IgE Ratio in Tears: A Predictive Tool of Ocular Allergic Inflammation.

PURPOSE: To demonstrate the tear IgE (measured/exuded) ratio (R) as a useful biological marker of ocular allergy in order to distinguish severe from less severe inflammatory status. METHODS: Tear samples and sera from 78 ocular allergy patients and 19 control subjects were analyzed. Total IgE and albumin were measured for calculating the tear IgE-R defining two subgroups (SG) of samples: R ≥ 4-SG and R < 4-SG. Eosinophil cationic protein, Th1 and Th2 cytokines (IFN-γ, IL-4, -5, -6, -8 and -10) and protein electrophoretic profiles were also investigated in tears. RESULTS: The R < 4-SG compared to the R ≥ 4-SG shows higher levels of tear albumin, eosinophil cationic protein, and Th1 and Th2 cytokines. Moreover, each subgroup presents a specific protein profile. CONCLUSION: This study showed that an IgE-R lower than four must be carefully interpreted as a warning sign of a severe inflammatory context and should be also associated with an exploration of immunological profile.

Prevalence of low serum vitamin a levels in young children with chalazia in southwest china.

PURPOSE: To detect risk factors that may be related to chalazia in children in southwest China. DESIGN: Prospective case-control study. METHODS: The case group, 88 children with chalazia, was divided into 2 subgroups. One had 48 children 6 months to 6 years of age (defined as young children), and the other had 40 children 7 to 12 years of age (defined as older children). The control group consisted of 40 young children and 32 older children. Clinical findings for patients were recorded. Serum was tested for concentrations of vitamin A, vitamin D3, and immunoglobulin E. RESULTS: World Health Organization definitions were used for vitamin A deficiency (< 0.7 µmol/L) and marginal vitamin A deficiency (0.7 to 1.05 µmol/L). The average level of serum vitamin A in the case group was significantly lower than that in the control group (P < .001). Analyses failed to find significant differences in vitamin D3 or immunoglobulin E levels between the case and control groups. The average vitamin A level in young children with multiple chalazia (0.65 ± 0.12 µmol/L) was low. Blepharitis was less prevalent than low serum vitamin A levels in the young child subgroup (odds ratios, 8.5 and 96.9, respectively), but higher than in older children (odds ratios, 17.5 and 9.0, respectively). CONCLUSIONS: Low serum vitamin A is associated with a chalazion in young children in southwest China, especially young children with multiple chalazia.

Correlation between ocular Demodex infestation and serum immunoreactivity to Bacillus proteins in patients with Facial rosacea.

PURPOSE: To investigate correlation between ocular Demodex infestation and serum. DESIGN: A prospective study to correlate clinical findings with laboratory data. PARTICIPANTS: We consecutively enrolled 59 patients: 34 men and 25 women with a mean age of 60.4+/-17.6 years (range, 17-93). METHODS: Demodex counting was performed based on lash sampling. Serum immunoreactivity to two 62-kDa and 83-kDa proteins derived from B oleronius was determined by Western blot analysis. Facial rosacea, lid margin, and ocular surface inflammation were documented by photography and graded in a masked fashion. MAIN OUTCOME MEASURES: Statistical significance based on correlative analyses of clinical and laboratory data. RESULTS: These 59 patients were age matched, but not gender matched, regarding serum immunoreactivity, ocular Demodex infestation, or facial rosacea. There was a significant correlation between serum immunoreactivity and facial rosacea (P = 0.009), lid margin inflammation (P = 0.040), and ocular Demodex infestation (P = 0.048), but not inferior bulbar conjunctival inflammation (P = 0.573). The Demodex count was significantly higher in patients with positive facial rosacea (6.6+/-9.0 vs. 1.9+/-2.2; P = 0.014). There was a significant correlation of facial rosacea with lid margin inflammation (P = 0.016), but not with inferior bulbar conjunctival inflammation (P = 0.728). Ocular Demodex infestation was less prevalent in patients with aqueous tear-deficiency dry eye than those without (7/38 vs. 12/21; P = 0.002). CONCLUSIONS: The strong correlation provides a better understanding of comorbidity between Demodex mites and their symbiotic B oleronius in facial rosacea and blepharitis. Treatments directed to both warrant future investigation.

Trace elements and blepharitis.

INTRODUCTION: Investigating the relationship between the serum levels of zinc and copper with blepharitis. METHODS: Twenty seven patients with blepharitis and 24 control group patients were evaluated for Schirmer, fluorescein break up time (FBUT) scores and serum levels of zinc and copper. Symptoms and clinical examination scores of blepharitis patients were also assessed. RESULTS: The serum level of zinc (65.78+/-15.51 in patients with blepharitis and 65.71+/-10.43 in patients without blepharitis, normal values in the laboratory: 70-127 microg/dl) and copper (67.17+/-22.24 in patients with blepharitis and 69.35+/-14.44 in patients without blepharitis, normal values in the laboratory: 70-150 microg/dl) were not different between the two groups. The symptom and clinical examination scores of blephraritis patients were not correlated with the serum levels of either zinc or copper. DISCUSSION: The zinc and copper levels in serum do not seem to be related to blepharitis. Their tear levels and sensory status of cornea should also be evaluated to better evaluate a possible relation.

The role of omega-3 dietary supplementation in blepharitis and meibomian gland dysfunction (an AOS thesis).

PURPOSE: Blepharitis and meibomian gland dysfunction (MGD) are common sources of complaints from patients. To evaluate the effect on ocular symptoms, ocular findings, and serum and meibomian gland contents, patients with blepharitis and MGD were prospectively evaluated to determine the effects of dietary supplementation with omega-3 fatty acids. METHODS: In a prospective randomized placebo-controlled masked trial, patients with simple obstructive MGD and blepharitis, who had discontinued all topical medications and tetracyclines, received oral omega-3 dietary supplementation consisting of two 1000-mg capsules 3 times a day. Patients were examined every 3 months for 1 year with the Ocular Surface Disease Index (OSDI) objective clinical measures, including tear production and stability, ocular surface and meibomian gland health, and biochemical plasma, red blood cell (RBC), and meibum evaluation. Primary outcome measures were change in tear breakup time (TBUT), meibum score, and overall OSDI score at 1 year. RESULTS: At 1 year, the omega-3 group had a 36% and 31% reduction in their omega-6 to omega-3 fatty acid ratios in RBCs and plasma, respectively (P = .3), whereas the placebo group demonstrated no change. At 12 months, the omega-3 group had an improvement in TBUT, OSDI score, and meibum score. Changes in meibum content were observed in the omega-3 group (P = .21); the level of meibum saturated fatty acids decreased. CONCLUSIONS: This trial demonstrated a decrease in the RBC and plasma ratios of omega-6 to omega-3 in patients taking omega-3 dietary supplementation, as compared to controls, and improvements in their overall OSDI score, TBUT, and meibum score. This is the first demonstration of an induced change in the fatty acid saturation content in meibum as a result of dietary supplementation with omega-3 fatty acids.