Elevated levels of caspase-1 in tears may serve as a potential biomarker for ocular surface damage, according to research published in the American Journal of Ophthalmology. 

Investigators conducted an analysis of 113 tear samples from a cohort of patients (N=64, mean age 58±18 years, 70% women). Among samples taken, 62 were from dry eye disease (DED) patients, 32 from patients taking glaucoma medications, and 20 from healthy controls (n=33, n=20, and n=11, respectively). Researchers conducted ophthalmic exams, performed Schirmer and tear breakup-up time tests, and administered the Ocular Surface Disease Index (OSDI) to all participants. 

Researchers observed an increased level in caspase-1 in patients taking glaucoma medication and DED eyes compared with the control group (P =.001, P=.003; 109.20±49.59 pg/mL, 91.62±43.86 pg/mL, and 54.88±23.04 pg/mL, respectively). Multivariable and univariable mixed models failed to show an association between caspase-1 levels and age or sex. The findings indicate a positive association in the number of topical medications taken in the glaucoma group and caspase-1 levels, but could not establish statistical significance (P =.25).

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“We found that caspase-1, a molecule involved in the Inflammasome cascade, was elevated in individuals using topical hypotensive medications and in those with a variety of ocular surface abnormalities,” according to the investigators. “Our data suggest that caspase-1 has potential as a screening test for ocular surface damage in clinics that do not have access to a slit lamp, such as primary care offices, perhaps leading to earlier treatment intervention.”

Study limitations include a small sample size, single center design, possible confounding due to different DED subtypes and glaucoma medications used by participants, and failure to use age-matched controls. 


Tovar A, Gomez A, Serrano A, et al. Role of caspase-1 as a biomarker of ocular surface damage. Am J Ophthalmol. Published online February 10, 2022. doi:10.1016/j.ajo.2022.01.020