Disruption of blood-aqueous barrier in dry eye disease

Purpose: To evaluate level of flare in aqueous humor of dry eye disease (DED) and compare it with normal controls. Methods: In this cross-sectional study, we compared the anterior chamber flare between 28 patients with DED (the DED group) and 27 normal age- and gender-matched controls (the control group). DED group was divided in Sjӧgren's syndrome dry eye (SDE, n = 10) and non- Sjӧgren's syndrome dry eye (non-SDE, n = 18) groups. Results: This study enrolled 55 participants including 28 patients with DED and 27 normal controls. The mean age was 53.4 ± 14.7 years in the DED group and 48.5 ± 14.7 years in the control group (P = 0.086). Mean flare was significantly higher in DED group (12.1 ± 10.2 ph/ms, range 2.7–68.3) compared to the control group (5.0 ± 3.9 ph/ms, range 1.30–30.0, P < 0.001). There was no statistically significant difference in the flare intensity between the Sjӧgren syndrome dry eye (SDE) group (14.5 ± 14.4 ph/ms) and the non-Sjӧgren dry eye (non-SDE) group (10.8 ± 6.9 ph/ms, P = 0.330). A significant correlation was observed between the flare intensity and the ocular surface staining in the SDE group (r = 0.62, P = 0.018). Conclusion: There is a significant increase in aqueous humor flare in patients with DED. Such finding, which is a marker of disruption of blood-aqueous barrier, demonstrates deeper tissue involvement than ocular surface in these patients.