Tear Fluid Inflammatory Markers And Ocular Surface Findings In Pediatric Patients With Ocular Rosacea

This study aimed to evaluate tear inflammatory markers in pediatric patients with ocular rosacea and to examine their relationship with tear function, clinical findings, and meibography measurements.

This study was conducted in a tertiary ophthalmology clinic and a translational medicine research center. 

This prospective study included 30 pediatric ocular rosacea patients (Group 1) and 28 age- and gender-matched healthy controls (Group 2). Tear break-up time (TBUT), non-invasive tear break-up time (NI-BUT), ocular surface staining with Oxford scoring, meibomian gland (MG) area loss percentage measured via meibography, and Schirmer test results were recorded for all participants. Clinical findings related to the eyelid, conjunctiva, and cornea were documented in Group 1. Tear fluid was collected using the Schirmer strips, and cytokine levels—including IL-1β, IFN-α2, IFN-γ, TNF-α, MCP-1, IL-6, IL-8, IL-10, IL-12p70, IL-17A, IL-18, IL-23, and IL-33—were measured via enzyme-linked immunosorbent assay.

TBUT and NI-BUT were significantly lower in Group 1 compared to Group 2, while MG area loss and Oxford scores were significantly higher (p<0.001, p=0.027, p<0.001, and p<0.001, respectively). In Group 1, IL-1β, MCP-1, IL-6, and IL-8 levels were significantly increased compared to Group 2 (p<0.001, p<0.001, p=0.005, and p<0.001, respectively). No significant correlations were found between cytokine levels, meibography measurements, and tear function parameters. However, corneal scarring/ulceration was positively correlated with IL-1β, TNF-α, and IFN-γ levels (r=0.470, p=0.009; r=0.471, p=0.009; and r=0.463, p=0.01, respectively). Additionally, MCP-1 levels showed a significant association with the presence of chalazion (r=0.509, p=0.004).

Pediatric ocular rosacea is associated with increased levels of pro-inflammatory cytokines in tear fluid, along with significant alterations in tear stability and meibomian gland morphology. The correlation between specific cytokines and corneal scarring/ulceration suggests a potential role of inflammation in disease severity. These findings highlight the importance of monitoring inflammatory markers in the disease process and their potential relevance for future therapeutic strategies.