Ocular Surface最新文献

{"title":"Development and validation of a method to generate phenol red thread tests","authors":"Bryan Puentes ,&nbsp;Erin A. Hisey ,&nbsp;Michelle Ferneding ,&nbsp;Vanessa N. Ureno ,&nbsp;Maria A.H. Do ,&nbsp;Paige M. Karpinen ,&nbsp;Chung-Chih Luo ,&nbsp;Sara M. Thomasy ,&nbsp;Brian C. Leonard","doi":"10.1016/j.jtos.2024.08.007","DOIUrl":"10.1016/j.jtos.2024.08.007","url":null,"abstract":"<div><h3>Purpose</h3><p>The aim of this study was to develop and validate a method to generate phenol red thread tests (PRTT) due to the lack of availability of commercial PRTT.</p></div><div><h3>Methods</h3><p>White cotton thread was dyed with phenol red (pH indicator) for 48 h, dried, cut, and sterilized. To validate its wicking ability, the thread was inserted into solutions of varying pH, flanking the pH of healthy tears, for different time intervals. To assess its diagnostic utility, PRTTs were performed <em>in vivo</em> on wildtype and a murine model of evaporative dry eye, <em>acyl-coA: wax alcohol acyltransferase 2</em> knockout (<em>Awat2</em> KO) mice.</p></div><div><h3>Results</h3><p>Two batches of PRTT were produced that had a similar appearance and function to the commercial product. <em>In vitro</em> testing revealed no significant differences in the wicking kinetics at any time point across the pH solutions for batch 1 and only one difference for batch 2 (pH 7.4 vs 7.8 at 5 s, <em>P</em> = 0.029). When comparing both batches, similar wicking kinetics were found with only two significant differences identified (pH 7.6 at 40 s and pH 7.8 at 35 s, <em>P</em> &lt; 0.01). <em>In vivo</em>, our PRTT yielded similar measurements to the commercial PRTT in wildtype and <em>Awat2</em> KO mice and detected a significant increase in aqueous tear volume in the <em>Awat2</em> KO mice (commercial: <em>P</em> = 0.015, our PRTT: <em>P</em> = 0.002).</p></div><div><h3>Conclusion</h3><p>Our method provides a reproducible diagnostic test that performs similarly to its commercial counterpart in a relevant dry eye model indicating that it can serve as a valid and reliable replacement.</p></div>","PeriodicalId":54691,"journal":{"name":"Ocular Surface","volume":"34 ","pages":"Pages 262-266"},"PeriodicalIF":5.9,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914993","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":"The effects of age and dysfunction on meibomian gland population dynamics","authors":"Julie Wiedemann ,&nbsp;Ghaidaa Kashgari ,&nbsp;Shelley Lane ,&nbsp;Brian C. Leonard ,&nbsp;Kelly E. Knickelbein ,&nbsp;Bogi Andersen ,&nbsp;James V. Jester","doi":"10.1016/j.jtos.2024.08.005","DOIUrl":"10.1016/j.jtos.2024.08.005","url":null,"abstract":"<div><h3>Purpose</h3><p>While meibomian gland dysfunction (MGD) is widely recognized as a major cause of evaporative dry eye disease, little is known about normal gland differentiation and lipid synthesis or the mechanism underlying gland atrophy and abnormal lipid secretion. The purpose of this study was to use single-cell and spatial transcriptomics to probe changes in cell composition, differentiation, and gene expression associated with two murine models of MGD: age-related gland atrophy in wild-type mice and altered meibum quality in acyl-CoA wax alcohol acyltransferase 2 (<em>Awat2</em>) knockout (KO) mice. Methods: Young (6 month) and old (22 month) wild type, C57Bl/6 mice and young (3 month) and old (13 month) Awat2 KO mice were used in these studies. For single-cell analysis, the tarsal plate was dissected from the upper and lower eyelids, and single cells isolated and submitted to the UCI Genomic Core, while for the spatial analysis frozen tissue sections were shipped to Resolve Biosciences on dry ice and sections probed in duplicate using a meibomian gland specific, 100 gene Molecular Chartography panel.</p></div><div><h3>Results</h3><p>Analysis of gene expression patterns identified the stratified expression of lipogenic genes during meibocyte differentiation, which may control the progressive synthesis of meibum lipids; an age-related decrease in meibocytes; and increased immune cell infiltration. Additionally, we detected unique immune cell populations in the <em>Awat2</em> KO mouse suggesting activation of psoriasis-like, inflammatory pathways perhaps caused by ductal dilation and hyperplasia.</p></div><div><h3>Conclusion</h3><p>Together these findings support novel mechanism controlling gland function and dysfunction.</p></div>","PeriodicalId":54691,"journal":{"name":"Ocular Surface","volume":"34 ","pages":"Pages 194-209"},"PeriodicalIF":5.9,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914997","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":"Topical anti-glaucoma medications effects on meibomian glands: Systematic review and meta-analysis","authors":"Bruna Grici Cascaldi ,&nbsp;Antero Pinto Cardoso Filho ,&nbsp;Gustavo Viani Arruda ,&nbsp;Eduardo Melani Rocha ,&nbsp;Jayter Silva Paula","doi":"10.1016/j.jtos.2024.07.011","DOIUrl":"10.1016/j.jtos.2024.07.011","url":null,"abstract":"<div><p>Meibomian gland (MG) dysfunction and glaucoma are very prevalent ocular conditions that significantly impact patients’ quality of life. A growing number of clinical and experimental studies have reported an association between the use of topical eye drops to reduce intraocular pressure and the development or exacerbation of MG dysfunction. Studies investigating the impact of glaucoma eyedrops on MG diagnostic parameters have shown variable results, particularly regarding the morphology and function of MG and tear film instability. Herein, we corroborated the findings of greater changes in morphological and functional variables related to MG in patients treated with antiglaucoma eye drops through a systematic review and meta-analysis.</p></div>","PeriodicalId":54691,"journal":{"name":"Ocular Surface","volume":"34 ","pages":"Pages 183-193"},"PeriodicalIF":5.9,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141891418","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":"Evolution of therapeutic strategy based on oxidant-antioxidant balance for fuchs endothelial corneal dystrophy","authors":"Yiming Wu ,&nbsp;Yanbo Liu ,&nbsp;Yuchong Feng ,&nbsp;Xiaoshuang Li ,&nbsp;Zhaoxiang Lu ,&nbsp;Hao Gu ,&nbsp;Wei Li ,&nbsp;Lisa J. Hill ,&nbsp;Shangkun Ou","doi":"10.1016/j.jtos.2024.08.003","DOIUrl":"10.1016/j.jtos.2024.08.003","url":null,"abstract":"<div><p>Fuchs endothelial corneal dystrophy (FECD) stands as the most prevalent primary corneal endothelial dystrophy worldwide, posing a significant risk to corneal homeostasis and clarity. Corneal endothelial cells exhibit susceptibility to oxidative stress, suggesting a nuanced relationship between oxidant-antioxidant imbalance and FECD pathogenesis, irrespective of FECD genotype. Given the constrained availability of corneal transplants, exploration into non-surgical interventions becomes crucial. This encompasses traditional antioxidants, small molecule compounds, biologics, and diverse non-drug therapies, such as gene-related therapy, hydrogen therapy and near infrared light therapy. This review concentrates on elucidating the mechanisms behind oxidant-antioxidant imbalance and the evolution of strategies to restore oxidant-antioxidant balance in FECD. It provides a comprehensive overview of both conventional and emerging therapeutic approaches, offering valuable insights for the advancement of non-surgical treatment modalities. The findings herein might establish a robust foundation for future research and the therapeutic strategy of FECD.</p></div>","PeriodicalId":54691,"journal":{"name":"Ocular Surface","volume":"34 ","pages":"Pages 247-261"},"PeriodicalIF":5.9,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1542012424000831/pdfft?md5=ae3a6b427ff8c26380bedff5a04f79e8&pid=1-s2.0-S1542012424000831-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141904113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preservatives and ocular surface disease: A review","authors":"Malik Y. Kahook ,&nbsp;Christopher J. Rapuano ,&nbsp;Elisabeth M. Messmer ,&nbsp;Nathan M. Radcliffe ,&nbsp;Anat Galor ,&nbsp;Christophe Baudouin","doi":"10.1016/j.jtos.2024.08.001","DOIUrl":"10.1016/j.jtos.2024.08.001","url":null,"abstract":"<div><p>Ocular surface disease (OSD) is a complex condition that can cause a range of symptoms (e.g, dryness, irritation, and pain) and can significantly impact the quality of life of affected individuals. Iatrogenic OSD, a common finding in patients with glaucoma who receive chronic therapy with topical ocular antihypertensive drugs containing preservatives such as benzalkonium chloride (BAK), has been linked to damage to the ocular surface barrier, corneal epithelial cells, nerves, conjunctival goblet cells, and trabecular meshwork. Chronic BAK exposure activates inflammatory pathways and worsens symptoms, compromising the success of subsequent filtration surgery in an exposure-dependent manner.</p><p>In eyes being treated for glaucoma, symptomatic treatment of OSD may provide some relief, but addressing the root cause of the OSD often necessitates reducing or, ideally, eliminating BAK toxicity. Strategies to decrease BAK exposure in patients with glaucoma encompass the use of preservative-free formulations or drugs with alternative and less toxic preservatives such as SofZia®, Polyquad, potassium sorbate, or Purite®. Though the benefits of these alternative preservatives are largely unproven, they might be considered when financial constraints prevent the use of preservative-free versions. For patients receiving multiple topical preserved drugs, the best practice is to switch to nonpreserved equivalents wherever feasible, regardless of OSD severity. Furthermore, nonpharmacological approaches, including laser or incisional procedures, should be considered.</p><p>This review explores the effects of BAK on the ocular surface and reviews strategies for minimizing or eliminating BAK exposure in patients with glaucoma in order to significantly improve their quality of life and prevent complications associated with chronic exposure to BAK.</p></div>","PeriodicalId":54691,"journal":{"name":"Ocular Surface","volume":"34 ","pages":"Pages 213-224"},"PeriodicalIF":5.9,"publicationDate":"2024-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141891417","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":"Unraveling the complexity – Insights and interventions of refractory vernal keratoconjunctivitis","authors":"Shweta Agarwal ,&nbsp;Serge Doan ,&nbsp;Bhaskar Srinivasan ,&nbsp;Geetha Iyer ,&nbsp;Andrea Leonardi","doi":"10.1016/j.jtos.2024.07.009","DOIUrl":"10.1016/j.jtos.2024.07.009","url":null,"abstract":"<div><p>Vernal keratoconjunctivitis (VKC) is a chronic severe ocular allergic inflammation mostly observed in children and young adults. The ocular manifestations are the expression of multifactorial immune mechanisms that generally have a good prognosis, however long-term inflammation may remarkably reduce the visual function due to complications and poor therapeutic responses.</p><p>Lack of responsiveness to a drug or treatment is relatively common in VKC and it is not only due to corneal involvement, which is considered the main sign of <em>severity</em>. The concept of <em>refractory</em> may be relative to multiple factors including the clinical condition, systemic co-morbidities, previous or concomitant drugs or regiments, compliance, patient's psychological condition or expectations, type of exposome and environmental conditions, doctor's experience and expectations, or timing of clinical evaluation. In this narrative review, the authors propose a definition of <em>refractory VKC</em> based on revised literature and clinical experience and consider potential new treatments for refractory patients and surgical management in case of complications.</p></div>","PeriodicalId":54691,"journal":{"name":"Ocular Surface","volume":"34 ","pages":"Pages 173-182"},"PeriodicalIF":5.9,"publicationDate":"2024-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141895127","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":"Deep-learning based analysis of in-vivo confocal microscopy images of the subbasal corneal nerve plexus’ inferior whorl in patients with neuropathic corneal pain and dry eye disease","authors":"Raul E. Ruiz-Lozano ,&nbsp;Matias Soifer ,&nbsp;Zane Z. Zemborain ,&nbsp;Nadim S. Azar ,&nbsp;Manuel E. Quiroga-Garza ,&nbsp;Sofia Murillo ,&nbsp;Symon Ma ,&nbsp;Seitaro Komai ,&nbsp;Anupama Horne ,&nbsp;Ali Khodor ,&nbsp;Luis A. Rodriguez-Gutierrez ,&nbsp;Sandra S. Stinnett ,&nbsp;Sina Farsiu ,&nbsp;Victor L. Perez","doi":"10.1016/j.jtos.2024.08.002","DOIUrl":"10.1016/j.jtos.2024.08.002","url":null,"abstract":"<div><h3>Purpose</h3><p>To evaluate and compare subbasal corneal nerve parameters of the inferior whorl in patients with dry eye disease (DED), neuropathic corneal pain (NCP), and controls using a novel deep-learning-based algorithm to analyze in-vivo confocal microscopy (IVCM) images.</p></div><div><h3>Methods</h3><p>Subbasal nerve plexus (SNP) images of the inferior whorl of patients with DED (n = 49, 77 eyes), NCP (n = 14, 24 eyes), and controls (n = 41, 59 eyes) were taken with IVCM and further analyzed using an open-source artificial intelligence (AI)-based algorithm previously developed by our group. This algorithm automatically segments nerves, immune cells, and neuromas in the SNP. The following parameters were compared between groups: nerve area density, average nerve thickness, average nerve segment tortuosity, junction point density, neuroma density, and immune cell density.</p></div><div><h3>Results</h3><p>160 eyes of 104 patients (63 % females), aged 56.8 ± 15.4 years, were included. The mean nerve area density was significantly lower in the DED (<em>P</em> = 0.012) and NCP (<em>P</em> &lt; 0.001) groups compared to the control group. The junction point density was lower in the NCP group compared with control (<em>P</em> = 0.001) and DED (<em>P</em> = 0.004) groups. The immune cell density was higher in the DED group compared with controls (<em>P</em> &lt; 0.001).</p></div><div><h3>Conclusions</h3><p>Deep-learning-based analysis of IVCM images of the corneal SNP inferior whorl distinguished a decreased mean nerve area density in patients with DED and NCP compared with controls and an increased immune cell density in patients with oGVHD- and SS-associated DED. These findings suggest that the inferior whorl could be used as landmark to distinguish between patients with DED and NCP.</p></div>","PeriodicalId":54691,"journal":{"name":"Ocular Surface","volume":"34 ","pages":"Pages 241-246"},"PeriodicalIF":5.9,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141891416","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":"Readership awareness series – Paper 12: Clinician-scientist – Threats to the endangered species and preservation strategies","authors":"Mohammad Javed Ali (Editor-in-Chief),&nbsp;Ali Djalilian (Former Editor-in-Chief)","doi":"10.1016/j.jtos.2024.07.008","DOIUrl":"10.1016/j.jtos.2024.07.008","url":null,"abstract":"","PeriodicalId":54691,"journal":{"name":"Ocular Surface","volume":"34 ","pages":"Pages 156-158"},"PeriodicalIF":5.9,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141877118","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":"A novel artificial intelligence model for diagnosing Acanthamoeba keratitis through confocal microscopy","authors":"Omar Shareef ,&nbsp;Mohammad Soleimani ,&nbsp;Elmer Tu ,&nbsp;Deborah Jacobs ,&nbsp;Joseph Ciolino ,&nbsp;Amir Rahdar ,&nbsp;Kasra Cheraqpour ,&nbsp;Mohammadali Ashraf ,&nbsp;Nabiha B. Habib ,&nbsp;Jason Greenfield ,&nbsp;Siamak Yousefi ,&nbsp;Ali R. Djalilian ,&nbsp;Hajirah N. Saeed","doi":"10.1016/j.jtos.2024.07.010","DOIUrl":"10.1016/j.jtos.2024.07.010","url":null,"abstract":"<div><h3>Purpose</h3><p>To develop an artificial intelligence (AI) model to diagnose <em>Acanthamoeba</em> keratitis (AK) based on <em>in vivo</em> confocal microscopy (IVCM) images extracted from the Heidelberg Retinal Tomograph 3 (HRT 3).</p></div><div><h3>Methods</h3><p>This retrospective cohort study utilized HRT 3 IVCM images from patients who had received a culture-confirmed diagnosis of AK between 2013 and 2021 at Massachusetts Eye and Ear. Two cornea specialists independently labeled the images as AK or nonspecific finding (NSF) in a blind manner. Deep learning tasks were then conducted through Python and TensorFlow. Distinguishing between AK and NSF was designed as the task and completed through a devised convolutional neural network.</p></div><div><h3>Results</h3><p>A dataset of 3312 confocal images from 17 patients with a culture-confirmed diagnosis of AK was used in this study. The inter-rater agreement for identifying the presence or absence of AK in IVCM images was 84 %, corresponding to a total of 2782 images on which both observers agreed and which were included in the model. 1242 and 1265 images of AK and NSF, respectively, were utilized in the training and validation sets, and 173 and 102 images of AK and NSF, respectively, were utilized in the evaluation set. Our model had an accuracy, sensitivity, and specificity of 76 % each, and a precision of 78 %.</p></div><div><h3>Conclusions</h3><p>We developed an HRT-based IVCM AI model for AK diagnosis utilizing culture-confirmed cases of AK. We achieved good accuracy in diagnosing AK and our model holds significant promise in the clinical application of AI in improving early AK diagnosis.</p></div>","PeriodicalId":54691,"journal":{"name":"Ocular Surface","volume":"34 ","pages":"Pages 159-164"},"PeriodicalIF":5.9,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S154201242400079X/pdfft?md5=7b82fdbda4d6ef92bddd196de7a49563&pid=1-s2.0-S154201242400079X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141862001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Demographic and lifestyle factors associated with dry eye disease in China: A cross-sectional multi-center study","authors":"Wanju Yang ,&nbsp;Haoyu Wang ,&nbsp;Jinghua Li ,&nbsp;Yuan Chen ,&nbsp;Yu Zhang ,&nbsp;Xiaoxia Niu ,&nbsp;Xiujun Song ,&nbsp;Yuhong Tang ,&nbsp;Dan Chen ,&nbsp;Honglin Han ,&nbsp;Hai Huang ,&nbsp;Ying Bao ,&nbsp;Xiaofeng Li ,&nbsp;Jianzhang Ye ,&nbsp;Yu Zheng ,&nbsp;Xiangxi Chen ,&nbsp;Chang Liu ,&nbsp;Congxiang Wang ,&nbsp;Tiehong Chen ,&nbsp;Bin Yu ,&nbsp;Shaowei Li","doi":"10.1016/j.jtos.2024.07.007","DOIUrl":"10.1016/j.jtos.2024.07.007","url":null,"abstract":"<div><h3>Purpose</h3><p>Associations were assessed between demographic/lifestyle factors and tear film breakup time (TBUT) defined dry eye disease (DED) in China.</p></div><div><h3>Methods</h3><p>The cross-sectional study involved 50,280 subjects (54 ± 17 y) in 217 clinics (25 provinces). Data included sleep disorders; digital screen exposure; and use of cosmetics, contact lenses, and eye drops (for asthenopia). Clinical examinations included TBUT; Schirmer I test; meibomian gland plug status. TBUT-defined DED was TBUT &lt;10 s, with TBUT ≤5 s also considered (i.e., short TBUT-type DED), either unilateral or bilateral.</p></div><div><h3>Results</h3><p>TBUT-defined DED was present in 81.6 % overall. The highest rates were in those 71 years or older, living in the north, with chronic daily sleep disorder, or daily cosmetic application; or daily digital screen exposure for 5 years, contact lenses 4 h, or 3 months eye drops. Compared with those without TBUT-defined DED, those with TBUT-defined DED showed lower Schirmer I results and more severe meibomian gland plug status (each, <em>P</em> &lt; 0.001). Independent risk factors of DED were: aging; living in the southwest; daily digital screen exposure ≥3 h; and occasional cosmetic use. Risk factors of DED TBUT ≤5 s were: living in the southwest; wearing contact lenses (&gt;3 y); and using eye drops. Rates of unilateral and bilateral DED were comparable.</p></div><div><h3>Conclusions</h3><p>DED in China is more likely in the aged and those in the north/southwest. DED rates increase with digital screen exposure, and use of cosmetics, contact lenses, or eye drops for asthenopia. Unilateral DED should be treated as promptly as bilateral.</p></div>","PeriodicalId":54691,"journal":{"name":"Ocular Surface","volume":"34 ","pages":"Pages 146-155"},"PeriodicalIF":5.9,"publicationDate":"2024-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141794470","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}