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Tear Lipid Layer Thickness and Symptoms in Patients with Dry Eye Disease following the use of Emollient versus Non-Emollient Artificial Tears

Weisenberger, Kimberly R
http://rave.ohiolink.edu/etdc/view?acc_num=osu158694773242849

Abstract Details

2020, Master of Science, Ohio State University, Vision Science.
Purpose: Dry eye disease is a common ocular disorder which is often managed by the use of over-the-counter (OTC) artificial tears. Many different artificial tear formulations, both emollient and non-emollient, are readily available to the public. Understanding how individual artificial tear formulations affect both the tear film and symptoms in dry eye sufferers is critical in appropriate clinical prescribing of these eye drops. This study sought to evaluate the effects of a new nano-droplet emollient artificial tear and a non-emollient artificial tear on both the tear film and symptoms of ocular dryness over time. The purpose of this study was two-fold: first, to measure the tear film lipid layer thickness (LLT) and symptoms in dry eye patients after single-dose instillation of an emollient and non-emollient eye drop, and second, to evaluate the tear LLT, tear break-up time, and symptoms of dry eye patients after four times daily-use (QID) of the emollient eye drop for one month. Methods: For Part 1, LLT and symptoms of ocular dryness were measured in a cross-over comparison after instillation of Systane Complete®, an emollient (nanoemulsion) artificial tear, and Systane Ultra®, a non-emollient artificial tear. Non-invasive keratograph break-up time (NIKBUT), LLT, and symptoms were assessed at each visit prior to drop instillation. Symptoms were assessed using a unique visual analogue scale (VAS) and the Ocular Surface Disease Index (OSDI). Following drop instillation, LLT was measured using a stroboscobic video color microscope (SVCM), a video-imaging device which captures data using interferometric principles. Tear LLT and VAS survey symptoms were measured at 15 minutes, 1 hour, 2 hours, 4 hours, and 6 hours after drop instillation. For Part 2, subjects used the emollient eye drop QID for one month. Symptoms of ocular dryness, LLT, and NIKBUT were then again evaluated. Subjects were stratified into groups of lower (<50nm) and higher LLT (≥50nm) based on baseline measurements obtained at the emollient eye drop test visit. Paired T-tests were used to determine if significant changes in LLT and symptoms occurred with instillation of either artificial tear, or at the one month follow-up. Results: 20 subjects completed the study (mean age = 45.6±7.9, 15 female). Part 1 found a significant increase in average LLT 15 minutes after emollient eye drop instillation in the overall and inferior third of the tear film for subjects with baseline LLT values <50nm. Average LLT values did not increase at any time point following use of the non-emollient eye drop. Symptoms improved up to 6 hours following instillation of both drops. Symptoms of all subjects revealed statistically significant improvement in average dryness (8.6±16.7mm) up to 6 hours, and eye fatigue (8.4±14.0mm) up to 4 hours after instillation of the emollient eye drop. Symptoms of all subjects also revealed statistically significant improvement in average dryness (9.8±19.9mm) and light sensitivity (10.3±20.5mm) up to 6 hours, and ocular discomfort (8.6±18.0mm) up to 15 minutes after instillation of the non-emollient eye drop. Part 2 results found that using the emollient eye drop QID for one month significantly improved average symptoms of ocular dryness reported on both the OSDI (5.3±10.3) and VAS surveys (10.2±21.2mm). No significant changes in tear LLT or NIKBUT values were found after QID-use of the emollient drop for one month. Conclusion: Single use of the tested emollient-containing artificial tear increased the LLT in individuals with baseline LLT values of <50nm in overall and inferior segments of the ocular surface up to 15 minutes after drop instillation. No significant increases in tear LLT were observed after 15 minutes for either the emollient or non-emollient eye drops. Symptoms in the entire study population, both the lower and higher baseline LLT group, had improvements for many hours after use of both the emollient and non-emollient drops. One month use of the emollient artificial tear did not significantly change LLT or NIKBUT, however, significant improvement in symptoms of ocular dryness were noted in all subjects both on the OSDI and VAS surveys. The study shows how different artificial tear formulations affect tear LLT and symptoms after single-dose instillation, as well as how QID-use of an emollient eye drop improves symptoms of dry eye after one month of use. The effects of this emollient-containing eye drop on tear LLT and symptoms had not previously been examined. Results of this study suggest that the tested emollient eye drop is effective in reducing symptoms of dry eye after both single-dose instillation and regular use for one month.
Nicklaus Fogt, OD, PhD (Advisor)
Jennifer Fogt, OD, MS (Advisor)
78 p.
Therapy
Dry eye disease; dry eye therapy; eye drops; artificial tears; lipid layer thickness

Recommended Citations

Citations

  • Weisenberger, K. R. (2020). Tear Lipid Layer Thickness and Symptoms in Patients with Dry Eye Disease following the use of Emollient versus Non-Emollient Artificial Tears [Master's thesis, Ohio State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=osu158694773242849

    APA Style (7th edition)

  • Weisenberger, Kimberly. Tear Lipid Layer Thickness and Symptoms in Patients with Dry Eye Disease following the use of Emollient versus Non-Emollient Artificial Tears. 2020. Ohio State University, Master's thesis. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=osu158694773242849.

    MLA Style (8th edition)

  • Weisenberger, Kimberly. "Tear Lipid Layer Thickness and Symptoms in Patients with Dry Eye Disease following the use of Emollient versus Non-Emollient Artificial Tears." Master's thesis, Ohio State University, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=osu158694773242849

    Chicago Manual of Style (17th edition)

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This open access ETD is published by The Ohio State University and OhioLINK.