Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Jun;34(3):179-186.
doi: 10.3341/kjo.2019.0145.

Tear Osmolarity and Matrix Metallopeptidase-9 in Dry Eye Associated with Sjögren's Syndrome

Kyung Yun Kook  1 , Rujun Jin  1 , Lan Li  1 , Hyeon Jeong Yoon  1 , Kyung Chul Yoon  2
Affiliations

Tear Osmolarity and Matrix Metallopeptidase-9 in Dry Eye Associated with Sjögren's Syndrome

Kyung Yun Kook et al. Korean J Ophthalmol. 2020 Jun.

Abstract

Purpose: To evaluate the correlations between tear osmolarity and matrix metallopeptidase-9 (MMP-9) and dry eye (DE) indices in patients with DE associated with Sjögren's syndrome (SS).

Methods: Sixty-three patients with DE associated with SS who underwent tear analysis were included. DE tests performed were ocular surface disease index, tear break-up time, Schirmer's test, ocular staining score, and tear osmolarity and MMP-9 tests. Correlations between tear osmolarity and DE indices, differences between patients with abnormal and normal tear osmolarity, and those between positive and negative MMP-9 patients were analyzed. Patients were classified into four groups according to tear osmolarity and MMP-9 results, and between-group differences were analyzed (group 1: abnormal tear osmolarity, MMP-9 positive; group 2: abnormal tear osmolarity, MMP-9 negative; group 3: normal tear osmolarity, MMP-9 positive; group 4: normal tear osmolarity, MMP-9 negative).

Results: Mean age of patients was 54.2 ± 13.9 years, and 96.2% were female. Thirty-five patients had abnormal tear osmolarity and 40 patients were MMP-9 positive. DE indices differed between groups with abnormal and normal tear osmolarity (p < 0.01), but not between positive and negative MMP-9 groups. There were 22 patients in group 1, 13 in group 2, 18 in group 3, and 10 in group 4. Compared to group 4, tear break-up time was shorter in groups 1 (p < 0.01) and 2 (p = 0.02). Schirmer's test values in group 1 were lower than those in group 4 (p = 0.03). Ocular staining score was higher in groups 1 (p < 0.01) and 2 (p < 0.05) than in group 4.

Conclusions: Tear osmolarity was correlated with ocular surface indices in DE associated with SS. Combination of tear osmolarity and MMP-9 test results may be helpful to determine the severity of DE associated with SS.

Keywords: Dry eye syndromes; Matrix metallopeptidase-9; Sjogren's syndrome; Tear osmolarity.

PubMed Disclaimer

Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1. Correlation between tear osmolarity level and dry eye indices. (A) No significant difference was evident between tear osmolarity and ocular surface disease index (OSDI). (B) Tear osmolarity correlated negatively with tear break-up time (TBUT), and (C) Schirmer test results, but (D) positively with ocular staining score (OSS), (E) corneal staining score, and (F) conjunctival staining score.
Fig. 2
Fig. 2. Comparison of four groups classified by tear osmolarity and matrix metalloproteinase-9 (MMP-9) in (A) ocular surface disease index (OSDI), (B) tear film break-up time (TBUT), (C) Schirmer test, (D) ocular staining score (OSS), (E) corneal staining score, and (F) conjunctival staining score. Group 1: abnormal tear osmolarity and positive MMP-9, group 2: abnormal tear osmolarity and negative MMP-9, group 3: normal tear osmolarity and positive MMP-9, group 4: normal tear osmolarity and negative MMP-9. *p < 0.05.
See this image and copyright information in PMC

References

    1. Thomas E, Hay EM, Hajeer A, Silman AJ. Sjogren's syndrome: a community-based study of prevalence and impact. Br J Rheumatol. 1998;37:1069–1076. - PubMed
    1. Jacobsson LT, Axell TE, Hansen BU, et al. Dry eyes or mouth--an epidemiological study in Swedish adults, with special reference to primary Sjogren's syndrome. J Autoimmun. 1989;2:521–527. - PubMed
    1. Bjerrum KB. Keratoconjunctivitis sicca and primary Sjogren's syndrome in a Danish population aged 30–60 years. Acta Ophthalmol Scand. 1997;75:281–286. - PubMed
    1. Jonsson R, Haga HJ, Gordon TP. Current concepts on diagnosis, autoantibodies and therapy in Sjogren's syndrome. Scand J Rheumatol. 2000;29:341–348. - PubMed
    1. Mavragani CP, Moutsopoulos HM. Sjogren's syndrome. Annu Rev Pathol. 2014;9:273–285. - PubMed