Impairment of ocular surface epithelium barrier function in patients with atopic dermatitis

Abstract

Aims-To assess the integrity of the ocular surface epithelium in patients with atopic dermatitis from the viewpoint of its barrier function. Methods-49 patients with atopic dermatitis with blepharoconjunctivitis (ABC group), 27 age matched patients with seasonal or perennial allergic conjunctivitis (AC group), and 20 volunteers with normal healthy eyes (NH group) were assigned to this study. Ocular surface epithelium barrier function was evaluated by the fluorophotometric method using a slit lamp fluorophotometer. 3 µl of 0.5% sodium fluorescein was instilled into the conjunctival sac of the right eye and fluorescein uptake (ng/ml) 30 minutes later (20 minutes after eye washing) was measured in the central cornea and the temporal bulbar conjunctiva. Fluorophoto metric measurements performed were analysed in each group and compared between the groups. Results-The ABC group showed significantly higher fluorescein uptake (mean 28.2 (SEM 3.3) ng/ml) in the cornea than the AC (11.4 (2.2), p=0.001) and NH groups (9.3 (2.1), p=0.001). There was no significant diVerence between the AC and NH groups (p=0.930). The ABC group also showed significantly higher fluorescein uptake in the bulbar conjunctiva (393.4 (54.0)) than the AC (182.9 (24.6), p=0.011) and NH groups (169.3 (29.1), p=0.012). There was also no significant diVerence in fluorescein uptake between the AC group and the NH group (p=0.987). Conclusion-This study suggested that ocular surface epithelium barrier function is impaired in patients with atopic dermatitis with blepharoconjunctivitis.

Mast Cell Chymase Decreases the Barrier Function and Inhibits the Migration of Corneal Epithelial Cells

“…Yokoi evaluated corneal epithelial barrier function in patients with atopic dermatitis and atopic blepharoconjunctivitis by measurement of fluorescein uptake using fluorescence photometry. 58 They found that this barrier was impaired in patients with atopic dermatitis and suggested several mechanisms that altered corneal epithelial permeability. Among them, eosinophil cationic protein, such as MBP and ECP, in the tear fluid are potential candidates, because these proteins have been demonstrated to have a cytotoxic effect on corneal epithelial cells in vitro.…”

Abnormal Rubbing and Keratectasia

“…For example, allergy-associated substances derived from eosinophils have been shown in tears and have been shown to have cytotoxic effects on corneal epithelial cells in vitro. 36 An impaired ocular surface epithelial barrier has been shown in patients with atopic dermatitis and mild blepharoconjunctivitis without keratopathy. 36 This impairment was not evident in control subjects with seasonal or perennial allergic conjunctivitis 36 and may increase susceptibility to trauma from abnormal rubbing.…”

Keratoconus, allergy, itch, eye‐rubbing and hand‐dominance

“…24 A family history of atopy is an important factor but the diagnosis is sometimes based on unspecified criteria. [26][27] In other cases an atopic family history diagnosis includes the specific criterion of atopic disease being present in a first-degree relati~e.~,*~ Even so, this criterion is dependent on an accurate diagnosis for the first degree relative. In addition, the lack of control samples in some studies may explain some of the conflicting evidence for an association between keratoconus and atopy.…”