Ocular Surface最新文献

{"title":"Corneal complications of Sjögren's disease: Insights from a large tertiary ophthalmological care center","authors":"Gustavo Ortiz-Morales ,&nbsp;Mauricio Muleiro-Alvarez ,&nbsp;Eber A. Medina-Estrada ,&nbsp;Guillermo Raúl Vera-Duarte ,&nbsp;Nicolás Kahuam-López ,&nbsp;Aida Jimenez-Corona ,&nbsp;Alejandro Navas ,&nbsp;Arturo Ramirez-Miranda ,&nbsp;Esen K. Akpek ,&nbsp;Enrique O. Graue-Hernandez","doi":"10.1016/j.jtos.2025.11.009","DOIUrl":"10.1016/j.jtos.2025.11.009","url":null,"abstract":"<div><h3>Purpose</h3><div>To report the demographic characteristics, clinical spectrum, and outcomes of patients with extra-glandular corneal manifestations of Sjögren's disease (SjD).</div></div><div><h3>Design</h3><div>Retrospective review of electronic medical records.</div></div><div><h3>Participants</h3><div>Consecutive patients with SjD diagnosed per the 2016 American College of Rheumatology/European League Against Rheumatism criteria at a tertiary ophthalmology center.</div></div><div><h3>Methods</h3><div>Patients were systematically evaluated, diagnosed, and followed longitudinally. A database was generated by searching electronic records, collecting data on demographics, clinical and laboratory findings, treatments, and outcomes.</div></div><div><h3>Main outcome measures</h3><div>Prevalence and management of extra-glandular corneal manifestations of SjD.</div></div><div><h3>Results</h3><div>A total of 415 patients were included, mostly female (92.5 %), with a mean age of 63 years (range: 18–91) and a mean follow-up of 34 months (range: 1–120). Standalone SjD was present in 126 patients (30.28 %), and 289 (69.63 %) had associated autoimmune diseases, most commonly rheumatoid arthritis (n = 221) and systemic lupus erythematosus (n = 26). Diagnosis was based on ACR/EULAR score-based criteria (score ≥4) with positive serology (n = 372, 89.63 %) and positive minor salivary gland biopsy (n = 46, 11.08 %). Corneal complications were observed in 113 patients (27.2 %), including scarring (38/113), epithelial defects (22/113), and perforation. Corneal perforation occurred in 53 patients (12.77 %), most commonly at presentation (47/53, 88.67 %). Perforation rates were 5.56 % (7/126) in standalone SjD and 15.92 % (46/289) in SjD with other autoimmune diseases. At presentation, 56.6 % of patients with perforation (30/53) were not on systemic immunomodulatory treatment (IMT); they were subsequently treated. Six patients (11.32 %) developed perforation during follow-up while already on IMT and required escalation. All six had coexisting autoimmune diseases, primarily rheumatoid arthritis. To manage complications, 75 surgical procedures were performed, including keratoplasty. Five eyes were enucleated or eviscerated due to delayed presentation and infection.</div></div><div><h3>Conclusions</h3><div>Corneal complications, including perforation, are common in SjD and may occur even in the absence of other autoimmune diseases. Many patients present without systemic treatment. These findings support incorporating corneal manifestations into SjD disease activity indices to enable earlier medical intervention alongside surgical care.</div></div>","PeriodicalId":54691,"journal":{"name":"Ocular Surface","volume":"39 ","pages":"Pages 41-45"},"PeriodicalIF":5.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145611705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global burden, risk factors, causative organisms and antibiotic susceptibility patterns in bacterial keratitis","authors":"Rohan Bir Singh ,&nbsp;Uday Pratap Singh Parmar ,&nbsp;Fasika Woreta ,&nbsp;Diyva Srikumaran ,&nbsp;Namrata Sharma ,&nbsp;Vishal Jhanji","doi":"10.1016/j.jtos.2025.12.003","DOIUrl":"10.1016/j.jtos.2025.12.003","url":null,"abstract":"<div><h3>Purpose</h3><div>This systematic review and meta-analysis aimed to evaluate the global burden, microbial causes, risk factors, and antibiotic susceptibility patterns of bacterial keratitis (BK) among patients with microbiologically confirmed infectious keratitis.</div></div><div><h3>Methods</h3><div>We conducted a systematic search of PubMed, Scopus, Cochrane CENTRAL, and PsycINFO through July 1, 2022. Eligible observational studies reported microbiologically confirmed BK cases and bacterial antibiotic susceptibility. Two reviewers independently screened studies and extracted data. Risk of bias was assessed, and a random-effects meta-analysis was performed to estimate the pooled proportion of BK among all infectious keratitis cases. The protocol was registered in PROSPERO (CRD420251088592). Reported risk factors and antibiotic susceptibility were synthesized descriptively.</div></div><div><h3>Results</h3><div>From 5180 records screened, 58 studies involving over 134,000 patients were included. The pooled global prevalence of BK was 44 % (95 % CI: 39–49 %) with high heterogeneity (I² ≈ 97 %). Regional variation was notable, ranging from ∼61 % in Oceania to ∼29 % in Africa. Of ∼25,000 bacterial isolates, 72 % were Gram-positive. Dominant species included <em>Staphylococcus epidermidis</em>(15 %), <em>Streptococcus pneumoniae</em> (13 %), <em>Staphylococcus aureus</em> (10 %), and <em>Pseudomonas aeruginosa</em> (17 %). Reported risk factors included trauma (∼44 %) and contact lens wear (∼23 %). Gram-positive isolates showed &gt;95 % susceptibility to vancomycin; Gram-negatives were &gt;90 % susceptible to aminoglycosides and cephalosporins. Fluoroquinolone susceptibility was lower (∼77 % for <em>S. aureus</em>), and ∼20 % of <em>S. aureus</em> were MRSA.</div></div><div><h3>Conclusion</h3><div>Nearly half of infectious keratitis cases worldwide are bacterial. Findings underscore the need for prevention strategies focused on trauma and contact lens hygiene, and broad empirical therapy targeting MRSA and <em>Pseudomonas</em>.</div></div>","PeriodicalId":54691,"journal":{"name":"Ocular Surface","volume":"39 ","pages":"Pages 49-57"},"PeriodicalIF":5.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145784492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanistic insights into conjunctivalization in limbal stem cell deficiency using a lineage tracing approach","authors":"Mijeong Park ,&nbsp;Elvis Pandzic ,&nbsp;John Males ,&nbsp;Nick Di Girolamo","doi":"10.1016/j.jtos.2025.11.011","DOIUrl":"10.1016/j.jtos.2025.11.011","url":null,"abstract":"<div><h3>Purpose</h3><div>Disease that develops on the ocular surface in animals and humans that have their limbal stem cells erased or their niche severely damaged by physical or chemical trauma, is difficult to visually evaluate in a progressive and long-term manner. When limbal stem cell deficiency (LSCD) develops under such circumstances, intravital clinical microscopy or other techniques cannot be used to accurately detail what transpires on the cornea. Here, we investigated the evolution of LSCD and characterize cellular transformations that arise when the limbal niche is lost.</div></div><div><h3>Methods</h3><div>We employed the multi-color K14CreER^T2-Confetti transgenic reporter mice (<em>n = 51</em>) to monitor LSCD in real-time, combined with proliferation markers and <em>in vitro</em> analyses to identify and characterize conjunctival epithelial transformations using wild-type C57BL/6 mice (<em>n = 31</em>).</div></div><div><h3>Results</h3><div>Conjunctival epithelia either spawn MUC5AC ⁺ goblet cells (GCs) or K12⁺ cornea-like epithelia. These cells arise from Ki67⁺ proliferating differentiated conjunctival squames as opposed to DNA label retaining conjunctival stem/progenitor cells. <em>In vitro</em> analyses suggests that GC metaplasia (GCM) and conjunctival transdifferentiation (CjTD) evolve from environmental stress and soluble keratocyte elaborated signals and corneal matrix-associated physical cues.</div></div><div><h3>Conclusions</h3><div>GCM is a pathological process, as opposed to CjTD, which is the cornea's attempt to self-repair. The co-existence of two fundamentally diverse cellular interchanges establishes a medical conundrum in LSCD which may be resolved via pharmacological or biological intervention in conjunction with surgery to replenish the stem cell pool.</div></div>","PeriodicalId":54691,"journal":{"name":"Ocular Surface","volume":"39 ","pages":"Pages 21-33"},"PeriodicalIF":5.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145611701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"It's time to retire the terms artificial tears and rewetting drops: A call for accurate terminology and updated clinical usage in eye care","authors":"Kaleb S. Abbott ,&nbsp;Andrew D. Pucker","doi":"10.1016/j.jtos.2025.08.010","DOIUrl":"10.1016/j.jtos.2025.08.010","url":null,"abstract":"","PeriodicalId":54691,"journal":{"name":"Ocular Surface","volume":"39 ","pages":"Pages 46-48"},"PeriodicalIF":5.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145689321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delphi panel on neuromodulation as a treatment strategy for dry eye disease: Unlocking the potential of natural tear production","authors":"Esen Akpek ,&nbsp;Lyndon Jones ,&nbsp;Kelly K. Nichols ,&nbsp;Lisa M. Nijm ,&nbsp;Stephen Pflugfelder","doi":"10.1016/j.jtos.2025.11.010","DOIUrl":"10.1016/j.jtos.2025.11.010","url":null,"abstract":"<div><h3>Purpose</h3><div>Chronic tear deficiency, through reduced production and/or increased evaporation, is regarded as a root cause of dry eye disease (DED). The goal of treating DED is restoration of the tear film ultimately resulting in ocular surface homeostasis. Multiple therapeutic prescription drugs to manage DED exist with varying speed of onset, overall magnitude of efficacy, and tolerability. Neuromodulation is an emerging treatment modality offering direct stimulation of natural tear production. A modified Delphi study was conducted to explore the role of neuromodulation as a treatment for DED.</div></div><div><h3>Methods</h3><div>Twenty DED experts participated in three rounds of structured electronic Delphi questionnaires. Consensus, defined as ≥ 80 %, was sought on 18 statements across three key DED topics: unmet treatment needs, the importance of natural tears in ocular surface homeostasis, and neuromodulation as a treatment approach. Statements were refined iteratively based on qualitative feedback and quantitative agreement from the panel.</div></div><div><h3>Results</h3><div>Consensus was reached on all 18 statements. Panelists affirmed that significant unmet needs persist in managing DED. Panelists agreed that stimulating patients’ natural tear production can help maintain and restore ocular surface homeostasis and that neuromodulation, through the ability to rapidly increase natural tear production, has the potential to effectively fill existing treatment gaps.</div></div><div><h3>Conclusion</h3><div>This Delphi panel reached consensus on the importance of restoring natural tear production as a primary goal in treating DED. Neuromodulation represents a promising treatment option for DED, offering a rapid and restorative therapeutic approach for natural tear production.</div></div>","PeriodicalId":54691,"journal":{"name":"Ocular Surface","volume":"39 ","pages":"Pages 34-40"},"PeriodicalIF":5.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145611704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In vivo calcium imaging of corneal sensory nerves with fluorescent stereoscopic microscopy","authors":"George E. Hoekel ,&nbsp;Changxiong J. Guo ,&nbsp;Timileyin Olugbenro ,&nbsp;Qin Liu ,&nbsp;Andrew J.W. Huang","doi":"10.1016/j.jtos.2025.10.001","DOIUrl":"10.1016/j.jtos.2025.10.001","url":null,"abstract":"","PeriodicalId":54691,"journal":{"name":"Ocular Surface","volume":"39 ","pages":"Pages 66-68"},"PeriodicalIF":5.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145921020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor regarding “Prospective consecutive case series of patients with neurotrophic keratopathy associated with unilateral total limbal stem cell deficiency caused by severe ocular surface burns”","authors":"Mehmet Gurdal ,&nbsp;Ozlem Barut Selver","doi":"10.1016/j.jtos.2025.11.004","DOIUrl":"10.1016/j.jtos.2025.11.004","url":null,"abstract":"","PeriodicalId":54691,"journal":{"name":"Ocular Surface","volume":"39 ","pages":"Pages 70-71"},"PeriodicalIF":5.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to Editor: Prospective consecutive case series of patients with neurotrophic keratopathy associated with unilateral total limbal stem cell deficiency caused by severe ocular surface burns","authors":"Francisco Figueiredo","doi":"10.1016/j.jtos.2025.11.003","DOIUrl":"10.1016/j.jtos.2025.11.003","url":null,"abstract":"","PeriodicalId":54691,"journal":{"name":"Ocular Surface","volume":"39 ","pages":"Page 69"},"PeriodicalIF":5.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of novel Sjögren's antibodies in a multi-center cohort of dry eye patients","authors":"David Hsu ,&nbsp;Yinxi Yu ,&nbsp;Esen K. Akpek ,&nbsp;Lee W. Guo ,&nbsp;Tiffany Liu ,&nbsp;Mina Massaro-Giordano ,&nbsp;Soo Abboud ,&nbsp;Franz Fogt ,&nbsp;Devica Bhutani ,&nbsp;Emma Iacobucci ,&nbsp;Jay Pendyala ,&nbsp;Frederick B. Vivino ,&nbsp;Alan N. Baer ,&nbsp;Gui-shuang Ying ,&nbsp;Vatinee Y. Bunya","doi":"10.1016/j.jtos.2025.12.001","DOIUrl":"10.1016/j.jtos.2025.12.001","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess the prevalence of novel Sjögren's disease (SjD) autoantibodies in dry eye disease (DED) patients with or without SjD.</div></div><div><h3>Participants</h3><div>DED patients were recruited from two tertiary care clinics and categorized by SjD status per the 2016 American College of Rheumatology and European Alliance of Associations for Rheumatology criteria.</div></div><div><h3>Methods</h3><div>Participants underwent a battery of DED evaluations (unanesthetized Schirmer's test, tear film break up time, corneal and conjunctival vital dye staining), and unstimulated salivary flow rate assessment. Blood specimens were tested for Salivary Protein-1 (SP-1), Carbonic Anhydrase VI (CA VI), and Parotid Secretory Protein (PSP) antibodies. Salivary gland biopsies were offered when necessary to determine SjD status.</div></div><div><h3>Results</h3><div>304 participants completed bloodwork testing and 38 (12.5 %) were diagnosed with SjD. SjD participants had significantly higher positive rates of IgA SP-1 (21 % vs. 10 %; p = 0.049), any SP-1 autoantibody isotype (42 % vs. 24 %; p = 0.02), and a higher mean number of novel autoantibody-positive results (SjD 1.5 (1.1); non-SjD 1.0 (1.0); p = 0.005). The positive labial salivary gland biopsy group had a significantly higher rate of any PSP autoantibody isotype than the negative biopsy group (47 % vs. 22 %; p = 0.04).</div></div><div><h3>Conclusions</h3><div>SjD participants had significantly higher rates of IgA SP-1, any SP-1 autoantibody isotype, and a higher number of positive novel autoantibodies in general. Participants with positive salivary gland biopsies had a significantly higher prevalence of any PSP autoantibody isotype. Positivity of these tests may indicate the inflammatory nature of dry eye in these patients and could be useful for informing treatment and follow-up.</div></div>","PeriodicalId":54691,"journal":{"name":"Ocular Surface","volume":"39 ","pages":"Pages 58-65"},"PeriodicalIF":5.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145731921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corneal sensitivity in dry eye disease: A systematic review","authors":"Emanuele Käser ,&nbsp;Estelle Reymond ,&nbsp;Daniela S. Nosch","doi":"10.1016/j.jtos.2025.11.005","DOIUrl":"10.1016/j.jtos.2025.11.005","url":null,"abstract":"<div><h3>Background</h3><div>Dry eye disease (DED) is a worldwide prevalent condition; however, its pathophysiology is not well understood. Corneal nerves play a primary role in DED, and a better understanding of the changes to their morphology and function is required. This systematic review investigated changes to the function of corneal nerves.</div></div><div><h3>Methods</h3><div>Relevant literature from inception to September 10, 2025 was searched for in PubMed, Web of Science and Scopus, following the PRISMA statement. Studies measuring corneal sensitivity in patients with DED and in healthy controls were included. Publication selection and analysis were conducted independently by two authors.</div></div><div><h3>Results</h3><div>Twenty-five studies involving 1580 participants (1001 with DED and 579 healthy controls) were included. Nineteen studies used the Cochet-Bonnet aesthesiometer and found a consistently reduced corneal sensitivity in patients with DED. No consistent correlation was found between corneal sensitivity and DED severity, possibly due to heterogeneity of study design and methodology. Six studies used a variant of the Belmonte air jet aesthesiometer, reporting inconsistent results for mechanical corneal sensitivity. Increased sensitivity in DED patients was reported, using a stimulus at ambient temperature. One study used the Brill aesthesiometer and found reduced corneal sensitivity in DED patients.</div></div><div><h3>Conclusion</h3><div>Cochet-Bonnet measurements suggest a decreased mechanical corneal sensitivity in DED patients. Air jet aesthesiometry results were inconsistent, indicating variable responses from functionally different corneal nerve endings. Future research should employ reliable corneal sensitivity measurement methods with a wide stimulus range and standardised study designs to improve understanding of changes in corneal sensitivity in dry eye disease.</div></div>","PeriodicalId":54691,"journal":{"name":"Ocular Surface","volume":"39 ","pages":"Pages 1-16"},"PeriodicalIF":5.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145509652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}