Abstract
Purpose:
To evaluate discontinued contact lens (CL) wearers with particular reference to secretory IgA (sIgA) and exudated serum albumin in tears as markers of local inflammation.
Methods:
45 CL wearers diagnosed as having dry eye (DE) according to DEWS guidelines (DEWS grade 1-3) and 25 matched normal non-CL wearer volunteers were included in this study. Patients had discontinued the use of various types of CLs (12 RGP, 33 soft disposable or frequent replacement CL-average time from last use 60±30 days) because of associated discomfort. OSDI questionnaire score, Schirmer test I, Break Up Time (BUT), Lissamine green vital staining, corneal esthesiometry (Cochet-Bonnet), conjunctival scraping and imprint cytology were performed. Total tear protein content (TP), Lysozyme-C (LYS-C), Lactoferrin (LACTO) and exudated serum albumin (ALB) were evaluated (mg/ml) with the 2100 Bioanalyzer (Agilent Technology, CA, USA, P230 Lab-chip kit). Validation of kDa range for heavy chain IgA bands in each lane was carried out as previously described (Versura P et al, Mol Vis 2012). The sIgA/LYS-C ratio was calculated as an index of the increased activity of the IgA-producing cells in the lachrymal gland. Data were statistically evaluated and correlated with wear parameters (Pearson’s r) (significance p<0,05).
Results:
A statistically significant decrease was found in CL-related DE patients vs controls (media±S.D.) for BUT (respectively 8.6±4.9vs12.4±3.6 sec), corneal esthesiometry (50.2±2.3vs55.5±3.2 mm/lenght), TP (7.5±2.9vs9.3±4.3 mg/ml), LYS-C (2.08±0.9vs 2.9±0.9), LACTO (1.7±0.9vs 2.1±0.9), while an increase was found for OSDI score (22.4±14,4vs5.5±2.2), scraping cytology score (4.3±1.5vs2.1±0.3), imprint cytology score (1.8±0.8vs0.5±0.2), ALB (1.1±1.3 vs 0.3±0.5) heavy chain sIgA (0.51±0.41vs0.38±0.33, band validated in the range 48.0-51.0 kDa) and sIgA/LYS-C ratio (0.21±0.1vs0.12±0.1). sIgA/LYS-C was found to be positively correlated to DE severity grade, scraping cytology score and OSDI (r=0,52, 0,42 and 0,45 respectively, p<0.05). No significant correlation was found with CL type, wear regimen, discontinuation time.
Conclusions:
Ocular surface parameters and tear proteins were significantly altered in CL-related DE patients, especially as regards local inflammation indexes. Data suggest that recovery of ocular surface homeostasis exceeds a three month CL use stop.
Keywords: 477 contact lens •
486 cornea: tears/tear film/dry eye •
557 inflammation