Abstract
Pterygium is a common eye disease, linked to an increased exposure to UV radiation and dry environments. The associated pathology culminates in visual impairment and, in some rare cases, blindness. However, there remains a lot of uncertainty concerning the pathogenesis of this fibrovascular lesion. As the composition of the tear film provides a reflection into the pathological changes at the ocular surface, tear analysis represents an ideal approach to gain insight in the progression of disease following pterygiectomy. This study enrolled 19 patients and age/gender-matched healthy controls. Tear film levels of interleukin- (IL-) 6, IL-8, and vascular endothelial growth factor (VEGF) were investigated over time, and preoperative concentrations were linked to corneal neovascularization and pterygium size. Diminished tear film levels were found in unilateral patients who show no clinical signs of pterygium recurrence over a period of one year. Hence, our results highlight the potential of using the course of IL-6, IL-8, and VEGF levels in tears as biomarkers for recovery. In addition, when focusing on the affected eyes (i.e., primary and recurrent pterygium), we detected fold changes in preoperative cytokine concentrations to correspond with disease severity. As our proposed biomarkers did not reveal a linear relationship with corneal neovascularization nor the invasive behaviour of pterygium, no exact role in the pterygium pathology could be established. Hence, our data point to these factors being contributors rather than decisive players in the pathological processes.
Highlights
Pterygium is a common anterior segment disease with a global prevalence of 12% [1]
In consonance with the more aggressive behaviour of recurrent pterygium (RPt) [46], we found the levels of IL-6, IL-8, and vascular endothelial growth factor (VEGF) to be significantly higher than those observed in Pi and primary pterygium (PPt)
We established a role for IL-6, IL-8, and VEGF in pterygium pathology, manifesting as a clear change and an eventual decrease in tear film levels one year after the surgery
Summary
Pterygium is a common anterior segment disease with a global prevalence of 12% [1]. It is categorised as a benign proliferative lesion or a neoplastic-like growth disorder, owing to the presence of tumour-like characteristics such as altered progenitor cells [2], loss of cell polarity [3], corneal invasiveness and matrix remodelling [4, 5], epithelial cell motility [2, 6], and a high recurrence rate with aberrant proliferation [7]. The reappearance of fibrovascular overgrowth is proposed to be the result of incomplete surgical removal, allowing aberrant or transformed limbal basal cells to reinfiltrate the adjacent conjunctiva and/or limbal epithelium [2]. These recurrence-inducing, infiltrating cells accumulate mutations over time, attributing to their more aggressive proliferative behaviour [13]
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