Extracellular MMP-9-Based Assessment of Ocular Surface Inflammation in Patients with Primary Open-Angle Glaucoma

Anna Zaleska-Żmijewska , Ewa Strzemecka , Zbigniew M. Wawrzyniak , Jacek Paweł Szaflik


Purpose. Objective assessment of dry eye disease (DED) severity and ocular inflammation using the InflammaDry® test for extracellular matrix metalloproteinase-9 (MMP-9) and the impact of antiglaucoma eye drops in people with primary open-angle glaucoma (POAG).Methods. Overall, 90 adults (180 eyes) were included: 60 had been diagnosed with POAG and were treated with prostaglandin analogue monotherapy and 30 were suspected of having POAG but did not receive any treatment (control group). Of those treated with prostaglandin eye drops, 30 received a preservative-free formulation (tafluprost) and 30 were treated with a formulation containing the preservative benzalkonium chloride (BAK) (latanoprost). Measurement of extracellular MMP-9 levels (InflammaDry test) provided a marker for ocular surface inflammation. Further assessments of disease severity and inflammation comprised Goldmann applanation tonometry for intraocular pressure (IOP), Schirmer’s test with anesthesia, ocular surface staining with unpreserved fluorescein (Oxford scale index), tear breakup time (TBUT), McMonnies questionnaire, and the Ocular Surface Disease index (OSDI).Results. Clinically significant MMP-9 levels (>40 ng/mL) were detected in tear film from 46.7% of subjects treated with BAK-containing medication. In contrast, only 16.7% of subjects treated with preservative-free medication or untreated individuals demonstrated similar MMP-9 levels. This difference was statistically significant (p<0.05). MMP-9 results correlated with other indicators of inflammation and disease severity. BAK-containing medication was associated with rapid TBUT (<5 seconds) in 50% of cases, while only 10% of untreated subjects and individuals using preservative-free medication demonstrated comparable TBUT results.Conclusion. Measurement of ocular surface MMP-9 level provides a useful marker for inflammation and DED in POAG. Use of a preservative-free topical prostaglandin formulation results in lower levels of ocular inflammation, compared with BAK-containing medication.
Author Anna Zaleska-Żmijewska - [Medical University of Warsaw]
Anna Zaleska-Żmijewska,,
, Ewa Strzemecka - [Medical University of Warsaw]
Ewa Strzemecka,,
, Zbigniew M. Wawrzyniak (FEIT / PE)
Zbigniew M. Wawrzyniak,,
- The Institute of Electronic Systems
, Jacek Paweł Szaflik - [Medical University of Warsaw]
Jacek Paweł Szaflik,,
Journal seriesJournal of Ophthalmology, ISSN 2090-004X
Issue year2019
Publication size in sheets0.5
ASJC Classification2731 Ophthalmology
URL https://www.hindawi.com/journals/joph/2019/1240537/
Languageen angielski
wawrzyniak_extracellular_joo.pdf 1.49 MB
Score (nominal)70
Score sourcejournalList
ScoreMinisterial score = 70.0, 09-06-2020, ArticleFromJournal
Publication indicators WoS Citations = 0; Scopus Citations = 3; Scopus SNIP (Source Normalised Impact per Paper): 2018 = 0.911; WoS Impact Factor: 2018 = 1.58 (2) - 2018=1.864 (5)
Citation count*5 (2020-08-20)
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* presented citation count is obtained through Internet information analysis and it is close to the number calculated by the Publish or Perish system.
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