Louisiana State University Medical School, Department of Ophthalmology, Louisiana State University Eye Center, New Orleans, LA, USA.
Cornea. 2013 Feb;32(2):211-6. doi: 10.1097/ICO.0b013e3182541e9a.
To evaluate the importance and practicality of testing for matrix metalloproteinase 9 (MMP-9) in dry eye and ocular surface disease. This enzyme, which can cause tissue damage, seems also to be the most reliable diagnostic indicator of ocular surface disease.
Enzyme-linked immunosorbent assay, polymerase chain reaction, diffusion, and InflammaDry, a new rapid immunoassay by RPS (Rapid Pathogen Screening Inc).
MMP-9 measurement is sensitive and accurate for diagnosing dry eye and ocular surface disease and compares favorably in both sensitivity and specificity against the existing methods of dry eye diagnosis. Abnormal elevations of MMP-9 may predict post-laser in situ keratomileusis complications and refractive complications such as epithelial ingrowth and corneal ulceration. The presence of elevated MMP-9 on the ocular surface will identify those patients who should receive antiinflammatory therapy, such as cyclosporine, and may predict those patients who will respond to this therapy.
A rapid in-office test that is sensitive for identifying inflammatory dry eye and ocular surface disease may facilitate better preoperative management of the ocular surface. Optimization of the ocular surface perioperatively would be expected to reduce complications from laser in situ keratomileusis and other surgeries that often make the underlying disease worse. This test may also indicate the need for antiinflammatory therapies, such as cyclosporine or steroids, and also may predict those patients who are more likely to respond.
评估检测基质金属蛋白酶 9（MMP-9）在干眼症和眼表疾病中的重要性和实用性。这种可以导致组织损伤的酶似乎也是眼表疾病最可靠的诊断指标。
酶联免疫吸附试验、聚合酶链反应、扩散法和 InflammaDry，一种由 RPS（快速病原体筛查公司）开发的新的快速免疫测定法。
MMP-9 的测量对于诊断干眼症和眼表疾病具有敏感性和准确性，在敏感性和特异性方面均优于现有的干眼症诊断方法。MMP-9 的异常升高可能预示着激光原位角膜磨镶术后并发症和屈光并发症，如上皮内植入和角膜溃疡。眼表存在升高的 MMP-9 可识别出需要抗炎治疗（如环孢素）的患者，并可预测这些患者对该治疗的反应。
一种能够敏感识别炎症性干眼症和眼表疾病的快速门诊检测方法，可能有助于更好地进行眼表术前管理。优化眼表的围手术期处理有望减少激光原位角膜磨镶术和其他手术引起的并发症，这些手术通常会使潜在疾病恶化。该检测还可能提示需要进行抗炎治疗，如环孢素或类固醇治疗，并且还可能预测那些更有可能对治疗有反应的患者。
