J Korean Ophthalmol Soc.  2019 Dec;60(12):1140-1147. 10.3341/jkos.2019.60.12.1140.

The Correlation between Tear Matrix Metalloproteinase-9 Concentration and Clinical Findings in Dry Eye Disease

• Kim HR
• Lee HK

• KMID: 2466163
• DOI: http://doi.org/10.3341/jkos.2019.60.12.1140

Abstract

PURPOSE
To investigate the correlation between the matrix metalloproteinase-9 (MMP-9) concentration, and subjective symptoms and objective signs in dry eye patients.
METHODS
We retrospectively reviewed the medical records of 134 eyes of 67 patients who were diagnosed with dry eye disease. The results of tear MMP-9, which were conducted at a care testing facility, were defined as negative (N), equivocal (E), weak positive (W), positive (P) or strong positive (S). Using three methods with different classification ranges, MMP-9 results were classified into a negative group or positive group. The objective signs of dry eye disease, including tear break-up time (TBUT), tear volume measured by Schirmer's test, degree of corneal erosion estimated by the Oxford stain score (OSS), and ocular surface disease index (OSDI) as the subjective symptom, were recorded. The differences of indices were compared between the negative and positive groups.
RESULTS
There was no significant difference of the TBUT, Schirmer's test, or OSS between the MMP-9 negative and positive groups. Also, the percentage of females was significantly higher in the negative group compared with the positive group regardless of the classification methods (all, p < 0.05). When the MMP-9N alone was classified as a negative group, the OSDI score was significantly higher in the positive group when compared to that of the negative group (p = 0.009).
CONCLUSIONS
The measurement of MMP-9 in patients with dry eye disease may be helpful in predicting subjective symptoms of dry eye disease.

Keyword

Dry eye disease; Matrix metalloproteinase 9; Ocular surface disease index; Tear matrix metalloproteinase-9

MeSH Terms

Classification
Eye Diseases*
Female
Humans
Matrix Metalloproteinase 9*
Medical Records
Retrospective Studies
Tears*
Matrix Metalloproteinase 9

Figure

• 

  Figure 1 Classification of matrix metalloproteinase-9 (MMP-9) test results. Distinct blue line in the result zone guarantees both the accuracy of test procedures and the validity of test results. Absence of red line is defined as ‘Negative (N)’ and marked red line parallel to blue line is defined as ‘Strong positive (S)’, with in-between subdivisions proportionally to the clarity of the red line. The red line gradually becomes more prominent from the left to the right configurations.

• 

  Figure 2 Categorization of the patients based on the results of matrix metalloproteinase-9 (MMP-9). (A) Result of MMP-9 negative was identified as negative group and the result of MMP-9 equivocal, weak positive, positive, and strong positive were categorized as positive group. (B) Result of MMP-9 negative and equivocal were categorized as negative group and the result of MMP-9 weak positive, positive, and strong positive were categorized as positive group. (C) Result of MMP-9 negative, equivocal, and weak positive were categorized as negative group while the other results of MMP-9 were categorized as positive group.

• 

  Figure 3 The difference of ocular surface disease index (OSDI) between the groups. (A) OSDI scores when result of matrix metalloproteinase-9 (MMP-9) negative was identified as negative. Note the significant difference of the average of OSDI scores between the negative (N) and positive (EWPS) (*p < 0.05). No significant difference of OSDI score was found when result of MMP-9 negative and equivocal were assumed as negative (B) nor result of MMP-9 negative, equivocal, and weak positive were assumed as negative (C).

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