Role of Tear Film Biomarkers in the Diagnosis and Management of Dry Eye Disease

Abstract

In recent years, there has been increasing scientific interest in the use of tear film biomarkers in the diagnosis and management of dry eye disease, owning to their potential important roles in the pathogenesis of ocular surface damage, as well as the technical feasibility of tear sample collection techniques. An Entrez Pubmed search was conducted on the 2nd of March 2019 to include papers investigating the use of tear film biomarkers in DED, and results were classified according to whether the DED is associated with systemic inflammatory disease or not, and further classified within each section according to the molecular nature of the biomarker for further discussion. A total of 58 relevant articles were reviewed. Certain cytokines, including IL-6, TNF-α, IL-17, IL-8 were found by a number of studies to consistently reflect disease severity well and had strong correlations with tear film metrics and tests for ocular surface damage in dry eye without systemic inflammatory disease. For dry eye with systemic inflammatory disease, IL-17, IL-8, IL-1RA were shown to be consistently higher in affected eyes and correlated well with ocular surface disease severity in more than one type of inflammatory disease. With the advancement in technology and lowered costs in the future, tear film biomarker counts would allow better diagnosis and monitoring of dry eye disease, as well as facilitate personalized treatment strategies.