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    In-office lab testing provides diagnostic information

    Quick, quality results saves time and improves patient care

     

    POC protocols

    As part of implementing a dry eye or red eye office protocol, a technician, prior to the clinician seeing the patient, can easily perform a POC test. For InflammaDry and AdenoPlus tests, collecting the sample and activating the test takes less than two minutes.

    Tears from the palpebral conjunctiva are collected on the sterile sampling fleece located on the sample collector. The sample collector is then assembled to the test cassette, bringing the antigen in direct contact with an immunoassay strip, which is then dipped into a buffer solution to activate the test.

    Within 10 minutes, either one blue control line or one blue control and one red result line appear in a readout area (much like a pregnancy test). A single blue control line indicates a negative result, and two lines (a blue control and red result line) indicate a positive result: either elevated MMP-9 or the presence of adenovirus. The more intense the red line, the more antigen is present.

    POC testing allows healthcare providers to administer and receive prompt results from laboratory-quality tests in a single healthcare setting, leading to time and cost efficiencies and savings.

    Related: Incorporating lactoferrin and immunoglobin testing

    References

    1. Chotikavanich S, de Paiva CS, Li de Q, Chen JJ, Bian F, Farley WJ, Pflugfelder SC. Production and activity of matrix metalloproteinase-9 on the ocular surface increase in dysfunctional tear syndrome. Invest Ophthalmol Vis Sci. 2009 Jul;50(7):3203-3209.

    2. Lanza NL, McClellan AL, Batawi H, Felix ER, Sarantopoulos KD, Levitt RC, Galor A. Dry Eye Profiles in Patients with a Positive Elevated Surface Matrix Metalloproteinase 9 Point-of-Care Test Versus Negative Patients. Ocul Surf. 2016 Apr;14(2):216-23.

    3. Sambursky R, Davitt WF 3rd, Friedberg M, Tauber S. Prospective, multicenter, clinical evaluation of point-of-care matrix metalloproteinase-9 test for confirming dry eye disease. Cornea. 2014 Aug;33(8):812-818.

    4. Tong L, Beuerman R, Simonyi S, Hollander DA, Stern ME. Effects of Punctal Occlusion on Clinical Signs and Symptoms and on Tear Cytokine Levels in Patients with Dry Eye. Ocul Surf. 2016;14(2):233-241.

    5. Aragona P, Aguennouz M, Rania L, Postorino E, Sommario MS, Roszkowska AM, De Pasquale MG, Pisani A, Puzzolo D. Matrix metalloproteinase 9 and transglutaminase 2 expression at the ocular surface in patients with different forms of dry eye disease. Ophthalmology. 2015 Jan;122(1):62-71

    6. Gürdal C, Genç I, Saraç O, Gönül I, Takmaz T, Can I. Topical cyclosporine in thyroid orbitopathy-related dry eye: clinical findings, conjunctival epithelial apoptosis, and MMP-9 expression. Curr Eye Res. 2010 Sep;35(9):771-7.

    7. Sambursky R, Trattler W, Tauber S, Starr C, Friedberg M, Boland T, McDonald M, DellaVecchia M, Luchs J. Sensitivity and specificity of the AdenoPlus test for diagnosing adenoviral conjunctivitis. JAMA Ophthalmol. 2013 Jan;131(1):17-22.

    8. Russell KL, Broderick MP, Franklin SE, Blyn LB, Freed NE, Moradi E, Ecker DJ, Kammerer PE, Osuna MA, Kajon AE, Morn CB, Ryan MA. Transmission dynamics and prospective environmental sampling of adenovirus in a military recruit setting. J Infect Dis. 2006 Oct 1;194(7):877-85.

    9. Ruttum MS, Ogawa G. Adenovirus conjunctivitis mimics preseptal and orbital cellulitis in young children. Pediatr Infect Dis J. 1996 Mar;15(3):266-7.

    10. Cheung D, Bremner J, Chan JT. Epidemic kerato-conjunctivitis--do outbreaks have to be epidemic? Eye (Lond). 2003 Apr;17(3):356-363.

    11. Rietveld RP, van Weert HC, ter Riet G, Bindels PJ. Diagnostic impact of signs and symptoms in acute infectious conjunctivitis: systematic literature search. BMJ. 2003 Oct 4;327(7418):789.

    12. O'Brien TP, Jeng BH, McDonald M, Raizman MB. Acute conjunctivitis: truth and misconceptions. Curr Med Res Opin. 2009 Aug;25(8):1953-1961.

    13. Roba LA, Kowalski RP, Gordon AT, Romanowski EG, Gordon YJ. Adenovirus ocular isolates demonstrate serotype-dependent differences in in vitro infectivity titers and clinical course. Cornea. 1995 Jul;14(4):388-93.

    14. Tabbara KF. Ganciclovir effects in adenoviral keratoconjunctivitis. Poster presented at 2001 Association of Research and Vision in Ophthalmology (ARVO) Conference; Poster B253:Fort Lauderdale, FL.

    Damon Dierker, OD, FAAO
    Dr. Dierker has helped to create a comprehensive ocular surface disease service within his practice that incorporates the latest ...

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