcoding of the 16S rRNA gene, and statistical analyses (alpha and beta diversity) were performed in R.

Results: Both groups predominantly harbored Staphylococcus caprae, Streptococcus oralis, and Corynebacterium spp., with OSSO and HPMC users showing distinct bacterial profiles. Alpha diversity showed no significant differences, but beta diversity revealed differences in bacterial composition between the groups.

Conclusions: The results seem to indicate that the use of ozonized oil reduces the bacterial load compared to the solution used as a control.

Objective: To investigate changes in corneal astigmatism (curvatures and corneal sagittal height difference (C-sagDiff) at 8-mm chord) after temporary discontinuation from long-term spherical and toric orthokeratology (ortho-k) lens wear in a Chinese population.

Methods: Relevant data were retrieved from 110 patients (55 wearing spherical ortho-k lenses, 55 wearing toric ortho-k lenses) who have been undergoing ortho-k treatment for at least one year and stopped lens wear temporarily for scheduled lens replacement. The topographic and refraction data at baseline and post-discontinuation was collected for all the patients. Only data from the right eye was used for analysis. Corneal curvature changes and C-sagDiff at 8-mm chord in the two principal meridians within each group and the corneal astigmatism changes between the two groups were analyzed.

Results: No significant differences in age, gender, baseline flat K (FK) and steep K (SK), myopia, refractive astigmatism, and duration of lens wear were noted between the two groups (P > 0.05). Baseline corneal astigmatism and C-sagDiff in toric ortho-k group was higher than spherical ortho-k group (P < 0.001). For both ortho-k groups, after treatment discontinuation of about 1-month (30-37 days), FK became flatter, SK remained unchanged, corneal astigmatism and C-sagDiff increased. Changes in corneal astigmatism for spherical and toric groups were 0.24 ± 0.33 and 0.32 ± 0.32 D, respectively. C-sagDiff increased from 22.85 ± 8.41 to 31.37 ± 12.98 μm and from 32.35 ± 12.39 to 45.40 ± 15.01 μm in the spherical and toric ortho-k groups, respectively. No significant between-group difference in corneal astigmatism change was found (P = 0.214). Corneal astigmatism change was affected by wearers' age and duration of ortho-k lens wear. The younger the subject and the longer the duration of ortho-k lens wear, the more significant the corneal astigmatism change after discontinuation of the treatment.

Conclusion: After 1-month discontinuation from long-term ortho-k lens wear, corneal flat K became flatter, steep K remained unchanged, the C-sagDiff and the corneal astigmatism increased, irrespective of whether spherical or toric lenses were used. The change of corneal astigmatism was about 0.25D on average, which was not clinically significant. There was no significant difference of corneal and refractive astigmatism change between spherical and toric ortho-k groups.

Purpose: To investigate the efficacy and safety of transient receptor potential (TRP) channel modulators for dry eye.

Methods: A thorough search for randomized clinical trials was conducted in seven databases up to February 16, 2024. Suitable studies were identified according to inclusion and exclusion criteria, extracted data were synthesized and analyzed using Review Manager 5.4, and risk of bias and quality of evidence were assessed using recommended tools.

Results: Six trials with 884 patients using two kinds of TRP channel modulators (TRPV1 antagonist and TRPM8 agonist) were included. TRP channel modulators were effective in reducing subjective symptom scores (standardized mean differences [SMD], -0.41; 95 % confidence interval [CI], -0.75 to -0.07), corneal fluorescence staining (mean differences [MD], -0.19; 95 % CI, -0.37 to -0.02), impact on quality of life and daily function, and increasing the non-anesthetic Schirmer's test score (MD, 11.71; 95 % CI, 9.59 to 13.83), instant tear meniscus height (MD, 245.52; 95 % CI, 14.02 to 477.02), improvement in conjunctival hyperemia (risk ratio [RR], 2.08; 95 % CI, 1.07 to 4.06). There was no increased incidence of adverse events with TRP modulators compared to vehicle solution controls.

Conclusions: TRP channel modulators have shown positive therapeutic effects in reducing the symptoms and signs of dry eye and improving the quality of life associated with the disease without raising the risk of adverse events. These modulators are expected to become a new therapy for dry eye.

Purpose: To evaluate the efficacy and safety of topical Ivermectin- Metronidazol in the management of demodex infestation and their effect in Meibomian gland dysfunction (MGD) METHODS: Fifty-four patients (108 eyes) with demodex diagnosis and Meibomian gland dysfunction received Ivermectin 0.3 %+Metronidazole 0.5 % gel in the night for 5 weeks. Parameters were evaluated before and 8 weeks after the last application of IVM-MTZ. This includes demodex counts, OSDI tests, non-invasive breakup time (NIBUT), average noninvasive breakup time (AvNIBUT), and infrared meibography with the determination of glandular dropout.

Results: A complete eradication of infestation was observed with the proposed treatment. A significant improvement in NIBUT, AvNIBUT, and OSDI score. The Meibomian gland improved with the treatment with a reduction of the glandular dropout from 50 ± 1.4 % to 39.05 ± 1.2 % (P < 0.0005) CONCLUSIONS: Management of demodex infestation in MGD improves tear film parameters, reduces ocular symptoms, and induces improvement in the anatomy of Meibomian glands. This is the first intervention that induces anatomical changes in Meibomian glands and must be considered as a modality for the treatment of MGD-demodex coexistence.

Purpose: This prospective study aimed to validate the translated Chinese versions of the Ocular Surface Disease Index (OSDI), 5-Item Dry Eye (DEQ-5), and Contact Lens Dry Eye Questionnaire-8 (CLDEQ-8) questionnaires and test their repeatability.

Methods: From August 2022 to July 2023, online (qualtrics.com) English and Chinese versions of OSDI, DEQ-5, and CLDEQ-8 questionnaires were distributed to residents of Hong Kong, mainland China, Taiwan, and Singapore ≥ 18 years old who could understand both written Chinese and English. Subjects who were regular contact lens wearers (wear contact lenses > 5 days/week and > 8 h/day) were invited to complete the English and Chinese versions of the CLDEQ-8 questionnaire. Those who were not regular contact lens wearers were requested to complete the English and Chinese OSDI and DEQ-5 questionnaires. Subjects who completed the questionnaires were invited to participate for the second time three days later. Cronbach's alpha coefficient and intraclass correlation coefficient were used to test the internal consistency test-retest reliability of the translated questionnaires, respectively.

Results: A total of 141 subjects completed the OSDI and DEQ-5 (50 (35 %) completed the second attempt) and 96 completed the CLDEQ-8 questionnaires (52 (54 %) completed the second time). All Chinese versions of the questionnaires showed adequate internal consistency (Cronbach's alpha coefficient ≥ 0.872) and high reliability. There were no significant differences between the two attempts for Chinese OSDI and DEQ-5, but a statistically (not clinically) significant difference for the Chinese CLDEQ-8. This indicates that the Chinese version is clinically comparable to the English version.

Conclusion: The Chinese versions of OSDI, DEQ-5, and CLDEQ-8 questionnaires showed adequate internal consistency and high reliability. Despite not being identical in measured scores, the translated Chinese questionnaires could effectively provide information about dry eye conditions and be used as alternative tools for assessing and diagnosing dry eye in clinical practice.

Purpose: Based on ideal outcomes of corneal topography following orthokeratology (OK), an innovative machine learning algorithm for corneal refractive therapy (CRT) was developed to investigate the precision of artificial intelligence (AI)-assisted OK lens fitting.

Methods: A total of 797 eyes that had been fitted with CRT lenses and demonstrated good lens centration with plus power ring intact in their topography were retrospectively included. A comprehensive AI model included spherical refraction, keratometry readings, eccentricity, corneal astigmatism, horizontal visible iris diameter, inferior-superior index, surface asymmetry index, surface regularity index and 8-mm chordal corneal height difference. A simplified AI model omitted the latter four parameters. Correlation and disparity in predicted lens parameters between the AI prediction and manufacturer's conventional lens fitting method were compared.

Results: There was overall no significant difference between AI predicted parameters and the final ordered parameters (p > 0.05). The horizontal return zone depth (RZD1, p = 0.022) and vertical return zone depth (RZD2, p < 0.001) values suggested by the conventional method were significantly lower, while the horizontal landing zone angle (LZA1) was significantly larger (p = 0.002) than those of the final ordered lens. The AI predicted parameters were significantly correlated to those of the final ordered lens (p < 0.01), with the correlation coefficients of base curve radius (BCR), RZD1, RZD2, LZA1, vertical LZA (LZA2) and total lens diameter (TD) being 0.958, 0.708, 0.773, 0.697, 0.654 and 0.730, respectively, for the comprehensive AI model. The correlation coefficients were higher in RZD2, LZA1 and TD with the AI model as compared to conventional method.

Conclusions: Compared with the conventional method, AI predicted lens parameters exhibit less disparity and improved accuracy, with a potential to facilitate more efficient and precise CRT OK lens fitting.

Purpose: To assess the short-term effects of topical insulin (TI) as compared to topical Systane Ultra^TM (Alcon, USA) as artificial tears (AT) and topical normal saline (NS) on tear inflammatory mediators; interleukin 1-alpha (IL-1a), interleukin 6 (IL-6) and matrix metalloproteinase 9 (MMP-9) and clinical dry eye parameters in diabetics with dry eye disease (DDED).

Methods: In this randomized, multi-arm parallel single-centre trial, 73 diabetics with dry eye disease (30 female and 43 male) aged 18 to 50 years were recruited. They were randomly assigned to four weeks of treatment of either TI 0.5 unit/drop, AT or NS four times per day. Tear sample analysis and clinical parameters of dry eye (Ocular Surface Disease Index (OSDI), tear break-up time (TBUT), corneal Oxford score and Schirmers test) were evaluated at baseline and four weeks later. Objective clinical parameters for corneal Oxford score and tear break-up time were assessed by two masked investigators.

Results: Significant reduction was seen in all inflammatory biomarkers (IL-1a, IL-6 and MMP-9) in all treatment groups at 4 weeks. In addition, inflammatory biomarkers demonstrated a significant reduction with TI (p < 0.001). Meanwhile, in AT and NS groups, reduction was also significant but less than TI group. Similarly, significant improvements were seen in all clinical parameters evaluated with all 3 treatments at 4 weeks; with TI group showing largest improvement as compared to AT and NS groups (p < 0.001). This is supported with the results as follows: mean difference -20.90 for OSDI as compared to -11.38 and -6.78 for AT and NS groups, respectively, 5.55 s for TBUT as compared to 3.00 s and 1.00 s for AT and NS group respectively, -2.40 for Oxford score as compared to -0.38 and -1.39 for AT and NS group respectively, and 5.20 mm for Schirmers test as compared to 3.00 mm and 1.00 mm for AT and NS group respectively.

Conclusion: Treatment with TI resulted in the greatest reduction in inflammatory biomarkers and ocular eye parameters, as compared to AT and NS. TI was most effective in improving clinical parameters of DDED, although all topical therapies showed significant improvements, suggesting that use of TI may be beneficial in treating DDED.