Tear Proteomics in Young Malays with Dry Eyes

Changes in tear protein concentrations may reflect ocular surface health. This study analyzes changes in tear protein concentrations of young Malays with dry eye (DE) and determines its association with the clinical findings. Methods: Subjects were screened using McMonnies questionnaire (MDEQ) and flourescein tear break up time (TBUT). Total tear protein concentration (TTPC) was determined using Bradford's technique and specific tear protein (sIgA, lysozyme, lactoferrin and human serum albumin (HSA)) concentrations were determined using SDS-PAGE. Parametric and nonparametric tests were used to compare means between groups. Spearman correlation was used to determine the association between variables measured. Results: A total of 42 subjects (21 DE and 21 NDE) were included. Mean MDEQ score for DE was 16.00±1.48 and NDE was 8.47±3.47. Mean TBUT for DE was 3.47±0.47s and NDE was 4.98±0.43s. Mean TTPC for DE and NDE was 9.84±2.40mg/ml and 8.96±1.84mg/ml respectively. Mean sIgA, lysozyme, lactoferrin and HSA for DE was 0.54±0.10mg/ml, 1.68±0.17mg/ml, 1.47±0.25mg/ml, 0.06±0.03mg/ml and for NDE was 0.57±0.09mg/ ml, 2.04±0.19mg/ml, 1.75±0.23mg/ml, 0.06±0.03mg/ml accordingly. Significant differences were noted in MDEQ score (p=0.01), TBUT (p=0.01), lactoferrin (p=0.01) and lysozyme (p=0.01) but not in TTPC (p=0.19), HSA (p=0.74) and sIgA (p=0.24) between groups. Significant correlations were noted between TBUT with lactoferrin (r=0.02, p=0.02) and lysozyme (r=0.63, p=0.01) and between MDEQ score with lactoferrin (r=-0.34, p=0.02) and lysozyme (r=-0.64, p=0.01). Conclusions: There are changes in specific tear protein in dry eye patients, which correlate well with clinical results. Tear protein analysis may play an important role in the diagnosis of the dry eye.

Tear evaluation of subjects wearing rigid gas permeable contact lens for six months: the Asian context.

OBJECTIVE: Asians are known to have different tear characteristics compared to Caucasians that may affect contact lens wear. There are scanty research studies that have evaluated tears during continuous wear contact lens in Asia. The present study aims to evaluate changes in tears in subjects wearing continuous wear rigid gas permeable contact lens (CWRGP) for 6 months. MATERIALS AND METHODS: Thirty five neophyte subjects (21 females, 14 females) were recruited for this study. Subjects were fitted with CWRGP lenses with Dk of 163 on both eyes. Tear was evaluated using Phenol red thread test (PRT), tear break up time (TBUT) test and tear meniscus height (TMH) measurement. Non parametric and parametric analyses were used to compare the parameters. RESULTS: Values at baseline (BL) and six months (6M) were as follow: PRT, BL=19.10 ± 3.86 mm, 6M= 21.02 ± 4.27 mm, TBUT, BL= 8.58 ± 4.90 sec, 6M=8.08 ± 5.32 sec, TMH, BL= 0.38 ± 0.12 mm, 6M= 0.34 ± 0.07 mm. Statistical analysis showed significant difference in tear volume for PRT only at 6 months (p=0.007). CONCLUSION: Our analysis showed minimal change in the tear characteristics after six months of CWRGP lens wear, which indicated low impact of CWRGP contact lens on tears characteristics of Asian eyes. However, careful monitoring is required to prevent development of adverse events during contact lens wear.

Tears evaluation of one sample of keratoconus patients in kuala lumpur.

OBJECTIVE: To evaluate tears of newly diagnosed keratoconus patients attending the Optometry clinic in Malaysia and to compare this with tears of normal myopic subjects. METHODS: The ocular surface of newly diagnosed keratoconus patients were evaluated using tear break up time (TBUT) test, non invasive tear break up time test (NIBUT) and Schirmer test. Twenty keratoconus patients (40 eyes) and 40 normal subjects (80 eyes) participated in this study. RESULTS: Significantly lower TBUT and NIBUT values were found in keratoconus patients than normal control subjects (p<0.05). Mean TBUT and NIBUT for keratoconus patients were 3.99±1.69s and 7.03±3.48s and for normal subjects were 7.24±4.39s and 13.67±10.81s respectively. However, no significant difference was detected in Schirmer test values. Mean values of Schirmer tests I and II for keratoconus patients were 20.52±10.66mm and 10.71±10.43mm and for normals were 23.83±11.34mm and 13.27±8.28mm accordingly. CONCLUSION: It was concluded from this study that keratoconus patients have poor tear stability which need to be considered appropriately during management of the patients.

Visual and binocular status of Down syndrome children in Malaysia.

BACKGROUND: Down syndrome is a common chromosomal anomaly. Few reported studies make reference to the ocular status in Asian children with Down syndrome. The purpose of this study was to determine the visual and binocular status of a sample of Down syndrome children in Malaysia. METHODS: A total of 73 Malaysian children with Down syndrome (38 boys and 35 girls) in the Kuala Lumpur area aged one to 12 years were examined. Cycloplegic refraction was performed on each eye and binocular visual acuity was assessed using the Cardiff acuity card or the LogMAR chart. Binocular functions were assessed using the cover test and Lang's stereo acuity test. RESULTS: The mean age of the subjects was 6.01 +/- 3.41 years. Refraction of the right eye showed that 10 per cent of the subjects were myopic, 20 per cent were hyperopic and 70 per cent had no significant refractive error. The mean spherical equivalent was +0.92 +/- 2.32 DS for the right eye and +0.99 +/- 2.21 DS for the left. The mean of binocular LogMAR VA was 0.36 +/- 0.22 (6/12). Cover test revealed that 21 subjects had strabismus (of those, 33 per cent had unilateral esotropia, 52 per cent had alternating esotropia, nine per cent had unilateral exotropia and five per cent had alternating exotropia). Only 22 subjects gave clear positive response to the stereotest. Other ocular findings included ptosis (one per cent), abnormal head posture (seven per cent) and nystagmus (six per cent). CONCLUSION: Malaysian children with Down syndrome have a high incidence of refractive error and strabismus. Regular visual examination is important so that corrective lenses can be prescribed to improve vision and to enhance the quality of life of these children in Malaysia.