Monday, October 17, 2011

Abstract: Topical Epigallocatechin Gallate (from green tea)

This is early stage mice research so don't get excited yet. Interesting stuff, though, & seems to have been studied extensively in the role of skin cancer prevention. In this study it reduced clinical signs and inflammation.

Therapeutic Efficacy of Topical Epigallocatechin Gallate in Murine Dry Eye.

To study the efficacy of topical epigallocatechin gallate (EGCG) for the treatment of dry eye disease (DED).

Seven- to 8-week-old female C57BL/6 mice were housed in the controlled environment chamber to induce DED. Topical 0.01% or 0.1% EGCG, or vehicle, was applied to the eyes of DED mice. Corneal fluorescein staining and the number of corneal CD11b+ cells were assessed in the different groups. Expression of interleukin-1β, tumor necrosis factor-α, chemokine ligand 2, and vascular endothelial growth factor (VEGF)-A/C/D was evaluated by real-time polymerase chain reaction in the corneas at day 9. Corneas were stained for lymphatic vessel endothelial hyaluronan receptor (LYVE)-1 to evaluate lymphangiogenesis, and the terminal transferase dUTP nick end labeling (TUNEL) assay was used to evaluate apoptosis of corneal epithelial cells.

Treatment with 0.1% EGCG showed a significant decrease in corneal fluorescein staining compared with the vehicle (24.6%, P = 0.001) and untreated controls (41.9%, P < 0.001). A significant decrease in the number of CD11b+ cells was observed in 0.1% EGCG-treated eyes, compared with the vehicle in the peripheral (23.3%, P = 0.001) and central (26.1%, P = 0.009) corneas. Treatment with 0.1% EGCG was associated with a significant decrease in the corneal expression of interleukin-1β (P = 0.029) and chemokine ligand 2 (P = 0.001) compared with the vehicle and in VEGF-A and VEGF-D levels compared with the untreated group (P = 0.007 and P = 0.048, respectively). EGCG 0.01% also showed a decrease in inflammation at the molecular level but no significant changes in the clinical signs of DED. No cellular toxicity to the corneal epithelium was observed with 0.01% or 0.1% EGCG.

Topical EGCG treatment is able to reduce the clinical signs and inflammatory changes in DED by suppressing the inflammatory cytokine expression and infiltration of CD11b+ cells in the cornea.

Cornea. 2011 Oct 11. [Epub ahead of print]
Lee HS, Chauhan SK, Okanobo A, Nallasamy N, Dana R.
From the Schepens Eye Research Institute, and Massachusetts Eye and Ear Infirmary; and Department of Ophthalmology, Harvard Medical School, Boston, MA.

NC center first to offer Lipiflow

I have really mixed feelings about Lipiflow. I love seeing the new innovations springing and at the same time I always seem to find myself gritting my teeth.

More effective than other methods? Probably.
How many patients cannot get sufficient improvement to MGD with other treatments? Dunno.
Pricing? Absolutely scary.
How much symptomatic relief and for how long? Probably all over the map based on what I've heard so far.

If they can make it work financially while using it on people who actually truly need it, great. One of my worries about this sort of thing is that the high-dollar treatments for the most part attract the desperate people who often have quite complex cases whose symptoms are probably not exclusively attributable to blocked MGs.

TearScience Announces First U.S.-Based Eye Care Practice, Carolina Vision Center, to Offer LipiFlow(R) Treatment

MORRISVILLE, N.C., Oct 14, 2011 (BUSINESS WIRE) -- TearScience, Inc., a privately-held medical device company, today announced that Fayetteville, North Carolina-based Carolina Vision Center, is the first eye care center in United States to commercially offer the LipiFlow(R) Thermal Pulsation System, a breakthrough treatment for evaporative dry eye disease. TearScience's LipiFlow is designed to address meibomian gland dysfunction, allowing for the treatment of eyelid gland blockages during a non-invasive procedure administered at an eye care office. Opening the blocked eyelid glands allows the glands to resume the natural production of lipids (oils) needed for a healthy tear film. TearScience received U.S. FDA clearance for its LipiFlow(R) medical device on June 28, 2011.

Abstract: Dry eye symptoms for glaucoma patients

Symptoms and signs of tear film dysfunction in glaucomatous patients.

The purposes of this study were to evaluate the presence of symptoms of tear film dysfunction by using the Ocular Surface Disease Index (OSDI) questionnaire in glaucomatous patients and to examine whether they have ocular surface signs.

Fifty patients with ocular hypertension or open-angle glaucoma were sequentially examined. All patients used preserved antiglaucomatous drops once, twice, 3 times, or 4 times a day. Each patient filled out an OSDI questionnaire. Fluorescein corneal staining, lissamine green conjunctival staining, break-up time, and Schirmer I test were performed in patients with positive OSDI.

Using the OSDI, 26 of 50 patients (52%) showed at least mild symptoms of tear film dysfunction (score >12); of them, 17 (34%) had severe OSDI (Score >32). Decrease in tear production was seen in only 8 glaucomatous patients. The break-up time was <7 s in 18 patients. Lissamine green conjunctival staining was positive in at least one eye of all the 26 patients, whereas fluorescein corneal staining was positive in at least one eye of 22 patients. A statistically significant (P<0.05) difference was found for lissamine green conjunctival staining between 16 patients using ipotensive drops once or twice a day and 10 patients using drops 3 or 4 times a day. In the group of patients using only β-blocker agents, we found a positive correlation between symptoms and vital staining of the ocular surface.

Fifty-two percent of patients in therapy with preserved antiglaucomatous drops showed symptoms of tear film dysfunction. Signs of ocular surface diseases seemed to be greater in patients under >2 medications. Symptoms correlated to signs only in patients in monotherapy with β-blockers drops.

J Ocul Pharmacol Ther. 2011 Jun;27(3):281-5. Epub 2011 May 10.
Valente C, Iester M, Corsi E, Rolando M.
Clinica Oculistica, Department of Neurosciences, Ophthalmology, and Genetics, University of Genoa, Genoa, Italy.