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Objective To investigate the application value of tear inflammatory factors in early evaluation of the occurrence of complications after trabeculectomy in glaucoma patients.Methods A total of 150 eyes of 150 patients with angle-closure glaucoma who underwent trabeculectomy in Department of Ophthalmology of Zhangjiagang Hospital of Traditional Chinese Medicine were included.The clinical data of all patients were collected,and the levels of inflammatory factors(including G-CSF,GM-CSF,IFN-γ,MCP-1,TNF-α,IL-12,IL-13,IL-15,IL-1β,IL-4,IL-7,IL-10,IL-17,IL-5)in tears were detected before surgery.According to the occurrence of postoperative complications,the patients were divided into the complication group and the control group,and the clinical data of the two groups were compared.Logistic regression was used to analyze the related factors of the occurrence of complications after trabeculectomy in glaucoma patients.The predictive model of tear inflammatory factors was established by Logistic regression,and the receiver operating characteristic(ROC)curve was drawn to analyze the value of this model in early evaluation of the occurrence of complications after trabeculectomy in glaucoma patients.Results Complications occurred in 35(23.33%)of 150 glaucoma patients after trabeculectomy,including 24 cases of shallow anterior chamber,5 cases of ciliary body or choroid detachment,3 cases of iridocyclitis,2 cases of hyphema,and 1 case of retinal detachment.IFN-γ,GM-CSF and IL-5 levels of the patients in the complication group were lower than those in the control group(P<0.05).There was no significant difference in the levels of other inflammatory factors of patients between the two groups(P>0.05).Multivariate Logistic regression analysis showed that increased levels of IFN-γ(OR=0.999),GM-CSF(OR=0.988)and IL-5(OR=0.996)were independent protective factors for complications after trabeculectomy in glaucoma patients(P<0.05).ROC curve analysis showed that the sensitivity and specificity of the model were 94.29%and 83.84%in early evaluation of the occurrence of complications after trabeculectomy in glaucoma patients,and the AUC was 0.906,which was higher than that predicted by IFN-γ(AUC=0.642),GM-CSF(AUC=0.721)and IL-5(AUC=0.666)alone.Conclusion Preoperative analysis of tear inflammatory factors in glaucoma patients can early evaluate the occurrence of postoperative complications,especially the combined detection of IFN-γ,GM-CSF and IL-5 levels is of great significance for predicting the occurrence of complications.
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Purpose: This study aims to investigate the effects of maqui?berry extract (MBE) in improving signs and symptoms of dry eye disease (DED) along with ocular surface inflammation in patients with DED. Methods: Twenty patients were randomly assigned to a MBE or a placebo group (PLC). DED parameters including Schirmer’s test 1 (ST1), tear film break?up time (TBUT), ocular surface disease index (OSDI), and corneal staining were assessed before treatment and 2 months post?treatment. Tear fluid samples before and after treatment from a subset of these patients were collected from the study subjects using sterile Schirmer’s strips, and the levels of interleukin (IL)?1?, IL?10, IL?6, IL?17A, tumor necrosis factor?? (TNF?), matrix metalloproteinase?9 (MMP9), soluble intercellular adhesion molecule?1 (sICAM1), and vascular endothelial growth factor?A (VEGF?A) were measured using a microfluidic cartridge?based multiplex ELISA. Results: The MBE group demonstrated a significant (p < 0.05) decrease in OSDI scores along with a significant increase in Schirmer’s test 1 compared to the PLC group. No significant change in TBUT and corneal staining was observed between the study groups. Levels of proinflammatory factors such as IL?1?, IL?6, IL?17A, TNF?, and MMP9 were observed to be significantly reduced, along with a significant increase in IL?10 levels following treatment in the MBE group compared with the PLC group. Conclusion: Consumption of MBE resulted in the resolution of DED signs and symptoms, along with a reduction in ocular surface inflammation.
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Purpose: To study ocular surface signs, symptoms, and tear film composition following prophylactic thermal pulsation therapy (TPT) prior to refractive surgery, and to compare these outcomes with those who underwent TPT after refractive surgery. Methods: Patients with mild?to?moderate evaporative dry eye disease (DED) and/or meibomian gland dysfunction (MGD) undergoing refractive surgery were included. Group 1 patients received TPT (LipiFlow) prior to laser?assisted in situ keratomileusis (LASIK; n = 32, 64 eyes), and Group 2 patients received TPT three months after LASIK (n = 27, 52 eyes). Ocular Surface Disease Index (OSDI) score, Schirmer’s test (ST1, ST2), Tear Breakup Time (TBUT), meibography, and tear fluid were obtained preoperatively and at three months postoperatively in Groups 1 and 2. Additional postoperative evaluation was performed three months after TPT in Group 2. Tear soluble factor profile was measured by multiplex enzyme?linked immunosorbent assay (ELISA) using flow cytometry. Results: Postoperative OSDI score was significantly lower and TBUT was significantly higher when compared with matched preoperative values of Group 1 participants. On the other hand, the postoperative OSDI score was significantly higher and TBUT significantly lower when compared with matched preoperative values of Group 2 participants. TPT significantly reduced the postoperative elevation in OSDI and significantly reduced the postoperative reduction in TBUT in Group 2 participants. Tear Matrix metalloproteinase?9/ Tissue inhibitor matrix metalloproteinase 1 (MMP?9/TIMP1) ratio was significantly higher, postoperatively, when compared with matched preoperative levels in Group 2. However, MMP9/TIMP1 ratio remained unaltered in Group 1 participants. Conclusion: TPT prior to refractive surgery improved postsurgical ocular surface signs and symptoms and reduced tear inflammatory factors, thereby suggesting the plausibility of reduced post?refractive surgery DED in patients.
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With changes in lifestyle, such as the increasing use of digital screens and rising demand for refractive surgery, dry eye disease has become increasingly prevalent in recent times. While we are equipped with a number of diagnostic modalities and a myriad of treatment forms, ranging from topical medication to procedural therapies, the condition remains an enigma in terms of varied patient satisfaction. An understanding of the molecular basis of a disease may open up new avenues in the customization of its treatment. We attempt to simplify this in the form of a stepwise protocol to incorporate biomarker assays in dry eye management.
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Purpose: To determine the levels of dopamine in tear fluid and demonstrate the use of tear fluid as a non-invasive source for dopamine measurements in humans. Methods: The study cohort included 30 clinically healthy individuals without any pre-existing ocular or systemic conditions. Matched tear fluid (using Schirmer's strips and capillary tubes) and plasma were collected from the subjects. Dopamine levels were evaluated using direct competitive chemiluminescent enzyme-linked immunosorbent assay (ELISA), dopamine kit (Cloud Clone Corp, TX, USA). Results: Significantly higher dopamine levels were found in the tear fluid compared to plasma in the study subjects. The level of dopamine was 97.2 ± 11.80 pg/ml (mean ± SEM), 279 ± 14.8 pg/ml (mean ± SEM), and 470.4 ± 37.64 pg/ml (mean ± SEM) in the plasma and in the tears collected using Schirmer's strips and capillary tubes, respectively. Conclusion: Dopamine was detectable in all the tear fluid samples tested and was also found to be at a higher concentration than in plasma samples. Tear fluid can be used as a non-invasive sample source to monitor dopamine levels.
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@#AIM: To observe the effect of ultrasonic atomization of Shufeng Mingmu Decoction on tear film stability and index of tear fluid in patients with allergic conjunctivitis.<p>METHODS: Totally 140 patients with allergic conjunctivitis were randomly divided into 2 groups. 70 patients in the control group were treated with olopatadine hydrochloride eye drops combined with normal saline atomization therapy, while the 70 patients in the observation group were treated with ultrasonic atomization of Shufeng Mingmu Decoction combined with oldpatadine hydrochloride eye drops. After 14d of continuous treatment, the single symptoms(lacrimation, itching, photophobia, foreign body sensation), the stability of tear film(BUT, FL), and the index of tear fluid(ECP, HA, IgE)of the two groups were compared and analyzed. The clinical effects of the two groups were compared. <p>RESULTS: The total effective rate of the observation group was significantly higher than that of the control group(90.7% <i>vs </i>74.3%, <i>P</i><0.05). After treatment, the scores of single symptoms in both groups were lower than those before treatment, and those in the observation group were lower than those in the control group(<i>P</i><0.05). After treatment, the index of BUT in both groups were significantly higher than before treatment(<i>P</i><0.05), while the index of FL was significantly lower than before treatment, and the improvement degree of which in the observation group was better than that of control group(<i>P</i><0.05). After treatment, the levels of HA, ECP and IgE in the two groups were significantly lower than before treatment, and the improvement degree of which in the observation group was better than that in the control group(<i>P</i><0.05).<p>CONCLUSION: Ultrasonic atomization treatment of Shufeng Mingmu Decoction can improve the index of tear fluid of allergic conjunctivitis patients and the stability of tear film, which help relieve local allergy and improve clinical symptoms of patients.
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Thyroid associated ophthalmopathy (TAO) is the most common autoimmune inflammatory orbital disease in adults.Because of its high incidence and the threat of vision,early detection and diagnosis is critical.Proteomics of tear fluid in TAO patients demonstrates that up-regulation of inflammatory proteins is associated with downregulation of protective proteins,reflecting autoimmunity and inflammation-induced dysfunction of the lacrimal gland.Lysozyme C,lactoferrin,tear protein,anti-albumin and zinc-α-2-glycoprotein 1,cysteine protease inhibitor c,α-1 antichymotrypsin and retinal dehydrogenase in tears of patients with TAO are up-regulated,suggesting that these proteins may be involved in the inflammatory process of TAO.These protein-biomarkers may be new approaches to the future research of TAO.The concentration of interleukin-7 (IL-7) in the patients with active Graves' ophthalmopathy was significantly lower.Targeting immune restitution using IL-7 may have disease modifying effects.Exophthalmos and increasing surface area of palpebral fissure in TAO patients result in stronger evaporation and tear film lipid layer to thin.The thinner tear film lipid layer leads to faster evaporation.Meanwhile,the loss of fluid further offects the coating efficiency of tear film.So TAO patients may develop secondary evaporative dry eye.Types of protein,cytokines and prostaglandin E2 is associated with TAO diagnosis and can be the evaluation index of TAO's disease stage.
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With the continuous increase in the incidence of diabetes mellitus in the world,the ocular complications are getting more and more attention.Diabetes mellitus can cause several complications,including diabetic retinopathy and diabetic cataract,as well as changes in the structure and micro-environment of ocular surface,which can further affect the composition and quality of tear fluid,even the stability of tear film.This review will provide a brief overview of ocular surface changes caused by diabetes mellitus,relevant detection methods and affecting factors.
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Tear is a complex fluid mainly secreted by lacrimal gland.It is a complex body fluid,which may contain thousands of protein/peptides and other molecules.Studies have determined that the changes in the chemical compositions of tears play an important role in some diseases and their progression.Tear components including protein,lipid and metabolites,which is easy to be obtained,not only can be used for biomarkers,can also be used to study an eye the onset of systemic disease process.Measuring the changes in composition of tear may be used to determine the critical path of the disease development,provide a new possibility for prevention and treatment.This article reviews the ophthalmic applications of tear markers in the systemic disease,which has not been determined so far.
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PURPOSE: Although various sampling methods of tears from conjunctival sac have been reported, no previous study compared their effectiveness or efficiency based on protein extraction. By comparing the compliance, volume and protein concentration of each tear sampling method, we searched for the most efficient tear collection method. METHODS: Resting tear samples of 14 eyes of normal subjects were collected using Schirmer paper, capillary tube, cellolose acetate rod and 3 different ophthalmic sponges made of different materials and density (Merocel(R), KeraCel(R) and Weck-Cel(R)). After centrifugation of the collected tear samples, the tear volume and protein concentration were measured for each method. Additionally, the compliance of each tear sampling method was analyzed by numerically representing the amount of discomfort experienced during resting tear collection. RESULTS: The average volume retrieved by each tear sampling method was 9.0 +/- 1.1 microL with no significant differences between groups. The average concentration of protein retrieved by each tear sampling method was 5.3 +/- 1.2 microg/microL. Merocel(R) retrieved 7.6 +/- 0.61 microg/microL, which was significantly higher than other sampling methods (p < 0.05). The compliance of Merocel(R) and the capillary tube were the highest, while KeraCel(R) showed the lowest compliance. CONCLUSIONS: Merocel(R) retrieved the highest amount of protein and showed high compliance and may be the most effective and easily applicable tear sampling method in clinical settings.
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Capilares , Centrifugación , Adaptabilidad , Métodos , Poríferos , LágrimasRESUMEN
Objective To investigate the relationship between HbA1c in blood and IL-6 in tear fluid of the elderly patients with diabetic retinopathy ( DR ) in Shijiazhuang urban communities , and the relationship between IL-6 in tear fluid and the severity of DR. Methods The elderly people who lived more than 5 years , older than ≥45 year old. in nine urban communities of Shijiazhuang were stratified randomly sampled and received cross-sectional epidemiology questionnaire survey and OGTT. A total of 1 447 subjects (509 males and 938 females) were included. Each participant underwent epidemiological surveys and oral glucose tolerance test (OGTT), according to the 1999 WHO diabetes mellitus (DM) diagnostic criteria established. For patients who were newly or previously diagnosed as DM. HbA1c level, tear fluid IL-6 and serum IL-6 tested.The severity of DR was evaluated by fundus examination, the people were divided into normal group(NGT), non-diabetic retinopathy ( NDR ) , non-proliferative diabetic retinopathy ( NPDR ) , and proliferative diabetic retinopathy ( PDR ) . The correlation of serum IL-6 and tear fluid IL-6,blood HbA1c and tear fluid IL-6 were assessed by SPSS 19.0 statistical software. Results Concentrations of tear fluid IL-6 were (3.10 ± 1.25)pg/mL in the NGT group, (10.25 ± 3.22)pg/mL in the NDR group,(16.80 ± 5.76)pg/mL in the NPDR group,(25.11 ± 5.20)pg/mL in the PDR group(P < 0.01). SNK-q test revealed significant differences between every two groups (P < 0.01,P <0.05,P < 0.05) Concentrations of serum IL-6 were (88.04 ± 17.06)pg/mL in the NGT group,(126.38 ± 20.73) pg/mL in the NDR group, (239.83 ± 40.33)pg/mL in the NPDR group, (268.36 ± 27.72)pg/mL in the PDR group(P < 0.01). SNK-q test revealed significant differences between every two groups (P < 0.01). Tear fluid IL-6 level was positively correlated with serum IL-6 level(R = 0.756,P < 0.01). Tear fluid IL-6 level was positively correlated with blood IL-6 level (R = 0.338, P < 0.01). Conclusion The tear fluid IL-6 levels of the elderly patients with DM in Shijiazhuang urban communities , increased; with the increased severity of DR , the levels of tear fluid IL-6 gradually increase. The level of tear fluid IL-6, serum IL-6, HbA1c closely correlates with the severity of DR.
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AlM: To monitor long - term changes of matrix metalloproteinase-2 ( MMP-2 ) in human tears fluid after laser in situ keratomileusis ( LASlK) . METHODS: Thirty - two myopia cases ( 64 eyes ) underwent uneventful LASlK were enrolled in the study. Tear fluid were collected and MMP-2 expression was analyzed by Western - bolt assay preoperatively and postoperatively on 15d, at 1, 3mo, and 1a. RESULTS:LASlK increased the concentration of MMP-2 in human tear fluid. At 15d postoperatively, the magnitude of MMP-2 was 1. 4 times that of preoperative, thereafter subsided, but didn't return to preoperative level by 3mo ( P 0. 05). CONCLUSlON: MMP- 2 is significantly expressed in human tear fluid after LASlK, then subsided with time, but didn't return to preoperative level by 3mo and almost recovered up to 1a, indicating wound healing of LASlK would continue up at least 3mo after surgery and almost recovered 1a postoperatively.