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International Ophthalmology

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Open Access 01-12-2019 | Xerophthalmia | Original Article

Association of Ramadan daytime fasting with ocular surface inflammation and dry eye

Authors: Brian K. Armstrong, Ivana Romac Coc, Prateek Agarwal, Scott Smith, Samuel Navon

Published in: International Ophthalmology | Issue 12/2019

Abstract

Purpose

Despite the widespread practice of fasting, there are no studies looking at ocular surface inflammation, specifically matrix metalloproteinase 9 (MMP-9) testing, during fasting. In this prospective study, we wanted to evaluate the effect of Ramadan fasting on the level of tear film MMP-9 as well as other standard indicators of dry eye disease.

Methods

Forty healthy patients without history of ocular disease were tested before and toward the end of Ramadan. Each patient was assessed at each timepoint for tear film MMP-9 positivity as measured by a commercially available test (InflammaDry; Quidel Corp., San Diego, CA, USA) which detects MMP-9 levels of more than 40 ng/ml. Ocular surface disease index (OSDI) scores, tear breakup time (TBUT), Schirmer I test (S1T) and corneal fluorescein staining (CFS) were also evaluated at each timepoint.

Results

InflammaDry was positive in 10 patients (25%) prior to Ramadan and 21 patients (52.5%) during Ramadan fasting, and this change was statistically significant (p = 0.02). Mean TBUT decreased from 7 s prior to Ramadan to 5.3 s during Ramadan fasting, and this change was statistically significant (p = 0.01). OSDI, CFS and S1T did not show any statistically significant changes (p > 0.05 for all).

Conclusion

Ramadan fasting has a significant impact on TBUT and ocular surface inflammation detected by Inflamma Dry testing. Patients who suffer from dry eye disease and those who develop symptoms during Ramadan are advised to consult with a physician before or during Ramadan fasting.

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Title: Association of Ramadan daytime fasting with ocular surface inflammation and dry eye
Authors: Brian K. Armstrong
Ivana Romac Coc
Prateek Agarwal
Scott Smith
Samuel Navon
Publication date: 01-12-2019
Publisher: Springer Netherlands
Keyword: Xerophthalmia
Published in: International Ophthalmology / Issue 12/2019
Print ISSN: 0165-5701
Electronic ISSN: 1573-2630
DOI: https://doi.org/10.1007/s10792-019-01133-5

At a glance: The STEP trials

Springer Medicine

Association of Ramadan daytime fasting with ocular surface inflammation and dry eye

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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