Controlled Adverse Environment Chambers in Dry Eye Research

ABSTRACT

Dry eye disease (DED) is a common condition with signs and symptoms that vary depending on a wide range of environmental factors to which people are exposed in their daily lives. Factors such as variable temperature, airflow velocity, relative humidity, seasonality, and pollutants can alter the rate of tear film evaporation, improving or exacerbating symptoms of DED. Results from currently available clinical tests do not always correlate well with patient-reported symptoms, and the continually changing environment and variability in DED symptoms present challenges for the design and conduct of clinical trials. Controlled adverse environment chambers allow standardization of temperature, humidity, and airflow and may minimize potential confounding factors in clinical investigations. Their use can promote accurate study of the pathophysiology of DED, discovery of disease biomarkers, and assessment of the effect of various therapeutic approaches on patients’ symptoms. Controlled adverse environment chambers have been used to simulate indoor surroundings such as airplane cabins and to test their effects on contact lens wearers. This review summarizes how these chambers may be useful for the development, approval, and differentiation of potential new treatments for DED.

KEYWORDS:

• Dry eye disease (DED)
• controlled adverse environment chamber
• tear evaporation
• contact lens
• MIM-D3
• SkQ1

Acknowledgments

The authors thank Synergy Medical Communications for writing and editorial support, which was funded by Allergan Pharmaceuticals.

Competing interests

MC consulting for or research grants from Shire, Allergan, Esteve, and Ferrer International. ML has acted as a consultant for Allergan, Alcon, Bausch & Lomb, Dompé, MSD, Novartis, Santen, and Thea. EMM has acted as an advisor and presenter for Allergan, Alcon, Bausch & Lomb, Croma-Pharma, MSD, Oculus, Santen, Thea and Ursapharm. SS none declared. YAA has acted as an advisor and presenter for Allergan, Thea, Bausch & Lomb and Alcon. KGB consulting for or research grants from Allergan, Santen, Thea. JM-L has received research grants from Thea and has acted as a consultant for Allergan. PA has acted as a consultant and presenter for Allergan, Alcon Italy, Bausch & Lomb, Santen, Medivis, Thea, Eupharmed, and Farmigea and has received a research grant from SOOFT Italia. JBdC has acted as a consultant for Allergan, Bausch & Lomb, Thea, Alcon, and Santen. GG has acted as a consultant or speaker for Allergan, Alcon, Bausch & Lomb, Chiesi, Oculus, Santen, Thea, TearLab, and TearScience. MR declares financial relationships with Allergan, Bausch & Lomb, Farmigea, Thea, Alcon, Eupharma, Santen/Novagali, and AlfaIntes. CB consulting for or research grants from Alcon, Allergan, Dompé, Horus Pharma, Santen, and Thea.

Additional information

Funding

Allergan provided funding for meetings and for the development of this manuscript. The authors were involved in the entire process, from outlining to critical revision of the manuscript, and maintained complete control over its content.

Notes on contributors

Margarita Calonge

Margarita Calonge defined the concept and scope of the review. Marc Labetoulle, Elisabeth M Messmer, Sunil Shah, Yonca A Akova, Kostas G Boboridis, Jesús Merayo-Lloves, Pasquale Aragona, José Benítez-del-Castillo, Gerd Geerling, Maurizio Rolando, and Christophe Baudouin provided critical review of the manuscript. All of the authors were involved in the finalization of the manuscript.