TY - JOUR
T1 - Defining dry eye from a clinical perspective
AU - Tsubota, Kazuo
AU - Pflugfelder, Stephen C.
AU - Liu, Zuguo
AU - Baudouin, Christophe
AU - Kim, Hyo Myung
AU - Messmer, Elisabeth M.
AU - Kruse, Friedrich
AU - Liang, Lingyi
AU - Carreno-Galeano, Jimena Tatiana
AU - Rolando, Maurizio
AU - Yokoi, Norihiko
AU - Kinoshita, Shigeru
AU - Dana, Reza
N1 - Funding Information:
Funding: This research was funded by Asia Dry Eye Society and, for N.Y., “Grants-in-Aid for scientific research from the Japanese Ministry of Education, Culture, Sports, Science and Technology (Grant number: 16K11269).
Funding Information:
Acknowledgments: N. Yokoi wishes to thank John Bush (Dept. of Foreign Affairs, Kyoto Prefectural University of Medicine, Kyoto, Japan) for reviewing part of the manuscript. Editorial support was provided by Synergy Vision (London, UK) and funded by the Asia Dry Eye Society. The authors wish to thank Catherine Oshima (Keio University) for providing administrative support.
Funding Information:
Conflicts of Interest: The funders had no role in the design of the study; in the collection, analyses or interpretation of data; in the writing of the manuscript or in the decision to publish the results. Lingyi Liang and Jimena Tatiana Carreno-Galeano have no conflicts of interest to report. Christophe Baudouin acts as a consultant for Alcon, Allergan, Dompe, Horus Pharma, Santen and Sifi, Thea Labs. Reza Dana reports research support from Allergan and Shire, consulting from Aldevra, Dompe, Novaliq, Kala and Santen and owns equity at Claris Bio. Hyo Myung Kim reports research funding from Santen Pharmaceutical Co., Ltd. Shigeru Kinoshita reports grant support from Santen Pharmaceutical Co., Otsuka Pharmaceutical Co., Senju Pharmaceutical Co., KOWA Co. Ltd., HOYA Co., Oncolys Biopharma. Friedrich Kruse received financial support for traveling from TRB Chemedica and Santen and acts as a consultant for KOWA. Zuguo Liu reports research funding from Alcon, Santen, Senju, Yuejia, Xingqi, Zhuhaiyisheng and Dakai, as well as consultancies and travel grants from Allergen, Novartis, Johnson & Johnson Vision, Santen, Senju, Yuejia, Xingqi, Zhuhaiyisheng, Reilin and Dakai. Elisabeth M. Messmer acts as a speaker or consultant for: Alcon/Novartis, Dompé, Kala, Pharm-Allergan GmbH, Santen GmbH, Sun, Théa Pharma GmbH, TRB-Chemedica AG, Ursapharm and Visufarma. Stephen C. Pflugfelder reports research support from Allergan and Santen and consulting from Allergan, Shire and Senju. Maurizio Rolando reports consultancies received from Alcon, Kala, SIFI, Sun Pharma and Théa, as well as travel and speaker grants from Allergan, Bausch and Lomb, Alfa Intes, Bruschettini, Dompé, Medivis, Off, Santen. Kazuo Tsubota reports consultancies and research funding received from Santen Pharmaceutical Co., Ltd. and Otsuka Pharmaceutical Co., Ltd., consultancies for Théa Laboratories and Novaliq GmbH and research funding from Wakamoto Pharmaceutical Co., Ltd., Kowa Company, Echo Electricity Co., Kao, Rohto and Ophtecs. He holds the patent rights for the method and the apparatus used for the measurement of functional visual acuity (US patent no: 255 7470026). He holds a joint patent with Jins, Inc. for moisture glasses. Tsubota is the CEO of Tsubota Laboratory, a company in the dry eye field. Norihiko Yokoi has received personal fees from Santen Pharmaceutical Co., Ltd., Otsuka Pharmaceutical Co., Ltd. and consultancies from Rhoto Co., Ltd. and Alcon Japan Co., Ltd. and patents for the ophthalmologic apparatus with Kowa Co., Ltd.
PY - 2020/12/1
Y1 - 2020/12/1
N2 - Over the past decades, the number of patients with dry eye disease (DED) has increased dramatically. The incidence of DED is higher in Asia than in Europe and North America, suggesting the involvement of cultural or racial factors in DED etiology. Although many definitions of DED have been used, discrepancies exist between the various definitions of dry eye disease (DED) used across the globe. This article presents a clinical consensus on the definition of DED, as formulated in four meetings with global DED experts. The proposed new definition is as follows: “Dry eye is a multifactorial disease characterized by a persistently unstable and/or deficient tear film (TF) causing discomfort and/or visual impairment, accompanied by variable degrees of ocular surface epitheliopathy, inflammation and neurosensory abnormalities.” The key criteria for the diagnosis of DED are unstable TF, inflammation, ocular discomfort and visual impairment. This definition also recommends the assessment of ocular surface epitheliopathy and neurosensory abnormalities in each patient with suspected DED. It is easily applicable in clinical practice and should help practitioners diagnose DED consistently. This consensus definition of DED should also help to guide research and clinical trials that, to date, have been hampered by the lack of an established surrogate endpoint.
AB - Over the past decades, the number of patients with dry eye disease (DED) has increased dramatically. The incidence of DED is higher in Asia than in Europe and North America, suggesting the involvement of cultural or racial factors in DED etiology. Although many definitions of DED have been used, discrepancies exist between the various definitions of dry eye disease (DED) used across the globe. This article presents a clinical consensus on the definition of DED, as formulated in four meetings with global DED experts. The proposed new definition is as follows: “Dry eye is a multifactorial disease characterized by a persistently unstable and/or deficient tear film (TF) causing discomfort and/or visual impairment, accompanied by variable degrees of ocular surface epitheliopathy, inflammation and neurosensory abnormalities.” The key criteria for the diagnosis of DED are unstable TF, inflammation, ocular discomfort and visual impairment. This definition also recommends the assessment of ocular surface epitheliopathy and neurosensory abnormalities in each patient with suspected DED. It is easily applicable in clinical practice and should help practitioners diagnose DED consistently. This consensus definition of DED should also help to guide research and clinical trials that, to date, have been hampered by the lack of an established surrogate endpoint.
KW - Corneal epitheliopathy
KW - Definition
KW - Dry eye
KW - Dry eye signs
KW - Dry eye symptoms
KW - Inflammation
KW - Neuropathic pain
KW - Tear film breakup
UR - http://www.scopus.com/inward/record.url?scp=85097395913&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85097395913&partnerID=8YFLogxK
U2 - 10.3390/ijms21239271
DO - 10.3390/ijms21239271
M3 - Review article
C2 - 33291796
AN - SCOPUS:85097395913
VL - 21
SP - 1
EP - 24
JO - International Journal of Molecular Sciences
JF - International Journal of Molecular Sciences
SN - 1661-6596
IS - 23
M1 - 9271
ER -