Abstract
Purpose: To correlate the tear levels of MMP9 with Schirmer’s test in patients with Ocular surface disorder (OSD) & to evaluate treatment with lubricants, steroids and anti-inflammatory drugs based on MMP-9 results.
Methods: 100 eyes with OSD underwent Schirmer’s test & MMP9 estimation. All cases were evaluated on ocular symptomology score (OSS). Association of MMP-9 results with three groups of dry eyes, improvement in objective and subjective parameter in Group I(MMP-9 positive) and Group II(MMP-9 negative) with lubricants and need for additions steroids & Cyclosporine was evaluated.
Results: Out of 100 eyes, 40 eyes tested positive for MMP9. MMP9 positive patients had a mean Schirmer’s value of 12.85 + 7.07 as against MMP9 negative patients who had a mean value of 19.18 + 8.941. 80% were MMP9 positive in severe, 55.6% in moderate and only 22.5% with normal tear secretion were MMP9+ve. No definite Association was found between MMP9 positivity and OSS (chi square test: p>0.05). All MMP9 positive patients were started on lubricants. At 06 months, 85% eyes were continued on lubricants. In 6 eyes (15%) an addition of steroids/Cyclosporine was needed. All patients who were MMP9 negative were started on lubricants, at of 06 months, 96.7% eyes (58 eyes) were continued on lubricants. In 2 eyes (3.3%), addition of Steroid/Cyclosporine was needed.
Conclusion: Results show a trend to evaluate all cases of OSD with MMP- 9 test and treat them depending on results of this test. There is also a case for starting steroids early in cases which are MMP-9 positive.