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Establishment of A Mouse Model of Aqueous Deficiency Dry Eye
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Autonomic Nerve Activity Features According to Dry Eye Type.

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  • 1Wada Eye Clinic, Chiba, Japan.

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|June 12, 2023
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Dry eye symptoms are linked to parasympathetic nerve activity in short tear break-up time dry eye (sBUTDE). Autonomic nervous system involvement appears minimal in aqueous tear-deficient dry eye (ADDE).

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Area of Science:

  • Ophthalmology
  • Autonomic Neuroscience
  • Medical Physiology

Background:

  • Dry eye (DE) is a prevalent ocular condition with diverse etiologies.
  • Understanding the role of the autonomic nervous system (ANS) in DE symptomology is crucial for targeted treatment.
  • Distinguishing between different DE subtypes, such as short tear break-up time DE (sBUTDE) and aqueous tear-deficient DE (ADDE), is essential for elucidating underlying pathophysiological mechanisms.

Purpose of the Study:

  • To investigate the association between autonomic nerve activity and symptom intensity in patients with different types of dry eye.
  • To determine if parasympathetic and sympathetic nerve activity, as well as their fluctuations, correlate with dry eye symptom severity.

Main Methods:

  • A prospective, cross-sectional study involving 25 patients with sBUTDE and 24 patients with ADDE.
  • Autonomic nerve activity was assessed using heart rate variability (HRV) parameters, including low-frequency (LF) and high-frequency (HF) components, and their variations (cvRR, ccvLF, ccvHF).
  • Symptom intensity and stress levels were evaluated using the Japanese version of the Ocular Surface Disease Index (J-OSDI) and a stress questionnaire.

Main Results:

  • In sBUTDE, higher J-OSDI scores significantly correlated with increased parasympathetic activity (HF) and its fluctuation (ccvHF), as well as higher subjective stress.
  • No significant correlations were found between J-OSDI scores and autonomic parameters or stress in the ADDE group.
  • These findings suggest a differential involvement of the ANS in the symptom experience of distinct dry eye subtypes.

Conclusions:

  • Dry eye symptoms in sBUTDE are significantly associated with the magnitude and fluctuation of parasympathetic nerve activity.
  • Parasympathetic activity plays a role in the development of symptoms specifically in sBUTDE.
  • The autonomic nervous system's involvement in symptom generation appears minimal in ADDE, suggesting different underlying mechanisms for each subtype.