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New point-of-care diagnostic put to the test
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Man, are we the most popular eye docs on the planet, or what? I’m talking about those of us who take care of dry eye and other ocular surface disease. Every month it seems we have either a new test, or a new wrinkle on an old test, or some kind of controversy about all kinds of dry eye testing. After spending decades as eye care’s red-haired stepchild, the health of the ocular surface is now the most happening place in eye care!
In keeping with this theme, we are hosting the nice folks from RPS at SkyVision to show us the ins and outs of the new point-of-service dry eye test, InflammaDry. Using a platform that is nearly identical to the Adeno+ test for adenovirus (marketed in the U.S. by Nicox), InflammaDry tells us whether, and to some degree how much, the inflammatory marker MMP-9 is elevated in the tears. Since we have been using Adeno+, our technical staff was able to start using InflammaDry after a very brief review. The test is quick and easy.
As you know if you’ve been reading any of my stuff at all, we are very big fans of testing tear osmolarity using the TearLab system. It is an integral part of our dry eye protocol, and our technicians have a series of guidelines that allow for a standing order to check a tear osmolarity under a number of circumstances. To simplify our first-pass evaluation of InflammaDry, we simply use it at the same time as we use the TearLab instrument. Our first tip: Do osmolarity first so that any reflex tearing that may occur after the InflammaDry test won’t skew the osmolarity results.
We are going to subject InflammaDry to our full SkyVision Business Lab protocol treatment, but we did have one very interesting impression after a single afternoon using it in the clinic. Just like our experience with Adeno+ and predicting who would test positive, we were all surprised at how poorly we predicted which patient would test positive for elevated MMP-9 based on both history and exam findings. This alone is valuable enough to incorporate InflammaDry into your dry eye protocol. I’ll have more to share after we get a bit more experience.
Disclosure: White is a consultant for Bausch + Lomb, Allergan, Nicox and Eyemaginations. He is on the speaker board for Bausch + Lomb, Allergan and TearLab.