Optimizing the treatment for dry eye syndrome in patients with allergic conjunctivitis
F.A. Bakhritdinova,1 Dr Sc (Med), Prof.; S.A. Mirrakhimova,2 Dr Sc (Med), Ass. Prof.; K.I. Narzikulova,1 Dr Sc (Med), Ass. Prof.; Zh.O. Safarov, 2 Assistant; O.I. Oripov,1 Assistant
1 Ophthalmology Department, Tashkent Medical Academy; Tashkent (Uzbekistan)
2 Eye Disease Department, Samarkand State Medical Institute; Samarkand (Uzbekistan)
TO CITE THIS ARTICLE: Bakhritdinova FA, Mirrakhimova SA, Narzikulova KI, Safarov ZhO, Oripov OI. Optimizing the treatment for dry eye syndrome in patients with allergic conjunctivitis. J.ophthalmol.(Ukraine).2020;2:30-35. http://doi.org/10.31288/oftalmolzh202023035
Background: Allergic conjunctivitis is commonly complicated by secondary dry eye syndrome that substantially affects the quality of life of patients and requires a comprehensive approach to treatment.
Purpose: To improve treatment of dry eye patients with allergic conjunctivitis through the use of artificial tears.
Material and Methods: Fifty-six patients with acute allergic conjunctivitis complicated by secondary dry eye syndrome were included in the study. The main group, but not the control group, received artificial tears as adjunct to basic therapy. A comprehensive analysis included a study of clinical symptoms, status of the tear complex and meibomian glands.
Results: In addition to improvements in scores of subjective symptom questionnaire, and Schirmer test and tear film break up time (TFBUT) measurements, more apparent improvements in signs of disease were found in patients who received artificial tears as an adjunct to basic therapy beginning from day 10. The most severe meibographic evidence of morphological defects in gland ducts was seen in the papillary and follicular forms of conjunctivitis.
Conclusion: Comprehensive therapy with introduction of artificial tears as an adjunct at day 10 of basic treatment is a reasonable and pathogenetically substantiated corrective treatment for poor tear film function in the acute phase of allergic conjunctivitis.
Keywords: allergic conjunctivitis, dry eye syndrome, tear substitute therapy, meibography
1.Brzheskiy VV. [On the prevalence of vernal keratoconjunctivitis and current possibilities of treatment]. Russian Ophthalmological Journal. 2017;10(4):74–81. Russian.
2.Brzheskiy VV. [Allergic conjunctivitis: a guide for an outpatient ophthalmologist]. Meditsinskoie oboztrniie. 2018;1(2):74–9. Russian.
3.Majchuk DIu., Chilingarian LB. [Tear replacement therapy for allergic eye conditions]. Oftal'mologiia. 2012; 2:72–6. Russian.
4.Zabegailo AO, Safonova TN, Makarov IA. [A new method to determine the severity of the blepharoconjunctival form of the dry eye syndrome]. Kataraktal'naia i refraktcionnaia khirurgiia. 2013;13(1):35–8. Russian.
5.Maichuk IuF, Mironkova EA. [Classification of meibomian gland dysfunction combined with dry eye syndrome and pathogenetic approaches to complex therapy]. Klinicheskaia oftal'mologiia. 2007;8(4):169–72. Russian.
6.Nebbioso M, Fameli V, Gharbiya M, Sacchetti M, Zicari AM, Lambiase A. Investigational drugs in dry eye disease. Expert Opin Investig Drugs. 2016;25(12): 1437–46.
7.Trubilin VN, Polunina EG, Markova EIu, Andzhelova DV, Kurenkova SV. [Methods of screening diagnosis of meibomian gland dysfunction]. Oftal'mologiia. 2016;13(4):235–40. Russian.
8.Fogt JS, Kowalski MJ, King-Smith PE, et al. Tear lipid layer thickness with eye drops in meibomian gland dysfunction. Clin Ophthalmol. 2016 Nov7;10:2237–43.
9.Tomlinson A, Bron AJ, Korb DR, et al. The international workshop on meibomian gland dysfunction: report of the diagnosis subcommittee. Invest Ophthalmol Vis Sci. 2011 Mar 30;52(4):1994-2005.
10.Zhao Y, Veerappan A, Yeo S, et al. Clinical Trial of Thermal Pulsation (LipiFlow) in Meibomian Gland Dysfunction With Preteatment Meibography. Eye Contact Lens. 2016 Nov;42(6):339–46.
11.Rötzer V, Egu D, Waschke J. Meibomian gland cells display a differentiation-dependent composition of desmosomes. Histochem Cell Biol. 2016 Dec;146(6):685-694.
12.Hom MM, Nguyen AL, Bielory L. Allergic conjunctivitis and dry eye syndrome. Ann Allergy Asthma Immunol. 2012 Mar;108(3):163-6.
13.Nichols KK, Foulks GN, Bron AJ, et al. The International Workshop on Meibomian Gland Dysfunction: Executive Summary. Invest Ophthalmol Vis Sci. 2011 Mar 30;52(4):1922-9.
14.Pult H, Nichols JJ. A Review of Meibography. Optom Vis Sci. 2012 May;89(5):E760-9.
15.Pult H, Riede Pult B.H. Non-contact meibography: keep it simple but effective. Cont Lens Anterior Eye. 2012 Apr;35(2):77-80.
The authors declare no conflict of interest.