Conjunctival Microvascular Characteristics as New Ocular Surface Inflammatory Indicators in Mild Dry Eye

Area of Science:

• Ophthalmology
• Ocular Surface Disease
• Microvascular Imaging

Background:

• Mild dry eye (DE) often involves subclinical ocular surface inflammation (OSI).
• Current methods may not detect early OSI, delaying appropriate treatment.
• Conjunctival microvasculature offers a potential window into inflammatory processes.

Purpose of the Study:

• To assess conjunctival microvasculature's ability to differentiate OSI in mild DE.
• To guide anti-inflammatory treatment strategies for mild DE with OSI.
• To correlate microvascular parameters with tear cytokine levels.

Main Methods:

• Cross-sectional study of 83 mild DE patients and 26 controls.
• Classification of DE patients into OSI and non-OSI groups based on tear cytokines.
• Analysis of microvascular parameters (BFV, WSR) and clinical signs.
• Development of a logistic regression model for OSI detection.
• Secondary analysis of a RCT evaluating 0.05% Cyclosporine A treatment.

Main Results:

• Mild DE with OSI showed significantly elevated BFV and WSR compared to those without OSI.
• BFV and WSR correlated with IL-6 levels.
• A logistic regression model using BFV and WSR achieved an AUC of 0.858 for OSI detection.
• Adjunctive 0.05% Cyclosporine A improved microvascular and clinical outcomes in mild DE with OSI.

Conclusions:

• Elevated BFV and WSR aid in the early detection of OSI in mild DE.
• Microvascular assessment can identify inflammation before overt symptoms or signs.
• This facilitates prompt anti-inflammatory interventions for better outcomes.