Study investigates features of dry eye disease flares

Evidence in the literature supporting the existence of dry eye disease (DED) flares can be found, highlighting risk factors and triggers, according to a rapid evidence assessment presented at the Women in Ophthalmology Meeting 2021 Summer Symposium.

In this study, 2093 publications on DED triggers, characteristics, and changes in biomarkers, were identified, with 21 publications involving 22 studies, meeting inclusion criteria. Most studies (n = 12) were controlled environment studies. The remaining studies focused on post-cataract and refractive surgery (n = 5) and daily life (n = 5).

In 3 of the studies involving controlled environment chambers, significant exacerbations affecting DED signs, more so than symptoms, were seen after exposure to adverse environments. EGF and IL-6 inflammatory markers were variable across all the controlled environment studies, and a rapid increase of MMP-9 expression suggests that an “innate immune response plays a role in DED flares which may be a suitable biomarker for the assessment of DED flares,” according to the authors.

In the post-cataract and refractive surgery studies, DED symptoms flares were reported because of lens-based and corneal-based refractive surgery. Patients with pre-operative dry eye were more likely to have severe post-operative dry eye in addition to significantly worse symptoms at 2 months post-surgery compared to baseline. Dry eye exacerbations after surgery were found to be more predictable and last long.

Data from 5 observational cohort studies found that daily life triggers that affect DED include air conditioning, wind, reading, low humidity, and watching TV, often resulting in blurred vision and increased corneal and conjunctival staining, which can last from weeks to months.

Reference
Owen D. 10 Year Rapid Evidence Assessment of Dry Eye Disease Flares. Presented at: WIO 2021 Summer Symposium.