Clinical Significance of Tear Matrix Metalloproteinase-9 Reaction Intensity in Thyroid Eye Disease
- 1Department of Ophthalmology, , Pusan National University School of Medicine, Yangsan 50612, Republic of Korea; (D.H.J.); (J.H.P.)
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.
Related
- Resistance to Thyroid Hormone Beta or Thyroid-Stimulating Hormone (TSH)-Secreting Pituitary Adenoma: A Diagnostic Dilemma With a THRB Variant of Uncertain Significance
- Prevalence and Outcomes of Thyroid Nodules with Atypia of Undetermined Significance (AUS) Cytology in a Tertiary Government Hospital: A Ten-year Review (2013 to 2022).
- Clinical Significance of the Identification of an Anti-M (IgG) Alloantibody in Pregnancy
- Ultrastructural pathological features and clinical significance of recurrent chordoma
- Clinical significance of ultra-low-amplitude electrograms during lattice-tip atrial mapping.
BibTeX
@article{jung2026clinical,
title = {{Clinical Significance of Tear Matrix Metalloproteinase-9 Reaction Intensity in Thyroid Eye Disease}},
author = {Do Hee Jung and Ji Ho Park and Jung Hyo Ahn and Ji Eun Lee},
journal = {Journal of clinical medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15197671},
url = {https://europepmc.org/article/PMC/PMC13665984},
note = {CC BY},
}
RIS
TY - JOUR
TI - Clinical Significance of Tear Matrix Metalloproteinase-9 Reaction Intensity in Thyroid Eye Disease
AU - Do Hee Jung
AU - Ji Ho Park
AU - Jung Hyo Ahn
AU - Ji Eun Lee
PY - 2026
DA - 2026/10/01
JO - Journal of clinical medicine
DO - 10.3390/jcm15197671
UR - https://europepmc.org/article/PMC/PMC13665984
AB - 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.
SN - 2077-0383
ER -