Cornea - ARVO

ARVO 2013 Annual Meeting Abstracts by Scientific Section/Group - Cornea(1.751±0.99μg/μL) the findings were consistent with findings fromprevious ELISA studies. Tear levels of prolactin-induced protein(0.09± 0.06μg/μL) and proline rich 4 (0.80±0.50μg/μL) are reportedhere for the first time.Conclusions: SRM method can be used for simultaneous detectionand quantification of the five selected proteins in low volume humantear samples (2.5µl per sample) without prior purification of eachprotein component or need for antibodies.Commercial Relationships: Simin Masoudi, None; Ling Zhong,None; Mark Raftery, None; Mark D. Willcox, Allergan Inc (C),Allergan Inc (R), Brien Holden Vision Institute (P), Bausch + Lomb(C), Basuch + Lomb (R)Program Number: 931 Poster Board Number: B0236Presentation Time: 1:00 PM - 2:45 PMDry Eye and Systemic DiseasesClaudia Henrich, Esen K. Akpek. Cornea, The Wilmer Eye Instituteat Johns Hopkins, Baltimore, MD.Purpose: To evaluate the prevalence of associated inflammatorysystemic diseases in a cohort of patients with dry eye syndrome.Methods: Medical records of patients who presented to the WilmerEye Institute Ocular Surface Diseases and Dry Eye Clinic with dryeye symptomatology during a period of two years (January 2010 toDecember 2011) were reviewed retrospectively. Patients weredivided into two groups: patients with clinically significant dry eyedisease (defined as Schirmer test result without topical anesthesia≤10 mm at 5 minutes in either eye or bulbar conjunctival stainingwith lissamine green scored based on Oxford scale ≥1 in either eye)and patients with dry eye symptomatology but without the clinicalfindings.Results: A patient list of 326 patients was generated electronicallyusing a diagnostic code of ICD 375.15. Sixty two patients wereexcluded as they presented primarily with other ocular surfaceproblems and dry eye was a secondary diagnosis. Two hundred andsixty four patients with a primary diagnosis of dry eye were includedin the analysis. The majority of the patients (215/264, 81.4%) werefemale. Two hundred and seventeen (217/264; 82.2%) had clinicallysignificant dry eye. About half of the patients (121/264, 45.8%) hadan underlying inflammatory systemic disease on presentation. Onehundred and nine of them (109/121, 90.1%) had a clinicallysignificant dry eye. Thirty one patients (31/264, 11.7%) had primarySjögren Syndrome, 38 (38/264; 14.4%) had thyroid disease (eitherhypothyroidism, Graves disease or Hashimotos thyroiditis), 13(13/264, 4.9%) had rheumatoid arthritis, 42 (42/264, 15.9%) hadother rheumatic diseases.In 50 patients (50/143, 35.0%) without a previously known systemicdisease (regardless of the severity of the dry eye) a further work upwas performed based on review of systems. In 12 patients (12/50,24.0%) a diagnosis based on the work up was established: 10 patients(10/50, 20.0%) were diagnosed with thyroid eye disease, 2 patients(2/50, 4.0%) were diagnosed with Sjögren syndrome or presumedSjögren syndrome, one (1/50, 2.0%) was diagnosed with a mixedconnective tissue disease.Conclusions: Dry eye is a very common condition. Although usuallya local disease with a benign course, prevalence of systemic diseaseassociation seems to be significant. Based on clinical suspicion andreview of systems, further diagnostic testing might uncover some ofthese previously undiagnosed conditions.Commercial Relationships: Claudia Henrich, None; Esen K.Akpek, Alcon (F), Allergan (F), Baush & Lomb (C)FODE Highlights Impression Based Mucin Defects on the OcularSurface in Dry Eye Patients: Kinetics and Retrieval by TearLipocalinPo-Ting Yeh 1, 2 , Ben J. Glasgow 2, 3 , Richard Casey 2 . 1 Ophthalmology,National Taiwan University Hospital, Taipei, Taiwan;2 Ophthalmology, Jules Stein Eye Institute, David Geffen School ofMedicine at UCLA, Los Angeles, CA; 3 Pathology and LaboratoryMedicine, David Geffen School of Medicine at UCLA, Los Angeles,CA.Purpose: A fluorescent probe was used to identify mucin depletedareas on the ocular surface and test the hypothesis that tear lipocalin,retrieves lipids from the eyes of normal and dry eye subjects.Methods: Fluorescein labeled octadecyl ester, FODE, wascharacterized by mass spectrometry and absorbancespectrophotometry. The use of FODE to define mucin defects wasstudied with impression membranes under conditions that selectivelydeplete mucin. The kinetics of FODE removal from the ocularsurface was analyzed by sampling tears from control and dry eyepatients at various times. The tear protein-FODE complexes wereisolated by gel filtration and ion exchange chromatographies,monitored with absorption and fluorescent spectroscopies andanalysed by gel electrophoresis. Immunoprecipitation verified FODEcomplexed to tear lipocalin.Results: FODE exhibits an isosbestic point at 473nm, pKa of 7.5,and red shift relative to fluorescein. The low solubility of FODE inbuffer is enhanced with 1% Tween 80 and ethanol. FODE adheres tothe ocular surface of dry eye patients. FODE produced visiblestaining at the contact sites of membranes, which correlated withremoval of mucin. Despite the fact that tear lipocalin was reduced indry eye patients, FODE removal followed similar rapid exponentialdecay functions for all subjects. The majority of FODE was elutedbound to tear lipocalin.Conclusions: Tear lipocalin retrieves lipid rapidly from the humanocular surface in mild to moderate dry eye disease and controls. Withimprovements in solubility, FODE may have potential as afluorescent probe to identify mucin depleted areas.FPLC of tear samples from dry eye subjects. (●) Absorbance at 280nm (○) Fluorescence intensity (λem=511 nm). Inset left, coomasssiestainedtricine-SDS-PAGE. Lane 1, fx 4-6. Lane 2, fx 8-10. Lane 3,fx 14-16. Lane 4, fx 21-23. Lane 5, fx 26-28. Lane M, molecularweight markers. Lactoferrin (Lf), lysozyme (Ly) and tear lipocalin(TL) are indicated at left. Inset right, fluorescence of anion exchangechromatography performed on fractions 21-23 of control subjects.Fluorescence was seen only in the elution buffer (high salt) fractions.Gel filtration chromatography of control sample was nearly identicalto that of dry eye.Program Number: 932 Poster Board Number: B0237Presentation Time: 1:00 PM - 2:45 PM©2013, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. 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