Duration 5min, Q&A 3min
Matrix-Metalloproteinase-9 (MMP-9) - Testing in Dry Eye Syndrome
The pathogenesis of Dry Eye Syndrome (DES) is complex. Inflammation seems to play a pivotal role to initiate and maintain the disease process. Multiple inflammatory markers, including MMP-9, have been isolated from the tear film of patients with DES.
Patients: A cohort of 101 healthy probands and patients with dry eye was evaluated.
Methods: A subjective symptom questionnaire (ocular surface disease index-OSDI), tear film break up time (TFBUT), conjunctival and corneal staining, Schirmer test and meibomian gland examination were performed. 120 healthy eyes and 82 eyes fulfilling diagnostic criteria of DES underwent MMP-9 testing of the tear film by a commercially available test (RPSInflammadry™) detecting MMP-9 levels > 40ng/ml.
Results and Conclusion
Results: The MMP-9 tear test showed a significant difference between healthy eyes and eyes with DES (p<0.001). It correlated well with subjective symptoms evaluated by OSDI (p=0.001), BUT (p<0.001), Schirmer test (p<0.001), conjunctival (p<0.001) as well as corneal staining (p=0.002). Moreover, it correlated with the number of obstructed meibomian ducts (p<0.001) and a pathologic meibomian gland secretion (p<0.001). It was significantly increased in female patients (p<0.001), patients with obvious signs of ocular surface inflammation (p=0.003), autoimmune disease, especially Sjögren-Syndrome (p<0.001, and thyroid disease (p=0.009).
Conclusions. MMP-9-testing in DES is a valuable new diagnostic tool. It correlates well with other dry eye tests. It is especially helpful to identify patients with ocular surface inflammation and autoimmune disease and may facilitate the decision to institute anti-inflammatory treatment in these patients.
[ Keyword ]
Dry eye / Inflammation / Matrix-Metalloproteinase
[ Conflict of Interest ]