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ARVO 2013 Annual Meeting Abstracts by Scientific Section/Group - Corneadepressive symptoms evaluation (78%). In 2011, the mean age of the1526 participants was 64.66 ± 9.47 years (50-91) and 900 werewomen (59%). Among them, 244 (16%) had dry eye disease and 142(9.3%) had depression. The ZDS was significantly correlated to dryeye symptoms (r=0.097; P Optive® > Systane Ultra®, with Opticol® evaporatingalmost instantly. Thealoz® was the only drop that did not precipitateor crystallize up to 48h, suggesting it is more stable than the othertested drops.Commercial Relationships: Constanca Coelho, Thea (F);Fernanda Azancoth, Thea (F)Support: Thea has funded all the reagents used in the submittedwork.Program Number: 6027 Poster Board Number: A0090Presentation Time: 10:30 AM - 12:15 PMAnterior segment OCT study of the pre-corneal film and itsrelationship with dry-eye patient`s symptoms and quantitativetests of the tear filmMaurizio Fossarello, Pietro E. Napoli, Giovanni M. Satta, FrancoCoronella. Ophthalmology, University of Cagliari, Cagliari, Italy.Purpose: To analyze the relationship among patient`s symptoms, thestability of the pre-corneal film as assessed by anterior segment OCT,and the "common" lacrimal tests such as: Schirmer`s test 1, tearbreak-up time (TBUT), and ocular surface staining.Methods: We examined a sample of 30 patients referred for dry eyesymptoms by means of McMonnies questionnaire, Schirmer`s test 1,TBUT, Oxford scheme for grading ocular surface staining. Tthedynamic distribution of the pre-corneal film was studied by usinganterior segment OCT (Carl Zeiss Meditec Cirrus HD OCT), and itwas quantitatively evaluated on the appearance of a double line of thetear film. OCT examination was performed before and after theinstillation of artificial tears up to the 5th minute. The kappa statisticwas used to assess the agreement between tests. All examinationswere conducted in the same conditions of temperature, brightness,humidity and time of the day.Results: Our population of dry-eye patients showed 3 levels ofseverity on the basis of subjective symptoms: mild, intermediate andsevere. A good association was shown between these 3 levels ofsymptoms and the OCT pattern of dynamic distribution of the precornealfilm: the tear film double line was reduced in height(Sperman's rho = 0.83; p=0.005), and the tear film showed a reducedresidence-time on the corneal surface (Sperman's rho = 0.65; p=0.01).This association between subjective patient`s symptoms and OCTpattern of the pre-corneal film was observed also in cases where theresults of the "common" objective tests resulted normal (kappa=0.78,p=0.03).Conclusions: The analysis by anterior segment OCT of the precornealfilm can reveal abnormalities of the dynamic pattern of tearsthat may explain the patient's symptoms, even when the commonlacrimal tests appear to be normal. The dynamic pattern of tears onthe cornea is most likely due to the adhesive properties of the ocularsurface that cannot be investigated by classical tests.Commercial Relationships: Maurizio Fossarello, None; Pietro E.Napoli, None; Giovanni M. Satta, None; Franco Coronella, NoneProgram Number: 6028 Poster Board Number: A0091Presentation Time: 10:30 AM - 12:15 PMEvaluation of the Standard Patient Evaluation of Eye Dryness(SPEED) QuestionnaireNancy J. Keir 1 , William Ngo 1 , Ping Situ 5 , Donald R. Korb 3, 4 ,Caroline A. Blackie 3, 4 , Trefford L. Simpson 2 . 1 School of Optometry-CCLR, University of Waterloo, Waterloo, ON, Canada; 2 School ofOptometry and Vision Science, University of Waterloo, Waterloo,ON, Canada; 3 TearScience, Morrisville, NC; 4 Korb Associates,Boston, MA; 5 School of Optometry, Indiana University,Bloomington, IN.Purpose: To evaluate the performance of the Standard PatientEvaluation of Eye Dryness (SPEED) questionnaire by assessing itsdimensionality, repeatability, validity, and by comparing it to four©2013, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permissionto reproduce any abstract, contact the ARVO Office at arvo@arvo.org.
ARVO 2013 Annual Meeting Abstracts by Scientific Section/Group - Corneaexisting dry eye questionnaires.Methods: A total of 50 subjects, 30 symptomatic and 20asymptomatic, as determined using the Ocular Surface Disease Index(OSDI) were enrolled. All subjects completed 5 different dry eyequestionnaires (SPEED, OSDI, DEQ, McMonnies and SESoD) in arandom order on two separate visits. Clinical measurements wereobtained on the first visit. Concordance correlation coefficient wasused to determine repeatability, Principal Component, Factor andRasch analyses were used to determine dimensionality, and thecomparison of SPEED scores to dry eye diagnosis defined by theOSDI (primarily using receiver-operator characteristic (ROC) curveanalysis) was used to determine validity.Results: The SPEED questionnaire was found to be uni-dimensionalusing Rasch analysis. Three principal components (dryness, burning,soreness/fatigue) were identified and SPEED scores between visitCCC was 0.923 (upper and lower 95% CI 0.868 to 0.955). The areaunder the ROC was 0.928. The only clinical measures that correlated“well” with SPEED scores were corneal staining (p < 0.05),meibomian gland score (MGS) (p < 0.05) and meibomian glandsyielding liquid secretion score (MGYLS) (p < 0.05).Conclusions: These results indicate that the SPEED questionnaire isa valid and repeatable instrument for measurement of dry eyesymptoms. The correlation of the SPEED score with clinicalmeasures of meibomian gland function suggests potential additionalclinical value for the diagnosis and/or management of meibomiangland dysfunction.Commercial Relationships: Nancy J. Keir, TearScience (F), Alcon(F), Alcon (R), Allergan (F), Johnson & Johnson (F), CooperVision(F), Visioneering, Inc. (F); William Ngo, None; Ping Situ, None;Donald R. Korb, TearScience (F); Caroline A. Blackie,TearScience (E); Trefford L. Simpson, NoneSupport: TearScienceProgram Number: 6029 Poster Board Number: A0092Presentation Time: 10:30 AM - 12:15 PMInhibition of Matrix Metalloproteinases by Mapracorat, a NovelSelective Glucocorticoid Receptor Agonist (SEGRA), in HumanCorneal Epithelial CellsThomas R. Vollmer, Karen L. Harrington, Jin-Zhong Zhang, MaryRichardson, Megan E. Cavet. Preclinical Pharmacology, Bausch +Lomb, Rochester, NY.Purpose: Dry eye disease is known to involve an increase in multiplematrix metalloproteinases (MMPs), particularly MMP-9, at the ocularsurface. Increased MMP-9 levels are associated with cornealepithelial barrier dysfunction that causes ocular irritation and visualdysfunction in dry eye disease. The aim of this study was todetermine the effect of mapracorat on MMP levels in human cornealepithelial cells (HCEpiC) exposed to hyperosmolarity and IL-1β.Methods: HCEpiC were challenged with 1 ng/ml IL-1β or 480mOsm hyperosmolar media (by the addition of sucrose) in thepresence of mapracorat or dexamethasone, both at 6 doses (1 - 300nM). After 24 h, culture medium was collected and evaluated forMMP release [MMP-1 MMP-2, MMP-3, MMP-9, MMP-10, MMP-12, and MMP-13] by Luminex. Dose response data were fitted to a 4parameter logistic equation to determine IC50 and efficacy.Results: IL-1β increased levels of all measured MMPs in theconditioned medium, while hyperosmolarity increased release of 4out of the 7 measured MMPs (MMP-1, 3, 9 and 13). Both IL-1β-(MMP-1, 2, 3, 9, 10, 12 and 13) and hyperosmolarity-induced(MMP-1, 3, 9, and 13) levels of MMPs were inhibited by mapracorat.Calculated IC50 values for inhibition of IL-1β and hyperosmolarityinducedMMPs for mapracorat were below 10 nM and were notstatistically significant from dexamethasone IC50 values. Mapracoratwas fully efficacious (>80% for the majority of MMPs) at reducingIL-1β and hyperosmolarity-induced cytokine release and nostatistically significant differences were identified when comparingMMP levels with those following dexamethasone treatment.Conclusions: Mapracorat potently reduced IL-1β andhyperosmolarity-induced MMP release to a similar extent asdexamethasone in HCEpiC. These data, together with mapracorat’sability to potently inhibit pro-inflammatory cytokines, and propensityfor an improved side effect profile as compared to traditional steroidswarrant investigation of this novel drug as a clinically effectivetreatment for dry eye disease.Commercial Relationships: Thomas R. Vollmer, Bausch + Lomb(E); Karen L. Harrington, Bausch + Lomb (E); Jin-Zhong Zhang,Bausch & Lomb, Inc (E); Mary Richardson, Bausch and Lomb (E);Megan E. Cavet, Bausch + Lomb (E)Program Number: 6030 Poster Board Number: A0093Presentation Time: 10:30 AM - 12:15 PMHistopathologic changes in punctal stenosisGary J. Lelli 1 , Alexander D. Port 3 , Yao-Tseng Chen 2 .1 Ophthalmology, Weill Cornell Medical College, New York, NY;2 Pathology and Laboratory Medicine, Weill Cornell Medical College,New York, NY; 3 Weill Cornell Medical College, New York, NY.Purpose: To describe the pathologic changes in punctal stenosis byreporting the histopathologic findings in a series of punctoplastyspecimens.Methods: Observational retrospective chart review. Electronic healthrecords of all patients having punctoplasty over a two-year period atan academic oculoplastic practice were examined. All patients whoserecords included pathology reports were entered into a database.Results: 24 patients, representing 30 eyes, had pathology records inthe EHR. Patients were 75% female, and had an average age of 65(19-88). Associated conditions included blepharitis (71%), dry eyesyndrome or Meibomian gland dysfunction (63%).Histopathologicexamination demonstrated chronic inflammation in 11 eyes (36.7%),fibrosis in 7 eyes (23.3%), chronic inflammation and fibrosis in 4eyes (13.3%), squamous metaplasia in 3 eyes (10%), normalconjunctival mucosa in 3 eyes (10%), and Acintomyces Israeliicanaliculitis in 2 eyes (6.7%).Conclusions: Nearly all histopathologic specimens revealed findingsconsistent with inflammation, fibrosis, or both. These findingsprovide evidence to support the hypothesis that the many etiologiccauses of punctal stenosis are linked by a common pathophysiologicmechanism involving inflammation.Representative histopathology findings in 3-snip punctoplastyspecimens. (A) Chronic inflammation with mainly lymphocyticinfiltrates in the conjunctival epithelium and underlying tissue.Magnification 400X©2013, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permissionto reproduce any abstract, contact the ARVO Office at arvo@arvo.org.
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