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1.
Cornea ; 30(3): 308-14, 2011 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-21045648

RESUMO

PURPOSE: To investigate the potential effect of dietary supplementation with omega-3 fatty acid on lipid composition of meibum, aqueous tear evaporation, and tear volume in patients with dry eye. METHODS: In a pilot, prospective, randomized, double-masked study, patients with dry eye received a daily dose of fish oil, containing 450 mg of eicosapentaenoic acid, 300 mg of docosahexaenoic acid, and 1000 mg of flaxseed oil (TheraTears Nutrition; Advanced Vision Research, Woburn, MA) for 90 days. There were 2 patient visits: baseline and final. At these visits, patients completed the ocular surface disease index to score subjective symptoms, and slit-lamp examinations, breakup time, corneal staining, Schirmer type I, fluorophotometry, evaporometry, and collection of meibomian gland secretion samples for lipid composition analysis were performed. RESULTS: A total of 36 patients with dry eye completed the study. At the end of the study, 70% of the patients became asymptomatic, whereas for the placebo group, 37% [corrected] of the symptomatic patients became asymptomatic. Schirmer testing and fluorophotometry suggested that the omega-3 supplement increased tear secretion. The lipid composition of the samples collected from the omega-3 group was found to be very similar to that from the placebo group. No trends between groups were seen for other objective parameters. CONCLUSIONS: Dietary supplementation with omega-3 fatty acids in dry eye showed no significant effect in meibum lipid composition or aqueous tear evaporation rate. On the other hand, the average tear production and tear volume was increased in the omega-3 group as indicated by both Schirmer testing and fluorophotometry.


Assuntos
Suplementos Nutricionais , Síndromes do Olho Seco/tratamento farmacológico , Ácidos Graxos Ômega-3/administração & dosagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Cápsulas , Cromatografia Líquida de Alta Pressão , Registros de Dieta , Método Duplo-Cego , Síndromes do Olho Seco/metabolismo , Feminino , Fluorofotometria , Humanos , Metabolismo dos Lipídeos , Lipídeos/análise , Masculino , Glândulas Tarsais/efeitos dos fármacos , Glândulas Tarsais/metabolismo , Pessoa de Meia-Idade , Projetos Piloto , Estudos Prospectivos , Espectrometria de Massas por Ionização por Electrospray , Inquéritos e Questionários , Lágrimas/metabolismo
2.
Eye Contact Lens ; 33(4): 174-6, 2007 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-17630623

RESUMO

PURPOSE: To quantitatively explore the relationship between low relative humidity conditions, as experienced in airplane cabins during flight, and increases in aqueous tear evaporation as a potential explanation for increased dry eye symptoms noted by people when in low humidity environmental conditions. METHODS: Prospective experimental laboratory study. Evaporative rates under two different ranges of increasing relative humidity, from 20% to 25% (similar to the relative humidity in airplane cabins or arid regions) and from 40% to 45% (similar to the relative humidity in nonarid regions), were obtained from 18 patients with dry eye and 11 healthy subjects. RESULTS: Statistically significant differences were found within all groups: patients with dry eye (divided into keratoconjunctivitis sicca [P=0.001] and meibomian gland dysfunction [P=0.007]) and healthy subjects (P

Assuntos
Aeronaves , Síndromes do Olho Seco/etiologia , Sistemas Ecológicos Fechados , Umidade , Doenças Profissionais/etiologia , Exposição Ocupacional/efeitos adversos , Adulto , Medicina Aeroespacial , Feminino , Humanos , Masculino , Glândulas Tarsais/metabolismo , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Fatores de Risco , Lágrimas/metabolismo
3.
Eye Contact Lens ; 33(4): 177-9, 2007 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-17630624

RESUMO

PURPOSE: To assess the relationship between the degree and anatomic location of ocular surface vital staining and the degree of aqueous tear deficiency in patients with dry eye, as measured by the Schirmer test, and the presence of meibomian gland dropout. METHODS: Twenty-two patients with dry eye (nine men and 13 women; mean age, 60 years) were prospectively enrolled in the study. Eleven subjects with no ocular disease were considered control subjects. Lissamine green vital staining, Schirmer test, and meibomian gland dropout were evaluated. RESULTS: Patients were stratified based on their vital staining pattern (presence or absence of corneal staining). A progressive decrease in the Schirmer test result was found when the vital staining score increased (r = -0.655; P<0.0001). Patients with dry eye showed an increase in meibomian gland dropout when compared to control subjects (P

Assuntos
Humor Aquoso/metabolismo , Córnea/patologia , Síndromes do Olho Seco/diagnóstico , Glândulas Tarsais/metabolismo , Coloração e Rotulagem/métodos , Lágrimas/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Corantes/administração & dosagem , Progressão da Doença , Síndromes do Olho Seco/etiologia , Síndromes do Olho Seco/metabolismo , Feminino , Humanos , Corantes Verde de Lissamina/administração & dosagem , Masculino , Pessoa de Meia-Idade , Soluções Oftálmicas , Reprodutibilidade dos Testes
4.
Am J Ophthalmol ; 141(4): 758-60, 2006 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-16564822

RESUMO

PURPOSE: To establish scientific relationship between relative humidity (RH) and aqueous tear evaporation to elucidate possible significance of this relationship in normals and aqueous tear deficiency patients. DESIGN: Prospective experimental laboratory study. METHODS: Ocular surface evaporation was determined using evaporometry and calculated for two ranges of RH, 25% to 35%, and 35% to 45% in a randomized clinical patient population. RESULTS: Average evaporative rate in the higher humidity range was between 0.029 +/- 0.009 through 0.043 +/- 0.016 microl/cm2/min. At lower humidity, range was between 0.044 +/- 0.013 through 0.058 +/- 0.018 microl/cm2/min. Differences in the corresponding evaporative rates were statistically significant (between P < .003 through P < .043) for each analysis. CONCLUSIONS: A decrease of 10% RH resulted in an average difference of between 28.33% to 59.42% increase in evaporation. The increase in evaporation at lower humidity has significant clinical implications for patients with aqueous deficient dry eyes, and possibly those undergoing laser-assisted in situ keratomileusis (LASIK).


Assuntos
Síndromes do Olho Seco/metabolismo , Umidade , Lágrimas/metabolismo , Volatilização , Água/metabolismo , Técnicas de Diagnóstico Oftalmológico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fenômenos Fisiológicos Oculares , Estudos Prospectivos
5.
Trans Am Ophthalmol Soc ; 104: 121-8, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-17471332

RESUMO

PURPOSE: To determine the impact of evaporation on preocular aqueous tear (AT) loss in normal subjects (controls) and patients with keratoconjunctivitis sicca (KCS). METHODS: Eighteen patients (32 eyes) with KCS with or without associated meibomian gland dysfunction (MGD) and 11 sex-matched controls had AT evaporation determined between relative humidity (RH) of 20% and 45% using an evaporometer. AT volume, flow, and turnover were determined with a fluorophotometer. RESULTS: Evaporative rates increased significantly when the RH was changed from 40%-45% to 20%-25% (P < .001). This change was similar in all groups and on average accounted for a 99.43% increase. There were no statistically significant differences in evaporative rate between controls, the KCS alone group, and the KCS/MGD group. Dry eye patients exhibited a decreased tear turnover when compared to controls. Evaporative contribution to tear loss at 40%-45% RH was 23.47% for controls, 30.99% for "classic" KCS patients, and 25.44% for KCS/MGD patients. At 20%-25% RH, the evaporative contribution was 41.66% for controls, 57.67% for classic KCS patients, and 50.28% for KCS/MGD patients. CONCLUSIONS: RH significantly impacts evaporation regardless of the presence of dry eye disease and probably accounts for the increased dry eye symptoms in people (controls and dry eye patients) in conditions of low RH (eg, deserts, airplane cabins, cold dry seasons). Contribution of evaporation to tear loss tends to be higher than previously described. The percent contribution is dependent on environmental conditions such as RH. There was a trend toward increased contribution to AT loss in dry eye patients vs controls, but statistical significance was not reached.


Assuntos
Água Corporal/metabolismo , Doenças Palpebrais/metabolismo , Umidade , Ceratoconjuntivite Seca/metabolismo , Glândulas Tarsais/metabolismo , Lágrimas/metabolismo , Adulto , Feminino , Fluorofotometria , Humanos , Masculino , Pessoa de Meia-Idade , Volatilização
6.
Trans Am Ophthalmol Soc ; 101: 141-52; discussion 152-4, 2003.
Artigo em Inglês | MEDLINE | ID: mdl-14971572

RESUMO

PURPOSE: To characterize patients with ocular surface drying and a diagnosis of keratoconjunctivitis sicca (KCS). METHODS: Patients with a prior diagnosis of KCS and symptoms of dryness or foreign-body sensation who also had vital staining of the interpalpebral fissure ocular surface in the absence of lid and ocular surface inflammation were entered into the study along with normal controls. Patients were segregated into those with "classic" KCS, who did not have concomitant meibomian gland dysfunction (MGD), and those with KCS and MGD. The latter had slit-lamp evidence of difficult-to-express or turbid meibomian secretions upon expression. Patients and normal controls were evaluated for tear volume, flow, and turnover using fluorophotometry; meibomian gland dropout by meibography; evaporation by evaporometry; and tear production by the Schirmer 1 test. RESULTS: All patients with KCS had decreased tear volume, flow, and Schirmer 1 values as well as increased meibomian gland dropout. None of the patient groups were found to have increased tear evaporation compared with normals or other disease subgroups. No correlation between degree of meibomian gland dropout and evaporation was found. The degree of total vital staining or presence of corneal staining correlated with a more severe aqueous deficiency. CONCLUSIONS: Patients with ocular surface drying in the absence of inflammation have decreased tear volume, flow, and Schirmer 1 values as well as increased meibomian gland dropout. The role of meibomian gland dropout or slit-lamp MGD in disease is unclear and in our study specifically did not correlate with increased tear evaporation.


Assuntos
Ceratoconjuntivite Seca/metabolismo , Lágrimas/metabolismo , Perda Insensível de Água , Estudos de Casos e Controles , Fluorofotometria , Humanos , Glândulas Tarsais/metabolismo , Coloração e Rotulagem
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