Ocular Surface Immune Cell Profiles in Contact Lens–Induced Discomfort

Abstract

Purpose Contact lens–induced discomfort (CLD) remains a primary factor in discontinuation or prevention of contact lens wear. Thus, we investigated the role of ocular surface immune cells in subjects with CLD. Methods Habitual contact lens (CL) wearers with CLD ( n = 19; 38 eyes) and without CLD ( n = 21; 42 eyes) as determined by the Contact Lens Dry Eye Questionnaire-8 was included in a trial. Enrolled subjects used either of the two types of CL (designated as CL-A or CL-D). Ocular surface cells from the bulbar conjunctiva were obtained by impression cytology. The collected cells were phenotyped using fluorochrome-conjugated antibodies specific for leukocytes (CD45 + ), neutrophils (CD66b +,High,Low ), macrophages (CD163 + ), T cells (CD3 + CD4 + , CD3 + CD8 + ), natural killer (NK) cells (CD56 +, High, Low ), natural killer T (NKT) cells (CD3 + CD56 + ), and gamma delta T (γδT) cells (CD3 + γδTCR + ) by flow cytometry. Further, corneal dendritic cell density (cDCD) was also determined using in vivo confocal microscopy. Results Significantly higher proportions of CD45 + cells were observed in subjects with CLD compared to those without CLD. The percentages of CD66b Total,Low , CD163 + , pan T cells, CD4 + T cells, CD8 + T cells, CD56 Total,High,Low (NK) cells, and NKT cells, as well as the CD4/CD8 ratio, were significantly higher in CLD subjects. The proportion of T cells (CD4, CD8, CD4/CD8 ratio, NKT cells) and macrophages exhibited a direct association with discomfort score. The percentages of CD45 + , CD66b Total,Low , CD163 + , CD3 + , CD56 Total,High,Low , and NKT cells and cDCD were significantly higher in CLD subjects wearing CL-D. The percentages of CD66b High , CD4 + T cells, CD8 + T cells, NKT cells, and CD4/CD8 ratio were significantly higher in CLD subjects wearing CL-A. Conclusions Increased proportions of ocular surface immune cells are observed in CLD, and the lens type could impact the immune cells associated with CLD. Translational Relevance The association between the proportion of altered ocular surface immune cell subsets and contact lens–induced discomfort underpins the importance of considering immune-related aspects ...

Ocular surface immune cell diversity in dry eye disease

“…[ 10 , 27 ] The indirect method is based on the phenotyping of the immune cells based on the cell type-specific molecular markers on the cell surface using fluorescence-tagged marker-specific antibodies by flow cytometry. The sampling method to assess the ocular surface immune cells using flow cytometry includes conjunctival impression cytology – CIC,[ 28 , 29 ] tear fluid,[ 30 , 31 ] or ocular surface wash.[ 32 , 33 ] The detailed procedure of these sampling methods and phenotyping strategies are described in the cited references…”

“…[ 33 ] However, its proportions were observed to be increased on the ocular surface in subjects with ocular surface discomfort following extended use of facemask and in subjects with contact lens induced discomfort. [ 29 , 41 ] Additional studies are required to improve the knowledgebase regarding NKT cells in DED.…”