Tears of joy for new dry eye disease expertise Dry eye disease (DED) if left untreated increases the possibility of ocular damage. An EU project has advanced know-how on DED and trained a team of PhD students for the future eye comfort of millions of sufferers. Health © EDEN Approximately 30 % of patients seeking ophthalmological treatment in developed countries have symptoms consistent with DED. Ageing populations exacerbate this problem and the number of patients with DED is expected to increase substantially with this demographic shift. EDEN 20/20 vision and aims The Marie Skłodowska-Curie programme-funded EDEN project focused on DED, the most common ophthalmic disease. Due to many factors at the ocular surface, it results in discomfort, visual disturbance, tear alterations and tear film instability. “Lack of definitive diagnosis and aetiology frustrates ophthalmologists and patients,” explains Dr David Madrid Costa, project coordinator. This lack of concurrence in signs and symptoms poses a problem, not only for diagnosing the disease, but also for assessing its severity and designing clinical trials to evaluate the clinical efficacy of drugs. The EDEN project tackled these shortfalls from two angles: to advance understanding of DED, and provide diagnostic and therapeutic innovations for this disease. “In parallel, we trained 10 early-stage researchers in state-of-the-art concepts and research techniques essential to the study of the human eye,” Dr Madrid Costa elaborates. Far-reaching impact The study of DED development to improve therapeutic solutions or diagnostic tools and investigating its various aetiologies has significantly increased the general knowledge about this eye disease. With prevention in mind, the researchers explored new techniques to assess ocular surface health and diagnose DED in its early stages. Analysis of the propensity to develop DED in the future and anticipate its evolution is crucial for sustainable eye health. Multidisciplinary consortium partners shared their experience and knowledge to develop a new technique for assessment of tear dynamics and stability. Thanks to the EDEN project, now there are new approaches to evaluate the tear film and to analyse meibomian glands that produce meibum, an oily substance preventing evaporation of the eye’s tear film. “We now know the relationship between gland morphology and its function, tear film quality and ocular surface integrity,” Dr Madrid Costa points out. New artificial tear formulations developed now incorporate liposomes, bioadhesive polymers, in situ gelling polymers or their combinations. Other important components are antioxidants, osmoprotectants, and immunomodulators. Successful product development – not a dry eye in the world All formulations demonstrated suitable properties for topical ophthalmic administration. The rheological data on how the tears flow suggested that the formulations incorporating gellan gum behave as in situ gelling systems. The researchers think this feature could provide extended ocular residence time after administration in DED treatment. Safety tests found that the artificial tears are well tolerated in rabbits. “In addition, we developed an in vitro animal model for dry eye to evaluate novel pharmaceutical approaches to DED management,” the coordinator continues.” Vision for the future of ophthalmology after EDEN “We are very proud of the early-stage researchers who were working in the project as all of them were awarded with a double PhD title,” he says enthusiastically. To help disseminate the research, they were also provided with strong career management skills and sound professional connections. With an eye towards the future, Dr Madrid Costa sums up: “It is very important to continue studying DED. In my opinion, the great challenge is to improve diagnostics tools to find the correlation between the signs and symptoms. Early diagnosis, as well as risk factors for prevention of the condition is crucial.” Keywords EDEN, DED, dry eye, tear film, tears, ocular surface, formulation, diagnostics, ophthalmological, polymer
