The Ocular Surface xxx (2017) 1e11

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The Ocular Surface
journal homepage: www.theocularsurface.com

The top 100 papers in dry eye e A bibliometric analysis
Marc Schargus a, b, *, Robert Kromer c, Vasily Druchkiv c, d, Andreas Frings aa

Department of Ophthalmology, Heinrich-Heine-University Düsseldorf, Germany
Eye Hospital Schweinfurt-Gerolzhofen, Gerolzhofen, GermanycDepartment of Ophthalmology, University Hospital Hamburg-Eppendorf, GermanydClínica Baviera, Valencia, Spainba r t i c l e i n f o

a b s t r a c t

Article history:
Received 7 May 2017
Received in revised form
12 September 2017
Accepted 12 September 2017

Purpose: Citation analysis represents one of the best currently available methods for quantifying theimpact of articles. Bibliometric studies list the ‘‘best sellers’’ in a single ﬁeld of interest. The purpose of
the present study was to identify and analyze the most frequently cited papers in dry eye research that
may be of high interest for researchers and clinicians.
Methods: We reviewed the database of the Institute for Scientiﬁc Information to identify articles published from 1900 to September 2016. All dry eye articles published in 59 ophthalmology journals wereidentiﬁed. The top 100 articles were selected for further analysis of authorship, source journal, number ofcitations, citation rate, geographic origin, article type, and level of evidence.
Results: The 100 most-cited articles were published between 1983 and 2011, with most of them in the
2000s. The number of citations per article ranged from 96 to 610, and was greatest for articles publishedin the 2000s. Each of these articles was published in one of 15 journals. Most articles represented LevelIII evidence, followed by Levels II and I.
Conclusions: The present study focusing on dry eye research revealed that 55% of the most-cited articles
came from the U.S. and 18% from Japan. Diagnostics and therapy were the areas of focus of most of theclinical articles; 13% of the most cited papers were review articles. This analysis provides researchers andclinicians with a detailed overview on the most cited dry eye papers over the past decades.
© 2017 Elsevier Inc. All rights reserved.

Keywords:
Bibliometrics
Citation index
Diagnostics
Dry eyeMedical literature
Scientometrics
Therapy

1. Introduction
The ﬁeld of professional scientiﬁc publication has undergone
seismic evolution in the last decade [1,2]. Almost daily changes
make electronic journal submission, publication, and access toperiodicals increasingly straightforward [1,2]. Bibliometric sciences
offer both a statistical and quantitative analysis of published articles and provide a measure of their impact in a particular ﬁeld of
research [3]. Bibliometric methods allow exploration of various
factors, including citation counts and detailed scientiﬁc output
statistics of single authors, special topics, institutions, or countries[3]. The “impact” of a journal on research can be assessed using thescientiﬁc citation index, which is the only available quantitative
estimate of a journal's scientiﬁc contributions [4e9]. Citation of awork indicates its relevance for its ﬁeld of interest [10,11]. The* Corresponding author. Department of Ophthalmology, Heinrich-HeineUniversity Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany.
E-mail address: marc.schargus@gmx.de (M. Schargus).

impact factor for a journal is a comparative measure of its ranking
among journals in a given speciality area. The impact factor is
calculated as the number of citations in a given year for articles
published in the journal in the preceding 2 years, divided by theoverall number of cited articles published in the same 2 years[12,13]. Since the publication of the ﬁrst article regarding bibliometric methods by Eugene Garﬁeld in the Journal of the American
Medical Association (JAMA) in 1987 [14], this ﬁeld of information
science has continuously evolved [15].
In the ﬁeld of ophthalmology, visual sciences and optometry,
more than 110 periodicals are listed [4]; Thomson Reuters Journal
Citation Reports lists 59 periodicals for the category “ophthalmology,” of which 52 have a journal impact factor of at least 1.00 or
higher [16]. Several bibliometric studies have been published thatprovide general analysis in the ﬁeld of ophthalmology [17,18].
Dry eye research has expanded greatly over the past few decades, largely related to new clinically available devices for diagnostics and the introduction of new treatment options [19e21].
Although bibliometric information on special topics in theophthalmology has been reported, to the best of our knowledge no

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M. Schargus et al. / The Ocular Surface xxx (2017) 1e11

analysis of the dry eye literature has been published [22,23]. In thepresent study, we identiﬁed the most frequently cited 100 articles
in dry eye research, using professional scientiﬁc databases to accessthese publications and analyze major journals, origin of publications, and main authors. This enables specialists and new researchers in the ﬁeld of dry eye to focus on these important articles.

2. Material and methods
Research platforms that provide bibliographic database services
are necessary for systematic analysis of publication data. For thisstudy, we used the Institute for Scientiﬁc Information (ISI) Web ofKnowledge database from the Thomson Reuters Web of Science(WoS) Core Collection. The overall search was conducted in October
2016.
The keywords used for the search were “dry eye” as the “topic”(title, abstract, author's keywords, and KeyWords Plus), a year-ofpublication range from 1900 until September 2016, the category“ophthalmology” predeﬁned by the Web of Science, and the
document type “articles.” The results were organized from the mostcited to the least cited publications. Each search result wasreviewed by two independent readers (AF and RK) to ensure its
relation to dry eye disease; no paper had to be excluded.
If we found identical numbers of total citations, the more recent
articles were ranked higher. The 100 articles with the highest
number of citations that matched the search criteria were thenanalyzed further, again by two independent investigators (MS and
AF). Data retrieved included journal name, publication date, ﬁrst
and last authors, year of publication, country of origin, total numberof citations for the article, overall citation rate (total citations/articleage), current citation rate (measured as the number of citations in
the year 2015), research nature (basic science, clinical research orreview), and level of evidence according to the 2009 revised Oxford(UK) Centre for Evidence-Based Medicine levels of Evidence (Level
1 to 5; Table 1). Review articles were deﬁned as articles summarizing previously published data and literature. Articles without an
identiﬁed ﬁrst author but with shared authorship from different
countries were classiﬁed as “multinational” origin. (These include
chapters from the 2007 Report of the International Dry Eye
WorkShop, whose PubMed entries note “No authors listed”).
A limitation of the citation-based searching method is thatrecent articles with high citation potential may not be captured
because they have not had time to accumulate citations. In order tocorrect for this, a search was performed using the same terms of themain analysis of the highest ranked 100 articles, but using a shortertime period (2015 and 2016).
If there were any discrepancies in the evaluation of the articles
between the three main investigators of our study, these were reevaluated and discussed with a fourth investigator (VD). Thismethod has been utilized in a range of previous publications on
bibliometric data [4,13,15].
The Shapiro-Wilk test was applied to test the normality of the

distribution of individual variables. We present data that werenormally distributed as the mean and standard deviation, andskewed data as the median and the range. The Tukey method was
also employed for plotting the whiskers and outliers. The p-values
from pairwise t-tests were adjusted according to either the Bonferroni post-hoc test or Mann-Whitney test to correct for the performance of multiple statistical analyses. All p-values were twotailed, and a p-value of 0.05 was considered to indicate statistical signiﬁcance. We used one-way analysis of variance (ANOVA) totest for differences in normally distributed data, and the KruskalWallis test for skewed data. The Spearman rank correlation was
employed to test for correlations among non-parametric variables.

3. Results
A total of 3823 eligible publications related to “dry eye” (category “ophthalmology,” document type “articles”) were listed inpeer-reviewed journals on the ISI Web of Knowledge WoS Core
Collection database (October 2016). Of these, 2.4% (n ¼ 92) had
been cited at least 100 times and 0.6% (n ¼ 24) more than 200
times. The publication dates for the 100 most-cited articles(Table 2) were between 1983 and 2011, and the total number ofcitations per article ranged from 96 to 610. Of the 100 articles, 16
were basic research, 71 were clinical research, and 13 were review
articles. Considering the number of citations per type of article, astatistically signiﬁcant difference was only found between thegroups of basic research and clinical research (Mann-Whitney test
p ¼ 0.032; basic research: median ¼ 118 [range ¼ 96e266]; clinicalresearch: median ¼ 150 [range ¼ 97e610] [Table 3, Fig. 1]). We
subdivided clinical research articles according to topics: diagnostic
research (n ¼ 47, 66%), epidemiology (n ¼ 10, 14%), and medical andsurgical treatment (n ¼ 14, 20%). Thirteen articles were review articles (mean 189 [range ¼ 105e576]; Table 3). The review articles
did not vary signiﬁcantly with respect to total citations per article
compared to the clinical or basic research articles (Fig. 1).
An evidence level of III was assigned to 29 articles in the ﬁeld ofclinical research and systematic reviews (median citations per
article 146 [range ¼ 98e438]), followed by IIa (n ¼ 18; median citations per article 162 [range ¼ 109e334]), IIb (n ¼ 11; mediancitations per article 142 [range ¼ 97e214]), Ib (n ¼ 9; median citations per article 152 [range ¼ 105e610]), Ia (n ¼ 7; median citations per article [range ¼ 126e576]) and IV (n ¼ 4; mediancitations per article 221 [range ¼ 117e256] (See Table 4 and Fig. 2.).
The Kruskal-Wallis Test exhibited no signiﬁcant differences between number of citations per article and the various levels ofevidence (p ¼ 0.216).
Most articles on the list were published from 2000 to 2009(n ¼ 62), followed by articles published from 2010 to 2016 (n ¼ 6;
Fig. 3 A). The total number of citations was greatest for articles
published from 2000 to 2009 (mean total number ofcitations ¼ 179), followed by articles published during the 1990's(mean total number of citations ¼ 166) and those published from

Table 1
Shortened depiction of Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence. Level may be graded down on the basis of study quality, imprecision, inconsistency
between studies, or because the absolute effect size is very small; Level may be graded up if there is a large or very large effect size (based on “Level of Evidence” published
online from German Network for Evidence-based Medicine (http://www.ebm-netzwerk.de/was-ist-ebm/images/evidenzklassen.jpg/view. Accessed October 30, 2016)).
Level
I
II
III
IV

Rating Criteria
Ia
Ib
IIa
IIb

Evidence obtained from a systematic review of relevant randomized controlled trials (including meta-analysis)
Evidence obtained from at least one properly designed randomized, controlled trial
Evidence obtained from at least one well-designed controlled trial without randomization
Evidence obtained from one well-designed, pseudo-experimental trial
Evidence obtained from a well-designed, non-experimental descriptive trial
Evidence obtained from case reports, expert opinion, consensus conference

Please cite this article in press as: Schargus M, et al., The top 100 papers in dry eye e A bibliometric analysis, The Ocular Surface (2017), http://dx.doi.org/10.1016/j.jtos.2017.09.006

M. Schargus et al. / The Ocular Surface xxx (2017) 1e11

3

Table 2
The 100 most-cited articles in dry eye.
Rank

ArticleCitationsCitations/Year
Since Publication

Citationsin 2015

1

Schiffman RM, Christianson MD, Jacobsen G, Hirsch JD, Reis BL. Reliability and validity of the Ocular Surface Disease
Index. Arch Ophthalmol. 2000 May; 118(5):615-21. PubMed PMID: 10815152
The deﬁnition and classiﬁcation of dry eye disease: report of the Deﬁnition and Classiﬁcation Subcommittee of theInternational Dry Eye WorkShop (2007). Ocul Surf. 2007 Apr; 5(2):75e92. Review. PubMed PMID: 17508116
Schaumberg DA, Sullivan DA, Buring JE, Dana MR. Prevalence of dry eye syndrome among US women. Am J Ophthalmol.
2003 Aug; 136(2):318-26. PubMed PMID: 12888056.
Moss SE, Klein R, Klein BE. Prevalence of and risk factors for dry eye syndrome. Arch Ophthalmol. 2000 Sep; 118(9):12648. PubMed PMID: 10980773~ oz B, Tielsch JM, Bandeen-Roche K, West S. Prevalence of dry eye among the elderly. Am J Ophthalmol.
Schein OD, Mun
1997 Dec; 124(6):723-8. PubMed PMID: 9402817
Sall K, Stevenson OD, Mundorf TK, Reis BL. Two multicenter, randomized studies of the efﬁcacy and safety ofcyclosporine ophthalmic emulsion in moderate to severe dry eye disease. CsA Phase 3 Study Group. Ophthalmology.
2000 Apr; 107(4):631-9
Solomon A, Dursun D, Liu Z, Xie Y, Macri A, Pﬂugfelder SC. Pro- and anti-inﬂammatory forms of interleukin-1 in the tear
ﬂuid and conjunctiva of patients with dry-eye disease. Invest Ophthalmol Vis Sci. 2001 Sep; 42(10):2283-92. PubMed
PMID: 11527941
Pﬂugfelder SC, Jones D, Ji Z, Afonso A, Monroy D. Altered cytokine balance in the tear ﬂuid and conjunctiva of patients€gren's syndrome keratoconjunctivitis sicca. Curr Eye Res. 1999 Sep; 19(3):201-11. PubMed PMID: 10487957
with Sjo
Tsubota K, Satake Y, Ohyama M, Toda I, Takano Y, Ono M, Shinozaki N, Shimazaki J. Surgical reconstruction of the ocularsurface in advanced ocular cicatricial pemphigoid and Stevens-Johnson syndrome. Am J Ophthalmol. 1996 Jul; 122(1):38
e52. PubMed PMID: 8659597
McCarty CA, Bansal AK, Livingston PM, Stanislavsky YL, Taylor HR. The epidemiology of dry eye in Melbourne, Australia.
Ophthalmology. 1998 Jun; 105(6):1114-9. PubMed PMID: 9627665
Luo L, Li DQ, Doshi A, Farley W, Corrales RM, Pﬂugfelder SC. Experimental dry eye stimulates production of inﬂammatory
cytokines and MMP-9 and activates MAPK signaling pathways on the ocular surface. Invest Ophthalmol Vis Sci. 2004
Dec; 45(12):4293-301. PubMed PMID: 15557435
Shimazaki J, Yang HY, Tsubota K. Amniotic membrane transplantation for ocular surface reconstruction in patients withchemical and thermal burns. Ophthalmology. 1997 Dec; 104(12):2068-76. PubMed PMID: 9400767
Nichols KK, Nichols JJ, Mitchell GL. The lack of association between signs and symptoms in patients with dry eye disease.
Cornea. 2004 Nov; 23(8):762-70. PubMed PMID: 15502475
Bron AJ, Evans VE, Smith JA. Grading of corneal and conjunctival staining in the context of other dry eye tests. Cornea.
2003 Oct; 22(7):640-50. Review. PubMed PMID: 14508260
Tsubota K, Goto E, Fujita H, Ono M, Inoue H, Saito I, Shimmura S. Treatment of dry eye by autologous serum application in€gren's syndrome. Br J Ophthalmol. 1999 Apr; 83(4):390-5. PubMed PMID: 10434857; PubMed Central PMCID:
Sjo
PMC1723012
The epidemiology of dry eye disease: report of the Epidemiology Subcommittee of the International Dry Eye WorkShop(2007). Ocul Surf. 2007 Apr; 5(2):93e107. Review. PubMed PMID: 17508117
Miljanovic B, Dana R, Sullivan DA, Schaumberg DA. Impact of dry eye syndrome on vision-related quality of life. Am J
Ophthalmol. 2007 Mar; 143(3):409-15. Epub 2007 Jan 2. PubMed PMID: 17317388; PubMed Central PMCID:
PMC1847608
Nelson JD, Havener VR, Cameron JD. Cellulose acetate impressions of the ocular surface. Dry eye states. Arch Ophthalmol.
1983 Dec; 101(12):1869-72. PubMed PMID: 6651590
 A, Liang H, Pauly A, Brignole-Baudouin F. Preservatives in eyedrops: the good, the bad and the ugly.
Baudouin C, Labbe
Prog Retin Eye Res. 2010 Jul; 29(4):312-34. doi: 10.1016/j.preteyeres.2010.03.001. Epub 2010 Mar 17. PubMed PMID:
20302969
Tomlinson A, Khanal S, Ramaesh K, Diaper C, McFadyen A. Tear ﬁlm osmolarity: determination of a referent for dry eye
diagnosis. Invest Ophthalmol Vis Sci. 2006 Oct; 47(10):4309-15. PubMed PMID: 17003420
Pisella PJ, Pouliquen P, Baudouin C. Prevalence of ocular symptoms and signs with preserved and preservative freeglaucoma medication. Br J Ophthalmol. 2002 Apr; 86(4):418-23. PubMed PMID: 11914211; PubMed Central PMCID:
PMC1771067
Lin PY, Tsai SY, Cheng CY, Liu JH, Chou P, Hsu WM. Prevalence of dry eye among an elderly Chinese population in Taiwan:
the Shihpai Eye Study. Ophthalmology. 2003 Jun; 110(6):1096-101. PubMed PMID: 12799232
Craig JP, Tomlinson A. Importance of the lipid layer in human tear ﬁlm stability and evaporation. Optom Vis Sci. 1997 Jan;
74(1):8e13. PubMed PMID:9148269
Behrens A, Doyle JJ, Stern L, Chuck RS, McDonnell PJ, Azar DT, Dua HS, Hom M, Karpecki PM, Laibson PR, Lemp MA,
Meisler DM, Del Castillo JM, O'Brien TP, Pﬂugfelder SC, Rolando M, Schein OD, Seitz B, Tseng SC, van Setten G, Wilson SE,
Yiu SC; Dysfunctional tear syndrome study group. Dysfunctional tear syndrome: a Delphi approach to treatment
recommendations. Cornea. 2006 Sep; 25(8):900-7. PubMed PMID: 17102664~ z B, Bandeen-Roche K, West S. Relation between signs and symptoms of dry eye in the
Schein OD, Tielsch JM, Muno
elderly. A population-based perspective. Ophthalmology. 1997 Sep; 104(9):1395-401. PubMed PMID: 9307632
Shimazaki J, Sakata M, Tsubota K. Ocular surface changes and discomfort in patients with meibomian gland dysfunction.
Arch Ophthalmol. 1995 Oct; 113(10):1266-70. PubMed PMID: 7575257
Pﬂugfelder SC. Antiinﬂammatory therapy for dry eye. Am J Ophthalmol. 2004 Feb; 137(2):337-42. Review. PubMed
PMID: 14962426
Brignole F, Pisella PJ, Goldschild M, De Saint Jean M, Goguel A, Baudouin C. Flow cytometric analysis of inﬂammatory
markers in conjunctival epithelial cells of patients with dry eyes. Invest Ophthalmol Vis Sci. 2000 May; 41(6):1356-63.
PubMed PMID: 10798650
Argüeso P, Balaram M, Spurr-Michaud S, Keutmann HT, Dana MR, Gipson IK. Decreased levels of the goblet cell mucin€gren syndrome. Invest Ophthalmol Vis Sci. 2002 Apr; 43(4):1004-11. PubMed
MUC5AC in tears of patients with Sjo
PMID: 11923240

610

35,88

115

576

57,6

135

438

31,29

49

398

23,41

40

356

17,8

16

354

20,82

27

334

20,88

30

330

18,33

24

321

15,29

7

305

16,05

30

266

20,46

33

256

12,8

10

255

19,62

35

252

18

56

239

13,28

22

233

23,3

66

224

22,4

39

214

6,29

9

212

30,29

34

210

19,09

31

206

13,73

23

206

14,71

24

204

10,2

13

202

18,36

26

199

9,95

13

195

8,86

21

189

14,54

18

188

11,06

9

187

12,47

15

186

10,94

11

2
3
4
5
6

7

8
9

10
11

12
13
14
15

16
17

18
19

20
21

22
23
24

25
26
27
28

29

30

(continued on next page)

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M. Schargus et al. / The Ocular Surface xxx (2017) 1e11

Table 2 (continued )
Rank

31
32

33
34

35

36
37

38
39

40
41
42

43

44

45

46

47

48

49

50
51

52
53
54

55
56
57
58
59

ArticleStevenson D, Tauber J, Reis BL. Efﬁcacy and safety of cyclosporin A ophthalmic emulsion in the treatment of moderateto-severe dry eye disease: a dose-ranging, randomized trial. The Cyclosporin A Phase 2 Study Group. Ophthalmology.
2000 May; 107(5):967-74. PubMed PMID: 10811092
Leung EW, Medeiros FA, Weinreb RN. Prevalence of ocular surface disease in glaucoma patients. J Glaucoma. 2008 Aug;
17(5):350-5. doi: 10.1097/IJG.0b013e31815c5f4f. PubMed PMID: 18703943
Gipson IK, Spurr-Michaud S, Argüeso P, Tisdale A, Ng TF, Russo CL. Mucin gene expression in immortalized humancorneal-limbal and conjunctival epithelial cell lines. Invest Ophthalmol Vis Sci. 2003 Jun; 44(6):2496-506. PubMed
PMID: 12766048
Goto E, Yagi Y, Matsumoto Y, Tsubota K. Impaired functional visual acuity of dry eye patients. Am J Ophthalmol. 2002
Feb; 133(2):181-6. PubMed PMID: 11812420
Sullivan BD, Whitmer D, Nichols KK, Tomlinson A, Foulks GN, Geerling G, Pepose JS, Kosheleff V, Porreco A, Lemp MA. An
objective approach to dry eye disease severity. Invest Ophthalmol Vis Sci. 2010 Dec; 51(12):6125-30. doi: 10.1167/
iovs.10e5390. Epub 2010 Jul 14. PubMed PMID: 20631232
Begley CG, Chalmers RL, Abetz L, Venkataraman K, Mertzanis P, Caffery BA, Snyder C, Edrington T, Nelson D, Simpson T.
The relationship between habitual patient-reported symptoms and clinical signs among patients with dry eye of varying
severity. Invest Ophthalmol Vis Sci. 2003 Nov; 44(11):4753-61. PubMed PMID: 14578396
Nichols KK, Mitchell GL, Zadnik K. The repeatability of clinical measurements of dry eye. Cornea. 2004 Apr; 23(3):272-85.
PubMed PMID: 15084861
Afonso AA, Sobrin L, Monroy DC, Selzer M, Lokeshwar B, Pﬂugfelder SC. Tear ﬂuid gelatinase B activity correlates with IL1alpha concentration and ﬂuorescein clearance in ocular rosacea. Invest Ophthalmol Vis Sci. 1999 Oct; 40(11):2506-12.
PubMed PMID: 10509643€gren
Marsh P, Pﬂugfelder SC. Topical nonpreserved methylprednisolone therapy for keratoconjunctivitis sicca in Sjo
syndrome. Ophthalmology. 1999 Apr; 106(4):811-6. PubMed PMID: 10201607
Stern ME, Gao J, Schwalb TA, Ngo M, Tieu DD, Chan CC, Reis BL, Whitcup SM, Thompson D, Smith JA. Conjunctival T-cell€ gren's and non-Sjo€ gren's patients with dry eye. Invest Ophthalmol Vis Sci. 2002 Aug; 43(8):2609subpopulations in Sjo
14. PubMed PMID: 12147592
Mathers WD. Ocular evaporation in meibomian gland dysfunction and dry eye. Ophthalmology. 1993 Mar; 100(3):34751. PubMed PMID: 8460004
Methodologies to diagnose and monitor dry eye disease: report of the Diagnostic Methodology Subcommittee of theInternational Dry Eye WorkShop (2007). Ocul Surf. 2007 Apr; 5(2):108-52. Review. PubMed PMID: 17508118
Schaumberg DA, Dana R, Buring JE, Sullivan DA. Prevalence of dry eye disease among US men: estimates from the
Physicians' Health Studies. Arch Ophthalmol. 2009 Jun; 127(6):763-8. doi: 10.1001/archophthalmol.2009.103. PubMed
PMID: 19506195; PubMed Central PMCID: PMC2836718
Doughty MJ, Fonn D, Richter D, Simpson T, Caffery B, Gordon K. A patient questionnaire approach to estimating theprevalence of dry eye symptoms in patients presenting to optometric practices across Canada. Optom Vis Sci. 1997 Aug;74(8):624-31. PubMed PMID: 9323733
Kunert KS, Tisdale AS, Gipson IK. Goblet cell numbers and epithelial proliferation in the conjunctiva of patients with dryeye syndrome treated with cyclosporine. Arch Ophthalmol. 2002 Mar; 120(3):330-7. Erratum in: Arch Ophthalmol 2002
Aug; 120(8):1099. PubMed PMID: 11879137
Kunert KS, Tisdale AS, Stern ME, Smith JA, Gipson IK. Analysis of topical cyclosporine treatment of patients with dry eye
syndrome: effect on conjunctival lymphocytes. Arch Ophthalmol. 2000 Nov; 118(11):1489-96. PubMed PMID:
11074805
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 Dec; 45(12):4302-11. PubMed PMID:
15557436
Lemp MA, Bron AJ, Baudouin C, Benítez Del Castillo JM, Geffen D, Tauber J, Foulks GN, Pepose JS, Sullivan BD. Tearosmolarity in the diagnosis and management of dry eye disease. Am J Ophthalmol. 2011 May; 151(5):792e798.e1. doi:
10.1016/j.ajo.2010.10.032. Epub 2011 Feb 18. PubMed PMID: 21310379€gren's syndrome: cytokine and Epstein-Barr viral gene
Jones DT, Monroy D, Ji Z, Atherton SS, Pﬂugfelder SC. Sjo
expression within the conjunctival epithelium. Invest Ophthalmol Vis Sci. 1994 Aug; 35(9):3493-504. PubMed PMID:
8056525
Poon AC, Geerling G, Dart JK, Fraenkel GE, Daniels JT. Autologous serum eyedrops for dry eyes and epithelial defects:
clinical and in vitro toxicity studies. Br J Ophthalmol. 2001 Oct; 85(10):1188-97. PubMed PMID: 11567963; PubMed
Central PMCID: PMC1723716
Tutt R, Bradley A, Begley C, Thibos LN. Optical and visual impact of tear break-up in human eyes. Invest Ophthalmol Vis
Sci. 2000 Dec; 41(13):4117-23. PubMed PMID: 11095604
De Paiva CS, Corrales RM, Villarreal AL, Farley WJ, Li DQ, Stern ME, Pﬂugfelder SC. Corticosteroid and doxycycline
suppress MMP-9 and inﬂammatory cytokine expression, MAPK activation in the corneal epithelium in experimental dryeye. Exp Eye Res. 2006 Sep; 83(3):526-35. Epub 2006 Apr 27. PubMed PMID: 16643899
Yeh S, Song XJ, Farley W, Li DQ, Stern ME, Pﬂugfelder SC. Apoptosis of ocular surface cells in experimentally induced dryeye. Invest Ophthalmol Vis Sci. 2003 Jan; 44(1):124-9. PubMed PMID: 12506064
Tsubota K. Tear dynamics and dry eye. Prog Retin Eye Res. 1998 Oct; 17(4):565-96. Review. PubMed PMID: 9777650
Lam H, Bleiden L, de Paiva CS, Farley W, Stern ME, Pﬂugfelder SC. Tear cytokine proﬁles in dysfunctional tear syndrome.
Am J Ophthalmol. 2009 Feb; 147(2):198e205. e1. doi: 10.1016/j.ajo.2008.08.032. Epub 2008 Nov 7. PubMed PMID:
18992869; PubMed Central PMCID: PMC3582020
Geerling G, Maclennan S, Hartwig D. Autologous serum eye drops for ocular surface disorders. Br J Ophthalmol. 2004
Nov; 88(11):1467-74. Review. PubMed PMID: 15489495; PubMed Central PMCID: PMC1772389
Mainstone JC, Bruce AS, Golding TR. Tear meniscus measurement in the diagnosis of dry eye. Curr Eye Res. 1996 Jun;
15(6):653-61. PubMed PMID: 8670769
Toda I, Asano-Kato N, Komai-Hori Y, Tsubota K. Dry eye after laser in situ keratomileusis. Am J Ophthalmol. 2001 Jul;
132(1):1e7. PubMed PMID: 11438046
Battat L, Macri A, Dursun D, Pﬂugfelder SC. Effects of laser in situ keratomileusis on tear production, clearance, and theocular surface. Ophthalmology. 2001 Jul; 108(7):1230-5. PubMed PMID: 11425680

CitationsCitations/Year
Since Publication

Citationsin 2015

183

20,33

25

181

12,93

12

174

11,6

13

168

24

36

165

11,79

20

163

12,54

20

163

9,06

11

162

9

7

161

10,73

10

159

6,62

6

158

15,8

35

157

19,62

26

156

7,8

10

152

10,13

10

150

8,82

10

149

11,46

17

148

24,67

39

147

6,39

8

146

9,12

12

146

8,59

14

145

13,18

19

145

10,36

14

144
142

7,58
17,75

7
18

139

10,69

25

139

6,62

13

137

8,56

10

135

8,44

10

131

21,83

30

Please cite this article in press as: Schargus M, et al., The top 100 papers in dry eye e A bibliometric analysis, The Ocular Surface (2017), http://dx.doi.org/10.1016/j.jtos.2017.09.006

M. Schargus et al. / The Ocular Surface xxx (2017) 1e11

5

Table 2 (continued )
Rank

60

61
62
63
64
65
66
67
68

69
70
71

72
73
74
75
76

77

78
79
80
81
82

83
84
85

86

87

88

ArticleKnop E, Knop N, Millar T, Obata H, Sullivan DA. The international workshop on meibomian gland dysfunction: report ofthe subcommittee on anatomy, physiology, and pathophysiology of the meibomian gland. Invest Ophthalmol Vis Sci.
2011 Mar 30; 52(4):1938-78. doi: 10.1167/iovs.10-6997c. Print 2011 Mar. Review. PubMed PMID: 21450915; PubMed
Central PMCID: PMC3072159
Chia EM, Mitchell P, Rochtchina E, Lee AJ, Maroun R, Wang JJ. Prevalence and associations of dry eye syndrome in anolder population: the Blue Mountains Eye Study. Clin Exp Ophthalmol. 2003 Jun; 31(3):229-32. PubMed PMID:
12786773
Begley CG, Chalmers RL, Mitchell GL, Nichols KK, Caffery B, Simpson T, DuToit R, Portello J, Davis L. Characterization ofocular surface symptoms from optometric practices in North America. Cornea. 2001 Aug; 20(6):610-8. PubMed PMID
Danjo Y, Watanabe H, Tisdale AS, George M, Tsumura T, Abelson MB, Gipson IK. Alteration of mucin in human
conjunctival epithelia in dry eye. Invest Ophthalmol Vis Sci. 1998 Dec; 39(13):2602-9. PubMed PMID: 9856770
Management and therapy of dry eye disease: report of the Management and Therapy Subcommittee of the International
Dry Eye WorkShop (2007). Ocul Surf. 2007 Apr; 5(2):163-78. Review. PubMed PMID: 17508120
Jaenen N, Baudouin C, Pouliquen P, Manni G, Figueiredo A, Zeyen T. Ocular symptoms and signs with preserved andpreservative-free glaucoma medications. Eur J Ophthalmol. 2007 MayeJun; 17(3):341-9. PubMed PMID: 17534814
Nichols JJ, Sinnott LT. Tear ﬁlm, contact lens, and patient-related factors associated with contact lens-related dry eye.
Invest Ophthalmol Vis Sci. 2006 Apr; 47(4):1319-28. PubMed PMID: 16565363
Dursun D, Wang M, Monroy D, Li DQ, Lokeshwar BL, Stern ME, Pﬂugfelder SC. A mouse model of keratoconjunctivitis
sicca. Invest Ophthalmol Vis Sci. 2002 Mar; 43(3):632-8. PubMed PMID: 11867577
Herreras JM, Pastor JC, Calonge M, Asensio VM. Ocular surface alteration after long-term treatment with an
antiglaucomatous drug. Ophthalmology. 1992 Jul; 99(7):1082-8. PubMed PMID: 1495787
Bacman S, Perez Leiros C, Sterin-Borda L, Hubscher O, Arana R, Borda E. Autoantibodies against lacrimal gland M3€gren's syndrome. Invest Ophthalmol Vis Sci. 1998 Jan;muscarinic acetylcholine receptors in patients with primary Sjo
39(1):151-6. PubMed PMID: 9430556
Tseng SC, Tsubota K. Important concepts for treating ocular surface and tear disorders. Am J Ophthalmol. 1997 Dec;
124(6):825-35. Review. PubMed PMID: 9402829
Yokoi N, Takehisa Y, Kinoshita S. Correlation of tear lipid layer interference patterns with the diagnosis and severity ofdry eye. Am J Ophthalmol. 1996 Dec; 122(6):818-24. PubMed PMID: 8956636
Lee AJ, Lee J, Saw SM, Gazzard G, Koh D, Widjaja D, Tan DT. Prevalence and risk factors associated with dry eye
symptoms: a population based study in Indonesia. Br J Ophthalmol. 2002 Dec; 86(12):1347-51. Review. PubMed PMID:
12446361; PubMed Central PMCID: PMC1771386
Schiffman RM, Walt JG, Jacobsen G, Doyle JJ, Lebovics G, Sumner W. Utility assessment among patients with dry eye
disease. Ophthalmology. 2003 Jul; 110(7):1412-9. PubMed PMID: 12867401
Mathers WD, Lane JA, Zimmerman MB. Tear ﬁlm changes associated with normal aging. Cornea. 1996 May; 15(3):22934. PubMed PMID: 8713923
Massingale ML, Li X, Vallabhajosyula M, Chen D, Wei Y, Asbell PA. Analysis of inﬂammatory cytokines in the tears of dryeye patients. Cornea. 2009 Oct; 28(9):1023-7. doi: 10.1097/ICO.0b013e3181a16578. PubMed PMID: 19724208
Nakamori K, Odawara M, Nakajima T, Mizutani T, Tsubota K. Blinking is controlled primarily by ocular surface conditions.
Am J Ophthalmol. 1997 Jul; 124(1):24e30. PubMed PMID: 9222228
Argüeso P, Spurr-Michaud S, Russo CL, Tisdale A, Gipson IK. MUC16 mucin is expressed by the human ocular surface
epithelia and carries the H185 carbohydrate epitope. Invest Ophthalmol Vis Sci. 2003 Jun; 44(6):2487-95. PubMed
PMID:12766047
Nelson JD, Shimazaki J, Benitez-del-Castillo JM, Craig JP, McCulley JP, Den S, Foulks GN. The international workshop on
meibomian gland dysfunction: report of the deﬁnition and classiﬁcation subcommittee. Invest Ophthalmol Vis Sci. 2011
Mar 30; 52(4):1930-7. doi: 10.1167/iovs.10-6997b. Print 2011 Mar. Review. PubMed PMID: 21450914; PubMed Central
PMCID: PMC3072158
Toda I, Fujishima H, Tsubota K. Ocular fatigue is the major symptom of dry eye. Acta Ophthalmol (Copenh). 1993 Jun;71(3):347-52. PubMed PMID: 8362634€gren syndrome.
Shimazaki J, Goto E, Ono M, Shimmura S, Tsubota K. Meibomian gland dysfunction in patients with Sjo
Ophthalmology. 1998 Aug; 105(8):1485-8. PubMed PMID: 9709762
Tsubota K, Yamada M. Tear evaporation from the ocular surface. Invest Ophthalmol Vis Sci. 1992 Sep; 33(10):2942-50.
PubMed PMID: 1526744
Mathers WD, Shields WJ, Sachdev MS, Petroll WM, Jester JV. Meibomian gland dysfunction in chronic blepharitis.
Cornea. 1991 Jul; 10(4):277-85. PubMed PMID: 1889213
Noble BA, Loh RS, MacLennan S, Pesudovs K, Reynolds A, Bridges LR, Burr J, Stewart O, Quereshi S. Comparison of
autologous serum eye drops with conventional therapy in a randomized controlled crossover trial for ocular surface
disease. Br J Ophthalmol. 2004 May; 88(5):647-52. PubMed PMID: 15090417; PubMed Central PMCID:PMC1772131
Begley CG, Caffery B, Nichols KK, Chalmers R. Responses of contact lens wearers to a dry eye survey. Optom Vis Sci. 2000
Jan; 77(1):40-6. PubMed PMID: 10654857
Moss SE, Klein R, Klein BE. Incidence of dry eye in an older population. Arch Ophthalmol. 2004 Mar; 122(3):369-73.
PubMed PMID: 15006852
Brignole F, Pisella PJ, De Saint Jean M, Goldschild M, Goguel A, Baudouin C. Flow cytometric analysis of inﬂammatory
markers in KCS: 6-month treatment with topical cyclosporin A. Invest Ophthalmol Vis Sci. 2001 Jan; 42(1):90-5. PubMed
PMID: 11133852
Tomlinson A, Bron AJ, Korb DR, Amano S, Paugh JR, Pearce EI, Yee R, Yokoi N, Arita R, Dogru M. The international
workshop on meibomian gland dysfunction: report of the diagnosis subcommittee. Invest Ophthalmol Vis Sci. 2011 Mar
30; 52(4):2006-49. doi: 10.1167/iovs.10-6997f. Print 2011 Mar. Review. PubMed PMID: 21450918; PubMed Central
PMCID: PMC3072162
Kojima T, Ishida R, Dogru M, Goto E, Matsumoto Y, Kaido M, Tsubota K. The effect of autologous serum eyedrops in thetreatment of severe dry eye disease: a prospective randomized case-control study. Am J Ophthalmol. 2005 Feb;
139(2):242-6. PubMed PMID: 15733983

CitationsCitations/Year
Since Publication

Citationsin 2015

131

9,36

13

130

8,12

12

130

6,84

8

126

12,6

33

123

12,3

15

122

11,09

12

122

8,13

18

122

4,88

6

121

6,37

4

121

6,05

7

119

5,67

6

118

7,87

16

117

8,36

13

117

5,57

4

115

14,38

23

115

5,75

8

114

8,14

8

110

18,33

19

110

4,58

11

109

5,74

11

109

4,36

5

109

4,19

10

108

8,31

11

108

6,35

8

106

8,15

12

106

6,62

3

105

17,5

22

105

8,75

15

104

10,4

13

(continued on next page)

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6

M. Schargus et al. / The Ocular Surface xxx (2017) 1e11

Table 2 (continued )
Rank

89

90
91
92

93

94

95

96
97
98
99
100

ArticleDe Paiva CS, Villarreal AL, Corrales RM, Rahman HT, Chang VY, Farley WJ, Stern ME, Niederkorn JY, Li DQ, Pﬂugfelder SC.
Dry eye-induced conjunctival epithelial squamous metaplasia is modulated by interferon-gamma. Invest Ophthalmol
Vis Sci. 2007 Jun; 48(6):2553-60. PubMed PMID: 17525184
Begley CG, Caffery B, Chalmers RL, Mitchell GL; Dry Eye Investigation (DREI) Study Group. Use of the dry eye
questionnaire to measure symptoms of ocular irritation in patients with aqueous tear deﬁcient dry eye. Cornea. 2002
Oct; 21(7):664-70. PubMed PMID: 12352083
Gao J, Schwalb TA, Addeo JV, Ghosn CR, Stern ME. The role of apoptosis in the pathogenesis of canine keratoconjunctivitis
sicca: the effect of topical Cyclosporin A therapy. Cornea. 1998 Nov; 17(6):654-63. PubMed PMID: 9820947
Korb DR. Survey of preferred tests for diagnosis of the tear ﬁlm and dry eye. Cornea. 2000 Jul; 19(4):483-6. PubMed
PMID: 10928763
Baudouin C, Brignole F, Becquet F, Pisella PJ, Goguel A. Flow cytometry in impression cytology specimens. A new method
for evaluation of conjunctival inﬂammation. Invest Ophthalmol Vis Sci. 1997 Jun; 38(7):1458-64. PubMed PMID:
9191610
Grus FH, Podust VN, Bruns K, Lackner K, Fu S, Dalmasso EA, Wirthlin A, Pfeiffer N. SELDI-TOF-MS ProteinChip array
proﬁling of tears from patients with dry eye. Invest Ophthalmol Vis Sci. 2005 Mar; 46(3):863-76. PubMed PMID:
15728542
Arita R, Itoh K, Inoue K, Amano S. Noncontact infrared meibography to document age-related changes of the meibomian
glands in a normal population. Ophthalmology. 2008 May; 115(5):911-5. doi: 10.1016/j.ophtha.2007.06.031. PubMed
PMID: 18452765
Mertzanis P, Abetz L, Rajagopalan K, Espindle D, Chalmers R, Snyder C, Caffery B, Edrington T, Simpson T, Nelson JD,
Begley C. The relative burden of dry eye in patients' lives: comparisons to a U.S. normative sample. Invest Ophthalmol Vis
Sci. 2005 Jan; 46(1):46e50. PubMed PMID: 15623753
Tsubota K, Hata S, Okusawa Y, Egami F, Ohtsuki T, Nakamori K. Quantitative videographic analysis of blinking in normal
subjects and patients with dry eye. Arch Ophthalmol. 1996 Jun; 114(6):715-20. PubMed PMID: 8639084
Yoon KC, Jeong IY, Park YG, Yang SY. Interleukin-6 and tumor necrosis factor-alpha levels in tears of patients with dry eye
syndrome. Cornea. 2007 May; 26(4):431-7. PubMed PMID: 17457192
Nishida T, Nakamura M, Mishima H, Otori T. Hyaluronan stimulates corneal epithelial migration. Exp Eye Res. 1991 Dec;
53(6):753-8. PubMed PMID: 1783012
Fujihara T, Murakami T, Fujita H, Nakamura M, Nakata K. Improvement of corneal barrier function by the P2Y(2) agonist
INS365 in a rat dry eye model. Invest Ophthalmol Vis Sci. 2001 Jan; 42(1):96e100. PubMed PMID: 11133853
Rocha EM, Wickham LA, da Silveira LA, Krenzer KL, Yu FS, Toda I, Sullivan BD, Sullivan DA. Identiﬁcation of androgen
receptor protein and 5alpha-reductase mRNA in human ocular tissues. Br J Ophthalmol. 2000 Jan; 84(1):76e84. PubMed
PMID: 10611104; PubMed Central PMCID: PMC1723240

CitationsCitations/Year
Since Publication

Citationsin 2015

101

6,73

11

101

5,32

5

100

5,88

6

100

5

2

99

8,25

8

98

10,89

20

98

8,17

9

98

4,67

6

97

9,7

12

97

3,73

6

97

6,06

14

96

5,65

4

Table 3Citations per type of article.
Citations per type of article

Basic research (Gr1)
Clinical research (Gr2)
Review article (Gr3)
Total

P*

N

Range (Min/Max)

Mean (±SD)

Median (Q25/Q75)

Gr1 vs Gr2

Gr1 vs Gr3

Gr2 vs Gr3

16
71
13
100

96/266
97/610105/576
96/610134 (±48)
179 (±93)
189 (±124)
173 (±93)

118 (99/147)
150 (117/204)
144 (126/210)
146 (115/197)

0.032

0.827

0.652

* Mann-Whitney test

2010 to 2016 (mean total number of citations ¼ 146; Fig. 3 B.) The
overall citation rate of an article was independent of its publication
date (r ¼ 0.00, p < 0.969, Mann-Kendall test; Fig. 4 A). However, thecurrent citation rate (measured as the number of citations in 2015)of an article indicated that articles published after 2000 were more
likely cited in recent years. This correlation was statistically signiﬁcant (r ¼ 0.46, p < 0.001, Mann-Kendall test; Fig. 4 B).
The 100 most-cited articles were published in 15 journals(Table 5). Articles originated from 13 countries, led by the UnitedStates (n ¼ 55), followed by Japan (n ¼ 18), France and the United
Kingdom (5 each), Australia (n ¼ 3) and Germany (n ¼ 3); Table 6.

Table 4
Citations per level of evidence (clinical research articles (n ¼ 78)).

Fig. 1. Bar graph showing the number of citations (and standard deviation) for the 100
most-cited articles according to type of article (clinical or basic research, review
article). Red point ¼ Mean value. Box: lower line ¼ 25th quartile, upper line ¼ 75th
quartile; black line in box ¼ Median value. White points ¼ Outliers. The Tukey method
was used for plotting the whiskers and outliers.

Ia
Ib
IIa
IIb
III
IV
Total

N

Range (Min/Max)

Mean (±SD)

Median (Q25/Q75)

7
9
18
11
29
4
78

126/576
105/610109/334
97/21498/438117/256
97/610243 (±151)
222 (±166)
172 (±66)
138 (±35)
182 (±95)
204 (±62)
184 (±100)

210 (158/233)
152 (108/224)
162 (122/188)
142 (100/161)
146 (117/206)
221 (160/248)
157 (118/206)

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M. Schargus et al. / The Ocular Surface xxx (2017) 1e117Four articles were of multinational origin, with no individual authors named. As shown in Table 6, several other countries were theorigin of one publication each.
There were 18 authors who had multiple ﬁrst authorships and10 with multiple last authorships in the list of 100 most-cited articles (Table 7). Stephen C. Pﬂugfelder had 12 last authorships andwas thus the most-cited author in this category. All of Pﬂugfelder'slast 12 authorship articles were cited a total of 1826 times (October2016). The article entitled “Reliability and validity of the ocularsurface disease index” from Rhett M. Schiffman was the most-cited
paper according to our analysis (total number of citations ¼ 610)[24]. The number of citations of this paper increased every year
since publication until 2015 up to 115 citations per year.
The top 25 most-cited articles from 2015 to 2016 using the samesearch details are listed in Table 8.
4. Discussion
Fig. 2. Bar graph showing the number of citations (and standard deviation) for the 100
most-cited articles according to the level of evidence based on the 2009 revised Oxford(UK) CEBM Levels of Evidence. Red point ¼ Mean value. Box: lower line ¼ 25thquartile, upper line ¼ 75th quartile; black line in box ¼ Median value. White
points ¼ Outliers. The Tukey method was used for plotting the whiskers and outliers.

Our analysis has identiﬁed the articles with the greatest impact
on the citation of results in the ﬁeld of dry eye research over the
past decades. This study highlights contributions that have led tosigniﬁcant developments in dry eye research and indicates current
trends in this ﬁeld.
The number of citations for an article is a measure of the impactthat it has on that particular ﬁeld, and has thus become a valuable

Fig. 3. For each type of article (clinical or basic research, review article), the total number of publications according to publication year (A) and the total number of citations (B) werevisualized.

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8

M. Schargus et al. / The Ocular Surface xxx (2017) 1e11
Table 6Countries from which the articles in the most-cited list
originated.
Country

No. of articles

U.S.
Japan
FranceU.K.
Multinational
Australia
Germany
Argentina
Belgium
CanadaSingapore
South Korea
Spain
Taiwan

55
18
5
5
4
3
3
1
1
1
1
1
1
1

Table 7First and last authors with multiple articles in the most-cited list.

Fig. 4. (A) Overall citation rate since publication, and (B) current (2015 ¼ last full year)
citation rate for the 100 most-cited articles according to the publication date of thearticle.

Frequent ﬁrst authors

No. of articles

Frequent last authors

No. of articles

Tsubota, K
Begley, CG
Mathers, WD
Shimazaki, J
Baudouin, C
De Paiva, CS
Nichols, KK
Schiffman, RM
Schaumberg, DA
Toda, I
Nelson, JD
Schein, OD
Kunert, KS
Moss, SE
Brignole, F
Argueso, P
Tomlinson, APﬂugfelder, SC

5
4
3
3
2
2
2
2
2
2
2
2
2
2
2
2
2
2

Pﬂugfelder, SC
Tsubota, K
Gipson, IK
Reis, BL
Sullivan, DA
Baudouin, C
Klein, BEK
Smith, JA
Mitchell, GL
West, S

12
9
5
3
3
3
2
2
2
2

to be cited [12]. Therefore, the group of highest-ranking articles
might be dominated by the oldest articles [25]. This may, however,be counteracted by the phenomenon of “obliteration by incorporation,” which occurs when the data from the most cited works
become part of current knowledge, so that the original papers arecited less frequently [26]. According to our data, the overall citation
rate of an article was independent of its publication date. However,tool for assessing both authors' works and journals [5,12]. However,it must be borne in mind that the number of citations for an article
accrues over time, so that the impact of an article as assessed bycitation numbers, besides judging the quality of the article, has atime factor; even the most-cited papers had no citations when justpublished [15]. Garﬁeld suggested that older papers are more likely

Table 5
Journals in which the 100 most-cited articles were published.
JournalNo. of articles

First issue

Impact Factora

Investigative Ophthalmology & Visual Science
Ophthalmology
American Journal of Ophthalmology
CorneaArchives of Ophthalmology (now: JAMA Ophthalmology)
British Journal of Ophthalmology
Ocular Surface
Optometry and Vision Science
Progress in Retinal and Eye Research
Current Eye ResearchExperimental Eye ResearchActa Ophthalmologica
Journal of Glaucoma
European Journal of Ophthalmology
Clinical and Experimental Ophthalmology

29
13
13
12
9
7
4
3
2
2
2
1
1
1
1

1962
1980
1884
1982
1929
1917
2003
1924
1994
1981
1961
1923
1992
1999
1973

3.303
8.204
5.052
2.010
5.625
3.806
4.383
1.409
11.587
2.238
3.332
3.157
2.263
1.192
3.000

a

Journal Citation Report Impact Factor for 2016.

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M. Schargus et al. / The Ocular Surface xxx (2017) 1e11

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Table 8The 25 most-cited articles in dry eye in 2015 and 2016.
Rank

ArticleCitationsCitations/Year
Since Publication

Citationsin 20161

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 Apr; 122(4):669-76. doi: 10.1016/
j.ophtha.2014.10.004. Epub 2014 Nov 22. PubMed PMID: 25458707.
Foulks GN, Forstot SL, Donshik PC, Forstot JZ, Goldstein MH, Lemp MA, Nelson JD, Nichols KK, Pﬂugfelder SC, Tanzer JM,€gren disease. Ocul Surf.
Asbell P, Hammitt K, Jacobs DS. Clinical guidelines for management of dry eye associated with Sjo2015 Apr; 13(2):118-32. doi: 10.1016/j.jtos.2014.12.001. Epub 2015 Jan 15. Review. PubMed PMID: 25881996.
Tauber J, Karpecki P, Latkany R, Luchs J, Martel J, Sall K, Raychaudhuri A, Smith V, Semba CP; OPUS-2 Investigators.
Liﬁtegrast Ophthalmic Solution 5.0% versus Placebo for Treatment of Dry Eye Disease: Results of the Randomized Phase
III OPUS-2 Study. Ophthalmology. 2015 Dec; 122(12):2423-31. doi: 10.1016/j.ophtha.2015.08.001. Epub 2015 Sep 11.
PubMed PMID: 26365210.
Bunya VY, Fuerst NM, Pistilli M, McCabe BE, Salvo R, Macchi I, Ying GS, Massaro-Giordano M. Variability of Tear
Osmolarity in Patients With Dry Eye. JAMA Ophthalmol. 2015 Jun; 133(6):662-7. doi: 10.1001/
jamaophthalmol.2015.0429. PubMed PMID: 25811641; PubMed Central PMCID: PMC4466048.
Shetty R, Ghosh A, Lim RR, Subramani M, Mihir K, Reshma AR, Ranganath A, Nagaraj S, Nuijts RM, Beuerman R, Shetty R,
Das D, Chaurasia SS, Sinha-Roy A, Ghosh A. Elevated expression of matrix metalloproteinase-9 and inﬂammatory
cytokines in keratoconus patients is inhibited by cyclosporine A. Invest Ophthalmol Vis Sci. 2015 Feb 3; 56(2):738-50.
doi: 10.1167/iovs.14e14831. PubMed PMID: 25648341.
Aragona P, Aguennouz M, Rania L, Postorino E, Sommario MS, Roszkowska AM, De Pasquale MG, Pisani A, Puzzolo D.
Matrix metalloproteinase 9 and transglutaminase 2 expression at the ocular surface in patients with different forms ofdry eye disease. Ophthalmology. 2015 Jan; 122(1):62e71. doi: 10.1016/j.ophtha.2014.07.048. Epub 2014 Sep 18.
PubMed PMID: 25240629.
Galor A, Zlotcavitch L, Walter SD, Felix ER, Feuer W, Martin ER, Margolis TP, Sarantopoulos KD, Levitt RC. Dry eye
symptom severity and persistence are associated with symptoms of neuropathic pain. Br J Ophthalmol. 2015 May;
99(5):665-8. doi: 10.1136/bjophthalmol-2014-306057. Epub 2014 Oct 21. PubMed PMID: 25336572.
Xu Y, Yang Y. Small-incision lenticule extraction for myopia: results of a 12-month prospective study. Optom Vis Sci.
2015 Jan; 92(1):123-31. doi: 10.1097/OPX.0000000000000451. PubMed PMID: 25397926.
Galor A, Felix ER, Feuer W, Shalabi N, Martin ER, Margolis TP, Sarantopoulos CD, Levitt RC. Dry eye symptoms align moreclosely to non-ocular conditions than to tear ﬁlm parameters. Br J Ophthalmol. 2015 Aug; 99(8):1126-9. doi: 10.1136/
bjophthalmol-2014-306481. Epub 2015 Feb 20. PubMed PMID: 25710726.
Schmidl D, Schmetterer L, Witkowska KJ, Unterhuber A, dos Santos VA, Kaya S, Nepp J, Baar C, Rosner P, Werkmeister RM,
Garhofer G. Tear ﬁlm thickness after treatment with artiﬁcial tears in patients with moderate dry eye disease. Cornea.
2015 Apr; 34(4):421-6. doi: 10.1097/ICO.0000000000000358. PubMed PMID:25651494.
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 Mar; 45:132-64. doi: 10.1016/j.preteyeres.2014.11.001. Epub 2014 Dec 3. Review.
PubMed PMID: 25479602; PubMed Central PMCID: PMC4364449.
Bron AJ, Argüeso P, Irkec M, Bright FV. Clinical staining of the ocular surface: mechanisms and interpretations. Prog Retin
Eye Res. 2015 Jan; 44:36-61. doi: 10.1016/j.preteyeres.2014.10.001. Epub 2014 Oct 23. Review. PubMed PMID:
25461622.
Blum M, T€
aubig K, Gruhn C, Sekundo W, Kunert KS. Five-year results of Small Incision Lenticule Extraction (ReLEx
SMILE). Br J Ophthalmol. 2016 Sep; 100(9):1192-5. doi: 10.1136/bjophthalmol-2015-306822. Epub 2016 Jan 8. PubMed
PMID: 26746577.
Arita R, Morishige N, Koh S, Shirakawa R, Kawashima M, Sakimoto T, Suzuki T, Tsubota K. Increased Tear Fluid Production
as a Compensatory Response to Meibomian Gland Loss: A Multicenter Cross-sectional Study. Ophthalmology. 2015 May;
122(5):925-33. doi: 10.1016/j.ophtha.2014.12.018. Epub 2015 Jan 24. PubMed PMID: 25626757.
van der Vaart R, Weaver MA, Lefebvre C, Davis RM. The association between dry eye disease and depression and anxiety
in a large population-based study. Am J Ophthalmol. 2015 Mar; 159(3):470-4. doi: 10.1016/j.ajo.2014.11.028. Epub 2014
Nov 26. PubMed PMID: 25461298; PubMed Central PMCID: PMC4329250.
Aggarwal S, Kheirkhah A, Cavalcanti BM, Cruzat A, Colon C, Brown E, Borsook D, Prüss H, Hamrah P. Autologous Serum
Tears for Treatment of Photoallodynia in Patients with Corneal Neuropathy: Efﬁcacy and Evaluation with In Vivo
Confocal Microscopy. Ocul Surf. 2015 Jul; 13(3):250-62. doi: 10.1016/j.jtos.2015.01.005. Epub 2015 Feb 20. PubMed
PMID: 26045233; PubMed Central PMCID: PMC4499014.
Yokoi N, Uchino M, Uchino Y, Dogru M, Kawashima M, Komuro A, Sonomura Y, Kato H, Tsubota K, Kinoshita S.
Importance of tear ﬁlm instability in dry eye disease in ofﬁce workers using visual display terminals: the Osaka study.
Am J Ophthalmol. 2015 Apr; 159(4):748-54. doi: 10.1016/j.ajo.2014.12.019. Epub 2014 Dec 30. PubMed PMID:
25555800.
Schmidl D, Witkowska KJ, Kaya S, Baar C, Faatz H, Nepp J, Unterhuber A, Werkmeister RM, Garhofer G, Schmetterer L. The
association between subjective and objective parameters for the assessment of dry-eye syndrome. Invest Ophthalmol
Vis Sci. 2015 Feb 3; 56(3):1467-72. doi: 10.1167/iovs.14e15814. PubMed PMID: 25650419.
Pucker AD, Haworth KM. The presence and signiﬁcance of polar meibum and tear lipids. Ocul Surf. 2015 Jan; 13(1):26
e42. doi: 10.1016/j.jtos.2014.06.002. Epub 2014 Oct 8. Review. PubMed PMID: 25557344.
Perez VL, Pﬂugfelder SC, Zhang S, Shojaei A, Haque R. Liﬁtegrast, a Novel Integrin Antagonist for Treatment of Dry Eye
Disease. Ocul Surf. 2016 Apr; 14(2):207-15. doi: 10.1016/j.jtos.2016.01.001. Epub 2016 Jan 22. Review. PubMed PMID:
26807723.
Villani E, Garoli E, Termine V, Pichi F, Ratiglia R, Nucci P. Corneal Confocal Microscopy in Dry Eye Treated withCorticosteroids. Optom Vis Sci. 2015 Sep; 92(9):e290-5. doi: 10.1097/OPX.0000000000000600. PubMed PMID:
25909241.
€fer G, Werkmeister
Kaya S, Schmidl D, Schmetterer L, Witkowska KJ, Unterhuber A, Aranha Dos Santos V, Baar C, Garho
RM. Effect of hyaluronic acid on tear ﬁlm thickness as assessed with ultra-high resolution optical coherence tomography.
Acta Ophthalmol. 2015 Aug; 93(5):439-43. doi: 10.1111/aos.12647. Epub 2015 Jan 20. PubMed PMID: 25601227.
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 Jul; 34(7):739-44. doi: 10.1097/
ICO.0000000000000449. PubMed PMID: 25909238.

39

13

22

27

9

13

22

7.33

11

21

7

7

20

6.67

11

20

6.67

11

19

6.33

7

16

5.33

8

15

5

8

15

5

4

15

5

8

15

5

6

14

7

3

14

4.67

7

14

4.67

6

13

4.33

6

13

4.33

8

13

4.33

7

13

4.33

8

12

6

6

12

4

5

12

4

5

12

4

9

2

3

4

5

6

7

8
9

10

11

12

13

14

15

16

17

18

19
20

21

22

23

(continued on next page)

Please cite this article in press as: Schargus M, et al., The top 100 papers in dry eye e A bibliometric analysis, The Ocular Surface (2017), http://dx.doi.org/10.1016/j.jtos.2017.09.006

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M. Schargus et al. / The Ocular Surface xxx (2017) 1e11

Table 8 (continued )Rank

ArticleCitationsCitations/Year
Since Publication

Citationsin 2016

24

Bhargava R, Kumar P, Phogat H, Kaur A, Kumar M. Oral omega-3 fatty acids treatment in computer vision syndrome
related dry eye. Cont Lens Anterior Eye. 2015 Jun; 38(3):206-10. doi: 10.1016/j.clae.2015.01.007. Epub 2015 Feb 16.
PubMed PMID: 25697893.
Bhargava R, Kumar P. Oral omega-3 fatty acid treatment for dry eye in contact lens wearers. Cornea. 2015 Apr;
34(4):413-20. doi: 10.1097/ICO.0000000000000386. PubMed PMID: 25719253.

12

4

8

12

4

6

25

articles published after 2000 were more likely to be cited in recent
years. This correlation was statistically signiﬁcant (r ¼ 0.46,
p < 0.001, Mann-Kendall test, Fig. 4 A).
Electronic access to publishing houses has continued to evolve,
making the whole process of article submission, review and publication, as well as accessing publications, now possible online [4].
We believe that the increasing number of publications in the ﬁeldof dry eye after 1990 is due to the rise of the World Wide Web with
its easy accessibility and its new and great advantages to the scientiﬁc community (Fig. 3).
Dry eye diagnostics and treatment have evolved rapidly over the
past decades. The top 100 list shows that most clinical articles fall
into three subject areas: diagnostic research (66%), medical andsurgical treatment (20%) and epidemiology (14%). Correspondingly,
the focus of individuals who were ﬁrst or last authors of multiple
articles in the list was also frequently on one of the ﬁrst two areas.
As in other medical ﬁelds (e.g., urology and general surgery), theU.S. was the most frequent country of origin, probably as a consequence of the greater resources compared to Europe [10,27]. In
some bibliometric studies, attempts have been made to get aclearer view of research activity in countries with fewer resources
by correcting for population size, without affecting the impact of
the authors of the most frequently cited articles [15,28]. One of themain confounding factors arises from the tendency of authors tocite articles published in ‘local’ journals, i.e., authors publishing inEuropean journals citing articles published in those journals, andauthors publishing in American journals citing papers from theirnational journals [15,29]. In our study, the most-cited dry eye articles from the U.S. were nearly always published in American
journals. Since the English-language journals from the U.K. and the
U.S. have the highest rank in ophthalmology, most authors of highquality material want their work to appear there, maintaining thestatus of these British and American journals. The 100 most-citedarticles in dry eye research were published in only 15 journals,
and 76 of the articles were published in 5 American journals. The
American journal “Investigative Ophthalmology and Visual Science,” established in 1962, topped the list with 29 articles.
As for earlier bibliometric studies [15,30,31], our top 100 list of
dry eye articles is not mainly comprised of articles with a high levelof evidence. Most articles in the list (29, with a mean of 182 ± 95
citations per article) were clinical outcome studies with an evidence level of III, demonstrating that small case series or cohort
studies presenting an original concept can still attract the interestof researchers and readers in the ﬁeld [15].
The top 3 most-cited authors in this study period (S.C. Pﬂugfelder, K. Tsubota, and I.K. Gibson) contributed 34 articles as ﬁrst
and/or last author, accruing a total of 4700 citations. Of these 34
articles, 20 were from American institutions and 14 from Japan. All
were single-centre studies. This highlights how a relatively few
authors can substantially contribute to the impact of a journal or aﬁeld of research [4]. Indeed, the three key authors contributed 34%of the top 100 articles and they attracted almost 27% of citations.
Diagnostic test methods are frequently described in the framework of dry eye articles and were therefore frequently cited. The
article entitled “Reliability and validity of the ocular surface diseaseindex” (R.M. Schiffman et al.) was the most-cited paper according
to our analysis (with 610 citations; Table 2).
Citation analysis does have certain limitations. First, mostjournals are not open access but pay-per-view and are therefore notaccessible for everyone. Second, language barriers are given between authors and readers. Finally, yet importantly, papers have to
be listed within the common online scientiﬁc search robots to get ahigh attraction for new authors.
Although bibliometrics provide a valuable snapshot of articles
that have been frequently cited, methods and treatments change,
especially in a rapidly developing ﬁeld such as ophthalmology, andthe importance of some previously frequently cited articles wanes[15].
Notwithstanding that citation count provides a valuable quantitative assessment, it does not offer a precise measure of the statusof a journal or article by itself [4]. There are several reasons for this:citation reports rely on only a selected number of journals; there
will be a bias towards larger journals that publish more articles[15]. Publications will also be cited for several reasons: because of
the results of a well-designed study or interesting statistical analysis, but, on the other hand, citations might also been used to show
studies with study design errors and studies with strong bias orinterpretation problems. Therefore, the number of citations is only
one of many quality indicators.
In addition, the basis for selecting articles may differ; varying
selection criteria may lead to a different list. When using citation
counts as a measure to quantify article impact in bibliometrics, themost-cited articles are often regarded as ‘‘citation classics’’ [15].
Obviously, recent papers are less cited due to limited timespansince publication. This “bias” is the key reason why papers after theyear 2011 are not listed under the top 100 dry eye papers. For thisreason, we added a list of the top cited papers of 2015 and 2016 to
identify the new “rising stars” in their ﬁeld (Table 8). This subanalysis does not reﬂect the overall trend, as the citation rate
might change signiﬁcantly over the next years on this actual selection of papers.
Analysis of authors and countries of origin were done only forﬁrst and last authorships. The main reason for this was the better
visualization of the results and the fact that these authors normally
have the highest impact on the work. Even if several previous
bibliometric papers applied this method in the past, one could statethat this selection is a bias of the current work because not all
authors were taken into account [11,15].
Finally, the choice of key words for the search can be a limitation. Since we used the key word “dry eye,” it is possible that otherrelevant articles that did not include this speciﬁc term may nothave been detected in the database search [31].
In conclusion, this is, to our knowledge, the ﬁrst bibliometricstudy to identify the top 100 most-cited papers in dry eye research.
Our study focusing on dry eye research shows that the majority ofthe most-cited articles were published in ﬁve of the top-ranked
journals. Most of the clinical articles were concerned with diagnostics. The majority of articles represented evidence level III
clinical outcome studies, indicating that small case series or cohort
studies can also gain attention. Bibliometric studies also need to be

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M. Schargus et al. / The Ocular Surface xxx (2017) 1e11

updated occasionally to include the more recent developments[1,32]. Despite its limitations, citation analysis provides an important quantitative method for comparing research in scientiﬁc ﬁelds.
Bibliometric studies are invaluable for researchers who are new tothe ﬁeld, and highlight the contributions leading to developments,
in this case in dry eye research. The results of bibliometric studies
emphasize the quality of prior scientiﬁc research and could evenstimulate new approaches [15].
Conﬂict of interest
No conﬂict of interest exists for any author. The authors have nocommercial or proprietary interest in any concept or productdescribed in this article. This research did not receive any speciﬁcgrant from funding agencies in the public, commercial, or not-forproﬁt sectors.
References[1] Fan JC, McGhee CN. Citation analysis of the most inﬂuential authors andophthalmology journals in the ﬁeld of cataract and corneal refractive surgery
2000-2004. Clin Exp Ophthalmol 2008;36:54e61.
[2] Bjork BC. A study of innovative features in scholarly open access journals.
J Med Internet Res 2011;13:e115.
[3] Agarwal A, Durairajanayagam D, Tatagari S, Esteves SC, Harlev A, Henkel R,
et al. Bibliometrics: tracking research impact by selecting the appropriate
metrics. Asian J Androl 2016;18:296e309.
[4] Chou CY, Chew SS, Patel DV, Ormonde SE, McGhee C. Publication and citation
analysis of the Australian and New Zealand journal of ophthalmology andclinical and experimental ophthalmology over a 10-year period: the evolutionof an ophthalmology journal. Clin Exp Ophthalmol 2009;37:868e73.
[5] Garﬁeld E. Citation indexes for science; a new dimension in documentation
through association of ideas. Science 1955;122:108e11.
[6] Gillies MC. New professionalism and the society journal. Clin Exp Ophthalmol
2002;30:389e91.
[7] Saha S, Saint S, Christakis DA. Impact factor: a valid measure of journal
quality? J Med Libr Assoc 2003;91:42e6.
[8] Sims JL, McGhee CN. Citation analysis and journal impact factors in ophthalmology and vision science journals. Clin Exp Ophthalmol 2003;31:14e22.
[9] Garﬁeld E. Citation analysis as a tool in journal evaluation. Science 1972;178:
471e9.
[10] Kelly JC, Glynn RW, O'Briain DE, Felle P, McCabe JP. The 100 classic papers oforthopaedic surgery: a bibliometric analysis. J Bone Jt Surg Br 2010;92:1338e43.

11[11] Skovrlj B, Steinberger J, Guzman JZ, Overley SC, Qureshi SA, Caridi JM, et al.
The 100 most inﬂuential articles in cervical spine surgery. Glob Spine J
2016;6:69e79.
[12] Garﬁeld E. The history and meaning of the journal impact factor. JAMA
2006;295:90e3.
[13] Steinberger J, Skovrlj B, Caridi JM, Cho SK. The top 100 classic papers inlumbar spine surgery. Spine (Phila Pa 1976) 2015;40:740e7.
[14] Garﬁeld E. 100 citation classics from the journal of the American medical
association. JAMA 1987;257:52e9.
[15] Ahmad SS, Evangelopoulos DS, Abbasian M, Roder C, Kohl S. The hundred
most-cited publications in orthopaedic knee research. J Bone Jt Surg Am
2014;96:e190.
[16] Journal citation report. 2017.
[17] Boudry C, Denion E, Mortemousque B, Mouriaux F. Trends and topics in eye
disease research in PubMed from 2010 to 2014. PeerJ 2016;4:e1557.
[18] Schulz CB, Kennedy A, Rymer BC. Trends in ophthalmology journals: a ﬁveyear bibliometric analysis (2009-2013). Int J Ophthalmol 2016;9:1669e75.
[19] Milner MS, Beckman KA, Luchs JI, Allen QB, Awdeh RM, Berdahl J, et al.
Dysfunctional tear syndrome: dry eye disease and associated tear ﬁlm disorders - new strategies for diagnosis and treatment. Curr Opin Ophthalmol
2017;27(Suppl 1):3e47.
[20] Jones L, Downie LE, Korb D, Benitez-Del-Castillo JM, Dana R, Deng SX, et al.
TFOS DEWS II management and therapy report. Ocul Surf 2017;15:575e628.
[21] Wolffsohn JS, Arita R, Chalmers R, Djalilian A, Dogru M, Dumbleton K, et al.
TFOS DEWS II diagnostic methodology report. Ocul Surf 2017;15:539e74.
[22] Boudry C, Mouriaux F. Eye neoplasms research: a bibliometric analysis from1966 to 2012. Eur J Ophthalmol 2015;25:357e65.
[23] Pekel E, Pekel G. Publication trends in corneal transplantation: a bibliometricanalysis. BMC Ophthalmol 2016;16:194.
[24] Schiffman RM, Christianson MD, Jacobsen G, Hirsch JD, Reis BL. Reliability andvalidity of the ocular surface disease index. Arch Ophthalmol 2000;118:615e21.
[25] Picknett T, Davis K. The 100 most-cited articles from JMB. J Mol Biol 1999;293:
171e6.
[26] Garﬁeld E. The obliteration phenomenon. Current Contents No 51/52: 5e7,(22
Dec 1975). 1975.
[27] Hennessey K, Afshar K, Macneily AE. The top 100 cited articles in urology. Can
Urol Assoc J 2009;3:293e302.
[28] Fendrich V, Rothmund M. Surgical research in Germanyean international
comparison. Chirurg 2010;81:328e33.
[29] Narin F, Hamilton KS. Bibliometric performance measures. Scientometrics
1996;36:293e310.
[30] Namdari S, Baldwin K, Kovatch K, Huffman GR, Glaser D. Fifty most citedarticles in orthopedic shoulder surgery. J Shoulder Elb Surg 2012;21:1796e802.
[31] Murray MR, Wang T, Schroeder GD, Hsu WK. The 100 most cited spine articles. Eur Spine J 2012;21:2059e69.
[32] Nason GJ, Tareen F, Mortell A. The top 100 cited articles in urology: an update.
Can Urol Assoc J 2013;7:E16e24.

Please cite this article in press as: Schargus M, et al., The top 100 papers in dry eye e A bibliometric analysis, The Ocular Surface (2017), http://dx.doi.org/10.1016/j.jtos.2017.09.006