What drives eye rubbing in keratoconus: a molecular biomarker study

Session Details

Session Title: Medical Cornea & Biomechanics

Session Date/Time: Sunday 23/09/2018 | 08:00-10:00

Paper Time: 09:48

Venue: Room A3, Podium 3

First Author: : P.Ahuja INDIA

Co Author(s): :    R. Shetty   A. Ghosh   S. Sethu   P. Khamar           

Abstract Details

Purpose:

IgE plays a major role in mediating allergic response and symptoms such as itching. Allergy induced eye rubbing is thought to be a critical contributor to keratoconus (KC) disease progression. This study was conducted to analyze the levels of IgE and inflammatory factors in tear samples of keratoconus patients with eye rubbing without obvious clinical signs of allergy.

Setting:

The study was conducted at Narayana Nethralaya Eye Hospital (a tertiary eye care center), Bangalore, India.

Methods:

On approval from institutional ethics committee, study subjects were included after obtaining written informed consent. A total of 45 patients with KC with history of eye rubbing (20 with allergic eye disease (AED) and 25 without AED) and 25 healthy controls were included in the study. Pre- operative retinoscopy, slit lamp biomicroscopy and topography (Pentacam) was used to classify patients of the disease cohort into different grades of severity as per the ABCD classification. Tear samples, collected using Schirmer’s strips, were extracted and analysed using multiplex ELISA (cytometric bead array) to study levels of IgE and inflammatory cytokines.

Results:

Significantly elevated levels of tear IgE, IL-4 and IL-13 were observed in KC patients compared to controls, both with and without AED. An increasing trend of tear IgE levels were seen with increasing grades of KC, similar to the serum IgE levels in our cohort. Furthermore when compared to controls, both groups of patients, with and without AED, demonstrated higher levels of tear IL-2, IL-23, MIP1b, RANTES, VCAM, CD62L and ICAM1.

Conclusions:

The raised levels of tear IgE in patients without evidence of active clinical allergic disease is a novel find and suggests its possible role in driving eye rubbing that contributes to KC pathogenesis. Increased tear IgE in the absence of such change in serum level in KC patients without allergy suggests its mechanistic role in mediating ocular surface inflammation. Thus, identifying these factors may present newer diagnostic modalities, as well as possible treatment targets in the future to reduce local and/or systemic IgE levels to manage KC.

Financial Disclosure:

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