Department of Ophthalmology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea.
PLoS One. 2020 Jul 10;15(7):e0235408. doi: 10.1371/journal.pone.0235408. eCollection 2020.
The tear matrix metalloproteinase-9 (MMP-9) immunoassay (Inflammadry) exhibits variable results in dry eye (DE) patients. We investigated if the tear volume in DE patients affects the results of MMP-9 immunoassay in clinical and in vitro settings. This cross-sectional study enrolled 188 eyes of 188 DE patients. The clinical symptoms and signs of DE were assessed using the Ocular Surface Disease Index and visual analog scale, strip meniscometry, tear break-up time, and tear meniscus height (TMH), area (TMA), and depth (TMD) using swept-source optical coherence tomography and corneal and conjunctival staining scores. For quantitative evaluation, the bands produced by the InflammaDry test were analyzed with ImageJ. DE subjects were grouped according to MMP-9 positivity and TMH. The InflammaDry-positive group showed greater TMH, TMA, and TMD than the MMP-9-negative group (p < 0.05). InflammaDry test band density in the high TMH group was significantly greater than that in the low and normal TMH groups (p < 0.05). InflammaDry test band density correlated positively with TMH, TMA, and TMD (all p < 0.05). InflammaDry test results were influenced by tear volume. Low tear volume in aqueous tear-deficient DE may induce false-negative results, and reflex tearing during the test may induce false-positive results.
泪液基质金属蛋白酶-9（MMP-9）免疫分析（Inflammadry）在干眼症（DE）患者中表现出不同的结果。我们研究了 DE 患者的泪液量是否会影响 MMP-9 免疫分析在临床和体外环境下的结果。这项横断面研究纳入了 188 名 DE 患者的 188 只眼。使用眼表面疾病指数和视觉模拟量表、条带式泪膜破裂时间、泪膜高度（TMH）、面积（TMA）和深度（TMD），使用扫频源光学相干断层扫描以及角膜和结膜染色评分评估 DE 患者的临床症状和体征。为了定量评估，使用 ImageJ 分析 InflammaDry 试验产生的条带。根据 MMP-9 阳性和 TMH 将 DE 患者分组。InflammaDry 阳性组的 TMH、TMA 和 TMD 均大于 MMP-9 阴性组（p<0.05）。高 TMH 组的 InflammaDry 试验条带密度明显大于低 TMH 和正常 TMH 组（p<0.05）。InflammaDry 试验条带密度与 TMH、TMA 和 TMD 呈正相关（均 p<0.05）。InflammaDry 试验结果受泪液量的影响。水样液缺乏性 DE 中的低泪液量可能导致假阴性结果，而测试期间的反射性流泪可能导致假阳性结果。
