To evaluate 3% diquafosol ophthalmic solution on ocular surface parameters and the alterations of lipid and muco-aqueous layer in tear film of patients with visual display terminal (VDT)-associated dry eye disease (DED).

This study included patients with VDT-associated DED. It was a prospective single-arm interventional clinical trial. Patients were provided with 3% diquafosol ophthalmic solution for 3mo and were followed up in 1, 2 and 3mo after treatment. Tear breakup time (TBUT), ocular surface staining score, and ocular surface disease index (OSDI) score were ocular surface characteristics. Lipid layer thickness (LLT), tear meniscus height (TMH), and mucin mRNA expression levels (MUC1, MUC4, MUC5AC, MUC16, and MUC20) were used to measure changes in the tear film. The LipiView interferometer was used to measure the partial blink rate (PBR).

Sixty-eight eyes of 68 participants (54 females; mean age 25.12±4.10y; mean spherical equivalent -4.35±2.69 D) were enrolled. Compared with the pre-treatment, OSDI scores and TBUT improved significantly at all follow-up time points (all P<0.01), and TMH increased significantly at 1 and 3mo (P<0.01, P<0.001, respectively). Conjunctival lissamine green staining improved only at 2mo (P<0.05), while corneal fluorescein staining showed no significant changes. Overall LLT remained unchanged, but the PBR<1 subgroup exhibited significant LLT elevation at 3mo (P<0.05), unlike the PBR=1 subgroup. Conjunctival mRNA expression of MUC1, MUC5AC, MUC16, and MUC20 was significantly upregulated at 1 and 3mo (all P<0.01), and MUC4 expression increased significantly only at 1mo (P<0.001).

In patients with VDT-associated DED, 3% diquafosol ophthalmic solution dramatically reduced symptoms and enhanced tear film stability by promoting ocular surface muco-aqueous secretion. Patients with better blinking habits (PBR<1) demonstrate greater LLT improvement than those with poorer habits.

To investigate the association between active corneal epithelial dendritic cells (CEDCs) and ocular pain in patients with dry eye disease (DED).

This cross-sectional study enrolled 67 DED patients, who were divided into two groups based on numerical rating scale (NRS) scores: the mild pain group (n=44) and the moderate-to-severe pain group (n=23). In vivo confocal microscopy (IVCM) was used to image the subbasal layer of the central cornea. Corneal nerve characteristics were analyzed using ACCMetrics software, while CEDCs were quantified manually with Image J software. Regression and correlation analyses were performed to assess the impact of active CEDCs on ocular pain. Additionally, the Luminex method was employed to compare the concentrations of inflammation-related cytokines in tears between patients with ≥2 CEDCs and those with <2 CEDCs. Differences in cytokine levels between the two groups were analyzed using Student’s t-test.

The study included 44 eyes of 44 patients with mild ocular pain (12 males and 32 females) and 23 eyes of 23 patients with moderate-to-severe ocular pain (3 males and 20 females). The mean age was 36.2±13.5y in the mild pain group and 39.7±12.4y in the moderate to severe pain group. There were no significant differences in age or sex between the two groups (P=0.30; P=0.19). Multivariable regression analysis showed that older age [odds ratio (OR) =1.05, 95% confidence interval (CI) 1.00–1.11] and a higher number of CEDCs (OR=1.80, 95%CI 1.17–2.76) were associated with ocular pain. Patients with ≥2 CEDCs had significantly higher tear concentrations of interleukin (IL)-6 (P<0.05), IL-8 (P<0.05), and tumor necrosis factor (TNF)-α (P<0.05) compared to those with <2 active CEDCs.

The findings suggest that infiltrating CEDCs in the corneal subbasal layer are a potential risk factor for ocular pain in DED.