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

Journal Article (Journal Article;Review)

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.

Full Text

Duke Authors

Cited Authors

  • Periman, LM; Perez, VL; Saban, DR; Lin, MC; Neri, P

Published Date

  • April 2020

Published In

Volume / Issue

  • 36 / 3

Start / End Page

  • 137 - 146

PubMed ID

  • 32175799

Pubmed Central ID

  • PMC7175622

Electronic International Standard Serial Number (EISSN)

  • 1557-7732

Digital Object Identifier (DOI)

  • 10.1089/jop.2019.0060


  • eng

Conference Location

  • United States