Dry eye (DE), characterized by a myriad of signs (e.g. decreased tear production, increased evaporation, and inflammation) and symptoms (e.g. pain, blurry vision and dryness), is a debilitating disease that affects quality of life. Many patients have persistent symptoms, because the available clinical therapies are not adequate to manage DE. Thus, managing DE requires solutions (i.e. beyond individual- level clinical interventions). An emerging literature suggests that environmental conditions can contribute to the onset and persistence of DE. Our microenvironment is a complex mixture of particulate matter (PM), gaseous air pollutants and allergens. However, individual specific data on microenvironment are not available. The project will test two novel hypotheses: 1) the clinical manifestations, measured by the types and severity of different measures of DE, vary with respect to types, levels and sources of air pollutants, allergens, humidity and temperature, specifically, exposure to PM, bioaerosols and gaseous pollutants is associated with epithelial disruption (ED), inflammation and evaporative tear deficiency (ETD), respectively; 2) DE signs are more strongly associated with indoor relative to outdoor air pollution, as we spend more time indoors and our indoor exposure dominates our total exposure to microenvironmental conditions. To test these hypotheses, we propose a prospective case-control design. We will recruit 360 subjects from Bascom Palmer Eye Institute (BPEI), ranked as the number 1 eye institute in the US consecutively for the past 12 years, and University of Maryland Ophthalmology ? Redwood (UMOR) clinics. 180 cases and age-, gender- and race/ethnicity-matched 180 controls will be determined after their clinical exams. Subjects who meet the inclusion criteria and have at least one of the three measures of DE, namely ED, inflammation, and ETD, will serve as cases, and controls will be free from these DE signs, and will meet inclusion criteria. Each subject will undergo four clinical exams one in each of the four seasons, and a weeklong intensive air pollution monitoring inside and outside their homes before the clinical exam. PRECISE (precise.ccs.miami.edu), our portable battery of direct-reading sensors, will measure air pollution in each subject's home for one full year. Over the same week, participants will record DE symptoms through web or phone. We will calculate time- weighted indoor and outdoor exposures, and model the effects of exposure on DE signs and symptoms using spatial econometric models. Our interdisciplinary team has the state-of-the-art laboratory facilities for clinical assessment of DE and exposure assessment as well as a collaborative track-record over four years. This project will generate knowledge that will potentially provide a new line of home-based environmental treatment to manage DE. This research aligns with the ?ocular infection, inflammation and immunology? priority areas of the National Eye Institute (NEI).

Public Health Relevance

Dry eye (DE) is the most common cause of visits to an eye clinic. Identifying whether indoor and outdoor environmental conditions affect DE has enormous public health implications. The knowledge generated through this project will formulate bases for developing individual-specific environmental interventions to improve DE status and expand non-clinical strategies to manage DE morbidity. Environmental interventions have the benefit of being preventative and therefore more cost-effective, and oftentimes more sustainable than clinical interventions for disease, and DE is likely no exception.

Agency
National Institute of Health (NIH)
Institute
National Eye Institute (NEI)
Type
Research Project (R01)
Project #
1R01EY026174-01A1
Application #
9176495
Study Section
Special Emphasis Panel (ZRG1)
Program Officer
Mckie, George Ann
Project Start
2016-09-01
Project End
2021-08-31
Budget Start
2016-09-01
Budget End
2017-08-31
Support Year
1
Fiscal Year
2016
Total Cost
Indirect Cost
Name
University of Miami School of Medicine
Department
Public Health & Prev Medicine
Type
Schools of Medicine
DUNS #
052780918
City
Coral Gables
State
FL
Country
United States
Zip Code
33146
Dermer, Harrison; Galor, Anat; Hackam, Abigail S et al. (2018) Impact of seasonal variation in meteorological conditions on dry eye severity. Clin Ophthalmol 12:2471-2481
Yesilirmak, Nilufer; Chhadva, Priyanka; Cabot, Florence et al. (2018) Post-Laser In Situ Keratomileusis Epithelial Ingrowth: Treatment, Recurrence, and Long-Term Results. Cornea 37:1517-1521
Akinsoji, Elizabeth; Goldhardt, Raquel; Galor, Anat (2018) A Glimpse into Uveitis in the Aging Eye: Pathophysiology, Clinical Presentation and Treatment Considerations. Drugs Aging 35:399-408
Sayed-Ahmed, Ibrahim; Murillo, Juan Carlos; Monsalve, Pedro et al. (2018) Blue Nevi of the Ocular Surface: Clinical Characteristics, Pathologic Features, and Clinical Course. Ophthalmology 125:1189-1198
Diel, Ryan J; Kroeger, Zachary A; Levitt, Roy C et al. (2018) Botulinum Toxin A for the Treatment of Photophobia and Dry Eye. Ophthalmology 125:139-140
Lee, Charity J; Felix, Elizabeth R; Levitt, Roy C et al. (2018) Traumatic brain injury, dry eye and comorbid pain diagnoses in US veterans. Br J Ophthalmol 102:667-673
Batawi, Hatim; Shalabi, Nabeel; Joag, Madhura et al. (2018) Sub-basal Corneal Nerve Plexus Analysis Using a New Software Technology. Eye Contact Lens 44 Suppl 1:S199-S205
Karanam, Veena C; Tamariz, Leonardo; Batawi, Hatim et al. (2018) Functional slit lamp biomicroscopy metrics correlate with cardiovascular risk. Ocul Surf :
Batawi, Hatim; Lollett, Ivonne Valentina; Maliakal, Cima et al. (2018) A Comparative Study of Central Corneal Epithelial, Stromal, and Total Thickness in Males With and Without Primary Open-Angle Glaucoma. Cornea 37:712-719
Sivanesan, Eellan; Levitt, Roy C; Sarantopoulos, Constantine D et al. (2018) Noninvasive Electrical Stimulation for the Treatment of Chronic Ocular Pain and Photophobia. Neuromodulation 21:727-734

Showing the most recent 10 out of 40 publications