Effect of maqui-berry extract in dry eye disease – A clinical and molecular analysis

Purpose: This study aims to investigate the effects of maqui?berry extract (MBE) in improving signs and symptoms of dry eye disease (DED) along with ocular surface inflammation in patients with DED. Methods: Twenty patients were randomly assigned to a MBE or a placebo group (PLC). DED parameters including Schirmer’s test 1 (ST1), tear film break?up time (TBUT), ocular surface disease index (OSDI), and corneal staining were assessed before treatment and 2 months post?treatment. Tear fluid samples before and after treatment from a subset of these patients were collected from the study subjects using sterile Schirmer’s strips, and the levels of interleukin (IL)?1?, IL?10, IL?6, IL?17A, tumor necrosis factor?? (TNF?), matrix metalloproteinase?9 (MMP9), soluble intercellular adhesion molecule?1 (sICAM1), and vascular endothelial growth factor?A (VEGF?A) were measured using a microfluidic cartridge?based multiplex ELISA. Results: The MBE group demonstrated a significant (p < 0.05) decrease in OSDI scores along with a significant increase in Schirmer’s test 1 compared to the PLC group. No significant change in TBUT and corneal staining was observed between the study groups. Levels of proinflammatory factors such as IL?1?, IL?6, IL?17A, TNF?, and MMP9 were observed to be significantly reduced, along with a significant increase in IL?10 levels following treatment in the MBE group compared with the PLC group. Conclusion: Consumption of MBE resulted in the resolution of DED signs and symptoms, along with a reduction in ocular surface inflammation.

A randomized controlled study evaluating outcomes of intense pulsed light and low-level light therapy for treating meibomian gland dysfunction and evaporative dry eye

Purpose: This randomized, controlled, blinded study evaluates the efficacy of intense pulsed light (IPL) therapy with low?level light therapy (LLLT) in the treatment of meibomian gland dysfunction (MGD) and evaporative dry eye (EDE) compared to a control group. Methods: Hundred patients with MGD and EDE were randomized into control (50 subjects, 100 eyes) and study group (50 subjects, 100 eyes). The study group underwent three sittings of IPL with LLLT 15 days apart and were followed up 1 month and 2 months after the last treatment sitting. The control group underwent sham treatment and was followed up at the same intervals. The patients were evaluated at baseline and 1 month and 3 months (post 1st treatment) for dry eye. Schirmer's test and tear breakup time (TBUT), OSDI, meibomian gland expression, and meibography. Results: The study group showed significant improvement in OSDI scores (P < 0.0001) compared to the control group and a significant improvement in TBUT (P < 0.005) compared to the control group. There was no change in schirmer's test and an improvement in the meibomian gland expression but not significant. Conclusion: The results show that a combined therapy of IPL with LLT is effective in treating MGD with EDE compared to controls, and repeated treatment sessions have a cumulative effect on the disease outcomes

Systemic investigations in dry eye disease

The incidence of dry eye disease has increased manifold in the past few years with more patients presenting with these complaints to our clinics every day. In the more severe forms of disease, it is important to evaluate for any systemic association which could be driving the disease such as in Sjogren’s syndrome. Understanding the possible varied etiopathogenesis and knowing when to evaluate, form an important part of treating this condition effectively. In addition, it is sometimes confusing as to which investigations to order and how to prognosticate the disease in these situations. This article simplifies this into an algorithmic approach with insights from the ocular and systemic point of view

A stitch in time saves my (ne) (vision)

Background: Corneal melt with iris prolapse is a rare complication of autoimmune diseases, especially rheumatoid arthritis. Purpose: To highlight a challenging case of a peripheral ulcerative keratitis (PUK) with corneal melt and iris prolapse in a patient’s only eye. Synopsis: A 56?year?old Asian Indian male presented with blurring of vision in the right eye and was diagnosed with cataract. He was a known type 2 diabetes mellitus and a rheumatoid arthritis patient and was not on treatment. He had been previously diagnosed with PUK in the left eye and was lost to follow?up due to coronavirus disease 2019 (COVID?19) after therapeutic penetrating keratoplasty and lost his vision in that eye. Cataract surgery in the right eye was done under cover of immunosuppression. Subsequently, he developed PUK and was treated with a glue and bandage contact lens. Again, he was lost to follow?up and then presented a few months later with corneal melt with iris prolapse in the right eye. We describe in the video the surgical and medical challenges and successful salvage of both the eyeball and the vision. Highlights: Highlights include the following: 1. A rare case of corneal melt with iris prolapse. 2. Demonstration of surgical technique of patch graft. 3. Anterior segment optical coherence tomography before and after the procedure.