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Inflammatory Cytokines Correlate with Dry Eye Indexes Estimated by Keratograph in Healthy Subjects


May N. Al-Muammar, Rania Fahmy, Mona Alonazi, Ramesa Shafi Bhat and Afaf El-Ansary*   Pages 1 - 8 ( 8 )


Background: Inflammation plays a major role in dry eye diseases and is the prime target in clinical treatments of the disease.

Objective: To determine whether the inflammatory cytokines in the tear film of patients with dry eye correlate with parameters such as tear break-up time (TBUT) and tear meniscus height (TMH) and could be used together as predictive biomarkers of disease severity

Method: This study included 58 eyes (29 female subjects; age, 19–25 years) comprising 20 normal eyes (control), 20 eyes (level 1 dryness), and 18 eyes (level 2 dryness). Dryness level 1 or 2 is keratographic diagnosis according to the tear breakup time cut-off value obtained. After ophthalmic examinations, including determination of non-invasive TBUT average and first second and TMH using Keratograph 4 (to measure dryness level), tears of all participants were collected. Five cytokines, including interleukin 6, 10, 12, interferon-γ, and tumor necrosis factor-α, were measured using ELISA.

Results: Significant changes were observed in all measured cytokines and these changes correlated with eye dryness severity scores. Both groups (levels 1 & 2) showed remarkable changes related to ocular surface alterations in clinical examinations. Significantly, shorter TBUT and TMH were recorded in both groups and were positively correlated with the dryness severity.

Conclusion: Cytokines could be used as predictive markers for pre-clinical diagnosis of dry eye diseases and as prognostic markers to monitor treatment effectiveness


Cytokines, Dry eyes, Keratograph, Tear breakup time, Tear meniscus height., Saudi population.


Department of Community Health, College of Applied Medical Sciences, King Saud University, Riyadh, Department of Ophthalmology, Faculty of Medicine, Cairo University, Cairo, Biochemistry Department, College of Sciences, King Saud University, Riyadh, Central Laboratory, Female Center for Medical Studies and Scientific Section, King Saud University, Riyadh, Saudi Arabia, Therapeutic Chemistry Department, National Research Centre, Dokki, Cairo

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