Impairment of ocular surface epithelium barrier function in patients with atopic dermatitis

AIMS—To assess the integrity of the ocular surface epithelium in patients with atopic dermatitis from the viewpoint of its barrier function. METHODS—49 patients with atopic dermatitis with blepharoconjunctivitis (ABC group), 27 age matched patients with seasonal or perennial allergic conjunctivitis (AC group), and 20 volunteers with normal healthy eyes (NH group) were assigned to this study. Ocular surface epithelium barrier function was evaluated by the fluorophotometric method using a slit lamp fluorophotometer. 3 µl of 0.5% sodium fluorescein was instilled into the conjunctival sac of the right eye and fluorescein uptake (ng/ml) 30 minutes later (20 minutes after eye washing) was measured in the central cornea and the temporal bulbar conjunctiva. Fluorophoto metric measurements performed were analysed in each group and compared between the groups. RESULTS—The ABC group showed significantly higher fluorescein uptake (mean 28.2 (SEM 3.3) ng/ml) in the cornea than the AC (11.4 (2.2), p=0.001) and NH groups (9.3 (2.1), p=0.001). There was no significant difference between the AC and NH groups (p=0.930). The ABC group also showed significantly higher fluorescein uptake in the bulbar conjunctiva (393.4 (54.0)) than the AC (182.9 (24.6), p=0.011) and NH groups (169.3 (29.1), p=0.012). There was also no significant difference in fluorescein uptake between the AC group and the NH group (p=0.987). CONCLUSION—This study suggested that ocular surface epithelium barrier function is impaired in patients with atopic dermatitis with blepharoconjunctivitis. Keywords: atopic blepharoconjunctivitis; ocular surface epithelium; barrier function; fluorophotometry