Ocular Surface最新文献

{"title":"Bringing ophthalmology into the scientific world: Novel nanoparticle-based strategies for ocular drug delivery","authors":"Milad Abbasi ,&nbsp;Hossein Aghamollaei ,&nbsp;Ahmad Vaez ,&nbsp;Ali Mohammad Amani ,&nbsp;Hesam Kamyab ,&nbsp;Shreeshivadasan Chelliapan ,&nbsp;Sajad Jamalpour ,&nbsp;Renato Zambrano-Dávila","doi":"10.1016/j.jtos.2025.03.004","DOIUrl":"10.1016/j.jtos.2025.03.004","url":null,"abstract":"<div><div>The distinctive benefits and drawbacks of various drug delivery strategies to supply corneal tissue improvement for sense organs have been the attention of studies worldwide in recent decades. Static and dynamic barriers of ocular tissue prevent foreign chemicals from entering and inhibit the active absorption of therapeutic medicines. The distribution of different medications to ocular tissue is one of the most appealing and demanding tasks for investigators in pharmacology, biomaterials, and ophthalmology, and it is critical for cornea wound healing due to the controlled release rate and increased drug bioavailability. It should be mentioned that the transport of various types of medications into the different sections of the eye, particularly the cornea, is exceedingly challenging because of its distinctive structure and various barriers throughout the eye. Nanoparticles are being studied to improve medicine delivery strategies for ocular disease. Repetitive corneal drug delivery using biodegradable nanocarriers allows a medicine to remain in different parts of the cornea for extended periods of time and thus improve administration route effectiveness. In this review, we discussed eye anatomy, ocular delivery barriers, as well as the emphasis on the biodegradable nanomaterials ranging from organic nanostructures, such as nanomicelles, polymers, liposomes, niosomes, nanowafers, nanoemulsions, nanosuspensions, nanocrystals, cubosomes, olaminosomes, hybridized NPs, dendrimers, bilosomes, solid lipid NPs, nanostructured lipid carriers, and nanofiber to organic nanomaterials like silver, gold, and mesoporous silica nanoparticles. In addition, we describe the nanotechnology-based ophthalmic medications that are presently on the market or in clinical studies. Finally, drawing on current trends and therapeutic approaches, we discuss the challenges that innovative optical drug delivery systems confront and propose future research routes. We hope that this review will serve as a source of motivation and inspiration for developing innovative ophthalmic formulations.</div></div>","PeriodicalId":54691,"journal":{"name":"Ocular Surface","volume":"37 ","pages":"Pages 140-172"},"PeriodicalIF":5.9,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733808","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":"Endoplasmic reticulum stress contributes to the development of ocular graft-vs-host disease in the eyelids and the ocular surface","authors":"Shinri Sato ,&nbsp;Yoko Ogawa ,&nbsp;Eisuke Shimizu ,&nbsp;Kazuki Asai ,&nbsp;Kazuno Negishi ,&nbsp;Kazuo Tsubota ,&nbsp;Masatoshi Hirayama","doi":"10.1016/j.jtos.2025.03.003","DOIUrl":"10.1016/j.jtos.2025.03.003","url":null,"abstract":"<div><h3>Background</h3><div>While endoplasmic reticulum (ER) stress has been implicated in various aspects of graft-versus-host disease (GVHD), its effects on the eyelids and ocular surface in patients with chronic GVHD (cGVHD) remains poorly understood. We aimed to investigate the relationship between ER stress and ocular GVHD using the ER stress suppressor, 4-phenylbutyric acid (PBA).</div></div><div><h3>Methods</h3><div>The study used allogeneic bone marrow transplantation (BMT) and syngeneic BMT to establish a cGVHD mouse model. cGVHD mice were treated with either intraperitoneal administration of PBA or 2 % PBA eye drops following BMT.</div></div><div><h3>Results</h3><div>The Intraperitoneal PBA-treated (PBAip) group retained a larger meibomian gland (MG) area and corneal epithelial damage and inflammatory and fibrotic cell infiltration in the ocular surface was attenuated compared to vehicle-treated cGVHD mice. The expression of unfolded protein response markers was significantly elevated in the vehicle group compared to the syngeneic control and the PBAip group. Electron microscopy and immunohistochemistry revealed that fibroblasts and macrophages infiltrated the eyelids and ocular surface of cGVHD mice under ER stress. The corneal fluorescein staining score was significantly lower in the PBA eye drop-treated group than in the vehicle-treated group. The numbers of leukocyte marker CD45-, T cell marker CD4-, and macrophage marker F4/80-positive cells were significantly reduced in the PBA eye drop-treated group compared to the vehicle group.</div></div><div><h3>Conclusions</h3><div>The study suggests that the ER stress response, which is triggered by cGVHD in ocular surface tissues, can be suppressed by PBA, an ER stress suppressor, potentially offering therapeutic benefits in ocular GVHD.</div></div>","PeriodicalId":54691,"journal":{"name":"Ocular Surface","volume":"37 ","pages":"Pages 115-131"},"PeriodicalIF":5.9,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701430","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":"Smoking negatively impacts ocular surface health and corneal nerve metrics","authors":"Ansa Anam ,&nbsp;Mingyi Yu ,&nbsp;Chang Liu ,&nbsp;Isabelle Xin Yu Lee ,&nbsp;Juanita Yang ,&nbsp;A.V. Shanmathi ,&nbsp;Ching-Yu Cheng ,&nbsp;Yu-Chi Liu","doi":"10.1016/j.jtos.2025.03.002","DOIUrl":"10.1016/j.jtos.2025.03.002","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the effects of smoking on ocular surface through comprehensive analysis of corneal nerves, corneal epithelium, dendritic cells (DCs), and clinical assessments.</div></div><div><h3>Methods</h3><div>This cross-sectional study included 250 healthy smokers and 272 healthy non-smokers. Patients’ smoking status and duration were recorded. In vivo confocal microscopy was performed to assess 7 quantitative corneal nerves parameters, 3 corneal neuroma parameters, 3 DCs parameters, and 3 epithelial parameters. Ocular surface evaluations included tear break-up time (TBUT), ocular surface and corneal staining, corneal sensitivity, and Schirmer test. Ocular Surface Disease Index questionnaire was used for symptom assessment.</div></div><div><h3>Results</h3><div>Compared to non-smokers, smokers exhibited significantly lower corneal nerve fiber density (CNFD), nerve branch density, nerve fiber length, nerve total branch density, corneal nerve fiber area (CNFA), and corneal nerve fractal dimension (CFracDim; all p &lt; 0.001). Smokers also presented with a significantly swollen corneal nerve fiber (p &lt; 0.001). Longer smoking duration was significantly associated with lower CNFD (β = −0.04, P = 0.010), lower CNFA (β = −0.00002, P = 0.033), and lower CFracDim (β = −0.0008, P = 0.016). Additionally, a significantly larger neuroma total area (p = 0.040), size (p &lt; 0.001) and perimeter (p &lt; 0.001), as well as a significantly higher DCs density (p &lt; 0.001), DCs count (p = 0.003), and lower DCs elongation which suggested higher DCs maturity (p &lt; 0.001), were observed in the smoking group. Smokers demonstrated significantly higher ocular surface staining scores (p &lt; 0.001) and reduced TBUT (p = 0.001). Corneal epithelial circularity was borderline higher in the smoking subjects (p = 0.059).</div></div><div><h3>Conclusions</h3><div>Smoking is associated with significant alterations in corneal nerve morphology and quantity, increased immunological cells, and compromised ocular surface integrity.</div></div>","PeriodicalId":54691,"journal":{"name":"Ocular Surface","volume":"37 ","pages":"Pages 105-114"},"PeriodicalIF":5.9,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143635049","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":"A masked study to differentiate in vivo confocal microscopic features of Pythium insidiosum and fungal filaments","authors":"Bhupesh Bagga ,&nbsp;Md Hasnat Ali ,&nbsp;K Shreeya Jain ,&nbsp;Tanmay Gokhale ,&nbsp;Joveeta Joseph ,&nbsp;Pabitra Duwal ,&nbsp;Amrita Mohanty ,&nbsp;Lakshminarayanan Gowtham ,&nbsp;Savitri Sharma","doi":"10.1016/j.jtos.2025.03.001","DOIUrl":"10.1016/j.jtos.2025.03.001","url":null,"abstract":"<div><h3>Purpose</h3><div>To describe <em>in vivo</em> confocal microscopic features of <em>Pythium insidiosum</em> in patients with <em>Pythium</em> keratitis and compare with those observed in fungal keratitis.</div></div><div><h3>Method</h3><div>We collected <em>in vivo</em> confocal images of the cornea from patients with microbiologically confirmed <em>Pythium</em> and fungal keratitis, analysing five putative distinguishing features: filament width (broad or thin), granularity within the filament (present or absent), filament continuity or traceability, the presence or absence of loops, and the double track sign. Three masked observers were shown images with concealed identities and tasked with detecting <em>Pythium</em> filaments<em>.</em> After initial assessment and training, their detection rates were calculated and compared before and after training. We did perform imageJ (Open Source software project Fiji) analysis of all the images for objectively assessment.</div></div><div><h3>Results</h3><div>Sixty confocal images of <em>Pythium</em> (n = 32,15 patients) and fungal (n = 28,12 patients) keratitis were analysed. The continuity of filaments and the presence of loops emerged as strong predictors of <em>Pythium</em>, with adjusted odds ratios (OR) of 18.1 and 19.29, respectively, based on multivariate logistic regression and decision tree splits. Pre-training accuracy was 0.51, 0.52, and 0.56, but post-training (95 % CI) improved to 0.75 (0.62–0.85), 0.80 (0.67–0.89), and 0.86 (0.75–0.94). Correct identification rates for <em>Pythium</em> were 27, 28, and 29 (84–89 %) out of 32, and for fungus were 16, 21, and 24 (57.4–85.7 %) out of 28 images with sensitivity and specificity ranging from 70.7 to 87.5 % and 80–85 % respectively. ImageJ analysis revealed a significant difference between <em>Pythium</em> and fungal filaments in both width (9.30 ± 1.21 μ vs. 6.20 ± 0.88 μ, <em>p</em> &lt; 0.001) and branching angle (83.92 ± 13.57° vs. 55.10 ± 6.03°, <em>p</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Based on our analysis, these features may be indicative of <em>Pythium</em> and could serve as a helpful reference for future prospective studies. However, further large scale studies and validation are needed to strengthen these observations.</div></div>","PeriodicalId":54691,"journal":{"name":"Ocular Surface","volume":"37 ","pages":"Pages 99-104"},"PeriodicalIF":5.9,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631155","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 15: How the ICMJE 2025 recommendations update impact the scientific community?","authors":"Mohammad Javed Ali MD, PhD, FRCS (Editor-in-Chief) ,&nbsp;Ali Djalilian MD (Former Editor-in-Chief)","doi":"10.1016/j.jtos.2025.02.009","DOIUrl":"10.1016/j.jtos.2025.02.009","url":null,"abstract":"","PeriodicalId":54691,"journal":{"name":"Ocular Surface","volume":"37 ","pages":"Pages 97-98"},"PeriodicalIF":5.9,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143569318","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":"Essential roles of sensory nerve in maintenance of cornea-phenotype in mice","authors":"Yuka Okada ,&nbsp;Takayoshi Sumioka ,&nbsp;Hiroki Iwanishi ,&nbsp;Shingo Yasuda ,&nbsp;Jianhua Zhang ,&nbsp;Yong Yuan ,&nbsp;Chia-Yang Liu ,&nbsp;Winston Whei-Yang Kao ,&nbsp;Shizuya Saika","doi":"10.1016/j.jtos.2025.02.012","DOIUrl":"10.1016/j.jtos.2025.02.012","url":null,"abstract":"<div><h3>Purpose</h3><div>To the best of our knowledge, no reports have been published on the long-term changes in corneal tissue during the course of neuroparalytic keratopathy caused by destruction of the ophthalmic nerve in experimental animals. To bridge this research gap, we investigated the histopathology of the cornea in mice 3, 12, and 24 months after coagulation of the ophthalmic nerve.</div></div><div><h3>Methods</h3><div>Nerves were severely coagulated by inserting an 18-gauge bipolar needle into the skull of C57Bl/6 mice, as previously reported. Mice were sacrificed 3, 12, and 24 months later. Eyes were processed for histological and immunohistochemical analyses to identify the phenotypes of corneal epithelium and stroma.</div></div><div><h3>Results</h3><div>At 3 months after denervation, the affected eyes showed severe inflammation and epithelial damage. In 3-, 14- and 24-month-old corneas, the stroma was found to be hypercellular with stromal neovascularization and keratinized epithelial hyperplasia. Such epithelium no longer expressed keratin 12, but markedly featured keratinization markers. The affected stroma had no keratocan expression, indicating loss of keratocyte cell-type differentiation. Neutrophils, macrophages, and Sox10-positive putative Schwann cells were found distributed in the affected stroma in association with the accumulation of Sonic hedgehog and galectin-3.</div></div><div><h3>Conclusions</h3><div>Ophthalmic denervation causes prolonged inflammation lasting up to 2 years, the appearance of repair-type Schwann cells in the stroma, loss of cornea-type differentiation of the epithelium with keratinization, and loss of stroma-specific gene expression. Sonic hedgehog and galectin-3 are upregulated in tissues and thought to be involved in pathology.</div></div>","PeriodicalId":54691,"journal":{"name":"Ocular Surface","volume":"37 ","pages":"Pages 80-96"},"PeriodicalIF":5.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143545130","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":"Topical low-dose heparin in ocular Stevens Johnson Syndrome and associated molecular correlations: A randomized controlled pilot study","authors":"Renu Venugopal ,&nbsp;Shivam Sharma ,&nbsp;Lata Singh ,&nbsp;Seema Sen ,&nbsp;Thirumurthy Velpandian ,&nbsp;Prafulla Kumar Maharana ,&nbsp;Seema Kashyap ,&nbsp;Sandeep Jain ,&nbsp;Namrata Sharma","doi":"10.1016/j.jtos.2025.02.013","DOIUrl":"10.1016/j.jtos.2025.02.013","url":null,"abstract":"<div><h3>Purpose</h3><div>To elucidate the efficacy of topical low dose heparin (LDH) as an adjuvant therapy in of sub -chronic and chronic ocular Stevens-Johnson Syndrome (SJS) and its effect on Neutrophil extracellular traps (NETs) associated markers.</div></div><div><h3>Design</h3><div>A prospective randomized controlled pilot trial.</div></div><div><h3>Methods</h3><div>72 clinically diagnosed SJS cases were recruited into sub-chronic and chronic groups. Both groups were randomly given either LDH eye drops with conservative treatment (CT) or CT alone for one month. Visual acuity, Schirmer's test, fluorescein and lissamine staining, OSDI score and ocular surface severity were evaluated. Tear and conjunctival cells were collected to detect NET-MPO complexes and NET-gene markers (TNFSF14, TLR9, IL-6, MyD88, C3a gene).</div></div><div><h3>Main outcome measures</h3><div>Improvement in ocular surface severity scores.</div></div><div><h3>Results</h3><div>Sub-chronic group showed significant improvement with topical LDH in TBUT (p = 0.0001), Lissamine stain score (p = 0.0162), corneal vascularisation score (p = 0.0001), conjunctival hyperaemia score (p = 0.001) and total severity score (p = 0.001) when compared to the LDH treated chronic group. No significant improvement was seen in visual acuity in either group after one month of therapy. Qualitative ELISA confirmed higher presence of NET-MPO complex in sub-chronic cases. Both groups showed upregulation of TNFSF14, TLR9, and MyD88, which significantly decreased post topical LDH treatment (p = 0.0038,0.002 and 0.043 respectively).</div></div><div><h3>Conclusion</h3><div>The presence of NETs mediated upregulated immune markers on sub-chronic and chronic SJS cases sheds newer light on its unresolved ocular pathology. Subsequent administration of topical LDH revealed a notable mitigation of NET associated immune markers, highlighting its promising anti-inflammatory effects within the ocular microenvironment.</div></div>","PeriodicalId":54691,"journal":{"name":"Ocular Surface","volume":"37 ","pages":"Pages 47-56"},"PeriodicalIF":5.9,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537992","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":"Decoding the corneal immune microenvironment in healthy and diabetic mice during corneal wound healing","authors":"Yujing Lin ,&nbsp;Xiaowen Zhang ,&nbsp;Di Sun ,&nbsp;Qun Wang ,&nbsp;Shengqian Dou ,&nbsp;Qingjun Zhou","doi":"10.1016/j.jtos.2025.02.010","DOIUrl":"10.1016/j.jtos.2025.02.010","url":null,"abstract":"<div><div>Diabetic keratopathy (DK) is an underdiagnosed ocular complication of diabetes mellitus. The changes of ocular immune microenvironment contribute to the pathogenesis of DK, while precise mechanisms remain inadequately understood. Here, we employed single-cell RNA sequencing (scRNA-seq) to elucidate the transcriptional alterations of immune cells from diabetic and healthy control mouse corneas during homeostasis and wound healing. Unbiased clustering analysis unveiled 3 major cell subsets and 11 subdivided cell clusters, including T cells, monocyte lineages, and neutrophil subpopulations. The further sub-clustering analysis demonstrated that T cells exhibited cytotoxicity characteristics in both homeostasis and wound healing of diabetic cornea. Moreover, dendritic cells preferred the migratory and maturation phenotype and may recruit and maintain cytotoxic T cells. Macrophages in diabetic cornea preferred the pro-inflammatory M1 phenotype. Under injury conditions, diabetic corneal neutrophils exhibited a more mature and functional possession of neutrophil extracellular traps (NETs). Furthermore, cell-cell communication revealed that the immune cells exhibited hyperactivation and pro-inflammatory responses, while the monocyte lineages exhibited the activating effect on T cells in diabetic cornea. This study represents the inaugural effort to establish a comprehensive scRNA-Seq transcriptomic profile of corneal immune cells during wound healing in healthy and diabetic mice, which offers a valuable reference for subsequent investigations into the pathological roles of immune cells in DK.</div></div>","PeriodicalId":54691,"journal":{"name":"Ocular Surface","volume":"37 ","pages":"Pages 68-79"},"PeriodicalIF":5.9,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537874","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 prospective, longitudinal study to assess progression of ocular surface signs, tear cytokines and protein profiles in young adults","authors":"Rachel K. Casemore ,&nbsp;James S. Wolffsohn ,&nbsp;Tor Paaske Utheim ,&nbsp;Sjur Reppe ,&nbsp;Hans Christian D. Aass ,&nbsp;Debarun Dutta","doi":"10.1016/j.jtos.2025.02.011","DOIUrl":"10.1016/j.jtos.2025.02.011","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare ocular surface characteristics, tear protein profiles, and cytokines in young adults with and without evaporative dry eye disease (DED), exploring any associations with lifestyle factors, and determine any progression after one year.</div></div><div><h3>Methods</h3><div>Fifty participants, aged 18–25 years, were recruited. Detailed ocular surface parameters were assessed following administration of lifestyle and symptom questionnaires. Tear samples collected by microcapillary tubes were analysed using the Agilent Bioanalyzer (7 proteins between 14 and 230 kDa); tears collected with Schirmer strips were analysed for ten cytokines using Luminex Assay.</div></div><div><h3>Results</h3><div>56 % of participants fulfilled the TFOS DEWS II criteria for DED. 48 % had at least 25 % meibomian gland loss in either lid regardless of dry eye status, while over 90 % had at least one diagnostic sign. Progression was observed, characterised by significant increases (p &lt; 0.05) in ocular redness, lid wiper epitheliopathy and blink rate. Albumin was upregulated (p = 0.003) in DED, while zinc-α2-glycoprotein, which showed significant correlations with several meibomian gland parameters, was downregulated. Upregulation of both pro- and anti-inflammatory cytokines was observed, with several significant clinical correlations, including IL-1β with meibomian gland parameters.</div></div><div><h3>Conclusions</h3><div>Evidence of inflammation and overlap of ocular signs in these young adults reinforces the need for early detection and differentiation of those likely to progress to DED. While upregulation of both pro- and anti-inflammatory cytokines has provided evidence of a mechanism to maintain homeostasis, the subtle progression of ocular surface disease observed suggests that counselling is required around the modifiable risk factors of DED identified, regardless of whether symptoms are present or not.</div></div>","PeriodicalId":54691,"journal":{"name":"Ocular Surface","volume":"37 ","pages":"Pages 57-67"},"PeriodicalIF":5.9,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525540","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":"Efficacy of eyelid warming devices as first-step treatment in meibomian gland dysfunction: A systematic review with meta-analysis","authors":"Antonio Ballesteros-Sánchez ,&nbsp;Carlos Rocha-de-Lossada ,&nbsp;José-María Sánchez-González","doi":"10.1016/j.jtos.2025.02.008","DOIUrl":"10.1016/j.jtos.2025.02.008","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate the efficacy of eyelid warming devices as first-step treatment in patients with meibomian gland dysfunction (MGD).</div></div><div><h3>Methods</h3><div>A systematic review with meta-analysis of RCTs, reporting the effects eyelid warming devices in 3 databases, PubMed, Scopus and Web of Science, was performed according to the PRISMA statement.</div></div><div><h3>Results</h3><div>Seven studies including 367 patients, and 440 eyes were analysed. The overall efficacy did not significantly favor either group when comparing eyelid warming devices to the control groups or warm towel compresses, nor between moisture chamber devices and warm compress devices. However, the change in OSDI questionnaire (SMD 0.91; 95 % CI: 0.44 to 1.39; P = 0.0002) and NIBUT (SMD 1.10; 95 % CI: 0.61 to 1.59; P &lt; 0.0001) were significantly favorable for eyelid warming devices compared to the control groups. Similar results were obtained for tear film stability (SMD 0.97; 95 % CI: 0.32 to 1.61; P = 0.003) when comparing eyelid warming devices to warm towel compresses. Specifically, the sensitivity analysis of these groups revealed that changes in OSDI questionnaire (MD 9.41; 95 % CI: 1.70 to 17.13; <em>P</em> = 0.02; I² = 49 %) and NIBUT (MD 2.24; 95 % CI: 1.20 to 3.28; <em>P</em> &lt; 0.0001; I² = 71 %) were significantly favorable for eyelid warming devices. When comparing moisture chamber devices and warm compress devices, only the change in TBUT (SMD 0.75; 95 % CI: 0.23 to 1.28; <em>P</em> = 0.005; I² = 30 %) were significantly favorable for moisture chamber goggles.</div></div><div><h3>Conclusions</h3><div>Despite their limited overall efficacy, eyelid warming devices significantly reduce OSDI questionnaire and improve NIBUT compared to controls or warm towel compress groups. Evidence remains insufficient to confirm whether moisture chamber devices provide better outcomes than warm compress devices. Further well-designed RCTs are needed to confirm these findings.</div></div>","PeriodicalId":54691,"journal":{"name":"Ocular Surface","volume":"37 ","pages":"Pages 33-46"},"PeriodicalIF":5.9,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143477339","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}