Elevated tear interleukin-6 and interleukin-8 levels in patients with conjunctivochalasis

PURPOSE: To determine the interleukin (IL)-6 and IL-8 levels in the tear samples of patients with conjunctivochalasis (CCh) and to correlate the severity of symptoms with tear IL levels. METHODS: Fifty-one eyes at different stages of CCh and 10 eyes of healthy controls were recruited for this prospective study undertaken at a single university-based hospital. CCh was graded based on the extent of inferior lid margin involvement as follows: 1 = single (temporal) location, 2 = 2 locations, and 3 = whole lid. The presence of punctal occlusion and fluorescein clearance patterns were recorded. Enzyme-linked immunosorbent assay was used to determine IL levels. Severity of symptoms was assessed with the ocular surface disease index. RESULTS: Of the 51 study patients (mean age = 63.4 ± 6.9 years), 16 had grade 1, 21 had grade 2, and 14 had grade 3 CCh. Tear IL-6 and IL-8 levels were significantly higher in patients with CCh than in controls (P ≤ 0.001). Higher IL levels were observed in grades 2 and 3 CCh than in grade 1 CCh and control eyes (P < 0.001). Patients with CCh who also had punctal occlusion and delayed fluorescein clearance results had higher tear IL levels than those who did not (P ≤ 0.001). Tear IL levels were positively correlated with the clinical severity of CCh as evaluated with the ocular surface disease index (r = 0.826, P < 0.001 for IL-6 and r = 0.726, P < 0.001 for IL-8). CONCLUSIONS: Inflammation may have a role in the pathogenesis of CCh. The clinical severity of CCh parallels the increased tear IL levels. Markers for inflammation are more pronounced in the advanced stages of this disease. © 2009 by Lippincott Williams & Wilkins.