Singapore National Eye Centre, Singapore, Republic of Singapore.
Ophthalmology. 2010 Dec;117(12):2353-8. doi: 10.1016/j.ophtha.2010.03.064. Epub 2010 Jul 13.
To determine the tear cytokine profile from medicated glaucoma patients scheduled for trabeculectomy and to establish whether a specifically elevated cytokine level is related to early postoperative scarring.
Prospective case-control study.
Sixty-one patients treated with topical antiglaucoma medications and 29 normal subjects with no prior topical treatment were recruited for the study.
Schirmer strips were used to collect tear samples. A multiplex bead assay was used to quantify the presence of proinflammatory cytokines in the tears. The patients were followed up for 6 months after surgery to determine whether any postoperative intervention to maintain filtering bleb function was required.
The level of cytokines in tear specimens from medicated glaucoma patients was the main outcome measure for the study. The need for postoperative bleb needling within 6 months was a secondary outcome measure.
Of the 17 cytokines assayed, only monocyte chemoattractant protein 1 (MCP-1) was elevated significantly in the medicated eyes compared with the unmedicated eyes (P < 0.0004). At 6 months after surgery, 18 (30%) of the 61 eyes required postoperative intervention. A much higher MCP-1 level was detected in these eyes compared with the remaining 43 that did not require intervention (P < 0.0001). The duration of use of topical medication correlated with increasing levels of MCP-1, although the types of glaucoma medication and the number of bottles of medications did not have any significant relationship with the level of MCP-1.
In tears from topically medicated glaucoma eyes in an Asian population, MCP-1 was found to be the predominant cytokine elevated. Eyes with a propensity to scar in the early postoperative period have a significantly raised level of MCP-1.
FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found after the references.
确定接受小梁切除术的局部用青光眼药物治疗患者的泪液细胞因子谱，并确定是否存在特定的细胞因子水平升高与早期术后瘢痕形成有关。
前瞻性病例对照研究。
招募了 61 名接受局部抗青光眼药物治疗的患者和 29 名无局部治疗史的正常对照者进行研究。
使用 Schirmer 条收集泪液样本。使用多重珠粒检测法来定量检测泪液中促炎细胞因子的存在。术后对患者进行 6 个月的随访，以确定是否需要任何术后干预来维持滤过泡功能。
研究的主要观察指标是局部用青光眼患者泪液标本中的细胞因子水平。术后 6 个月内需要进行滤过泡针吸术是次要观察指标。
在所检测的 17 种细胞因子中，只有趋化因子单核细胞蛋白 1（MCP-1）在用药眼与未用药眼之间显著升高（P<0.0004）。术后 6 个月时，61 只眼中有 18 只（30%）需要术后干预。与不需要干预的其余 43 只眼相比，这些眼的 MCP-1 水平明显升高（P<0.0001）。局部用药时间与 MCP-1 水平升高呈正相关，尽管青光眼药物类型和药物瓶数与 MCP-1 水平无任何显著关系。
在亚洲人群局部用青光眼药物治疗的眼中，发现 MCP-1 是升高的主要细胞因子。在术后早期有瘢痕形成倾向的眼中，MCP-1 水平显著升高。
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