Purpose

To investigate long-term correlations between Matrix Metalloproteinase-9 (MMP-9) testing and dry eye (DE) parameters. Additionally, to evaluate variability in MMP-9 results over time and with anti-inflammatory treatment.

Methods

Retrospective cohort study of DE patients with equal MMP-9 testing results (positive or negative) in both eyes and a minimum of 6 months of follow up. Our main outcome measure was to examine whether initial MMP-9 status affected change in DE parameters over time. Secondarily, we evaluated the frequency of MMP-9 status change over time and examined whether MMP-9 status change was impacted by treatment.

Results

67 patients (76% female) fit the inclusion criteria. Mean age was 63 years with a mean follow up of 10.6 months. The majority (37/67, 55%) had concomitant systemic immune disease. MMP-9 testing was positive in both eyes in 39 individuals (58%) and negative in both eyes in 27 (42%) individuals. Of all DE parameters, initial MMP status predicted change in tear production. Individuals in the MMP-9 positive group had a greater decrease in production from baseline to final visit compared to the negative group (−2.6 vs 2.1, P = 0.013). In those initially MMP-9 positive, the frequency of becoming MMP-9 negative was higher in eyes treated with anti-inflammatory therapy compared to artificial tears (22.9% vs 3.3%, P = 0.106). However, only Lifitegrast 5% showed statistical significance compared to artificial tears (31.3% vs 3.3%, P = 0.044).

Conclusions

Eyes with detectable MMP-9 had significantly decreased tear production over time compared to those without detectable MMP-9. Anti-inflammatory treatment more frequently normalized MMP-9 compared to PFATs.

中文翻译：

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基质金属蛋白酶 9 阳性预测泪液产生长期减少

目的

研究 Matrix Metalloproteinase-9 (MMP-9) 测试与干眼 (DE) 参数之间的长期相关性。此外，评估 MMP-9 结果随时间和抗炎治疗的变异性。

方法

对双眼 MMP-9 检测结果（阳性或阴性）相同且至少随访 6 个月的 DE 患者进行的回顾性队列研究。我们的主要结果测量是检查初始 MMP-9 状态是否影响 DE 参数随时间的变化。其次，我们评估了 MMP-9 状态随时间变化的频率，并检查了 MMP-9 状态变化是否受到治疗的影响。

结果

67 名患者（76% 女性）符合纳入标准。平均年龄为 63 岁，平均随访时间为 10.6 个月。大多数人（37/67，55%）伴有全身性免疫疾病。39 人 (58%) 的双眼 MMP-9 检测均为阳性，27 人 (42%) 的双眼均为阴性。在所有 DE 参数中，初始 MMP 状态预测泪液产生的变化。与阴性组相比，MMP-9 阳性组的个体从基线到最终访问的产量下降幅度更大（-2.6 对 2.1，P  = 0.013）。在最初 MMP-9 阳性的患者中，与人工泪液相比，接受抗炎治疗的眼睛中 MMP-9 阴性的频率更高（22.9% vs 3.3%，P = 0.106）。然而，与人工泪液相比，只有 Lifitegrast 5% 显示出统计学意义（31.3% vs 3.3%，P  = 0.044）。

结论

与没有可检测到 MMP-9 的眼睛相比，具有可检测到 MMP-9 的眼睛随着时间的推移显着减少了泪液产生。与 PFAT 相比，抗炎治疗更频繁地使 MMP-9 正常化。