Investigative Ophthalmology & Visual Science Cover Image for Volume 65, Issue 7
June 2024
Volume 65, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2024
Exploring the Impact of Glaucoma on Maximal Tear Production: A Study Using the i-Onion Device
Author Affiliations & Notes
  • Ana Zaldivar
    University of Miami Mary and Edward Norton Library of Ophthalmology, Miami, Florida, United States
  • Anat Galor
    University of Miami Mary and Edward Norton Library of Ophthalmology, Miami, Florida, United States
  • Drew Baeza
    University of Miami Mary and Edward Norton Library of Ophthalmology, Miami, Florida, United States
  • Anna Junk
    University of Miami Mary and Edward Norton Library of Ophthalmology, Miami, Florida, United States
  • Simran Mangwani Mordani
    University of Miami Mary and Edward Norton Library of Ophthalmology, Miami, Florida, United States
  • Paula A. Sepulveda-Beltran
    University of Miami Mary and Edward Norton Library of Ophthalmology, Miami, Florida, United States
  • David Valdes
    University of Miami Mary and Edward Norton Library of Ophthalmology, Miami, Florida, United States
  • Araliya Naomi Gunawardene
    University of Miami Mary and Edward Norton Library of Ophthalmology, Miami, Florida, United States
  • Therese Albans
    Alban Vision, Florida, United States
  • Kimberly Cabrera
    University of Miami Mary and Edward Norton Library of Ophthalmology, Miami, Florida, United States
  • Connie Wu
    University of Miami Mary and Edward Norton Library of Ophthalmology, Miami, Florida, United States
  • Footnotes
    Commercial Relationships   Ana Zaldivar None; Anat Galor None; Drew Baeza None; Anna Junk None; Simran Mangwani Mordani None; Paula Sepulveda-Beltran None; David Valdes None; Araliya Gunawardene None; Therese Albans None; Kimberly Cabrera None; Connie Wu None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2024, Vol.65, 1876. doi:
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      Ana Zaldivar, Anat Galor, Drew Baeza, Anna Junk, Simran Mangwani Mordani, Paula A. Sepulveda-Beltran, David Valdes, Araliya Naomi Gunawardene, Therese Albans, Kimberly Cabrera, Connie Wu; Exploring the Impact of Glaucoma on Maximal Tear Production: A Study Using the i-Onion Device. Invest. Ophthalmol. Vis. Sci. 2024;65(7):1876.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : This study investigates glaucoma's impact on lacrimal gland capacity using the i-Onion device.

Methods : The i-Onion device introduces an innovative approach for assessing tear gland capacity. By emitting controlled bursts of highly concentrated CO2 (99.9%) onto the ocular surface, it stimulates the lacrimal glands' maximum secretory capacity. Study participants included 14 individuals with varying glaucoma severity and 40 controls. Participant information included age, gender, race, ethnicity, smoking, and contact lens use. Glaucoma severity, medication count, and disease duration were recorded. Tear capacity was tested using baseline unanesthetized Schirmer's measurements, followed by a 3-second i-Onion gas stimulation and repeat Schirmer’s measurements. The main outcome was the change in Schirmer (ΔSchirmer) post versus pre-stimulation. Secondary analyses explored correlations of demographic data, co-morbidities, and medications with maximum secretory capacity.

Results : The mean age was 44±21 years, 31% self-identified as female, 79% as White, and 21% as Hispanic. Cases were significantly older than controls (68±20 vs 36±14 years[WCM1] ) and spent less time on electronic devices (2.6±1.2 vs 4.1±1.2 hours, p<0.001); other demographics were matched between the groups. Baseline and post-stimulation Schirmer scores were lower in cases versus controls (pre: 11.46±8.27 vs 19.02±10.90 mm, p<0.001; post: 19.38±11.06 vs 26.95±8.30 mm, p<0.001). However, ΔSchirmer was similar between the two groups (7.93±8.81 and 8.43±4.05 mm, p=0.77). These findings held even when adjusting for potential confounders, including age and device use. Within cases, baseline Schirmer, post-stimulation Schirmer, and ΔSchirmer were not significantly related to glaucoma severity (r=-0.06 to 0.34[WCM2] ), number of drops (r=-0.23 to -0.08, p>0.05), and duration of glaucoma (r=-0.24 to 0.01, p>0.05). Baseline Schirmer score was the only factor found to correlate with ΔSchirmer (r= -0.54, p<0.001).

Conclusions : This study provides insights into lacrimal functional capacity in individuals with glaucoma using the i-Onion device. Glaucoma and topical glaucoma treatments do not seem to impact secretory tear capacity, measured as ΔSchirmer to a CO2 stimulus. Future research with larger numbers of participants and other ocular conditions may improve understanding of factors related to lacrimal gland function.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.

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