Tear film inflammatory cytokine upregulation in contact lens discomfort |
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| Institution: | 1. Department of Optometry and Vision Sciences, Australia;2. Department of Microbiology and Immunology at the Peter Doherty Institute of Infection and Immunity, The University of Melbourne, Parkville, Victoria, 3010, Australia;1. Bascom Palmer Eye Institute, University of Miami, 900 NW 17th Street, Miami, FL, 33136, USA;2. Miami Veterans Administration Medical Center, 1201 NW 16th St, Miami, FL, 33125, USA;1. Miami VA, Veterans Affairs Medical Center, Miami, FL, USA;2. Division of Population Health and Computational Medicine, USA;3. Bascom Palmer Eye Institute, Miller School of Medicine at the University of Miami, Miami, FL, USA;1. CJ Shah Cornea Services/Dr G Sitalakshmi Memorial Clinic for Ocular Surface Disorders Medical Research Foundation, Sankara Nethralaya, 18 College Road, Chennai, Tamil Nadu, India;2. Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, 18 College Road, Chennai, Tamil Nadu, India;3. Smt Jadhavbai Nathamal Singhvee Glaucoma Services, Sankara Nethralaya, 18 College Road, Chennai, Tamil Nadu, India;1. Sussex Eye Hospital, Brighton, UK;2. Brighton and Sussex Medical School, Brighton, UK;3. Queen''s Medical Centre, Nottingham, UK;4. Jordanian Royal Medical Services, Jordan;5. Tongdean Eye Clinic, Brighton, UK;1. Sussex Eye Hospital, Brighton, UK;2. Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Iran;3. Brighton and Sussex Medical School, Brighton, UK;4. Sankara Nethralaya, Chennai, Tamil Nadu, India;5. Alexandria University, Egypt;6. Kindai University, Osaka, Japan;7. Ortenauklinikum, Offenburg, Germany;8. Massachusetts Eye and Ear – Harvard Medical School, Boston, USA;9. Tongdean Eye Clinic, Hove, UK |
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| Abstract: | PurposeTo investigate the ocular inflammatory response, using clinical and immunological techniques, in people experiencing contact lens (CL) discomfort.MethodsThis study involved 38 adults who were full-time, silicone-hydrogel CL wearers. Participants were categorized into groups based upon a validated CL dry-eye questionnaire (CLDEQ-8) (n = 17 ‘asymptomatic’, CLDEQ-8 score <9; n = 21 ‘symptomatic’, CLDEQ-8 score ≥13). Examinations were performed at two visits (one with, and one without, CL wear), separated by one-week. Testing included: tear osmolarity, ocular redness, tear stability, ocular surface staining, meibography, tear production and tear collection. Tear osmolarity was taken from the inferior-lateral and superior-lateral menisci. The ‘Inferior-Superior Osmotic Difference’, I-SOD, was the absolute osmolarity difference between these menisci. Concentrations of seven cytokines (IL-2, IL-4, IL-6, IL-10, IL-17A, IFN-gamma, TNF-alpha) were assayed from basal tears using multiplex cytometric bead array.ResultsAt baseline, there was no significant difference in key clinical signs between asymptomatic and symptomatic CL wearers (p > 0.05). The I-SOD was greater in symptomatic than asymptomatic CL wearers (23.1 ± 2.6 versus 11.3 ± 1.4 mOsmol/L, p = 0.001). People experiencing CL discomfort had higher tear IL-17A (122.6 ± 23.7 versus 44.0 ± 10.0 pg/mL, p = 0.02) and reduced tear stability (6.3 ± 1.1 versus 10.4 ± 1.6 s, p = 0.03) after several hours of CL wear. Tear IL-17A levels correlated with both the I-SOD (r = 0.43, p = 0.01) and CLDEQ-8 score (r = 0.40, p = 0.01).ConclusionsCL discomfort occurs in individuals having no clinical dry eye signs, and is associated with higher tear levels of the pro-inflammatory cytokine IL-17A. These findings support an association between the discomfort response and low-grade, ocular surface inflammation. |
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| Keywords: | Contact lens Contact lens discomfort Interleukin Inflammation Tear film IL-17A Cytokine Interleukin Ocular surface |
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