Eyeworld

58 | EYEWORLD |JULY 2019 O UTSIDE THE OR RESEARCH HIGHLIGHT Contact information Ooi: kenneth.ooi@sydney.edu.au by Maxine Lipner EyeWorld Senior Contributing Writer Dr. Ooi and fellow investigators in another study 3 identified the enzyme that controlled cholesterol metabolism—HMG-CoA reduc- tase—and identified its presence in meibomian glands, pilosebaceous glands of hair follicles, and vascular endothelium, Dr. Ooi reported. "It had a positive control in terms of its presence in sebaceous glands of the skin," he said. They also reviewed the effect of oral statins on dry eye. In a large epidemiological study 4 involving 1,680 participants, investigators exam- ined whether taking oral statins at conventional dosing could reduce dry eye symptoms. No re- duction was found to any one dry eye symptom, Dr. Ooi noted. But literature indicates that high systemic cholesterol is associated with meibo- mian gland dysfunction and dry eye. "There are independent epidemiologic studies that have shown that in moderate to severe meibomian gland dysfunction in young to middle-aged patients, if there is no docu- mented history of hypercholesterolemia, you'll find more often than not there's an association between these patients and hypercholesterol- emia," Dr. Ooi said. "These patients are more W hile statins are well-known for their role in heart disease and controlling cholesterol, new research indicates they may also be helpful in ophthalmology. In a recent study, 1 investigators re- viewed the literature and found that these drugs, which also have anti-inflam- matory properties and vascular effects, may play a role in reducing the burden of ophthalmic conditions, such as dry eye, glaucoma, macular degeneration, diabetic retinopathy, and more. "It came to me that inflammation is the same everywhere," said Kenneth Ooi, MD, the study's primary author. Knowing that inflammation is associated with dry eye and research indicates that there might be excess-free cholesterol in meibomian gland dysfunction in the lipid layer, Dr. Ooi de- cided to look into a potential statin connection. "We did a pilot study 2 of 10 patients with blepharitis and dry eye and got positive results with reduced corneal fluorescein staining and improved tear breakup times," he said. "I had one patient who was able to keep her eyes open after treatment (without blinking) for 90 seconds." Getting to the heart of potential statin use in the eye About the doctor Kenneth Ooi, MD Clinical senior lecturer Save Sight Institute, Sydney Eye Hospital Campus University of Sydney Sydney, Australia Financial interests Ooi: Dr. Ooi and his co-investiga- tor Prof. Stephanie Watson have a patent on topical statins as novel tear film stabilizers. continued on page 60 George Waring IV, MD, and more from the 2019 ASCRS ASOA Annual Meeting

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