Purpose

To characterize and predict the clinical and tear molecular response of contact lens (CL) wearers exposed to a controlled adverse desiccating environment (CADE).

Methods

Objective and subjective variables and tear cytokine levels were evaluated of monthly silicone hydrogel CL wearers pre- and post-90 min of CADE exposure. Unsupervised hierarchical agglomerative clustering based on relative change from baseline values was used to identify response profiles (clusters). A multiple logistic regression model was used to identify cluster membership predictors.

Results

Forty-seven CL wearers were divided into 3 clusters having similar age (mean: 27.7 ± 7.7 years) and sex distribution. All of them showed a significant (p ≤ 0.05) increase in limbal hyperemia and staining after CADE exposure. Additionally, Cluster-1 (n = 22, 46.8%) membership was characterized by a significant (p ≤ 0.05) higher worsening of corneal and limbal staining, increased CL wear symptoms, and reduced epidermal-growth-factor and increased interleukin (IL)-4 and IL-6 tear levels. Cluster-2 (n = 22, 46.8%) showed no changes (p > 0.05) in symptoms after CADE; however, their IL-12p70, monocyte-chemoattractant-protein-1 and regulated-on-activation, normal-T-cell-expressed-and-secreted (RANTES) post-exposure tear levels significantly (p ≤ 0.05) increased. Finally, Cluster-3 (n = 3, 6.4%) mainly showed significant higher blink rate (78.1 ± 21.7) during CADE. Corneal staining and tear IL-12p70 levels were identified as Cluster-1 membership predictors.

Conclusions

Most of silicone hydrogel CL wearers exposed to CADE showed a worsening of the ocular surface integrity and an upregulated tear inflammatory status. However, only half of them reported worsening of CL wear symptoms. These CL wearers were detected based on corneal integrity and tear inflammatory status. These findings can help reduce CL wear discontinuation and drop out.

中文翻译：

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炎症状态预示着在不利的环境条件下隐形眼镜会感到不适。

目的

表征和预测暴露在受控不利干燥环境（CADE）中的隐形眼镜（CL）佩戴者的临床和泪液分子反应。

方法

在CADE暴露90分钟之前和之后，每月对有机硅水凝胶CL佩戴者的客观和主观变量以及泪液细胞因子水平进行了评估。基于相对于基线值的相对变化的无监督分层聚集聚类用于识别响应配置文件（集群）。使用多元逻辑回归模型来识别聚类成员预测因子。

结果

47名CL佩戴者被分为年龄和性别分布相似的3个组（平均年龄：27.7±7.7岁）。所有这些均显示，CADE暴露后，边缘性充血和染色明显增加（p≤0.05）。此外，Cluster-1的成员（n = 22，46.8％）的特征是角膜和角膜染色的恶化程度显着（p≤0.05），CL磨损症状增加，表皮生长因子减少和白介素（IL）增加-4和IL-6泪液水平。在CADE后，Cluster-2（n = 22，46.8％）的症状无变化（p> 0.05）；然而，他们的IL-12p70，单核细胞趋化蛋白1和激活后调节，正常T细胞表达和分泌（RANTES）暴露后泪液水平显着增加（p≤0.05）。最后，Cluster-3（n = 3，6.4％）主要表现出较高的眨眼率（78.1±21）。7）在CADE期间。角膜染色和泪液IL-12p70水平被确定为Cluster-1成员预测因子。

结论

暴露于CADE的大多数有机硅水凝胶CL佩戴者表现出眼表完整性恶化和泪液炎症状态上调。但是，只有一半的人报告了CL磨损症状的恶化。根据角膜完整性和泪液炎症状态检测出这些CL佩戴者。这些发现有助于减少CL磨损的中断和脱落。