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Tear Cytokine Profile of Boston Keratoprosthesis Type 1 Patients with and without Glaucoma

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First Author: D.Geoffrion CANADA

Co Author(s):    M. Robert   R. Koenekoop   Y. Agoumi   M. Harissi-Dagher           

Abstract Details

Purpose:

Cytokines are biomarkers for glaucoma and play a role in its pathogenesis. The purpose was to determine cytokine levels in the tear film of Boston keratoprosthesis (KPro) patients with and without glaucoma, relative to healthy controls, and correlate cytokine levels with clinical parameters.

Setting:

Centre hospitalier de l'Université de Montréal, Montreal (Quebec), Canada

Methods:

This prospective cross-sectional study included 58 eyes from 58 patients: 41 KPro eyes with glaucoma, 7 KPro eyes without glaucoma, and 10 healthy controls. Tear samples were collected from all patients by micropipette following saline instillation. Levels of 27 different inflammatory cytokines were measured in tear samples by multiplex bead immunoassay. Intraocular pressure (IOP), cup-to-disk ratio (CDR), retinal nerve fiber layer thickness, visual acuity, topical medications, and angle closure were assessed in all KPro eyes. Cytokine level differences between groups were analyzed by non-parametric tests, and correlations with clinical parameters by Spearman’s test.

Results:

Levels of TNF-a, IL-1b, FGF-2, IFN-γ were significantly higher in KPro with glaucoma compared to KPro without glaucoma (P=0.020; 0.008; 0.043; 0.018, respectively). Both KPro groups had similar baseline characteristics, diagnoses, and topical antibiotic and steroid regimen. Levels of IL-1Ra, IL-15, VEGF, RANTES were significantly higher in KPro with glaucoma compared to healthy controls (P=<0.001; 0.034; <0.001; 0.001, respectively). IL-1b and IFN-γ levels were positively correlated with CDR (r=0.309, P=0.039 and r=0.452, P=0.006, respectively) and IOP (r=0.292, P=0.047 and r=0.368, P=0.023, respectively). TNF-a and FGF-2 levels were positively correlated with CDR (r=0.348, P=0.022 and r=0.344, P=0.021, respectively).

Conclusions:

TNF-a, IL-1b, FGF-2, IFN-γ are elevated in tear fluid of KPro patients with glaucoma and correlate with CDR and IOP. These results show, for the first time in humans, concordance with documented elevations of TNF-a and IL-1b in murine KPro model. Ocular surface inflammation may reflect an inflammatory process of KPro glaucoma.

Financial Disclosure: