Skip to main content
Home
Zeitschriften
Zeitungen
Podcast
Gesundheitspolitik
Praxis
Allerlei
Jobs
Fachgebiete
Allgemeinmedizin Anästhesiologie & Intensivmedizin Apotheke Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kinder & Jugendheilkunde Neurologie & Psychiatrie Orthopädie & Unfallchirurgie Pflege Urologie Zahnmedizin
Subfächer Innere Medizin
Diabetologie Gastroenterologie Infektiologie Kardiologie Onkologie und Hämatologie Pneumologie Rheumatologie
Fortbildungen
Überblick Fortbildungen DFP-Literaturstudium-Artikel DFP-Webcast Fortbildungen DFP-Podcasts
Erweiterte Suche
Anmelden
nach oben
Spektrum der Augenheilkunde
Erschienen in:

18.12.2023 | review

Osmolarity spatial variations on the ocular surface

verfasst von: Hugo Pena-Verdeal, MSc, PhD, Jacobo Garcia-Queiruga, MSc, PhD, Noelia Nores-Palmas, OD, MSc, Veronica Noya-Padin, OD, MSc, Maria J. Giraldez, MSc, PhD, Eva Yebra-Pimentel, OD, PhD

Erschienen in: Spektrum der Augenheilkunde | Ausgabe 1/2025

Einloggen, um Zugang zu erhalten

Summary

Maintaining a healthy balance of tear production, preservation, and elimination is crucial for proper eye function. Tear osmolarity and its variations have been suggested to be reliable indicators for diagnosing high-prevalence pathologies such as dry eye disease (DED). It is important to note that in most methods used to estimate tear osmolarity, the fluid sample is collected from the inferior tear meniscus. However, tear film is distributed in different compartments across the ocular surface with distinctive characteristics. Clinicians should be aware that tear osmolarity sampled from that area can help estimate the value in other compartments and serve as an indicator in diagnosing DED, but it may not reflect the exact osmolarity due to different effects or forces. The present review aims to summarize the current experimental clinical knowledge regarding tear osmolarity variation and its significance in diagnosing tear film problems using mathematical models for assessing tear dynamics.
Vorheriger Artikel Visuelles Training bei trockener altersbedingter Makuladegeneration
Nächster Artikel Auswertung der Umfrage der Kommission für Kataraktchirurgie und intraokulare Implantate für 2023
Literatur
1.
Bron AJ, de Paiva CS, Chauhan SK, et al. TFOS DEWS II pathophysiology report. Ocul Surf. 2017;15:438–510.PubMed
2.
Wolffsohn JS, Arita R, Chalmers R, et al. TFOS DEWS II Diagnostic Methodology report. Ocul Surf. 2017;15:539–74.PubMed
3.
Craig JP, Nichols KK, Akpek EK, et al. TFOS DEWS II Definition and Classification Report. Ocul Surf. 2017;15:276–83.PubMed
4.
Stahl U, Willcox M, Stapleton F. Osmolality and tear film dynamics. Clin Exp Optom. 2012;95:3–11.PubMed
5.
Sullivan BD, Crews LA, Messmer EM, et al. Correlations between commonly used objective signs and symptoms for the diagnosis of dry eye disease: clinical implications. Acta Ophthalmol. 2014;92:161–6.PubMed
6.
van Setten GB. Osmokinetics: Defining the Characteristics of Osmotic Challenge to the Ocular Surface. Klin Monbl Augenheilkd. 2020;237:644–8.PubMed
7.
van Setten GB. Osmokinetics: A new dynamic concept in dry eye disease. J Fr Ophtalmol. 2019;42:221–5.PubMed
8.
Pena-Verdeal H, Garcia-Resua C, Garcia-Queiruga J, Sabucedo-Villamarin B, Yebra-Pimentel E, Giraldez MJ. Diurnal variations of tear film osmolarity on the ocular surface. Clin Exp Optom. 2023;106:351–61.PubMed
9.
Erstad BL. Osmolality and osmolarity: narrowing the terminology gap. Pharmacotherapy. 2003;23:1085–6.PubMed
10.
Pena-Verdeal H, Garcia-Resua C, Vazquez-Sanchez C, Garcia-Queiruga J, Yebra-Pimentel E, Giraldez MJ. Reproducibility in measuring tear samples using a freezing point depression osmometer. Clin Exp Optom. 2019;102:571–5.PubMed
11.
Nolfi J, Caffery B. Randomized comparison of in vivo performance of two point-of-care tear film osmometers. Clin Ophthalmol. 2017;11:945–50.PubMedPubMedCentral
12.
Keech A, Senchyna M, Jones L. Impact of time between collection and collection method on human tear fluid osmolarity. Curr Eye Res. 2013;38:428–36.PubMed
13.
Sabucedo-Villamarin B, Pena-Verdeal H, Garcia-Queiruga J, Giraldez MJ, Garcia-Resua C, Yebra-Pimentel E. Categorization of the Aqueous Deficient Dry Eye by a Cut-Off Criterion of TMH Measured with. Tearscope Life (basel). 2022;12.
14.
Liu H, Begley C, Chen M, et al. A link between tear instability and hyperosmolarity in dry eye. Invest Ophthalmol Vis Sci. 2009;50:3671–9.PubMed
15.
King-Smith PE, Ramamoorthy P, Braun RJ, Nichols JJ. Tear film images and breakup analyzed using fluorescent quenching. Invest Ophthalmol Vis Sci. 2013;54:6003–11.PubMedPubMedCentral
16.
Peng CC, Cerretani C, Braun RJ, Radke CJ. Evaporation-driven instability of the precorneal tear film. Adv Colloid Interface Sci. 2014;206:250–64.PubMed
17.
Braun RJ, King-Smith PE, Begley CG, Li L, Gewecke NR. Dynamics and function of the tear film in relation to the blink cycle. Prog Retin Eye Res. 2015;45:132–64.PubMed
18.
King-Smith PE, Nichols JJ, Nichols KK, Fink BA, Braun RJ. Contributions of evaporation and other mechanisms to tear film thinning and break-up. Optom Vis Sci. 2008;85:623–30.PubMed
19.
Luo L, Li DQ, Pflugfelder SC. Hyperosmolarity-induced apoptosis in human corneal epithelial cells is mediated by cytochrome c and MAPK pathways. Cornea. 2007;26:452–60.PubMed
20.
Tomlinson A, McCann LC, Pearce EI. Comparison of human tear film osmolarity measured by electrical impedance and freezing point depression techniques. Cornea. 2010;29:1036–41.PubMed
21.
Masmali A, Alrabiah S, Alharbi A, El-Hiti GA, Almubrad T. Investigation of tear osmolarity using the TearLab Osmolarity System in normal adults in Saudi Arabia. Eye Contact Lens. 2014;40:74–8.PubMed
22.
Wolffsohn JS, Wang MTM, Vidal-Rohr M, et al. Demographic and lifestyle risk factors of dry eye disease subtypes: A cross-sectional study. Ocul Surf. 2021;21:58–63.PubMed
23.
Garcia-Queiruga J, Pena-Verdeal H, Sabucedo-Villamarin B, Giraldez MJ, Garcia-Resua C, Yebra-Pimentel E. A cross-sectional study of non-modifiable and modifiable risk factors of dry eye disease states. Cont Lens Anterior Eye. 2023;46:101800.PubMed
24.
Tavakoli A, Markoulli M, Flanagan J, Papas E. The validity of point of care tear film osmometers in the diagnosis of dry eye. Ophthalmic Physiol Opt. 2022;42:140–8.PubMed
25.
Park J, Choi Y, Han G, et al. Evaluation of tear osmolarity measured by I‑Pen osmolarity system in patients with dry eye. Sci Rep. 2021;11:7726.PubMedPubMedCentral
26.
Sergio P, Giancarlo I, Matteo F, et al. Analysis of tear film in cystinosis patients treated with topical viscous cysteamine hydrochloride (Cystadrops((R))). Eur J Ophthalmol. 2022;11206721221078649.
27.
Pena-Verdeal H, Garcia-Resua C, Vazquez-Sanchez C, Garcia-Queiruga J, Giraldez MJ, Yebra-Pimentel E. Inter-eye osmolarity differences in patients with symptomatic and non-symptomatic dry eyes. Arq Bras Oftalmol. 2020;83:103–8.PubMed
28.
King-Smith PE, Fink BA, Nichols JJ, Nichols KK, Braun RJ, McFadden GB. The contribution of lipid layer movement to tear film thinning and breakup. Invest Ophthalmol Vis Sci. 2009;50:2747–56.PubMed
29.
Nichols JJ, Mitchell GL, King-Smith PE. Thinning rate of the precorneal and prelens tear films. Invest Ophthalmol Vis Sci. 2005;46:2353–61.PubMed
30.
Garcia-Queiruga J, Pena-Verdeal H, Giraldez MJ, Garcia-Resua C, Yebra-Pimentel E. Inter-week variation of meibometry and tear break-up time in healthy subjects. Clin Exp Optom. 2021;104:691–7.PubMed
31.
Bron AJ, Tiffany JM, Yokoi N, Gouveia SM. Using osmolarity to diagnose dry eye: a compartmental hypothesis and review of our assumptions. Adv Exp Med Biol. 2002;506:1087–95.PubMed
32.
Gaffney EA, Tiffany JM, Yokoi N, Bron AJ. A mass and solute balance model for tear volume and osmolarity in the normal and the dry eye. Prog Retin Eye Res. 2010;29:59–78.PubMed
33.
Willcox MDP, Argueso P, Georgiev GA, et al. TFOS DEWS II Tear Film Report. Ocul Surf. 2017;15:366–403.PubMedPubMedCentral
34.
McMonnies CW. An examination of the relationship between ocular surface tear osmolarity compartments and epitheliopathy. Ocul Surf. 2015;13:110–7.PubMed
35.
Thiagarajah JR, Verkman AS. Aquaporin deletion in mice reduces corneal water permeability and delays restoration of transparency after swelling. J Biol Chem. 2002;277:19139–44.PubMed
36.
Levin MH, Verkman AS. Aquaporin-dependent water permeation at the mouse ocular surface: in vivo microfluorimetric measurements in cornea and conjunctiva. Invest Ophthalmol Vis Sci. 2004;45:4423–32.PubMed
37.
Levin MH, Verkman AS. Aquaporins and CFTR in ocular epithelial fluid transport. J Membr Biol. 2006;210:105–15.PubMed
38.
Alishahi M, Kamali R. Forced diffusion of water molecules through aquaporin‑5 biomembrane; a molecular dynamics study. Biophys Physicobiol. 2018;15:255–62.PubMedPubMedCentral
39.
Luke RA, Braun RJ, Driscoll TA, Awisi-Gyau D, Begley CG. Parameter Estimation for Mixed-Mechanism Tear Film Thinning. Bull Math Biol. 2021;83:56.PubMed
40.
McDonald JE, Brubaker S. Meniscus-induced thinning of tear films. Am J Ophthalmol. 1971;72:139–46.PubMed
41.
Miller KL, Polse KA, Radke CJ. Black-line formation and the “perched” human tear film. Curr Eye Res. 2002;25:155–62.PubMed
42.
Owens H, Phillips JR. Tear spreading rates: post-blink. Adv Exp Med Biol. 2002;506:1201–4.PubMed
43.
King-Smith PE, Hinel EA, Nichols JJ. Application of a novel interferometric method to investigate the relation between lipid layer thickness and tear film thinning. Invest Ophthalmol Vis Sci. 2010;51:2418–23.PubMedPubMedCentral
44.
Kimball SH, King-Smith PE, Nichols JJ. Evidence for the major contribution of evaporation to tear film thinning between blinks. Invest Ophthalmol Vis Sci. 2010;51:6294–7.PubMedPubMedCentral
45.
Braun RJ, Fitt AD. Modelling drainage of the precorneal tear film after a blink. Math Med Biol. 2003;20:1–28.PubMed
46.
Maissa C, Guillon M. Tear film dynamics and lipid layer characteristics—effect of age and gender. Cont Lens Anterior Eye. 2010;33:176–82.PubMed
47.
Blanco-Campoy DG, Graue-Hernandez EO, Quiroz-Casian N, Velez-Cordero JR, Yanez-Soto B. In-vitro evaluation of the evaporation retardation by Meibomian lipids in homogeneous and non-homogeneous evaporation. J Colloid Interface Sci. 2022;625:210–9.PubMed
48.
Benjamin WJ, Hill RM. Tonicity of human tear fluid sampled from the cul-de-sac. Br J Ophthalmol. 1989;73:624–7.PubMedPubMedCentral
49.
Benjamin WJ, Hill RM. Tear osmotic differences across the ocular surface. Graefes Arch Clin Exp Ophthalmol. 1986;224:583–6.PubMed
50.
Pena-Verdeal H, Noya-Padin V, Losada-Oubina M, Saborido-Rey M, Vilas-Alonso M, Giraldez MJ. Changes of symptomatology, tear film and ocular surface integrity one week during Somofilcon‑A and Omafilcon‑A lens wear. Eur J Ophthalmol. 2022;11206721221131131.
51.
Zubkov VS, Breward CJ, Gaffney EA. Coupling fluid and solute dynamics within the ocular surface tear film: a modelling study of black line osmolarity. Bull Math Biol. 2012;74:2062–93.PubMed
52.
Li L, Braun RJ, Driscoll TA, Henshaw WD, Banks JW, King-Smith PE. Computed tear film and osmolarity dynamics on an eye-shaped domain. Math Med Biol. 2016;33:123–57.PubMed
53.
Braun RJ, Gewecke NR, Begley CG, King-Smith PE, Siddique JI. A model for tear film thinning with osmolarity and fluorescein. Invest Ophthalmol Vis Sci. 2014;55:1133–42.PubMedPubMedCentral
54.
Aydemir E, Breward CJ, Witelski TP. The effect of polar lipids on tear film dynamics. Bull Math Biol. 2011;73:1171–201.PubMed
55.
Zhu H, Chauhan A. A mathematical model for ocular tear and solute balance. Curr Eye Res. 2005;30:841–54.PubMed
56.
Siddiquea J, Braun R. Tear film dynamics with evaporation, osmolarity and surfactant transport. Appl Math Model. 2015;39.
57.
Braun R. Dynamics of the Tear Film. Annu Rev Fluid Mech. 2012;44.
58.
Abelson MB, Ousler GW 3rd, Nally LA, Welch D, Krenzer K. Alternative reference values for tear film break up time in normal and dry eye populations. Adv Exp Med Biol. 2002;506:1121–5.PubMed
59.
Lemp MA. Report of the National Eye Institute/Industry workshop on Clinical Trials in Dry Eyes. Clao J. 1995;21:221–32.PubMed
60.
Johnson ME, Murphy PJ. The Effect of instilled fluorescein solution volume on the values and repeatability of TBUT measurements. Cornea. 2005;24:811–7.PubMed
61.
Pena-Verdeal H, Ramos L, Garcia-Queiruga J, Garcia-Resua C, Giraldez MJ, Yebra-Pimentel E. Validation of a New Software Application for Tear Breakup Measurement. Optom Vis Sci. 2022;99:159–66.PubMed
62.
Luo L, Li DQ, Corrales RM, Pflugfelder SC. Hyperosmolar saline is a proinflammatory stress on the mouse ocular surface. Eye Contact Lens. 2005;31:186–93.PubMed
63.
Li DQ, Luo L, Chen Z, Kim HS, Song XJ, Pflugfelder SC. JNK and ERK MAP kinases mediate induction of IL-1beta, TNF-alpha and IL‑8 following hyperosmolar stress in human limbal epithelial cells. Exp Eye Res. 2006;82:588–96.PubMed
64.
Li DQ, Chen Z, Song XJ, Luo L, Pflugfelder SC. Stimulation of matrix metalloproteinases by hyperosmolarity via a JNK pathway in human corneal epithelial cells. Invest Ophthalmol Vis Sci. 2004;45:4302–11.PubMed
65.
Kam W, Sullivan DA, Sullivan BD, Venkiteshwar M. Does hyperosmolarity induce an irreversible process leading to human corneal epithelial cell death? Investigative Ophthalmology & Visual. Science. 2016;57.
66.
Schargus M, Ivanova S, Kakkassery V, Dick HB, Joachim S. Correlation of Tear Film Osmolarity and 2 Different MMP-9 Tests With Common Dry Eye Tests in a Cohort of Non-Dry Eye Patients. Cornea. 2015;34:739–44.PubMed
67.
Varikooty J, Simpson TL. The interblink interval I: the relationship between sensation intensity and tear film disruption. Invest Ophthalmol Vis Sci. 2009;50:1087–92.PubMed
68.
Begley C, Simpson T, Liu H, et al. Quantitative analysis of tear film fluorescence and discomfort during tear film instability and thinning. Invest Ophthalmol Vis Sci. 2013;54:2645–53.PubMedPubMedCentral
69.
Singh R, Joseph A, Umapathy T, Tint NL, Dua HS. Impression cytology of the ocular surface. Br J Ophthalmol. 2005;89:1655–9.PubMedPubMedCentral
70.
Versura P, Profazio V, Campos EC. Performance of tear osmolarity compared to previous diagnostic tests for dry eye diseases. Curr Eye Res. 2010;35:553–64.PubMed
71.
Versura P, Profazio V, Fresina M, Campos EC. A novel scraping cytology score system (SCSS) grades inflammation in dry eye patients. Curr Eye Res. 2009;34:340–6.PubMed
72.
Lopin E, Deveney T, Asbell PA. Impression cytology: recent advances and applications in dry eye disease. Ocul Surf. 2009;7:93–110.PubMed
73.
Schmidl D, Witkowska KJ, Kaya S, et al. The association between subjective and objective parameters for the assessment of dry-eye syndrome. Invest Ophthalmol Vis Sci. 2015;56:1467–72.PubMed
74.
Alves M, Reinach PS, Paula JS, et al. Comparison of diagnostic tests in distinct well-defined conditions related to dry eye disease. Plos One. 2014;9:e97921.PubMedPubMedCentral
75.
Chao C, Golebiowski B, Stapleton F. The role of corneal innervation in LASIK-induced neuropathic dry eye. Ocul Surf. 2014;12:32–45.PubMed
76.
Ambrosio R Jr., Tervo T, Wilson SE. LASIK-associated dry eye and neurotrophic epitheliopathy: pathophysiology and strategies for prevention and treatment. J Refract Surg. 2008;24:396–407.PubMed
77.
Lee JB, Ryu CH, Kim J, Kim EK, Kim HB. Comparison of tear secretion and tear film instability after photorefractive keratectomy and laser in situ keratomileusis. J Cataract Refract Surg. 2000;26:1326–31.PubMed
78.
Hassan Z, Szalai E, Berta A, Modis L Jr., Nemeth G. Assessment of tear osmolarity and other dry eye parameters in post-LASIK eyes. Cornea. 2013;32:e142–5.PubMed
79.
Denoyer A, Landman E, Trinh L, Faure JF, Auclin F, Baudouin C. Dry eye disease after refractive surgery: comparative outcomes of small incision lenticule extraction versus LASIK. Ophthalmology. 2015;122:669–76.PubMed
80.
Bron AJ, Yokoi N, Gaffney EA, Tiffany JM. A solute gradient in the tear meniscus. II. Implications for lid margin disease, including meibomian gland dysfunction. Ocul Surf. 2011;9:92–7.PubMed
81.
Bron AJ, Yokoi N, Gaffney EA, Tiffany JM. A solute gradient in the tear meniscus. I. A hypothesis to explain Marx’s line. Ocul Surf. 2011;9:70–91.PubMed
82.
Pult H, Korb DR, Blackie CA, Knop E, Marx E. About vital staining of the eye and eyelids. I. The anatomy, physiology, and pathology of the eyelid margins and the lacrimal puncta by E. Marx. Optom Vis Sci. 1924;2010(87):718–24.
83.
Gokhale M, Stahl U, Jalbert I. In situ osmometry: validation and effect of sample collection technique. Optom Vis Sci. 2013;90:359–65.PubMed
84.
Szczesna-Iskander DH. Measurement variability of the TearLab Osmolarity System. Cont Lens Anterior Eye. 2016;39:353–8.PubMed
Metadaten
Titel
Osmolarity spatial variations on the ocular surface
verfasst von
Hugo Pena-Verdeal, MSc, PhD
Jacobo Garcia-Queiruga, MSc, PhD
Noelia Nores-Palmas, OD, MSc
Veronica Noya-Padin, OD, MSc
Maria J. Giraldez, MSc, PhD
Eva Yebra-Pimentel, OD, PhD
Publikationsdatum
18.12.2023
Verlag
Springer Vienna
Erschienen in
Spektrum der Augenheilkunde / Ausgabe 1/2025
Print ISSN: 0930-4282
Elektronische ISSN: 1613-7523
DOI
https://doi.org/10.1007/s00717-023-00561-0

Weitere Artikel der Ausgabe 1/2025

Eine Analyse der Tätigkeiten von em. Univ.-Prof. Jürgen Faulborn zu seinem 90. Geburtstag 2024 aus der Sicht eines Klinikers

  • editorial

Auswertung der Umfrage der Kommission für Kataraktchirurgie und intraokulare Implantate für 2023

  • originalarbeit

Bewertung einer möglichen Linderung von OSD-spezifischen Symptomen von PURALID® Lipogel in Kombination mit Augenlidhygiene bei Patienten mit anteriorer Blepharitis und konsekutiver Meibom-Drüsen-Dysfunktion

  • Open Access
  • originalarbeit

Visuelles Training bei trockener altersbedingter Makuladegeneration

  • originalarbeit

Anterior segment optical coherence tomography-assisted surgical planning of an organic intralamellar corneal foreign body removal: a case report

  • Open Access
  • case report