title: Evaluation of ocular surface damage and dry eye status in chronic hepatitis C at different stages of hepatic fibrosis.
abstract: OBJECTIVE
  The purpose of this study was to explore changes in ocular surface and tear function parameters in chronic hepatitis C at different stages of hepatic fibrosis.
  
  
  METHODS
  Fifty-four patients with biopsy-proven chronic hepatitis C and 54 age- and sex-matched healthy control subjects without systemic hepatitis C infection were examined with the Ocular Surface Disease Index questionnaire, Schirmer with and without anesthesia, tear film breakup time, and scoring of ocular surface Lissamine green staining using modified Oxford and van Bijsterveld scoring systems and corneal fluorescein staining.
  
  
  RESULTS
  Patients with chronic hepatitis C scored significantly worse than the control subjects on all parameters: modified Oxford scores of Lissamine green staining (5.5/3.0; P <0.001), Oxford and van Bijsterveld scores (4.0/2.0; P <0.001), and corneal fluorescein staining (1.5/0.0; P = 0.001). The chronic hepatitis C group also had higher Ocular Surface Disease Index scores than the control subjects (22.3/13.7; P = 0.001). Schirmer with and without anesthesia and tear film breakup time scores were found to be lower in patients with chronic hepatitis C (P <0.001). Moreover, patients with advanced stages of hepatic fibrosis (stages 4-6) had significantly lower values of tear film breakup time and worse Ocular Surface Disease Index scores and ocular surface vital dye staining than those with initial stages of hepatic fibrosis (stages 0-3).
  
  
  CONCLUSIONS
  Patients with chronic hepatitis C, especially those with advanced stages of hepatic fibrosis, were more likely to exhibit severe ocular surface damage and signs of dry eye.
authors.affiliation: Department of Ophthalmology, Division of Gastroenterology, Erciyes University School of Medicine, Kayseri 38039, Turkey. drkorayg@hotmail.com
authors.forename: Koray
authors.initials: K
authors.lastname: Gumus
authors.forename: Alper
authors.initials: A
authors.lastname: Yurci
authors.forename: Ertugrul
authors.initials: E
authors.lastname: Mirza
authors.forename: Hatice
authors.initials: H
authors.lastname: Arda
authors.forename: Ayse
authors.initials: A
authors.lastname: Oner
authors.forename: Duygu
authors.initials: D
authors.lastname: Topaktas
authors.forename: Sarper
authors.initials: S
authors.lastname: Karakucuk
mesh_terms: D000328:Adult; D000368:Aged; D003316:Corneal Diseases / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism; D003430:Cross-Sectional Studies; D015352:Dry Eye Syndromes / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism; D005260:Female; D015590:Fluorophotometry; D016174:Hepacivirus / Q000502:physiology; D019698:Hepatitis C, Chronic / Q000145:classification / Q000150:complications*; D006801:Humans; D008103:Liver Cirrhosis / Q000145:classification / Q000150:complications*; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood; D011795:Surveys and Questionnaires; D013666:Tears / Q000378:metabolism; D019562:Viral Load
chemical_list: D012367:RNA, Viral