To characterize tear metabolomic differences between active blepharokeratoconjunctivitis (BKC) and herpes simplex keratitis (HSK; epithelial type) and identify diagnostic biomarkers.
Approach:
Patient Enrollment: Tear samples were collected from 24 HSK patients, 19 BKC patients, and 15 healthy controls from October 2020 to 2021.
Metabolomic Profiling: Metabolomic profiling was performed via LC-MS/MS, and data were analyzed using MetaboAnalyst 5.0.
Key Findings:
HSK exhibited 21 altered metabolites compared to healthy controls.
BKC showed 19 altered metabolites compared to healthy controls.
L-isoleucine, L-phenylalanine, and pantothenol were significantly lower in both HSK and BKC after FDR correction.
4-dodecylbenzenesulfonic acid and carnosol were lower in HSK-specific samples.
Sorbitol was lower in BKC-specific samples.
A combined panel of metabolites (4-dodecylbenzenesulfonic acid, carnosol, sorbitol) showed good specificity and sensitivity for differentiating BKC from HSK.
Interpretation:
Limitations:
Study conducted at a single center with a limited sample size.
Nearly 10 years of observational follow-up suggested sustained axial-length slowing, although refractive findings were less consistent and comparisons relied on statistical modeling.
