The role of the Tear Film and Ocular Surface Society (TFOS) Dry Eye Workshop (DEWS) II Diagnostic Methodology Subcommittee was 1) to identify tests used to diagnose and monitor dry eye disease (DED), 2) to identify those most appropriate to fulfil the definition of DED and its sub-classifications, 3) to propose the most appropriate order and technique to conduct these tests in a clinical setting, and 4) to provide a differential diagnosis for DED and distinguish conditions where DED is a comorbidity. Prior to diagnosis, it is important to exclude conditions that can mimic DED with the aid of triaging questions. Symptom screening with the DEQ-5 or OSDI confirms that a patient might have DED and triggers the conduct of diagnostic tests of (ideally non-invasive) breakup time, osmolarity and ocular surface staining with fluorescein and lissamine green (observing the cornea, conjunctiva and eyelid margin). Meibomian gland dysfunction, lipid thickness/dynamics and tear volume assessment and their severity allow sub-classification of DED (as predominantly evaporative or aqueous deficient) which informs the management of DED. Videos of these diagnostic and sub-classification techniques are available on the TFOS website. It is envisaged that the identification of the key tests to diagnose and monitor DED and its sub-classifications will inform future epidemiological studies and management clinical trials, improving comparability, and enabling identification of the sub-classification of DED in which different management strategies are most efficacious.

TFOS DEWS II Diagnostic Methodology report

1. Curcumin is the active ingredient of the dietary spice turmeric and has been consumed for medicinal purposes for thousands of years. Modern science has shown that curcumin modulates various signalling molecules, including inflammatory molecules, transcription factors, enzymes, protein kinases, protein reductases, carrier proteins, cell survival proteins, drug resistance proteins, adhesion molecules, growth factors, receptors, cell cycle regulatory proteins, chemokines, DNA, RNA and metal ions. 2. Because of this polyphenol's potential to modulate multiple signalling molecules, it has been reported to possess pleiotropic activities. First demonstrated to have antibacterial activity in 1949, curcumin has since been shown to have anti-inflammatory, anti-oxidant, pro-apoptotic, chemopreventive, chemotherapeutic, antiproliferative, wound healing, antinociceptive, antiparasitic and antimalarial properties as well. Animal studies have suggested that curcumin may be active against a wide range of human diseases, including diabetes, obesity, neurological and psychiatric disorders and cancer, as well as chronic illnesses affecting the eyes, lungs, liver, kidneys and gastrointestinal and cardiovascular systems. 3. Although many clinical trials evaluating the safety and efficacy of curcumin against human ailments have already been completed, others are still ongoing. Moreover, curcumin is used as a supplement in several countries, including India, Japan, the US, Thailand, China, Korea, Turkey, South Africa, Nepal and Pakistan. Although inexpensive, apparently well tolerated and potentially active, curcumin has not been approved for the treatment of any human disease. 4. In the present article, we discuss the discovery and key biological activities of curcumin, with a particular emphasis on its activities at the molecular and cellular levels, as well as in animals and humans.

/pdf/discovery-of-curcumin-a-component-of-golden-spice-and-its-5ge0bwb9x7.pdf

Discovery of curcumin, a component of golden spice, and its miraculous biological activities

Anterior segment optical coherence tomography.

Curcumin, an active polyphenol of the golden spice turmeric, is a highly pleiotropic molecule with the potential to modulate the biological activity of a number of signaling molecules. Traditionally, this polyphenol has been used in Asian countries to treat such human ailments as acne, psoriasis, dermatitis, and rash. Recent studies have indicated that curcumin can target newly identified signaling pathways including those associated with microRNA, cancer stem cells, and autophagy. Extensive research from preclinical and clinical studies has delineated the molecular basis for the pharmaceutical uses of this polyphenol against cancer, pulmonary diseases, neurological diseases, liver diseases, metabolic diseases, autoimmune diseases, cardiovascular diseases, and numerous other chronic diseases. Multiple studies have indicated the safety and efficacy of curcumin in numerous animals including rodents, monkeys, horses, rabbits, and cats and have provided a solid basis for evaluating its safety and efficacy in humans. To date, more than 65 human clinical trials of curcumin, which included more than 1000 patients, have been completed, and as many as 35 clinical trials are underway. Curcumin is now used as a supplement in several countries including the United States, India, Japan, Korea, Thailand, China, Turkey, South Africa, Nepal, and Pakistan. In this review, we provide evidence for the pharmaceutical uses of curcumin for various diseases.

Curcumin, a component of turmeric: From farm to pharmacy

• PURPOSE: To compare biometry performed by an enhanced version of dual beam partial coherence interferometry and applanation ultrasound in a prospective study of 85 cataract eyes to improve refractive outcome of cataract surgery due to a more accurate calculation of intraocular lens power. • METHODS: The SRK II formula using ultrasound biometry data was employed. Three months after surgery, partial coherence interferometry biometry was repeated and refractive outcome was determined. Preoperative partial coherence interferometry biometry data were used to determine the refractive power of the intraocular lenses retrospectively and to calculate the possible refractive outcome. • RESULT: Precision of partial coherence interferometry biometry was more than 10 times better than that of ultrasound. Therefore, the possible mean absolute error for postoperative refraction achieved with partial coherence interferometry biometry was 0.49 diopters (compared with 0.67 diopters with ultrasound biometry), resulting in an improvement of 27%. Axial eye length measured with the two techniques differed by a mean of 460 μm. The difference in lens thickness measured with partial coherence interferometry and ultra-sound significantly correlated with cataract grade. A mean shortening of 120 μm of axial eye length following cataract surgery was also detected by partial coherence interferometry. • CONCLUSIONS: The enhanced version of partial coherence interferometry offers biometry with un, precedented precision (<10 μm) and resolution (~12 μm), therefore improving the refractive outcome in cataract surgery. This noninvasive technique provides a high degree of comfort for the patient, with no need for local anesthesia or pupil dilation and minimized risk of corneal infection.

Partial Coherence Interferometry: A Novel Approach to Biometry in Cataract Surgery

PURPOSE. A side effect associated with long-term treatment of various diseases with steroids is a high incidence of posterior subcapsular cataracts (PSC). To understand the mechanism underlying steroid-induced cataract, the cultured lens model was developed, and the expression of potential candidate proteins during opacity formation was examined. METHOD. Rat lenses were carefully dissected from the surrounding ocular tissue and incubated in medium 199. Dexamethasone was then added to the medium. The lenses were cultured for 7 days and photographed daily to record the development of opacity. Differential expression of candidate proteins was examined by Western blot analysis. RESULT. Various degrees of opacity were observed on the posterior subcapsular region as early as 5 days after incubation with dexamethasone. The expression of E-cadherin and N-cadherin decreased in the cultured rat lenses during the development of opacity. CONCLUSIONS. The pattern of opacity that developed in cultured rat lenses closely resembled that observed in patients with PSC. The results suggest that the decrease in E-cadherin plays a role in the formation of steroid-induced cataract.

Alteration of cadherin in dexamethasone-induced cataract organ-cultured rat lens.

Epidemiology of Infectious Keratitis(II): A Multi-center Study.

Purpose: To investigate the anti-angiogenic effect of topical curcumin on corneal neovascularization in a rabbit model.Materials and Methods: One week after suturing, six eyes were treated with balanced salt solution (BSS) (group A), and six eyes were treated with curcumin 40, 80, or 160 μmol/L (groups B, C, and D, respectively), topically two times a day. After one week, light microscopy was used to analyze corneal neovascularization. The concentration of vascular endothelial growth factor (VEGF) mRNA in the corneal tissue was measured by reverse transcriptase-polymerase chain reaction (RT-PCR), and the activation of NF-kappaB was examined by immunofluorescent staining.Results: Seven days after treatment, the sizes of the neovascularized areas were significantly reduced in groups B (50.1% ± 6.7%), C (43.2% ± 8.1%), and D (29.5% ± 7.8%) compared with group A (69.5% ± 1.5%) (p < 0.05). The corneal VEGF mRNA levels were significantly lower in groups C and D than they were in group A (p < 0.05). Immunofluore...

The effect of curcumin on corneal neovascularization in rabbit eyes.

To determine the effects of intra-operative Korean traditional music on pain experienced by Korean patients undergoing sequential bilateral cataract surgery. This was a two-sequence, two-period, and two-treatment crossover study. Fifty-two patients with cataracts were divided into two groups by block randomization, and bilateral cataract surgery was performed. In group 1, patients listened to Korean traditional music (KTM) during their first but not second cataract surgery. This sequence was reversed for patients in group 2. After each surgery, patients scored their pain intensity (PI) using a visual analog scale (VAS) ranging from 0 to 10, where 0 was ‘no pain’ and 10 was ‘unbearable pain.’ There was a statistically significant reduction in the mean VAS score with KTM (3.1 ± 2.0) compared to that without KTM (4.1 ± 2.2; p = 0.013). However, there were no statistically significant differences in blood pressure or pulse rates. KTM had a significant effect on reducing pain experienced by patients during cataract surgery. This may be useful in the context of other surgical procedures to reduce pain in Korean patients.

/pdf/crossover-clinical-trial-of-pain-relief-in-cataract-surgery-20mzm2qvfd.pdf

Crossover clinical trial of pain relief in cataract surgery.

Purpose: To determine the efficacy of topical application and subconjunctival injection of bevacizumab in the treatment of corneal neovascularization. Methods: Corneal neovascularization was induced with a silk suture of the corneal stroma in 12 rabbits (24 eyes). One week after suturing, four rabbits were treated with topical bevacizumab at 5 mg/mL (group A) and another four rabbits were treated with topical bevacizumab 10 mg/mL (group B) in the right eyes twice a day for two weeks. A subconjunctival injection of bevacizumab 1.25 mg/mL was done in the right eyes of four rabbits (group C). All of the left eyes (12 eyes) were used as controls. The area of corneal neovascularization was measured after one and two weeks, and the concentration of vascular endothelial growth factor (VEGF) in corneal tissue was measured after two weeks. Results: The neovascularized area was smaller in all treated groups than in the control group (p<0.001). Upon analysis of the neovascularized area, there was no significant difference between groups A and B. However, the mean neovascularized area of group B was significantly smaller than that of group C after two weeks of treatment (p=0.043). The histologic examination revealed fewer new corneal vessels in all treated groups than the control group. The concentration of VEGF was significantly lower in all treated groups compared to the control group (p<0.01), but no difference was shown between treated groups. Conclusions: Topical and subconjunctival bevacizumab application may be useful in the treatment of corneal neovascularization and further study is necessary.

The Effect of Bevacizumab on Corneal Neovascularization in Rabbits

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