Clinical improvement of ocular surface parameters in dry eye patients following treatment with urea/crosslinked-hyaluronate eyedrops correlates with the secretion of MUC-4

ABSTRACT

Objectives

To assess the ocular surface status after treatment with urea/crosslinked hyaluronate (U-HACL) tear substitute in dry eye (DE) patients.

Methods

Seventeen DE patients were included in the study. They instilled U-HACL drops three times/day for 2 months. Symptoms (by OSDI and VAS), osmolarity, tear film (through Schirmer and tear film breakup time), corneal and conjunctival damage (with NEI and van Bijsterveld scores), impression cytology (number of PAS positive cells and MUC-4 immunostaining), and tear sampling were analyzed pre- and post-treatment.

Results

After the treatment, there was a significant improvement of VAS (7.16 ± 2.59 vs. 3.94 ± 2.23), OSDI (56.96 ± 25.97 vs. 29.94 ± 20.15), Schirmer (8.22 ± 6.86 vs. 10.66 ± 6.92), TFBUT (3.16 ± 2.28 vs. 5.55 ± 2.47), NEI (7.16 ± 2.50 vs. 2.88 ± 2.80), and van Bijsterveld (10.27 ± 4.25 vs. 6.5 ± 3.79) score, p < 0.01. There was a significant increase of PAS positive cells and MUC-4 (respectively, 44.21 ± 14.8 vs. 67.0 ± 10.1 and 49.79 ± 20.0 vs. 75.9 ± 20.7), p < 0.01.

Conclusion

The rise of MUC-4 expression probably contributed to the increase in ocular wettability and amelioration of clinical parameters following the administration of U-HACL eye drops.

KEYWORDS:

• Dry eye
• cross-linked hyaluronic acid
• urea
• mucin
• cytokines
• ocular surface

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Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Author contributions

Rosa Longo: Study conception and design, acquisition of data, analysis and interpretation of data; drafted the article.

Anna Avesani: Study Design, acquisition of data, analysis and interpretation of data, drafted the article

Giulia Dalla Mura: Acquisition of data

Daniele Dell’Orco: Study Design, supervised the analysis and interpretation of data, revised the manuscript

Stefano Manfredini: Study Design, supervised the analysis and interpretation of data, revised the manuscript

Giacomo Panozzo: Study conception, revised the manuscript

Additional information

Funding

This paper was not funded.