Abstract
Purpose :
Ocular surface inflammation is thought to play a role in the etiology of dry eye disease (DED). We performed a latent profile analysis of tear cytokines to identify subgroups of DED patients with different cytokine profiles and compare their DED symptoms and signs among subtypes.
Methods :
Patients with moderate to severe DED were enrolled in the Dry Eye Assessment and Management (DREAM) Study. At baseline, tear cytokine (IL-1β, IL-6, IL-8, IL-10, IL-17A, IFNγ and TNFα) were measured using a magnetic bead assay, scores for DED symptoms [Ocular Surface Disease Index (OSDI)] and signs [corneal and conjunctival staining, tear break-up time (TBUT), Schirmer’s test, tear osmolarity and meibomian gland dysfunction (MGD)] were obtained using standardized procedures. Latent profile analysis for baseline tear cytokines was performed to identify subtypes. Comparisons of demographic characteristics, scores of DED symptoms and signs among subtypes were performed using generalized linear regression models with inter-eye correlation accounted for using generalized estimating equations for comparison of eye-specific DED signs.
Results :
Among 131 patients with total tear volume from both eyes ≥4 µl at baseline, two subtypes of cytokine profiles were identified with Subtype 1 (n=23) characterized by significantly higher levels of IL-6 and IL-8 (all p<0.001), Subtype 2 (n=108) characterized by significantly higher levels of IL-10 (p=0.03), IL-17A (p<0.001) and IFNγ (p<0.001) (Figure 1). As shown in Table 1, two subtypes were similar in demographic characteristics and DED symptoms, but Subtype 1 had significantly more severe DED signs than Subtype 2 in terms of higher scores of conjunctival lissamine staining [mean (SD): 3.38 (1.71) vs. 2.69 (1.29), p=0.04] and corneal fluorescein staining [4.26 (2.33) vs. 3.03 (2.70), p=0.03], lower score of Schirmer’s test [8.20 (5.14) vs. 13.72 (8.89), p<0.001], and higher composite severity score of DED sign [0.62 (0.27) vs. 0.45 (0.27), p=0.002].
Conclusions :
We identified two DED subtypes with different profiles of tear cytokines. Patients in these two subtypes differed significantly in DED signs, supporting the inflammation may play a role in the development and progression of DED.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.