{
  "abstract": "Background/Objectives: The objectives of this study were to investigate the association between tear matrix metalloproteinase-9 (MMP-9) grade and thyroid eye disease (TED) activity and to evaluate its discriminatory performance for active TED. Methods: This retrospective cross-sectional study included 322 patients with TED, including 188 with inactive disease and 134 with active disease. Tear MMP-9 reaction intensity was graded from 0 to 3 using InflammaDry, and active TED was defined as a Clinical Activity Score (CAS) of ≥3. Receiver operating characteristic analysis was used to assess discriminatory performance. Multivariable logistic regression was used to evaluate the independent association between a grade 3 result and active TED, adjusting for age, sex, and serum thyroid-stimulating hormone receptor antibody level. The main outcome measures were the association of tear MMP-9 grade with CAS, area under the receiver operating characteristic curve, adjusted odds ratio, and diagnostic performance for active TED. Results: Tear MMP-9 grade was significantly higher in active than in inactive TED and correlated positively with disease activity (Spearman’s ρ = 0.253, p < 0.001). Its overall discriminatory performance for active TED was modest (area under the curve, 0.619; 95% confidence interval, 0.552–0.682). A grade 3 result was independently associated with active TED (adjusted odds ratio, 8.65; 95% confidence interval, 2.86–26.17; p < 0.001) and demonstrated high specificity (97.9%) but low sensitivity (19.4%), with a positive predictive value of 86.7% and a positive likelihood ratio of 9.12. Conclusions: Tear MMP-9 grade was associated with TED activity and may provide clinically relevant information regarding ocular surface inflammation in TED.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Ophthalmology, , Pusan National University School of Medicine, Yangsan 50612, Republic of Korea; (D.H.J.); (J.H.P.)"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Do Hee Jung"
    },
    {
      "affs": [
        0
      ],
      "name": "Ji Ho Park"
    },
    {
      "affs": [
        0
      ],
      "name": "Jung Hyo Ahn"
    },
    {
      "affs": [
        0
      ],
      "name": "Ji Eun Lee"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/7741h60y35nt7.bib",
  "cited_by": 0,
  "doi": "10.3390/jcm15197671",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13665984/?tool=EBI",
  "id": "7741h60y35nt7",
  "issns": [
    "2077-0383"
  ],
  "landing_url": "https://europepmc.org/article/PMC/PMC13665984",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2734|Ophthalmology and Eye Disorders"
    ]
  ],
  "openalex": "W7220360221",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13665984/pdf/?tool=EBI",
  "pmcid": "PMC13665984",
  "pmid": null,
  "published": "2026-10-01",
  "publisher": "MDPI AG",
  "ris": "https://research.draconitic.com/paper/7741h60y35nt7.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:31Z",
      "native_id": "PMC:PMC13665984",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13665984"
    },
    {
      "first_seen": "2026-10-30T12:20:00Z",
      "native_id": "10.3390/jcm15197671",
      "source": "crossref",
      "url": "https://www.mdpi.com/2077-0383/15/19/7671"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2734|Ophthalmology and Eye Disorders",
      "subfield": "general"
    }
  ],
  "title": "Clinical Significance of Tear Matrix Metalloproteinase-9 Reaction Intensity in Thyroid Eye Disease",
  "title_text": "Clinical Significance of Tear Matrix Metalloproteinase-9 Reaction Intensity in Thyroid Eye Disease",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:00Z",
  "url": "https://research.draconitic.com/paper/7741h60y35nt7",
  "venue": "Journal of clinical medicine",
  "versions": []
}