The practical detection of mmp-9 diagnoses ocular surface disease and may help prevent its complications.
OBJECTIVE
To evaluate the importance and practicality of testing for matrix metalloproteinase 9 (MMP-9) in dry eye and ocular surface disease. This enzyme, which can cause tissue damage, seems also to be the most reliable diagnostic indicator of ocular surface disease.


METHODS
Enzyme-linked immunosorbent assay, polymerase chain reaction, diffusion, and InflammaDry, a new rapid immunoassay by RPS (Rapid Pathogen Screening Inc).


RESULTS
MMP-9 measurement is sensitive and accurate for diagnosing dry eye and ocular surface disease and compares favorably in both sensitivity and specificity against the existing methods of dry eye diagnosis. Abnormal elevations of MMP-9 may predict post-laser in situ keratomileusis complications and refractive complications such as epithelial ingrowth and corneal ulceration. The presence of elevated MMP-9 on the ocular surface will identify those patients who should receive antiinflammatory therapy, such as cyclosporine, and may predict those patients who will respond to this therapy.


CONCLUSIONS
A rapid in-office test that is sensitive for identifying inflammatory dry eye and ocular surface disease may facilitate better preoperative management of the ocular surface. Optimization of the ocular surface perioperatively would be expected to reduce complications from laser in situ keratomileusis and other surgeries that often make the underlying disease worse. This test may also indicate the need for antiinflammatory therapies, such as cyclosporine or steroids, and also may predict those patients who are more likely to respond.
Louisiana State University Medical School, Department of Ophthalmology, Louisiana State University Eye Center, New Orleans, LA, USA. hkaufm@gmail.com
Herbert E
HE
Kaufman
D003233:Conjunctivitis, Allergic / Q000175:diagnosis* / Q000188:drug therapy / Q000201:enzymology; D003316:Corneal Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000201:enzymology; D015352:Dry Eye Syndromes / Q000175:diagnosis* / Q000188:drug therapy / Q000201:enzymology; D004797:Enzyme-Linked Immunosorbent Assay; D006801:Humans; D007118:Immunoassay / Q000379:methods*; D020780:Matrix Metalloproteinase 9 / Q000032:analysis*; D019095:Point-of-Care Systems; D016133:Polymerase Chain Reaction; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
C579270:MMP9 protein, human; D020780:Matrix Metalloproteinase 9