June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
A Latent Profile Analysis of Tear Cytokine Levels for Their Association with Severity of Dry Eye Disease in the Dry Eye Assessment and Management (DREAM) Study
Author Affiliations & Notes
  • Yineng Chen
    Department of Ophthalmology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States
  • Penny A Asbell
    The University of Tennessee Health Science Center VolShop Memphis, Memphis, Tennessee, United States
  • Gui-Shuang Ying
    Department of Ophthalmology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States
  • Footnotes
    Commercial Relationships   Yineng Chen None; Penny Asbell Glia, Senju,Blephex, Code C (Consultant/Contractor), Regeneron, Mitotech, Sylentis, Tear Science, MC2, Code F (Financial Support); Gui-Shuang Ying None
  • Footnotes
    Support  NIH Grants U10EY022879, U10EY022881, R21EY031338
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 674. doi:
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      Yineng Chen, Penny A Asbell, Gui-Shuang Ying; A Latent Profile Analysis of Tear Cytokine Levels for Their Association with Severity of Dry Eye Disease in the Dry Eye Assessment and Management (DREAM) Study. Invest. Ophthalmol. Vis. Sci. 2023;64(8):674.

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

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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.

 

Figure 1: Two subtypes identified by latent profile analysis

Figure 1: Two subtypes identified by latent profile analysis

 

Table 1: Baseline demographic, DED symptoms and sign between two subtypes

Table 1: Baseline demographic, DED symptoms and sign between two subtypes

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