The vicious cycle of dry eye disease: a look into promising novel drug therapies

ABSTRACT

Introduction

Dry eye disease (DED) is a very common ocular condition with a considerable socioeconomic impact affecting patient’s visual function and quality of life. Currently, thanks to the better knowledge on DED pathophysiology, therapeutical approaches are focused on the primary core mechanisms of DED. Furthermore, new drugs and compounds are being explored in the light of recent findings concerning unique disease-related pathways. The purpose of this review is to stress DED pathogenesis, addressing its vicious cycle, and highlighting the cutting-edge drug therapy approaches under development.

Areas covered

A literature search on the PubMed and Scopus databases was carried out. The database search strategy was formulated around the term ‘dry eye disease’ and other terms regarding its pathophysiology and therapeutic strategy. Additional search was conducted on ClinicalTrials.gov for unpublished results and ongoing clinical trials.

Expert opinion

The primary approaches used for DED include lifestyle, environmental changes, tears supplementation, and control of the eyelids and ocular surface inflammation. In selected cases, medical therapy could benefit by technological device-based management. Due to the complexity of DED and the continuous growth of disease prevalence and patients’ unmet needs, new therapeutic approaches focused on its pathogenesis are currently under investigation, while others are pending approval.

KEYWORDS:

• Dry eye
• DED
• ocular surface
• tear film
• dry eye treatment
• dry eye pathophysiology

Article highlights

• With a significant socioeconomic influence on patients’ quality of life and visual function, dry eye disease (DED) is the most frequent condition diagnosed during an ophthalmic consultation.

• In the past years, DED treatment strategies principally relied on compensating for tear loss.

• Nowadays, thanks to increased understanding of the DED pathophysiology, therapeutic strategies increasingly concentrate on the main underlying DED pathways.

• In addition to conventional therapeutic strategies and novel therapies already approved for the DED treatment, several novel and innovative drugs and molecules are currently under investigation.

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.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.