Evaluation of oxidative stress levels in the conjunctival epithelium of patients with or without dry eye, and dry eye patients treated with preservative-free hyaluronic acid 0.15 % and vitamin B12 eye drops.
OBJECTIVE
Increased levels of oxidative stress have been seen in animal models of dry eye and in the conjunctival epithelial cells of patients with Sjögren's syndrome. The aims of this study were to compare the levels of oxidative stress in patients with dry eye and patients without dry eye and to evaluate the effects of treatment with preservative-free eye drops containing hyaluronic acid 0.15 % and vitamin B12 on oxidative stress and dry eye symptoms.


METHODS
Three cohorts of patients who were to undergo planned cataract surgery were enrolled: patients with dry eye randomized to either no treatment (n = 29) or treatment (n = 32) with hyaluronic acid/vitamin B12 eye drops, and patients without dry eye (n = 42). Patients were assessed by Schirmer's type I test, fluorescein clearance test (FCT), Break Up Time (BUT), and Ocular Surface Disease Index (OSDI). Lipid peroxidation, a marker of oxidative stress, was assessed by LP-CHOLOX test.


RESULTS
Compared with patients without dry eye, patients with dry eye had significantly increased levels of oxidative stress, higher OSDI and FCT scores, and significantly lower Schirmer's test and BUT scores. Treatment with eye drops containing hyaluronic acid 0.15 % and vitamin B12 was associated with significantly reduced levels of oxidative stress and OSDI and FCT scores and significantly increased Schirmer's test and BUT scores.


CONCLUSIONS
These findings indicate that oxidative stress is associated with dry eye and that hyaluronic acid/vitamin B12 eye drops may attenuate oxidative stress and inflammation, improving dry eye symptoms. Further study in controlled clinical trials is warranted.
U.O. Oculistica, IRCSS - Azienda Ospedaliera Universitaria San Martino IST - Istituto Nazionale per la Ricerca sul Cancro, Largo R. Benzi 10 - Padiglione Oculistica, Genoa, Italy, macria70@gmail.com.
Angelo
A
Macri
Chiara
C
Scanarotti
Anna Maria
AM
Bassi
Sebastiano
S
Giuffrida
Giorgio
G
Sangalli
Carlo Enrico
CE
Traverso
Michele
M
Iester
D000287:Administration, Topical; D000368:Aged; D003228:Conjunctiva / Q000187:drug effects* / Q000378:metabolism; D004338:Drug Combinations; D015352:Dry Eye Syndromes / Q000188:drug therapy* / Q000378:metabolism; D004848:Epithelium / Q000187:drug effects / Q000378:metabolism; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage*; D015227:Lipid Peroxidation; D008297:Male; D009883:Ophthalmic Solutions; D009994:Osmolar Concentration; D018384:Oxidative Stress / Q000187:drug effects*; D011310:Preservatives, Pharmaceutical; D011446:Prospective Studies; D013666:Tears / Q000737:chemistry; D055675:Viscosupplements / Q000008:administration & dosage*; D014805:Vitamin B 12 / Q000008:administration & dosage*; D014803:Vitamin B Complex / Q000008:administration & dosage*
D004338:Drug Combinations; D009883:Ophthalmic Solutions; D011310:Preservatives, Pharmaceutical; D055675:Viscosupplements; D014803:Vitamin B Complex; D006820:Hyaluronic Acid; D014805:Vitamin B 12