A Study of the Short-Term Effect of Artificial Tears on Contrast Sensitivity in Patients With Sjogren's Syndrome
Primary Sjögren's syndrome often includes dry eye manifestations, including a reduction in optical quality from the compromised ocular surface. This study was designed to measure the effect of different artificial tears on the contrast sensitivity of Sjögren's syndrome patients from 5 minutes to 4 hours after instillation.
Ten normal subjects and 10 subjects with ocular manifestations of Sjögren's syndrome were compared at baseline, including staining scores, a dry eye questionnaire, and contrast sensitivity testing. Changes in contrast sensitivity in the Sjögren's syndrome group were measured over a 4-hour period after instillation of a variety of artificial tears.
Statistically significant differences in staining, subjective questionnaire scores, and contrast sensitivity were measured between the normal and Sjögren's syndrome groups. Statistically significant changes in contrast sensitivity were measured over time after artificial tear instillation, with the greatest effect at 3 to 6 cycles/deg. The more mucoadhesive artificial tears demonstrated a significantly greater effect.
The effects of artificial tears on measured contrast sensitivity in dry eye patients in the postinstillation period of 5 minutes to 4 hours appear limited, but an artificial tear with more mucoadhesive properties showed more benefit than those that do not. Modest effects on contrast sensitivity, primarily at medium spatial frequencies, were observed with the more mucoadhesive formulations.
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ABSTRACT: Background: Dry eye disease (DED) is common; its prevalence around the world varies from 5% to 34%. Its putative pathogenetic mechanisms include hyperosmolarity of the tear film and inflammation of the ocular surface and lacrimal gland. Dry eye is clinically subdivided into two subtypes: one with decreased tear secretion (aqueous-deficient DED), and one with increased tear evaporation (hyperevaporative DED). Methods: This review is based on pertinent publications retrieved by a selective PubMed search and on the authors' own clinical and scientific experience. Results: The diagnostic evaluation of dry eye disease should include a detailed patient history, thorough split-lamp examination, and additional tests as indicated. Few randomized controlled therapeutic trials for dry eye have been published to date. Artificial tears of various kinds are recommended if the symptoms are mild. Lid hygiene is helpful in the treatment of hyperevaporative dry eye, while collagen or silicon plugs can be used for partial occlusion of the efferent lacrimal ducts to treat severe hyposecretory dry eye. The benefit of long-term topical anti-inflammatory treatment of moderate or severe dry eye disease with corticosteroids or cyclosporine A eye drops has been documented in clinical trials on a high evidence level. Orally administered tetraycycline derivatives and omega-3 or omega-6 fatty acids are also used. Conclusion: The treatment of dry eye has evolved from tear substitution alone to a rationally based therapeutic algorithm. Current research focuses on pathophysiology, new diagnostic techniques, and novel therapies including secretagogues, topical androgens, and new anti- inflammatory drugs.Deutsches Ärzteblatt International 01/2015; 112(5):71-U32. DOI:10.3238/arztebl.2015.0071 · 3.52 Impact Factor