Skip to main content

Advertisement

SpringerLink
Log in

Clinical evaluation of the effect of diquafosol ophthalmic solution in glaucoma patients with dry eye syndrome

  • Clinical Investigation
  • Published:
Japanese Journal of Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To investigate the effects of diquafosol on intraocular pressure (IOP) and dry eye symptoms in glaucoma patients with dry eye syndrome (DES).

Methods

This study evaluated a total of 138 glaucoma patients with DES who were treated with diquafosol ophthalmic solution (DIQUAS®). Before treatment and 1, 4, 12, 36, and 52 weeks after treatment, IOP, ocular surface disease index (OSDI), tear film break-up time (BUT), Schirmer I test scores, fluorescein staining, conjunctival impression cytology, and adverse drug reactions were evaluated.

Results

Throughout the treatment period, the mean IOP for all the patients remained stable after treatment with diquafosol (15.4 ± 2.8 mmHg at baseline and 16.0 ± 2.8 mmHg at 52 weeks). The mean OSDI score improved significantly at 4, 12, and 52 weeks after diquafosol treatment. The BUT and Schirmer I test scores were significantly increased after diquafosol treatment. The Oxford scheme score was significantly decreased at 1, 4, 12, 36, and 52 weeks after diquafosol treatment. A significant improvement in goblet cell density was observed after 4 weeks of treatment with diquafosol. Adverse drug reactions were reported in 22 (15.9 %) patients. There were no serious adverse drug reactions.

Conclusions

Diquafosol was effective in improving objective and subjective symptoms and maintained a stable IOP in glaucoma patients with DES. Therefore, the addition of diquafosol treatment in glaucoma patients with DES or ocular surface side effects using anti-glaucoma medication may be beneficial.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Van Buskirk EM, Cioffi GA. Glaucomatous optic neuropathy. Am J Ophthalmol. 1992;113:447–52.

    Article  PubMed  Google Scholar 

  2. Ammar DA, Kahook MY. Effects of glaucoma medications and preservatives on cultured human trabecular meshwork and non-pigmented ciliary epithelial cell lines. Br J Ophthalmol. 2011;95:1466–9.

    Article  PubMed  Google Scholar 

  3. Jaenen N, Baudouin C, Pouliquen P, Manni G, Figueiredo A, Zeyen T. Ocular symptoms and signs with preserved and preservative-free glaucoma medications. Eur J Ophthalmol. 2007;17:341–9.

    CAS  PubMed  Google Scholar 

  4. Lee SY, Wong TT, Chua J, Boo C, Soh YF, Tong L. Effect of chronic anti-glaucoma medications and trabeculectomy on tear osmolarity. Eye (London). 2013;27:1142–50.

    Article  CAS  Google Scholar 

  5. Li Y, Kuang K, Yerxa B, Wen Q, Rosskothen H, Fischbarg J. Rabbit conjunctival epithelium transports fluid, and P2Y2 receptor agonists stimulate Cl- and fluid secretion. Am J Physiol Cell Physiol. 2001;281:595–602.

    Google Scholar 

  6. Jumblatt JE, Jumblatt MM. Regulation of ocular mucin secretion by P2Y2 nucleotide receptors in rabbit and human conjunctiva. Exp Eye Res. 1998;67:341–6.

    Article  CAS  PubMed  Google Scholar 

  7. Murakami T, Fujihara T, Horibe Y, Nakamura M. Diquafosol elicits increases in net Cl- transport through P2Y2 receptor stimulation in rabbit conjunctiva. Ophthalmic Res. 2004;36:89–93.

    Article  CAS  PubMed  Google Scholar 

  8. Fujihara T, Murakami T, Nagano T, Nakamura M, Nakata K. INS365 suppresses loss of corneal epithelial integrity by secretion of mucin-like glycoprotein in a rabbit short-term dry eye model. J Ocul Pharmacol Ther. 2002;18:363–70.

    Article  CAS  PubMed  Google Scholar 

  9. Fujihara T, Murakami T, Fujita H, Nakamura M, Nakata K. Improvement of corneal barrier function by the P2Y(2) agonist INS365 in a rat dry eye model. Invest Ophthalmol Vis Sci. 2001;42:96–100.

    CAS  PubMed  Google Scholar 

  10. Matsumoto Y, Ohashi Y, Watanabe H, Tsubota K, Diquafosol Ophthalmic Solution Phase 2 Study Group. The efficacy and safety of diquafosol ophthalmic solution in patients with dry eye syndrome: a Japanese phase 2 clinical trial. Ophthalmology. 2012;119:1954–60.

    Article  PubMed  Google Scholar 

  11. Takamura E, Tsubota K, Watanabe H, Ohashi Y, Diquafosol Ophthalmic Solution Phase 3 Study Group. A randomized, double-masked comparison study of diquafosol versus sodium hyaluronate ophthalmic solutions in dry eye patients. Br J Ophthalmol. 2012;96:1310–5.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Koh S, Ikeda C, Takai Y, Watanabe H, Maeda N, Nishida K. Long-term results of treatment with diquafosol ophthalmic solution for aqueous-deficient dry eye. Jpn J Ophthalmol. 2013;57:440–6.

    Article  CAS  PubMed  Google Scholar 

  13. Guzman-Aranquez A, Pintor J. Focus on molecules: purinergic P2Y(2) receptor. Exp Eye Res. 2012;105:83–4.

    Article  Google Scholar 

  14. Martin-Gil A, de Lala MJ, Crooke A, Santano C, Peral A, Pintor J. Silencing of P2Y(2) receptors reduces intraocular pressure in New Zealand rabbits. Br J Pharmacol. 2012;165:1163–72.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Pintor J, Peral A, Pelaez T, Martin S, Hoyle CH. Presence of diadenosine polyphosphates in the aqueous humor: their effect on intraocular pressure. J Pharmacol Exp Ther. 2003;304:342–8.

    Article  CAS  PubMed  Google Scholar 

  16. Behrens A, Doyle JJ, Stern L, Chuck RS, McDonnell PJ, Azar DT, et al. Dysfunctional tear syndrome: a Delphi approach to treatment recommendations. Cornea. 2006;25:900–7.

    Article  PubMed  Google Scholar 

  17. Lemp MA, Baudouin C, Baum J, Dogru M, Foulks GN, Kinoshita S, et al. The definition and classification of dry eye disease: report of the Definition and Classification Subcommittee of the International Dry Eye Workshop. Ocul Surf. 2007;5:75–92.

    Article  Google Scholar 

  18. Schmidl D, Witkowska KJ, Kaya S, Baar C, Faatz H, Nepp J, et al. The association between subjective and objective parameters for the assessment of dry eye syndrome. Invest Ophthalmol Vis Sci. 2015;56:1467–72.

    Article  PubMed  Google Scholar 

  19. Miller KL, Walt JG, Mink DR, Satram-Hoang S, Wilson SE, Perry HD, et al. Minimal clinically important difference for the ocular surface disease index. Arch Ophthalmol. 2010;128:94–101.

    Article  PubMed  Google Scholar 

  20. Bron AJ, Evans VE, Smith JA. Grading of corneal and conjunctival staining in the context of other dry eye tests. Cornea. 2003;22:640–50.

    Article  PubMed  Google Scholar 

  21. Lütjen-Drecoll E, Tamm E, Kaufman PL. Age changes in rhesus monkey ciliary muscle: light and electron microscopy. Exp Eye Res. 1988;47:885–99.

    Article  PubMed  Google Scholar 

  22. Fine BS, Yanoff M, Stone RA. A clinicopathologic study of four cases of primary open-angle glaucoma compared to normal eyes. Am J Ophtalmol. 1981;91:88–105.

    Article  CAS  Google Scholar 

  23. Kunert KS, Tisdale AS, Gipson IK. Goblet cell numbers and epithelial proliferation in the conjunctiva of patients with dry eye syndrome treated with cyclosporine. Arch Ophthalmol. 2002;120:330–7.

    Article  CAS  PubMed  Google Scholar 

  24. Leung EW, Medeiros FA, Weinreb RN. Prevalence of ocular surface disease in glaucoma patients. J Glaucoma. 2008;17:350–5.

    Article  PubMed  Google Scholar 

  25. Skalicky SE, Goldberg I, McCluskey P. Ocular surface disease and quality of life in patients with glaucoma. Am J Ophthalmol. 2012;153:1–9.

    Article  PubMed  Google Scholar 

  26. Fechtner RD, Godfrey DG, Budenz D, Stewart JA, Stewart WC, Jasek MC. Prevalence of ocular surface complaints in patients with glaucoma using topical intraocular pressure lowering medications. Cornea. 2010;29:618–21.

    PubMed  Google Scholar 

Download references

Acknowledgments

The authors thank American Journal Experts for providing editing services for this manuscript.

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Dong-A University Medical Center, #26 Daesingongwon-ro, Seo-gu, Busan, 602-715, Republic of Korea

    Sang Wook Jin & Ji Sang Min

Authors
  1. Sang Wook Jin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ji Sang Min
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sang Wook Jin.

Ethics declarations

Conflicts of interest

S. W. Jin, None; J. S. Min, None.

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Jin, S.W., Min, J.S. Clinical evaluation of the effect of diquafosol ophthalmic solution in glaucoma patients with dry eye syndrome. Jpn J Ophthalmol 60, 150–155 (2016). https://doi.org/10.1007/s10384-016-0430-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10384-016-0430-8

Keywords

Search

Navigation