Abstract

AbstractPurposeA red eye is common in the ophthalmic practice, and redness is one out of four cardinal signs of inflammation. The correlation between the conjunctival bulbar redness (CBR) and ocular surface parameters, including tear cytokine levels, was investigated, in patients suffering from Dry Eye (DE).MethodsThirty five patients diagnosed as suffering from DE and fifteen age and sex matched healthy volunteers and were analyzed with respect to: 1. subjective symptoms of discomfort with the Ocular Surface Disease Index (OSDI ranging 0‐100), and Visual Analogue Score (VAS, ranging 0‐100 mm) ; 2.Tear Film Break Up Time (TFBUT, seconds); 3. Corneal vital and conjunctival vital staining scored by the NEI system (score 0‐15, and 0‐18, respectively); 4. Tear levels of exudated serum albumin (ALBU, mg/ml), and of the following Interleukins (IL): IL1b. IL‐6. IL‐17A. and Tumor Necrosis Factor (TNF)a (pg/ml), detected by the Luminex Technology Multiplex Assays; 5. the quantification of CBR analyzed on slit lamp digital images by using image processing of relative Red‐channel activity with the free Image J software (NIH). Parameters were statistically analyzed in the two groups of subjects by using t‐test and Mann‐Whitney U test for parametric and nonparametric variables respectively. Relationship between variables was investigated using Spearman r correlation tests (significance p < 0.05).ResultsCBR was higher in DE as compared to controls (49.6 ± 3.5 vs 41.1 ± 2.4. p < 0.001). Tear IL‐6 level was higher in DE patients vs controls (25.5 ± 15.5 vs 5.9 ± 3.1, p < 0.0001), whereas IL1b, IL‐17A, and TNFa were detected in only the DE patients (median 5.73, 5.74, and 13.88 respectively) A significant correlation was found between CBR and IL‐6 (r = 0.524), TNFa (0.571) TFBUT (‐0.561), VAS score (0.832), and ALBU (0.628), p always <0.001.ConclusionsData suggests that digitized CBR analysis may be a useful tool to quantify inflammation in the clinical setting.

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