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Tony Lin, Cindy M L Hutnik, Joy Wang, Hong Liu, Alexander Mao; Impression Cytology Implicates Autophagic Cell Death in Aqueous Tear Deficiency. Invest. Ophthalmol. Vis. Sci. 2014;55(13):1986. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
Objective diagnosis of dry eye has been difficult due to heterogeneous symptoms, signs and varying degrees of disease severity. An objective cellular biomarker of cell autophagy was used to assess its role in dry eye pathogenesis and its correlation with standard clinical tests for dry eye.
67 treatment naïve eyes were subjected to a series of dry eye tests performed in the following order: Tear film break-up time, Schirmer test, Ocular Surface Disease Index, and impression cytology. The technique of impression cytology used in this study is novel. Cytology impressions were taken from the bulbar conjunctiva and processed into frozen sections. Frozen sections were then treated with primary and secondary antibodies for LC3, a marker of cell autophagy. The relationships between the various tests were analyzed using Pearson’s correlation coefficient. Additional statistical analysis was performed using one-way ANOVA followed by Tukey’s Multiple Comparison Test.
Pearson’s correlation coefficients among the five variables tested was highest between the Schirmer test and LC3 staining, r = 0.355 (p < 0.05). This indicates a positive linear relationship between the two tests. The r values of all other test pairs (Schirmer vs. Age, TBUT, and OSDI; LC3 staining vs. patient age, TBUT, and OSDI; Age vs. OSDI; TBUT vs. OSDI) were less than 0.148 (p > 0.05). There was no relationship found between patient age and TBUT, r = 0. One-way ANOVA was only significant between Schirmer test and LC3 staining (p < 0.05).
This study confirms a lack of correlation between Schirmer test, TBUT and OSDI. This finding is not surprising as dry eye is a dynamic, multi-faceted condition. Correlation between LC3 staining and Schirmer test suggest that cell autophagy may be an important component in the pathogenesis of aqueous-deficient dry eye.
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