Effect of topical 3% diquafosol sodium on eyes with dry eye disease and meibomian gland dysfunction

Figures & data

Table 1 Changes in ocular surface parameters over time

Parameters	Pretreatment	1 month		2 months		3 months
			p-value		p-value		p-value
Telangiectasia
%	92.3 (60.9–98.9)	87.7 (59.5–97.2)	0.604	69.2 (40.9–88.0)	0.078	61.5 (34.4–83.0)	0.041
Number/eye	7.3 (5.2–9.4)	5.2 (3.1–7.3)	0.015	3.4 (1.3–5.5)	<0.001	2.8 (0.8–4.9)	<0.001
Anterior shift of MCJ, %	53.8 (28.2–77.6)	40.8 (19.0–66.9)	0.143	38.5 (17.0–65.6)	0.130	38.5 (17.0–65.6)	0.130
Lid margin irregularity, %	38.5 (17.0–65.6)	39.2 (17.4–66.3)	0.387	23.1 (7.6–52.2)	0.133	30.8 (12.0–59.1)	0.300
Gland orifice plugging
%	100.0	75.0		69.2		69.2
Number/eye	6.3 (4.5–8.1)	3.4 (1.5–5.2)	<0.001	2.2 (0.4–4.0)	<0.001	1.8 (0.0–3.6)	<0.001
Meibum score	2.3 (1.9–2.7)	2.2 (1.8–2.6)	0.617	2.2 (1.8–2.6)	0.658	1.8 (1.5–2.2)	0.011
Meiboscore
Upper eyelid	1.4 (0.8–2.0)	1.2 (0.6–1.8)	0.269	1.3 (0.7–1.9)	0.589	1.2 (0.6–1.8)	0.283
Lower eyelid	1.2 (0.8–1.7)	1.2 (0.8–1.7)	0.921	1.0 (0.5–1.5)	0.082	1.0 (0.5–1.5)	0.082
Total score	2.6 (1.7–3.6)	2.5 (1.5–3.4)	0.418	2.3 (1.3–3.3)	0.091	2.2 (1.3–3.2)	0.036
Schirmer I test result, mm	7.5 (6.4–8.7)	8.6 (7.4–9.9)	0.177	7.9 (6.7–9.2)	0.614	10.1 (8.9–11.3)	0.002
Tear breakup time, seconds	3.3 (1.6–5.0)	6.2 (4.5–7.9)	0.0007	6.4 (4.7–8.0)	0.0003	7.5 (5.9–9.2)	<0.0001
Fluorescein staining score	1.5 (0.9–2.2)	0.5 (0–1.2)	0.0004	0.4 (0–1.0)	<0.0001	0.4 (0–1.0)	<0.0001

Notes: Percentages for telangiectasia, shift of MCJ, lid margin irregularity, and plugging are percentages of eyes in which each sign is present. Data are presented as mean (95% CI). As the plugged ratio was 100% before treatment, CIs could not be estimated. p-values show comparisons with pretreatment values.

Abbreviation: MCJ, mucocutaneous junction.

Table 2 Tear lipid layer thickness immediately before and 20 minutes after administration of topical diquafosol sodium in eyes with dry eye disease and meibomian gland dysfunction

Parameters			Compared with pretreatment	Compared with first measurement
		LLT value (nm)	p-value	p-value
First measurement (before diquafosol administration)	Pretreatment	81.8 (64.5–99.2)
	1 month	77.0 (59.3–94.7)	0.563
	2 months	81.1 (63.7–98.4)	0.925
	3 months	79.7 (62.3–97.1)	0.791
Second measurement (20 minutes after diquafosol administration)	Pretreatment	94 (76.6–111.4)		0.138
	1 month	88.5 (70.8–106.2)	0.511	0.177
	2 months	90.5 (73.2–107.9)	0.671	0.247
	3 months	96.7 (79.3–114.1)	0.741	0.039

Note: 95% CIs are shown in parentheses.

Abbreviation: LLT, lipid layer thickness.

Table 3 Severity of dry eye disease symptoms in subjects with meibomian gland dysfunction before and after treatment with diquafosol sodium ophthalmic solution

Parameters			Estimated value	p-value
DEQS	Ocular symptoms	Pretreatment	20.5 (13.0–28.0)
		1 month	19.2 (11.4–26.9)	0.788
		2 months	14.4 (7.0–21.9)	0.220
		3 months	11.2 (3.7–18.7)	0.065
	Influence on daily life	Pretreatment	10.9 (4.3–17.5)
		1 month	8.0 (1.2–14.8)	0.493
		2 months	7.9 (1.4–14.5)	0.469
		3 months	9.6 (3.1–16.2)	0.756
	Total score	Pretreatment	14.8 (8.6–20.9)
		1 month	12.5 (6.1–18.9)	0.572
		2 months	10.5 (4.4–16.7)	0.284
		3 months	10.3 (4.1–16.4)	0.256
MGD questionnaire		Pretreatment	8.5 (5.2–11.7)
		1 month	9.4 (6.0–12.8)	0.659
		2 months	7.8 (4.5–11.0)	0.739
		3 months	4.8 (1.5–8.0)	0.081

Notes: Data are presented as mean (95% CIs). A higher score indicates a more severe symptomatic disease. p-values shown are for comparison with pretreatment values.

Abbreviations: DEQS, dry eye-related quality of life score; MGD, meibomian gland dysfunction.