RESUMEN
Purpose: Dry eye disease (DED) is characterized by altered ocular surface proinflammatory and antiinflammatory factors. Interferons (IFNs) are a class of pleiotropic cytokines well known for their antimicrobial, inflammatory, and immunomodulatory roles. Hence, this study investigates the ocular surface expression of different types of IFNs in patients with DED. Methods: The cross?sectional, observational study included patients with DED and normal subjects. Conjunctival impression cytology (CIC) samples were obtained from the study subjects (controls, n = 7; DED, n = 8). The mRNA expression levels of type 1 IFN (IFN?, IFN?), type 2 IFN (IFN?), and type 3 IFN (IFN?1, IFN?2, IFN?3) were measured by quantitative PCR (polymerase chain reaction) in CIC samples. IFN? and IFN? expression under hyperosmotic stress was also studied in human corneal epithelial cells (HCECs) in vitro. Results: The mRNA expression levels of IFN? and IFN? were significantly lower and that of IFN? was significantly higher in DED patients compared to healthy controls. The mRNA levels of IFN?, IFN?, and IFN? were significantly lower compared to IFN? in DED patients. An inverse association between tonicity?responsive enhancer?binding protein (TonEBP; hyperosmotic stress maker) and IFN? or IFN? expression and a positive association between TonEBP and IFN? expression was observed in CIC samples. The expression of IFN? was lower than IFN? in HCECs undergoing hyperosmotic stress compared to HCECs without the stress. Conclusion: The presence of an imbalance between type 1 and type 2 IFNs in DED patients suggests newer pathogenic processes in DED, plausible ocular surface infection susceptibility in DED patients, and potential therapeutic targets in the management of DED
RESUMEN
Purpose: The coronavirus disease (COVID?19) pandemic continues to play havoc in our lives. During the first “ lockdown” in 2020, we were keen on assessing the anxiety levels of patients who sought ophthalmic care despite the lockdown. Public health actions, such as social distancing, were necessary to reduce the spread of COVID?19. As a result, most people felt isolated and lonely, thereby causing increased levels of stress and anxiety in them. We aimed to assess the anxiety levels using the Hamilton Anxiety Scale and personality assessment using the 57?point Eysenck’s Personality Inventory (EPI) questionnaire among patients visiting a tertiary eye care hospital during the lockdown period. Methods: Consecutive patients attending an ophthalmic tertiary care hospital during the COVID?19 pandemic and lockdown were approached to be a part of this prospective cross?sectional survey. Results: In total, 1,088 responses were analyzed during the 2?month study period with the mean age being 45.7 + 16.9 years. The majority had completed graduation (78%) with 15 years or more of formal education. The purpose of the visit was an emergency consultation in 42% (n = 455), a review appointment in 42% (n = 457), and the remaining (16%, n = 176) came for a routine consultation. The majority of the patients (>90%) did not report experiencing any of the 14 sets of symptoms. A mild level of anxiety was noted in 1,086 (>99%) respondents, whereas only 2 (<1%) respondents showed mild–moderate levels of anxiety. Financial concerns such as affordability of medications (6% vs. 3%, P = 0.05) and fear of losing their job (16% vs. 11%, P = 0.02) were significantly more in those experiencing any anxiety compared to those with no anxiety. Conclusion: Our study revealed that patients visiting a tertiary ophthalmic center during lockdown were graduates, sought eye consultation primarily for emergency or a review, and had no major anxiety symptoms. In those with anxiety, the affordability of medicines and loss of jobs were the main concerns.