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 eves at different stages of CCh and 10 eves of healthy controls were recruited for this prospective Study undertaken at a single university-based hospital. CCh was graded based on the extent of interior 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 5 1 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.