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Current Concept and Emerging Treatments for Ocular Surface Diseases

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Ophthalmology".

Deadline for manuscript submissions: closed (15 March 2024) | Viewed by 8262

Special Issue Editor


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Guest Editor
Department of Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), 28040 Madrid, Spain
Interests: cataract surgery; corneal diseases; corneal topography; phacoemulsification; cataract extraction; cornea bankinge
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Special Issue Information

Dear Colleagues,

Ocular surface diseases (OSD) are a group of conditions that affect the outermost layers of the eye, including conjunctival diseases, corneal diseases, dry eye disease, ocular herpes, and other infections. Current concepts and emerging treatments for OSD aim to improve cures, control symptoms, and prevent worsening of the disease. Treatment options may include artificial tears, anti-inflammatory medications, antibiotics, and immunomodulators. Moreover, emerging strategies for the treatment of OSD hold great promise in improving patient outcomes. However, several challenges remain in the diagnosis and treatment of OSD, including the lack of standardized diagnostic tests and the difficulty in monitoring disease progression. Continued research into effective prevention and treatment methods will be critical in achieving optimal management of OSD.

The purpose of this Special Issue is to highlight novel research findings on ocular surface disease. We invite researchers to submit original research and review articles on advanced treatments for the management of cornea and ocular surface diseases.

Dr. Bárbara Burgos-Blasco
Guest Editor

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Keywords

  • ocular surface disease
  • corneal ulcer
  • dry eye
  • keratoplasty
  • conjunctival disease
  • keratitis

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Published Papers (4 papers)

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Research

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15 pages, 1034 KiB  
Article
Frequency of Topical Immunomodulatory and Immunosuppressive Therapies for Ocular Chronic Graft-versus-Host Disease
by David Sinan Koca and Tina Dietrich-Ntoukas
J. Clin. Med. 2024, 13(16), 4728; https://doi.org/10.3390/jcm13164728 - 12 Aug 2024
Cited by 2 | Viewed by 1328
Abstract
Introduction: The purpose of the study was to evaluate the frequency of topical immunomodulatory and immunosuppressive therapies in patients with ocular chronic graft-versus-host disease (cGVHD) in consideration of inflammatory activity and systemic immunosuppressive therapies in a tertiary care university hospital setting. Methods: We [...] Read more.
Introduction: The purpose of the study was to evaluate the frequency of topical immunomodulatory and immunosuppressive therapies in patients with ocular chronic graft-versus-host disease (cGVHD) in consideration of inflammatory activity and systemic immunosuppressive therapies in a tertiary care university hospital setting. Methods: We included 95 adult patients (48 male, 47 female) with ocular chronic graft-versus-host disease (cGVHD) after alloHSCT (median age 49.5 years). Clinical ophthalmological findings and the grade of ocular cGVHD according to the NIH eye score and the German–Austrian–Swiss Consensus (GAS) Grading were analyzed. Systemic GVHD manifestations as well as the prevalence of topical and systemic (immunomodulatory) therapies were assessed. Results: A total of 74 of 95 patients (77.8%) had manifestations of systemic chronic graft-versus-host disease other than ocular GVHD. 68.42% (65/95) of patients were under systemic immunosuppressive therapy with at least one immunosuppressive medication. All patients (95/95) received lid-margin hygiene and phosphate- and preservative-free lubricating eye drops. Twenty-five percent of the cohort (24/95) were treated with autologous serum eye drops (ASEDs). In total, 80% (76/95) of patients required topical steroid therapy to treat acute exacerbation of inflammation at least once; continuous topical steroid therapy was only necessary for a minor part (12%) with refractory chronic inflammation. A total of 92.63% (88/95) were primarily treated with ciclosporin A 0.1% as Ikervis®, of whom at least one third did not continue the therapy because of intolerable side effects during follow-up and received alternative topical formulations. Conclusions: Our data show that patients with ocular cGVHD mostly need topical therapy including anti-inflammatory agents despite systemic immunosuppressive therapy. In our cohort, 80% of patients received topical steroids, and more than 90% received topical ciclosporin A eye drops, which were tolerated by only two thirds of patients due to side effects. Full article
(This article belongs to the Special Issue Current Concept and Emerging Treatments for Ocular Surface Diseases)
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9 pages, 904 KiB  
Article
Evaluating GlicoPro Tear Substitute Derived from Helix aspersa Snail Mucus in Alleviating Severe Dry Eye Disease: A First-in-Human Study on Corneal Esthesiometry Recovery and Ocular Pain Relief
by Antonio Ballesteros-Sánchez, José-María Sánchez-González, Giovanni Roberto Tedesco, Carlos Rocha-de-Lossada, Gianluca Murano, Antonio Spinelli, Cosimo Mazzotta and Davide Borroni
J. Clin. Med. 2024, 13(6), 1618; https://doi.org/10.3390/jcm13061618 - 12 Mar 2024
Cited by 3 | Viewed by 1678
Abstract
Background: To evaluate the effects of 10% GlicoPro tear substitute therapy in patients with severe dry eye disease (DED). Methods: In this prospective longitudinal study, 30 individuals receiving 10% GlicoPro four times daily for DED were evaluated. The ocular surface disease index (OSDI) [...] Read more.
Background: To evaluate the effects of 10% GlicoPro tear substitute therapy in patients with severe dry eye disease (DED). Methods: In this prospective longitudinal study, 30 individuals receiving 10% GlicoPro four times daily for DED were evaluated. The ocular surface disease index (OSDI) questionnaire, average non-invasive break-up time (A-NIBUT), non-anesthetic and anesthetic corneal esthesiometry (CE), ocular pain, and the presence of conjunctivochalasis (CCH) were used as clinical endpoints. Treatment compliance using dosing diaries and AEs was assessed. Results: A significant improvement was observed in the clinical endpoints: the ΔOSDI questionnaire was −39.27 ± 13.22 [−65 to −15] points, ΔA-NIBUT was 3.10 ± 1.31 [1 to 5] s, Δnon-anesthetic CE was 14 ± 6.35 [5 to 25] mm, and Δanesthetic CE was 13 ± 5.35 [5 to 20] mm (p < 0.001 for all comparisons). Ocular pain was reduced in 92.5% of the patients at the end of the follow-up. However, there was no change in the presence of CCH. In addition, all the patients were fully compliant with the dosing and no AEs related to the use of the 10% GlicoPro tear substitute were reported. Conclusions: The 10% GlicoPro tear substitute has the potential to achieve beneficial effects in ocular surface treatments. Full article
(This article belongs to the Special Issue Current Concept and Emerging Treatments for Ocular Surface Diseases)
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10 pages, 2805 KiB  
Article
Challenges of DMEK Technique with Young Corneal Donors’ Grafts: Surgical Keys for Success—A Pilot Study
by Mayte Ariño-Gutierrez, Mercedes Molero-Senosiain, Barbara Burgos-Blasco, Beatriz Vidal-Villegas, Pedro Arriola-Villalobos, Jose Antonio Gegundez-Fernandez, Gregory Moloney and Luis Daniel Holguín
J. Clin. Med. 2023, 12(19), 6316; https://doi.org/10.3390/jcm12196316 - 30 Sep 2023
Cited by 1 | Viewed by 1507
Abstract
Purpose: To report on the surgical maneuvers recommended for a successful unfolding of very young donors in order to accomplish an uneventful Descemet Membrane Endothelial Keratoplasty (DMEK) surgery. Methods: Five patients (three females and two males, mean age 71.2 ± 6.7 years) with [...] Read more.
Purpose: To report on the surgical maneuvers recommended for a successful unfolding of very young donors in order to accomplish an uneventful Descemet Membrane Endothelial Keratoplasty (DMEK) surgery. Methods: Five patients (three females and two males, mean age 71.2 ± 6.7 years) with Fuchs endothelial cell dystrophy who underwent DMEK with very young donors (between 20 and 30 years old) were included. The following demographic data were assessed: donor’s age, donor’s endothelial cell density (ECD), preservation time, recipient’s age and sex and unfolding surgical time. Best-corrected visual acuity (BCVA; decimal system), ECD and corneal central thickness (CCT) were assessed preoperatively and at 6-month follow-up. Results: Donors’ mean age was 23.6 ± 3.6 years (range 21 to 30) and the mean ECD was 2748.6 ± 162.6 cells/mm2. All of them underwent an uneventful DMEK as a single procedure performed by one experienced surgeon (MAG) with a mean unfolding time of 7.2 ± 4.9 min (range 4 to 15). The essential steps, including patient preparation as well as DMEK graft implantation, orientation, unrolling and centering are detailed. At 6 months, BCVA was 0.6 ± 0.2, ECD was 1945.0 ± 455.5 cells/mm2 and CCT was 497.0 ± 19.7 microns. Conclusions: We hereby present the keys to overcome tightly scrolled grafts of very young donors, which prove perfectly suitable for DMEK surgery. The graft shape tends towards a double-roll and specific maneuvers are strongly recommended. Full article
(This article belongs to the Special Issue Current Concept and Emerging Treatments for Ocular Surface Diseases)
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Review

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13 pages, 2013 KiB  
Review
Trehalose and Dry Eye Disease: A Comprehensive Systematic Review of Randomized Controlled Trials
by Antonio Ballesteros-Sánchez, Clara Martinez-Perez, Cristina Alvarez-Peregrina, Miguel Ángel Sánchez-Tena, Concepción De-Hita-Cantalejo, María Carmen Sánchez-González and José-María Sánchez-González
J. Clin. Med. 2023, 12(23), 7301; https://doi.org/10.3390/jcm12237301 - 25 Nov 2023
Cited by 7 | Viewed by 3148
Abstract
The purpose of the research project was to extensively review the efficacy and safety of a trehalose tear-substitute treatment in cases of dry eye disease (DED). A systematic review that included only full-length randomized controlled studies (RCTs) reporting the effects of trehalose tear-substitute [...] Read more.
The purpose of the research project was to extensively review the efficacy and safety of a trehalose tear-substitute treatment in cases of dry eye disease (DED). A systematic review that included only full-length randomized controlled studies (RCTs) reporting the effects of trehalose tear-substitute treatment in three databases, PubMed, Scopus and Web of Science, was performed according to the PRISMA statement. The search period included papers published before 8 August 2023. The Cochrane risk-of-bias tool was used to analyze the quality of the studies selected. A total of 10 RCTs were included in this systematic review. Trehalose tear-substitute treatments achieved a higher improvement than did control group interventions in all reported variables. The mean differences between both groups were in favor of trehalose, and were as follows: ocular surface disease index (OSDI) questionnaire score of −8.5 ± 7 points, tear film breakup time (TBUT) of 1.9 ± 1 s, tear film thickness (TFT) of 0.25 ± 0.1 μm, tear meniscus height (TMH) of 0.02 ± 0.02 mm, Schirmer test (ST) of 0.8 ± 1.4 mm, corneal fluorescein staining (CFS) of −0.7 ± 0.1 points and visual acuity (VA) of 0.3 ± 2.1 letters. No adverse events after trehalose tear-substitute treatments were reported. Trehalose tear substitutes are a safe and effective treatment for DED. Therefore, trehalose tear substitutes should be recommended for patients with dry eye disease. In addition, there is specific evidence to support its use in the preoperative cataract surgery period. Full article
(This article belongs to the Special Issue Current Concept and Emerging Treatments for Ocular Surface Diseases)
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