Tear cytokine profile in medicated glaucoma patients: effect of monocyte chemoattractant protein 1 on early posttrabeculectomy outcome.
OBJECTIVE
To determine the tear cytokine profile from medicated glaucoma patients scheduled for trabeculectomy and to establish whether a specifically elevated cytokine level is related to early postoperative scarring.


METHODS
Prospective case-control study.


METHODS
Sixty-one patients treated with topical antiglaucoma medications and 29 normal subjects with no prior topical treatment were recruited for the study.


METHODS
Schirmer strips were used to collect tear samples. A multiplex bead assay was used to quantify the presence of proinflammatory cytokines in the tears. The patients were followed up for 6 months after surgery to determine whether any postoperative intervention to maintain filtering bleb function was required.


METHODS
The level of cytokines in tear specimens from medicated glaucoma patients was the main outcome measure for the study. The need for postoperative bleb needling within 6 months was a secondary outcome measure.


RESULTS
Of the 17 cytokines assayed, only monocyte chemoattractant protein 1 (MCP-1) was elevated significantly in the medicated eyes compared with the unmedicated eyes (P < 0.0004). At 6 months after surgery, 18 (30%) of the 61 eyes required postoperative intervention. A much higher MCP-1 level was detected in these eyes compared with the remaining 43 that did not require intervention (P < 0.0001). The duration of use of topical medication correlated with increasing levels of MCP-1, although the types of glaucoma medication and the number of bottles of medications did not have any significant relationship with the level of MCP-1.


CONCLUSIONS
In tears from topically medicated glaucoma eyes in an Asian population, MCP-1 was found to be the predominant cytokine elevated. Eyes with a propensity to scar in the early postoperative period have a significantly raised level of MCP-1.


BACKGROUND
Proprietary or commercial disclosure may be found after the references.
Chong
Rachel S
RS
Singapore National Eye Centre, Singapore, Republic of Singapore.
Jiang
Yu Zhen
YZ
Boey
Pui Yi
PY
Yu
Shang Juan
SJ
Htoon
Hla Myint
HM
Aung
Tin
T
Khaw
Peng T
PT
Wong
Tina T
TT
D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D016022:Case-Control Studies; D018932:Chemokine CCL2 / Q000378:metabolism*; D016207:Cytokines / Q000378:metabolism; D005136:Eye Proteins / Q000378:metabolism*; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000188:drug therapy / Q000378:metabolism* / Q000601:surgery; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011446:Prospective Studies; D013666:Tears / Q000378:metabolism*; D014130:Trabeculectomy; D016896:Treatment Outcome
D000959:Antihypertensive Agents; D018932:Chemokine CCL2; D016207:Cytokines; D005136:Eye Proteins; C042434:tear proteins