Clinical and Molecular Outcomes After Combined Intense Pulsed Light Therapy With Low-Level Light Therapy in Recalcitrant Evaporative Dry Eye Disease With Meibomian Gland Dysfunction

Sharon D'Souza; Archana Padmanabhan Nair; Gowtham Iyappan; Mor M Dickman; Prashansa Thakur; Ritika Mullick; Gairik Kundu; Swaminathan Sethu; Arkasubhra Ghosh; Rohit Shetty

doi:10.1097/ICO.0000000000002954

Clinical and Molecular Outcomes After Combined Intense Pulsed Light Therapy With Low-Level Light Therapy in Recalcitrant Evaporative Dry Eye Disease With Meibomian Gland Dysfunction

Sharon D'Souza^*, Archana Padmanabhan Nair, Gowtham Iyappan, Mor M Dickman, Prashansa Thakur, Ritika Mullick, Gairik Kundu, Swaminathan Sethu, Arkasubhra Ghosh, Rohit Shetty

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

PURPOSE: Dry eye disease (DED) is a leading cause of ocular morbidity worldwide. This study evaluates the effects of combined light therapy [intense pulsed light (IPL) and low-level light therapy (LLLT)] on clinical and molecular outcomes in evaporative DED with meibomian gland dysfunction (MGD).

METHODS: This prospective study evaluated 94 eyes (47 subjects) with chronic MGD treated with combined light therapy. Patients underwent a detailed evaluation of MGD and DED using the Ocular Surface Disease Index, dry eye tests-tear breakup time and Schirmer test, ocular surface staining, meibomian gland expressibility scoring, and meibography. Patients underwent a single session of combined light therapy (IPL + LLLT treatment) using the Eye-light device. All these tests were repeated at 3 and 6 months after treatment. Tear fluid and ocular surface wash samples were collected from a subset of patients before and after treatment for cellular and secreted immune factor profiling by flow cytometry.

RESULTS: Combined light therapy (IPL + LLLT) demonstrated a marked improvement in the clinical metrics studied. Three months after treatment, Ocular Surface Disease Index showed a significant reduction in 95.6% (P < 0.0001), tear breakup time increased in 72.3% (P < 0.0001), and meibomian gland expressibility scoring increased in 80.8% (P < 0.0001) of the eyes. These effects were observed to be sustained during the 6-month follow-up visit. Significant (P < 0.05) reduction in tear fluid levels of interleukin-1β, interleukin-17F, and MMP9; MMP9/TIMP1 ratio; and ocular surface B-cell proportions was observed.

CONCLUSIONS: Combined light therapy shows promising results in patients with chronic MGD and DED, even in recalcitrant cases. Clinical and molecular factor alterations support the improved symptomatology and reduced inflammation.

Original language	English
Pages (from-to)	1080-1087
Number of pages	8
Journal	Cornea
Volume	41
Issue number	9
Early online date	15 Dec 2021
DOIs	https://doi.org/10.1097/ICO.0000000000002954
Publication status	Published - Sept 2022

Keywords

COMBINATION
CYTOKINES
DEFINITION
EXPRESSION
INTERNATIONAL WORKSHOP
OCULAR-SURFACE
STRESS
SYMPTOMS
TEAR FLUID
TRIAL
immune cells
intense pulsed light
low-level light therapy
meibomian gland dysfunction
molecular factors

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10.1097/ICO.0000000000002954

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D'Souza, S., Padmanabhan Nair, A., Iyappan, G., Dickman, M. M., Thakur, P., Mullick, R., Kundu, G., Sethu, S., Ghosh, A., & Shetty, R. (2022). Clinical and Molecular Outcomes After Combined Intense Pulsed Light Therapy With Low-Level Light Therapy in Recalcitrant Evaporative Dry Eye Disease With Meibomian Gland Dysfunction. Cornea, 41(9), 1080-1087. https://doi.org/10.1097/ICO.0000000000002954

@article{50902932b04e400285a10ce23f82f4e0,

title = "Clinical and Molecular Outcomes After Combined Intense Pulsed Light Therapy With Low-Level Light Therapy in Recalcitrant Evaporative Dry Eye Disease With Meibomian Gland Dysfunction",

abstract = "PURPOSE: Dry eye disease (DED) is a leading cause of ocular morbidity worldwide. This study evaluates the effects of combined light therapy [intense pulsed light (IPL) and low-level light therapy (LLLT)] on clinical and molecular outcomes in evaporative DED with meibomian gland dysfunction (MGD).METHODS: This prospective study evaluated 94 eyes (47 subjects) with chronic MGD treated with combined light therapy. Patients underwent a detailed evaluation of MGD and DED using the Ocular Surface Disease Index, dry eye tests-tear breakup time and Schirmer test, ocular surface staining, meibomian gland expressibility scoring, and meibography. Patients underwent a single session of combined light therapy (IPL + LLLT treatment) using the Eye-light device. All these tests were repeated at 3 and 6 months after treatment. Tear fluid and ocular surface wash samples were collected from a subset of patients before and after treatment for cellular and secreted immune factor profiling by flow cytometry.RESULTS: Combined light therapy (IPL + LLLT) demonstrated a marked improvement in the clinical metrics studied. Three months after treatment, Ocular Surface Disease Index showed a significant reduction in 95.6% (P < 0.0001), tear breakup time increased in 72.3% (P < 0.0001), and meibomian gland expressibility scoring increased in 80.8% (P < 0.0001) of the eyes. These effects were observed to be sustained during the 6-month follow-up visit. Significant (P < 0.05) reduction in tear fluid levels of interleukin-1β, interleukin-17F, and MMP9; MMP9/TIMP1 ratio; and ocular surface B-cell proportions was observed.CONCLUSIONS: Combined light therapy shows promising results in patients with chronic MGD and DED, even in recalcitrant cases. Clinical and molecular factor alterations support the improved symptomatology and reduced inflammation.",

keywords = "COMBINATION, CYTOKINES, DEFINITION, EXPRESSION, INTERNATIONAL WORKSHOP, OCULAR-SURFACE, STRESS, SYMPTOMS, TEAR FLUID, TRIAL, immune cells, intense pulsed light, low-level light therapy, meibomian gland dysfunction, molecular factors",

author = "Sharon D'Souza and {Padmanabhan Nair}, Archana and Gowtham Iyappan and Dickman, {Mor M} and Prashansa Thakur and Ritika Mullick and Gairik Kundu and Swaminathan Sethu and Arkasubhra Ghosh and Rohit Shetty",

year = "2022",

month = sep,

doi = "10.1097/ICO.0000000000002954",

language = "English",

volume = "41",

pages = "1080--1087",

journal = "Cornea",

issn = "0277-3740",

publisher = "LIPPINCOTT WILLIAMS & WILKINS",

number = "9",

}

D'Souza, S, Padmanabhan Nair, A, Iyappan, G, Dickman, MM, Thakur, P, Mullick, R, Kundu, G, Sethu, S, Ghosh, A & Shetty, R 2022, 'Clinical and Molecular Outcomes After Combined Intense Pulsed Light Therapy With Low-Level Light Therapy in Recalcitrant Evaporative Dry Eye Disease With Meibomian Gland Dysfunction', Cornea, vol. 41, no. 9, pp. 1080-1087. https://doi.org/10.1097/ICO.0000000000002954

Clinical and Molecular Outcomes After Combined Intense Pulsed Light Therapy With Low-Level Light Therapy in Recalcitrant Evaporative Dry Eye Disease With Meibomian Gland Dysfunction. / D'Souza, Sharon; Padmanabhan Nair, Archana; Iyappan, Gowtham et al.
In: Cornea, Vol. 41, No. 9, 09.2022, p. 1080-1087.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Clinical and Molecular Outcomes After Combined Intense Pulsed Light Therapy With Low-Level Light Therapy in Recalcitrant Evaporative Dry Eye Disease With Meibomian Gland Dysfunction

AU - D'Souza, Sharon

AU - Padmanabhan Nair, Archana

AU - Iyappan, Gowtham

AU - Dickman, Mor M

AU - Thakur, Prashansa

AU - Mullick, Ritika

AU - Kundu, Gairik

AU - Sethu, Swaminathan

AU - Ghosh, Arkasubhra

AU - Shetty, Rohit

PY - 2022/9

Y1 - 2022/9

N2 - PURPOSE: Dry eye disease (DED) is a leading cause of ocular morbidity worldwide. This study evaluates the effects of combined light therapy [intense pulsed light (IPL) and low-level light therapy (LLLT)] on clinical and molecular outcomes in evaporative DED with meibomian gland dysfunction (MGD).METHODS: This prospective study evaluated 94 eyes (47 subjects) with chronic MGD treated with combined light therapy. Patients underwent a detailed evaluation of MGD and DED using the Ocular Surface Disease Index, dry eye tests-tear breakup time and Schirmer test, ocular surface staining, meibomian gland expressibility scoring, and meibography. Patients underwent a single session of combined light therapy (IPL + LLLT treatment) using the Eye-light device. All these tests were repeated at 3 and 6 months after treatment. Tear fluid and ocular surface wash samples were collected from a subset of patients before and after treatment for cellular and secreted immune factor profiling by flow cytometry.RESULTS: Combined light therapy (IPL + LLLT) demonstrated a marked improvement in the clinical metrics studied. Three months after treatment, Ocular Surface Disease Index showed a significant reduction in 95.6% (P < 0.0001), tear breakup time increased in 72.3% (P < 0.0001), and meibomian gland expressibility scoring increased in 80.8% (P < 0.0001) of the eyes. These effects were observed to be sustained during the 6-month follow-up visit. Significant (P < 0.05) reduction in tear fluid levels of interleukin-1β, interleukin-17F, and MMP9; MMP9/TIMP1 ratio; and ocular surface B-cell proportions was observed.CONCLUSIONS: Combined light therapy shows promising results in patients with chronic MGD and DED, even in recalcitrant cases. Clinical and molecular factor alterations support the improved symptomatology and reduced inflammation.

AB - PURPOSE: Dry eye disease (DED) is a leading cause of ocular morbidity worldwide. This study evaluates the effects of combined light therapy [intense pulsed light (IPL) and low-level light therapy (LLLT)] on clinical and molecular outcomes in evaporative DED with meibomian gland dysfunction (MGD).METHODS: This prospective study evaluated 94 eyes (47 subjects) with chronic MGD treated with combined light therapy. Patients underwent a detailed evaluation of MGD and DED using the Ocular Surface Disease Index, dry eye tests-tear breakup time and Schirmer test, ocular surface staining, meibomian gland expressibility scoring, and meibography. Patients underwent a single session of combined light therapy (IPL + LLLT treatment) using the Eye-light device. All these tests were repeated at 3 and 6 months after treatment. Tear fluid and ocular surface wash samples were collected from a subset of patients before and after treatment for cellular and secreted immune factor profiling by flow cytometry.RESULTS: Combined light therapy (IPL + LLLT) demonstrated a marked improvement in the clinical metrics studied. Three months after treatment, Ocular Surface Disease Index showed a significant reduction in 95.6% (P < 0.0001), tear breakup time increased in 72.3% (P < 0.0001), and meibomian gland expressibility scoring increased in 80.8% (P < 0.0001) of the eyes. These effects were observed to be sustained during the 6-month follow-up visit. Significant (P < 0.05) reduction in tear fluid levels of interleukin-1β, interleukin-17F, and MMP9; MMP9/TIMP1 ratio; and ocular surface B-cell proportions was observed.CONCLUSIONS: Combined light therapy shows promising results in patients with chronic MGD and DED, even in recalcitrant cases. Clinical and molecular factor alterations support the improved symptomatology and reduced inflammation.

KW - COMBINATION

KW - CYTOKINES

KW - DEFINITION

KW - EXPRESSION

KW - INTERNATIONAL WORKSHOP

KW - OCULAR-SURFACE

KW - STRESS

KW - SYMPTOMS

KW - TEAR FLUID

KW - TRIAL

KW - immune cells

KW - intense pulsed light

KW - low-level light therapy

KW - meibomian gland dysfunction

KW - molecular factors

U2 - 10.1097/ICO.0000000000002954

DO - 10.1097/ICO.0000000000002954

M3 - Article

C2 - 34907942

SN - 0277-3740

VL - 41

SP - 1080

EP - 1087

JO - Cornea

JF - Cornea

IS - 9

ER -

Clinical and Molecular Outcomes After Combined Intense Pulsed Light Therapy With Low-Level Light Therapy in Recalcitrant Evaporative Dry Eye Disease With Meibomian Gland Dysfunction

Abstract

Keywords

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