Elevated Caspase-1 Levels May Be a Biomarker of Ocular Surface Damage

CLOSE UP: Vividly colored green eye frantically looking around room.
CLOSE UP: Pretty green eye frantically looking around bright room. Woman wearing mascara opens eye to continue reading. Iris moving from side to side and pupil contracting and expanding.
Clinicians in primary care offices or facilities without a biomicroscope may eventually be able to analyze caspase-1 levels as a means to screen for ocular surface damage.

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).

“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