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Tear cytokine profiling in patients with superior limbic keratoconjunctivitis who underwent medical treatment or in conjunction with surgical management
  1. Yi-Chen Sun1,2,
  2. Yi-Hua Tang3,
  3. Hau-Min Liou3,
  4. Wei-Li Chen3,
  5. Fung-Rong Hu3,4
  1. 1 Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
  2. 2 Taipei Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
  3. 3 Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
  4. 4 Ophthalmology, National Taiwan University, College of Medicine, Taipei, Taiwan
  1. Correspondence to Professor Fung-Rong Hu,Ophthalmology, National Taiwan University, College of Medicine, Taipei, Taiwan; fungronghu{at}


Purpose To determine the correlation between superior limbic keratoconjunctivitis (SLK) and selected tear cytokines and to evaluate the efficacy of these cytokines in monitoring the response of patients with SLK to either medical treatment alone or in combination with conjunctival resection.

Design A cohort study.

Methods Twenty-five eyes of 13 patients with SLK were assigned to either medically responsive or surgical treatment groups depending on their responses 1 month after initial medical treatment. Treatment efficacy was assessed by improvements in clinical grading and decreases in the levels of tear cytokines.

Results Fourteen eyes were improved by medical treatment alone, whereas satisfactory outcomes were achieved for the remaining 11 eyes after surgical management. The overall grading prior to medical treatment was lower in medically responsive group compared with surgical treatment group (p=0.0139). Among the examined tear cytokines, monocyte chemoattractant protein (MCP)-1 was positively associated with the severity of clinical grading (p=0.0251). While both treatments significantly decreased the levels of MCP-1 and interleukin-6, surgical treatment also decreased the levels of interferon-γ and tumour necrosis factor-α. Notably, overall cytokine levels after surgical treatment were lower than those after medical treatment alone.

Conclusions Since an association of tear MCP-1 level with the clinical grading and treatment response of SLK was observed in this study, tear MCP-1 may be a potential indicator of SLK disease severity. According to the degree to which the tear cytokine levels were decreased, surgical treatment appears to be an effective treatment modality for patients with SLK who are refractory to medical treatment alone.

  • superior limbic keratoconjunctivitis
  • tear cytokine
  • MCP-1

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  • Contributors Y-CS: conception or design of the work, data collection, data analysis and interpretation, drafting of the article, critical revision of the article. Y-HT: data collection. H-ML: data collection. WLC: data analysis and interpretation. F-RH: conception and design of the work, patient collection, surgical performance and critical revision of the article.

  • Funding This work was supported by the Ministry of Science and Technology, Taiwan (grant NSC-103-2314-B-002-075-MY2) and Taipei Tzu Chi Hospital (TCRD-TPE-107-07).

  • Competing interests None declared.

  • Patient consent for publication Parental/guardian consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.