Article Text
Abstract
Objectives Dry eye is common when external beam radiation is used for the treatment of choroidal melanoma (CM). As meibum structure and composition have been related to dry eye, we determined if plaque bachytherapy for CM alters meibum composition.
Design 1H-NMR spectroscopy was used to measure the lipid composition of meibum.
Setting The University of Louisville, Kentucky, USA.
Participants All 13 participants had CM and one participant had iris melanoma.
Main outcome measures Cholesteryl ester (CE) to wax ester (WE) ratio, amount of meibum esters (ME) and meibum lipid saturation were measured.
Results ME decreased by 80%±18% (±99% CI) in 11 eyes that were treated compared with the contralateral untreated eye. ME increased by 181% in two eyes that were treated compared with the contralateral untreated eye. The mole % CE/WE for meibum was significantly (p<0.0001) 67% lower in eyes that were irradiated compared with control eyes from donors without CM and were not treated. Plaque brachytherapy induced the de-esterification of CE. The intensity of the meibum cis double bond resonances did not change significantly (p>0.05).
Conclusion Eyes that had plaque brachytherapy had a lower amount of expressible meibum and a lower CE/WE ratio compared with meibum from the contralateral eye that received no treatment and eyes that did not have uveal melanoma. Both the quality and quantity of meibum should be considered in designing a therapy for dry eye after plaque brachytherapy.
- eye lids
- ocular surface
- pathology
- tears
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Footnotes
Contributors DB was responsible for collecting and analysing data, writing and submitting the article and funding support. SFA was responsible for collecting and analysing data and editing the manuscript. AR was responsible for designing the study, collecting samples and editing the manuscript.
Funding This work has received support from the National Institute of Health R01EY026180 and an unrestricted grant from Research to Prevent Blindness Inc. New York, New York, USA, GN151619B.
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Patient consent for publication Not required.
Ethics approval Protocols and procedures were reviewed by the University of Louisville Institutional Review Board # 11.0319, August 2016. All procedures were in accord with the Declaration of Helsinki.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement All data relevant to the study are included in the article.