Korean Journal of Ophthalmology

The Korean Ophthalmological Society (대한안과학회)
권호 표지
DOI QR코드

DOI QR Code

Changes in Tear Volume after 3% Diquafosol Treatment in Patients with Dry Eye Syndrome: An Anterior Segment Spectral-domain Optical Coherence Tomography Study

  • Lee, Kwan Bok (Department of Ophthalmology, Kim's Eye Hospital, Myung-Gok Eye Research Institute, Konyang University College of Medicine) ;
  • Koh, Kyung Min (Department of Ophthalmology, Kim's Eye Hospital, Myung-Gok Eye Research Institute, Konyang University College of Medicine) ;
  • Kwon, Young A (Department of Ophthalmology, Kim's Eye Hospital, Myung-Gok Eye Research Institute, Konyang University College of Medicine) ;
  • Song, Sang Wroul (Department of Ophthalmology, Kim's Eye Hospital, Myung-Gok Eye Research Institute, Konyang University College of Medicine) ;
  • Kim, Byoung Yeop (Department of Ophthalmology, Kim's Eye Hospital, Myung-Gok Eye Research Institute, Konyang University College of Medicine) ;
  • Chung, Jae Lim (Department of Ophthalmology, Kim's Eye Hospital, Myung-Gok Eye Research Institute, Konyang University College of Medicine)
  • Received : 2016.05.30
  • Accepted : 2016.08.29
  • Published : 2017.08.05
⟨ Previous Next ⟩

Abstract

Purpose: To evaluate changes in the tear meniscus area and tear meniscus height over time in patients with dry eye syndrome, using anterior segment spectral-domain optical coherence tomography after the instillation of 3% diquafosol ophthalmic solution. Methods: Sixty eyes from 30 patients with mild to moderate dry eye syndrome were included. Tear meniscus images acquired by anterior segment spectral-domain optical coherence tomography were analyzed using National Institutes of Health's image-analysis software (ImageJ 1.44p). Tear meniscus area and tear meniscus height were measured at baseline, 5 minutes, 10 minutes, and 30 minutes after instillation of a drop of diquafosol in one eye and normal saline in the other eye. Changes in ocular surface disease index score, tear film break-up time, corneal staining score by Oxford schema, and meibomian expressibility were also evaluated at baseline, and after 1 week and 1 month of a diquafosol daily regimen. Results: Sixty eyes from 30 subjects (mean age, 29.3 years; 8 men and 22 women) were included. In eyes receiving diquafosol, tear volume was increased at 5 and 10 minutes compared with baseline. It was also higher than saline instilled eyes at 5, 10, and 30 minutes. Changes in tear volume with respect to baseline were not statistically different after the use of diquafosol for 1 month. Ocular surface disease index score, tear film break-up time, and Oxford cornea stain score were significantly improved after 1 week and 1 month of daily diquafosol instillation, but meibomian expressibility did not change. Conclusions: Topical diquafosol ophthalmic solution effectively increased tear volume for up to 30 minutes, compared to normal saline in patients with dry eye syndrome.

Keywords

Acknowledgement

Supported by : Santen Pharmaceutical Co., Ltd.

References

  1. The definition and classification of dry eye disease: report of the definition and classification Subcommittee of the International Dry Eye WorkShop (2007). Ocul Surf 2007;5:75-92. https://doi.org/10.1016/S1542-0124(12)70081-2
  2. Nichols KK, Yerxa B, Kellerman DJ. Diquafosol tetrasodium: a novel dry eye therapy. Expert Opin Investig Drugs 2004;13:47-54. https://doi.org/10.1517/13543784.13.1.47
  3. Koh S, Ikeda C, Takai Y, et al. Long-term results of treatment with diquafosol ophthalmic solution for aqueous-deficient dry eye. Jpn J Ophthalmol 2013;57:440-6. https://doi.org/10.1007/s10384-013-0251-y
  4. Yokoi N, Kato H, Kinoshita S. Facilitation of tear fluid secretion by 3% diquafosol ophthalmic solution in normal human eyes. Am J Ophthalmol 2014;157:85-92.e1. https://doi.org/10.1016/j.ajo.2013.09.009
  5. Bitton E, Jones L, Simpson T, Woods C. Influence of the blink interval on tear meniscus height in soft contact lens and nonlens wearers. Eye Contact Lens 2010;36:156-63. https://doi.org/10.1097/ICL.0b013e3181dae228
  6. Ibrahim OM, Dogru M, Kawashima S, et al. Visante optical coherence tomography and tear function test evaluation of cholinergic treatment response in patients with sjogren syndrome. Cornea 2013;32:653-7. https://doi.org/10.1097/ICO.0b013e318261eb4a
  7. Ibrahim OM, Dogru M, Takano Y, et al. Application of visante optical coherence tomography tear meniscus height measurement in the diagnosis of dry eye disease. Ophthalmology 2010;117:1923-9. https://doi.org/10.1016/j.ophtha.2010.01.057
  8. Shen M, Wang J, Tao A, et al. Diurnal variation of upper and lower tear menisci. Am J Ophthalmol 2008;145:801-6. https://doi.org/10.1016/j.ajo.2007.12.024
  9. Keech A, Flanagan J, Simpson T, Jones L. Tear meniscus height determination using the OCT2 and the RTVue-100. Optom Vis Sci 2009;86:1154-9. https://doi.org/10.1097/OPX.0b013e3181bab0f5
  10. Bron AJ, Evans VE, Smith JA. Grading of corneal and conjunctival staining in the context of other dry eye tests. Cornea 2003;22:640-50. https://doi.org/10.1097/00003226-200310000-00008
  11. Pflugfelder SC, Tseng SC, Sanabria O, et al. Evaluation of subjective assessments and objective diagnostic tests for diagnosing tear-film disorders known to cause ocular irritation. Cornea 1998;17:38-56. https://doi.org/10.1097/00003226-199801000-00007
  12. Nichols KK, Mitchell GL, Zadnik K. The repeatability of clinical measurements of dry eye. Cornea 2004;23:272-85. https://doi.org/10.1097/00003226-200404000-00010
  13. Fukuda R, Usui T, Miyai T, et al. Tear meniscus evaluation by anterior segment swept-source optical coherence tomography. Am J Ophthalmol 2013;155:620-4.e1-2. https://doi.org/10.1016/j.ajo.2012.11.009
  14. Wang J, Palakuru JR, Aquavella JV. Correlations among upper and lower tear menisci, noninvasive tear break-up time, and the Schirmer test. Am J Ophthalmol 2008;145:795-800. https://doi.org/10.1016/j.ajo.2007.12.035
  15. Yokoi N, Bron A, Tiffany J, et al. Reflective meniscometry: a non-invasive method to measure tear meniscus curvature. Br J Ophthalmol 1999;83:92-7. https://doi.org/10.1136/bjo.83.1.92
  16. Brennen PM, Kagemann L, Friberg TR. Comparison of StratusOCT and Cirrus HD-OCT imaging in macular diseases. Ophthalmic Surg Lasers Imaging 2009;40:25-31. https://doi.org/10.3928/15428877-20090101-01
  17. Ho J, Sull AC, Vuong LN, et al. Assessment of artifacts and reproducibility across spectral- and time-domain optical coherence tomography devices. Ophthalmology 2009;116:1960-70. https://doi.org/10.1016/j.ophtha.2009.03.034
  18. Nguyen P, Huang D, Li Y, et al. Correlation between optical coherence tomography-derived assessments of lower tear meniscus parameters and clinical features of dry eye disease. Cornea 2012;31:680-5. https://doi.org/10.1097/ICO.0b013e3182261577
  19. Qiu X, Gong L, Lu Y, et al. The diagnostic significance of Fourier-domain optical coherence tomography in Sjogren syndrome, aqueous tear deficiency and lipid tear deficiency patients. Acta Ophthalmol 2012;90:e359-66. https://doi.org/10.1111/j.1755-3768.2012.02413.x
  20. Tung CI, Perin AF, Gumus K, Pflugfelder SC. Tear meniscus dimensions in tear dysfunction and their correlation with clinical parameters. Am J Ophthalmol 2014;157:301-10.e1. https://doi.org/10.1016/j.ajo.2013.09.024
  21. Yokoi N, Komuro A. Non-invasive methods of assessing the tear film. Exp Eye Res 2004;78:399-407. https://doi.org/10.1016/j.exer.2003.09.020
  22. Wang Y, Zhuang H, Xu J, et al. Dynamic changes in the lower tear meniscus after instillation of artificial tears. Cornea 2010;29:404-8. https://doi.org/10.1097/ICO.0b013e3181bd476c
  23. Finis D, Pischel N, Schrader S, Geerling G. Evaluation of lipid layer thickness measurement of the tear film as a diagnostic tool for Meibomian gland dysfunction. Cornea 2013;32:1549-53. https://doi.org/10.1097/ICO.0b013e3182a7f3e1

Cited by

  1. The effects of 3% diquafosol sodium eye drop application on meibomian gland and ocular surface alterations in the Cu, Zn-superoxide dismutase-1 (Sod1) knockout mice vol.256, pp.4, 2017, https://doi.org/10.1007/s00417-018-3932-x
  2. Tear film lipid layer increase after diquafosol instillation in dry eye patients with meibomian gland dysfunction: a randomized clinical study vol.9, pp.None, 2017, https://doi.org/10.1038/s41598-019-45475-7