title: Effects of Dry Eye Therapies on Environmentally Induced Ocular Surface Disease.
abstract: OBJECTIVE
  To evaluate the effectiveness of artificial tears and corticosteroids on mitigating the acute ocular surface response to low-humidity environments.
  
  
  METHODS
  Single-group, crossover clinical trial.
  
  
  METHODS
  Twenty subjects with aqueous deficient dry eye were enrolled. Subjects meeting inclusion criteria at visit 1 were exposed to a baseline 90-minute low-humidity environment at visit 2. They then used artificial tears for 2 weeks prior to low-humidity exposure at visit 3, followed by 0.1% dexamethasone for 2 weeks prior to the final low-humidity exposure at visit 4. Outcome measures included corneal and conjunctival staining, blink rate, and irritation symptoms before and after each low-humidity exposure. Digital polymerase chain reaction (PCR) was performed to measure HLA-DR RNA transcripts in conjunctival cells taken by impression cytology at each visit.
  
  
  RESULTS
  There was significantly less corneal and conjunctival epitheliopathy after the low-humidity exposure at visit 4 compared to after the low-humidity exposure at visit 3 (P = .003). Subjects reported significantly less eye irritation during the low-humidity exposure after using the dexamethasone (visit 4) compared to artificial tears (visit 3) (P = .01). HLA-DR transcripts significantly decreased after the stress at visit 4 (post dexamethasone) compared to visit 2.
  
  
  CONCLUSIONS
  Our study demonstrates that corticosteroid eye drops mitigate the acute adverse effects of an experimental low-humidity challenge, likely owing to suppression of stress-activated inflammatory pathways. While extended use of corticosteroids is not indicated, other anti-inflammatory therapies with activity against stress-activated pathways may prove as effective.
authors: Department of Ophthalmology, Ocular Surface Center, Cullen Eye Institute, Baylor College of Medicine, Houston, Texas.
authors: Quianta L
authors: QL
authors: Moore
authors: Department of Ophthalmology, Ocular Surface Center, Cullen Eye Institute, Baylor College of Medicine, Houston, Texas.
authors: Cintia S
authors: CS
authors: De Paiva
authors: Department of Ophthalmology, Ocular Surface Center, Cullen Eye Institute, Baylor College of Medicine, Houston, Texas. Electronic address: stevenp@bcm.edu.
authors: Stephen C
authors: SC
authors: Pflugfelder
mesh_terms: D000287:Administration, Topical; D000328:Adult; D001767:Blinking / Q000502:physiology; D003228:Conjunctiva / Q000378:metabolism; D018592:Cross-Over Studies; D003907:Dexamethasone / Q000008:administration & dosage / Q000627:therapeutic use*; D015352:Dry Eye Syndromes / Q000188:drug therapy* / Q000209:etiology / Q000235:genetics; D004780:Environment, Controlled; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use*; D006684:HLA-DR Antigens / Q000235:genetics; D006801:Humans; D006813:Humidity / Q000009:adverse effects; D065346:Lubricant Eye Drops / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D009883:Ophthalmic Solutions; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D012313:RNA / Q000235:genetics; D016037:Single-Blind Method; D013666:Tears
chemical_list: D005938:Glucocorticoids; D006684:HLA-DR Antigens; D065346:Lubricant Eye Drops; D009883:Ophthalmic Solutions; D012313:RNA; D003907:Dexamethasone