Reflex Tear Ascorbate in Hong Kong Chinese Subjects: Method Comparison and Biological Variation

Is ascorbate in human tears from corneal leakage or from lacrimal secretion?

BACKGROUND

This study investigated whether fresh main lacrimal gland secretion contains ascorbate, with a view to providing indirect evidence of an immediate source of this antioxidant in tears. Our hypothesis was that, if the source is corneal leakage, continuous tearing or rinsing of the eye will result in a marked decrease, by dilution, in ascorbate concentration in the reflex tears collected. Alternatively, the ascorbate concentration will be relatively constant if the main lacrimal gland secretion is the main immediate source.

METHODS

Five successive samples of yawn-induced reflex tears were collected from the same eye of each of 42 subjects. In 36 of these volunteers, the testing eye was then flushed with 10 ml of saline and a sixth tear sample ('post-flush') was collected immediately. Tear ascorbate concentrations were measured using a validated high performance liquid chromatography method.

RESULTS

The ascorbate concentration of the first sample (baseline) was slightly but significantly (P < 0.0001) lower (17.3 +/- 8.9 micro M) than the four subsequent samples in all subjects (average 21.4 microM). Ascorbate concentrations of post-flush samples were very similar to pre-flush values. Mean +/- SD ascorbate concentrations of pre- and post-flush samples were, respectively, 22.5 +/- 10.9 and 17.3 +/- 5.8 microM.

DISCUSSION

Results show that ascorbate is present in fresh reflex tears. Data do not support the view that the cornea is the source of tear ascorbate in healthy eyes. Rather, results indicate that ascorbate is present in main lacrimal gland secretion and that this antioxidant is depleted in basal tears. Measurement of tear ascorbate may offer useful information regarding antioxidant supply to and protection of the cornea.

Measurement of tear glucose levels with amperometric glucose biosensor/capillary tube configuration

An amperometric needle-type electrochemical glucose sensor intended for tear glucose measurements is described and employed in conjunction with a 0.84 mm i.d. capillary tube to collect microliter volumes of tear fluid. The sensor is based on immobilizing glucose oxidase on a 0.25 mm o.d. platinum/iridium (Pt/Ir) wire and anodically detecting the liberated hydrogen peroxide from the enzymatic reaction. Inner layers of Nafion and an electropolymerized film of 1,3-diaminobenzene/resorcinol greatly enhance the selectivity for glucose over potential interferences in tear fluid, including ascorbic acid and uric acid. Further, the new sensor is optimized to achieve very low detection limits of 1.5 ± 0.4 μM of glucose (S/N = 3) that is required to monitor glucose levels in tear fluid with a glucose sensitivity of 0.032 ± 0.02 nA/μM (n = 6). Only 4-5 μL of tear fluid in the capillary tube is required when the needle sensor is inserted into the capillary. The glucose sensor was employed to measure tear glucose levels in anesthetized rabbits over an 8 h period while also measuring the blood glucose values. A strong correlation between tear and blood glucose levels was found, suggesting that measurement of tear glucose is a potential noninvasive substitute for blood glucose measurements, and the new sensor configuration could aid in conducting further research in this direction.

Antioxidant content and ultraviolet absorption characteristics of human tears

PURPOSE

Dry eye syndrome is a common age-related disorder, and decreased antioxidant/ultraviolet (UV) radiation protection in tears may be part of the cause. This study aimed to compare the tear antioxidant content and flow rate in young and older adults. The total antioxidant content and UV absorbing properties of various commercially available ophthalmic solutions used to alleviate dry eye symptoms were also examined.

METHODS

Minimally stimulated tears were collected from 120 healthy Chinese adults with no ocular pathology. Two age groups were studied: 19 to 29 years (n = 58) and 50 to 75 years (n = 62). Tear samples from each subject and 13 ophthalmic solutions were analyzed for total antioxidant content (as the Ferric Reducing/Antioxidant Power value). Tear flow rates were estimated from time taken to collect a fixed volume of tear fluid. UV absorbance spectra of pooled fresh reflex tear fluid and the ophthalmic solutions were determined.

RESULTS

Results showed that the antioxidant content of minimally stimulated tears from older subjects (398 ± 160 μmol/l) was not significantly lower than that of younger subjects (348 ± 159 μmol/l; p = 0.0915). However, there was a significant difference in the tear flow rates between the two groups (p < 0.0001), with the younger group having three to four fold higher flow rate. None of the commercial preparations tested had detectable antioxidant content, and none showed the UV absorption characteristics of natural reflex tears.

CONCLUSIONS

The effect of low flow rate on the dynamic antioxidant supply to the corneal surface indicates that older subjects have poorer overall defense against photooxidative and other oxidative processes. This could predispose older persons to corneal stress and development of dry eye syndrome. The commercially available artificial tears tested lack both the antioxidant content and UV absorbing characteristics of natural tears. Artificial tears formulations that help restore natural antioxidant and UV absorbing properties to the tear film of the aging eye may help prevent or improve dry eye symptoms and promote ocular health.