Response to dry eye therapy among subjects with normal and abnormal tear film osmolarity

Session Details

Session Title: Cornea Medical II

Session Date/Time: Tuesday 13/09/2016 | 08:00-10:30

Paper Time: 09:42

Venue: Hall C3

First Author: : G.Smith UK

Co Author(s): :    J. Wolffsohn   V. Manoj                 

Abstract Details

Purpose:

To measure and compare response to dry eye therapy among subjects with normal and abnormal tear film osmolarity (TO).

Setting:

6 eye care clinics in UK

Methods:

120 subjects with dry eye symptoms were categorized into normal and hyper osmolar (>308mOsm/L) groups. Enrolled subjects were randomized into one of 3 treatments: Saline drops, Hypromellose 0.3% drops and HOW therapy (0.2% sodium hyaluronate drops, Omega-3 tablets, warm compress). At 3-month following treatment tear osmolarity, composite score for dry eye severity, and symptoms (SPEED questionnaire) were compared between normal and hyperosmolar subjects with all 3 treatments. Dry eye composite score was derived from an equally-weighted function with normalized dry eye signs including tear osmolarity, tear break up time (TBUT), Meibomian gland dysfunction grade (MGD), and corneal staining.

Results:

Following therapy, TO decreased only in the hyperosmolar group; greatest reduction measured with HOW at 3-mo vs baseline (337±23.18 vs 309.9±17.3) compared to saline (334.6±9.7 vs 317.7±11.1) and hypromellose (334.6±13.8 vs 316.7±19.9). Change from baseline in composite score was greatest with HOW therapy in the hyperosmolar group (-0.15±0.12). Composite score did not change significantly in the normal osmolar group (<-0.07±0.09). SPEED questionnaire showed greater reduction in symptoms in the normal osmolar group with HOW (-8.8±5.5) and saline (-5±6.1) versus Hypromellose (-0.63±7.03). Among hyperosmolar subjects, symptom reduction was greatest with HOW (-5.9±4.5) versus saline (-3.4±5.7) or hypromellose (-4.7±5.0).

Conclusions:

Tear osmolarity and Composite dry eye severity score reduced significantly in the hyperosmolar group; reduction was greatest with HOW therapy vs saline or hypromellose. Reduction in symptoms was greater among normal compared to hyper osmolar subjects with HOW and saline drops. Change in measured parameters between the normal and hyperosmolar groups, in response to the three therapies, highlights the utility of osmolarity measurement in differential diagnosis and management of ocular surface disease.

Financial Disclosure:

... is employed by a for-profit company with an interest in the subject of the presentation