The Immunological Basis of Dry Eye Disease and Current Topical Treatment Options

Laura M. Periman; Victor L. Perez; Daniel R. Saban; Meng C. Lin; Piergiorgio Neri

doi:10.1089/jop.2019.0060

journal article Open Access Apr 01, 2020

The Immunological Basis of Dry Eye Disease and Current Topical Treatment Options

Laura M. Periman Victor L. Perez

Daniel R. Saban

Meng C. Lin Piergiorgio Neri

Journal of Ocular Pharmacology and Therapeutics Vol. 36 No. 3 pp. 137-146 · SAGE Publications

View at Publisher Save 10.1089/jop.2019.0060

Abstract

Homeostasis of the lacrimal functional unit is needed to ensure a well-regulated ocular immune response comprising innate and adaptive phases. When the ocular immune system is excessively stimulated and/or immunoregulatory mechanisms are disrupted, the balance between innate and adaptive phases is dysregulated and chronic ocular surface inflammation can result, leading to chronic dry eye disease (DED). According to the Tear Film and Ocular Surface Society Dry Eye Workshop II definition, DED is a multifactorial disorder of the ocular surface characterized by impairment and loss of tear homeostasis (hyperosmolarity), ocular discomfort or pain, and neurosensory abnormalities. Dysregulated ocular immune responses result in ocular surface damage, which is a further contributing factor to DED pathology. Several therapeutics are available to break the vicious circle of DED and prevent chronic disease and progression, including immunosuppressive agents (steroids) and immunomodulators (cyclosporine and lifitegrast). Given the chronic inflammatory nature of DED, each of these agents is commonly used in clinical practice. In this study, we review the immunopathology of DED and the molecular and cellular actions of current topical DED therapeutics to inform clinical decision making.

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Details

Published: Apr 01, 2020
Vol/Issue: 36(3)
Pages: 137-146
License: View

Authors

L

Laura M. Periman

Periman Eye Center, Seattle, Washington.

V

Victor L. Perez

Duke Eye Center, Duke University School of Medicine, Durham, North Carolina.

D

Daniel R. Saban

Duke Eye Center, Duke University School of Medicine, Durham, North Carolina.

M

Meng C. Lin

School of Optometry, Clinical Research Center, University of California, Berkeley, California.

P

Piergiorgio Neri

The Eye Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates.

Cite This Article

Laura M. Periman, Victor L. Perez, Daniel R. Saban, et al. (2020). The Immunological Basis of Dry Eye Disease and Current Topical Treatment Options. Journal of Ocular Pharmacology and Therapeutics, 36(3), 137-146. https://doi.org/10.1089/jop.2019.0060

The Immunological Basis of Dry Eye Disease and Current Topical Treatment Options

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