Abstract
Purpose: Prospective study to evaluate the anti-inflammatory efficacy of isotonic seawater solution on metalloproteinase 9 (MMP-9) levels in the tears of patients with dry eye disease (DED). Methods: A total of 50 patients were included, with the following dry eye criteria in both eyes: InflammaDry? test initially positive, ocular surface disease index (OSDI) score ≥ 12 and Results: The InflammaDry test was positive in 100% of the patients (n = 50) and in 100% (n = 100) of the eyes before treatment. In 14 (28%) patients the test became negative in both eyes, and in 15 (30%) it was negative in one of the eyes. In 43% (n = 43) of the positive eyes, MMP-9 became undetectable in the tear fluid following treatment with isotonic seawater. This change was statistically significant (p Conclusions: The washes with ophthalmic isotonic seawater solution have a significant impact on inflammation of the ocular surface in dry eye disease, with an ability to make MMP-9 levels negative in 43% of cases.
Highlights
Dry eye disease (DED) is a multifactorial pathology in which inflammation plays an important role in the physiopathology of the disease [1]
Prospective study to evaluate the anti-inflammatory efficacy of isotonic seawater solution on metalloproteinase 9 (MMP-9) levels in the tears of patients with dry eye disease (DED)
All the patients selected corresponded to a dry eye type 2 - 3 severity degree - mild and moderate - Dry Eye Workshop Study (DEWS) classification
Summary
Dry eye disease (DED) is a multifactorial pathology in which inflammation plays an important role in the physiopathology of the disease [1]. Of the various proinflammatory cytokines implicated, such as interleukin IL-1beta, IL-6, tumour necrosis factor-alpha (TNF-alpha), interferon IFN gamma, caspase, transglutaminase 2 and matrix metalloproteinase MMP-3, etc., MMP-9 plays a fundamental role in the start, progression and creation of the vicious inflammatory circle that leads to chronic perpetuation of the disease, as well as to secondary lesions and irreversible damage to the corneal and conjunctival epithelial cells (clinical keratoconjunctivitis) [2] [3] [4]. InflammaDry is a non-invasive commercial test that allows for the simple, accurate and rapid measurement of tear MMP-9 levels on an outpatient basis. It positively identifies levels greater than 40 ng/ml [5]. Several studies have shown a correlation between tear MMP-9 levels and the various clinical and anatomical parameters of dry eye, especially the Ocular surface disease index (OSDI), conjunctival staining and corneal staining. Several studies have demonstrated a significant reduction in tear MMP-9 levels, indicated by a negative InflammaDry test, following different anti-inflammatory treatments such as corticosteroids, tacrolimus and topical cyclosporine [6] [7]
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