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Acta Ophthalmol. 2013 Sep;91(6):e437-44. doi: 10.1111/aos.12134. Epub 2013 Apr 26.

Effects of amino acids enriched tears substitutes on the cornea of patients with dysfunctional tear syndrome.

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1
Department of Experimental Medical-Surgical Sciences, Ocular Surface Diseases Unit, University of Messina, Italy. paragona@unime.it

Abstract

PURPOSE:

To evaluate the effect of aminoacid enriched artificial tears on the ocular surface of patients with dysfunctional tear syndrome (DTS).

METHODS:

Forty patients were divided into two groups: group 1 treated for 90 days with sodium hyaluronate (SH) 0.15% 1 drop × 5 times/day; group 2 treated for 90 days with SH 0.15% + aminoacids mixture 1 drop × 5 times/day. Symptom score questionnaire, tear break-up time (TBUT), corneal fluorescein stain, Shirmer's I test and confocal microscopy were performed at baseline and after 30 and 90 days. Confocal images underwent morphometric analysis.

RESULTS:

Both treatments improved symptoms after 1 month. Group 2 patients showed at 1 month an improvement of TBUT and corneal stain, maintained throughout the study. Also Shirmer's I test improved after 3 months. In group 1, an improvement of TBUT and corneal stain was observed after 3 months. The morphometric analysis of confocal images demonstrated at month 1 an improvement of nerve tortuosity in group 2; after 3 months both groups showed a significant improvement versus baseline. The epithelium showed, in both groups, a reduction in hyperreflective large cells starting from 1 month; the area of the cells was significantly reduced after 3 months, with a significant higher reduction in group 2. The perineural stromal opacity was significantly increased after 3 months, particularly in group 2.

CONCLUSION:

This is the first study addressing corneal changes after amino acids administration in a DTS population. The treatment with amino acids enriched SH can be considered a useful tool in the treatment of DTS.

KEYWORDS:

amino acids; confocal microscopy; corneal epithelium; corneal morphometry; corneal nerves; corneal stroma

PMID:
23617248
DOI:
10.1111/aos.12134
[Indexed for MEDLINE]
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