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Abnormal tear osmolarity considered a biomarker of dry eye disease

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NEW ORLEANS — Tear osmolarity is an important biomarker of ocular surface disease, according to a study presented at the American Society of Cataract and Refractive Surgery meeting here.

“We know that osmolarity causes cytotoxicity to cells of the ocular surface. Because of this lack of specificity and sensitivity of using symptoms alone, perhaps tear osmolarity testing can aid in differential diagnosis and initiation of target therapy,” Jay S. Pepose, MD, PhD, said.

Jay S. Pepose

Hyperosmolar stress causes cell death, even in the absence of inflammation and other factors in an in vivo setting, Pepose said.

The retrospective study included 9,429 patients treated at more than 200 centers in the U.S. Mean patient age was 55.9 years, ranging from 7 years to 104 years. Investigators measured tear osmolarity and evaluated patient-reported symptoms.

Abnormal osmolarity was defined as a measurement of more than 308 mOsm/L in both eyes and/or a between-eye difference of more than 8 mOsm/L. Normal osmolarity was defined as a measurement of less than 308 mOsm/L in both eyes and a between-eye difference of less than 8 mOsm/L.

Patient-reported symptoms were tired eyes, itching, watering, redness, light sensitivity, burning, fluctuation in vision, contact lens discomfort and grittiness.

Sixty-one percent of patients had abnormal osmolarity, and 39% had normal osmolarity.

Among patients with abnormal osmolarity, 46% had osmolarity greater than 308 mOsm/L in at least one eye.

Osmolarity measurements were more repeatable among patients with normal osmolarity; patients with abnormal osmolarity had greater fluctuations in osmolarity.

“This instability and this variation is a hallmark of dry eye disease,” Pepose said.

Abnormal osmolarity was prevalent in 60% to 66% of patients who reported any symptoms. – by Matt Hasson and Patricia Nale, ELS

Reference:

Pepose JS. Prevalence of dry-eye disease characteristic in a large multisite U.S. study. Presented at: American Society of Cataract and Refractive Surgery meeting; May 6-10, 2016. New Orleans.

Disclosure: Pepose reports he is a consultant for TearLab.