June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Tear biomarkers of depression and post-traumatic stress disorder in US Veterans
Author Affiliations & Notes
  • Ashlyn Anzu Gary
    University of Miami School of Medicine, Miami, Florida, United States
  • Amanda Prislovsky
    VA Memphis Medical Center, Memphis, Tennessee, United States
  • Arianna Tovar
    Surgical Services, Miami Veterans Affairs Medical Center, Miami, Florida, United States
    Bascom Palmer Eye Institute, University of Miami, Miami, Florida, United States
  • Elyana Vittoria Tessa Locatelli
    Surgical Services, Miami Veterans Affairs Medical Center, Miami, Florida, United States
    Bascom Palmer Eye Institute, University of Miami, Miami, Florida, United States
  • Elizabeth Felix
    Research Service, Miami Veterans Affairs Medical Center, Miami, Florida, United States
    Department of Physical Medicine & Rehabilitation, University of Miami, Miami, Florida, United States
  • Nawajes Mandal
    VA Memphis Medical Center, Memphis, Tennessee, United States
    Departments of Ophthalmology, Anatomy and Neurobiology and Pharmaceutical Sciences, The University of Tennessee Health Science Center Department of Ophthalmology Hamilton Eye Institute, Memphis, Tennessee, United States
  • Anat Galor
    Surgical Services, Miami Veterans Affairs Medical Center, Miami, Florida, United States
    Bascom Palmer Eye Institute, University of Miami, Miami, Florida, United States
  • Footnotes
    Commercial Relationships   Ashlyn Gary None; Amanda Prislovsky None; Arianna Tovar None; Elyana Locatelli None; Elizabeth Felix None; Nawajes Mandal None; Anat Galor None
  • Footnotes
    Support  Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Clinical Sciences R&D (CSRD) I01 CX002015 (Dr. Galor), Biomedical Laboratory R&D (BLRD) Service I01 BX004893 (Dr. Galor), Rehabilitation R&D (RRD) I21 RX003883 (Dr. Galor), Department of Defense Gulf War Illness Research Program (GWIRP) W81XWH-20-1-0579 (Dr. Galor) and Vision Research Program (VRP) W81XWH-20-1-0820 (Dr. Galor), National Eye Institute U01 EY034686 (Dr. Galor), R01EY026174 (Dr. Galor) and R61EY032468 (Dr. Galor), NIH Center Core Grant P30EY014801 (institutional) and Research to Prevent Blindness Unrestricted Grant GR004596-1 (institutional).
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 1400. doi:
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      Ashlyn Anzu Gary, Amanda Prislovsky, Arianna Tovar, Elyana Vittoria Tessa Locatelli, Elizabeth Felix, Nawajes Mandal, Anat Galor; Tear biomarkers of depression and post-traumatic stress disorder in US Veterans. Invest. Ophthalmol. Vis. Sci. 2023;64(8):1400.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Inflammation has been associated with depression and anxiety. In this study, we examine correlations between inflammatory proteins in tears and symptoms of depression and PTSD-associated anxiety.

Methods : 39 individuals from the Miami Veterans Affairs eye clinic were prospectively recruited. All filled out questionnaires regarding depression (Patient Health Questionnaire 9, PHQ-9) and PTSD-associated anxiety (Post Traumatic Stress Disorder Checklist-Military Version, PCL-M). Anesthetized tears were collected from the right eye using a Schirmer’s strip (5-minute collection) then stored at -80oC until protein extraction. Information about other features was collected, including demographics and Schirmer strip wetting length. For quantitative determination of 23 inflammatory proteins, a multiplex assay system was custom designed from ThermoFisher and run with reagents, standards, and protocols supplied by the vendor. Pearson correlations examined associations between symptoms of depression, PTSD, and tear inflammatory proteins. Multivariable models were built to examine the impact of potential confounders.

Results : The mean age of the population was 61±13 years, 95% self-identified as male, 69% as Black, and 15% as Hispanic. The mean PHQ-9 score was 11.3±8.1 (0-27) and the mean PCL-M score was 45.2±20.1 (range 17-85). Symptoms of depression and PTSD-associated anxiety were highly correlated (r=0.82, p<0.005). Both scores positively correlated with Intercellular Adhesion Molecule 1 (ICAM-1) (PHQ9: r=0.36, p=0.03; PCL-M: r=0.36, p=0.03) and Interleukin 8 (IL-8) (PHQ9: r=0.38, p=0.02; PCL-M: r=0.38, p=0.02). In addition, depression was positively associated with IL-1α, IL-1β, Macrophage Inflammatory Protein-1 (MIP-1) α and β (r~0.35 for all). When demographics, Schirmer length, and all measured proteins were included in a multivariable model, MIP-1 α remained associated with depression (standardized β 0.37) and IL-8 with anxiety (β 0.38).

Conclusions : Several tear proteins are associated with symptoms of depression and PTSD-associated anxiety in a US Veteran sample. Past research has linked higher serum levels of these inflammatory markers to depression and anxiety; thus, tear biomarkers may be a less-invasive analysis tool. More research is needed to investigate whether tear biomarkers can help with the diagnosis of mental health disorders or aid in evaluating the impact of treatment.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

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