Purpose : The human microbiome has been studied for centuries and recently has been associated with health issues ranging from metabolic disorders such as obesity and diabetes to inflammatory disorders such as inflammatory bowel disease.5 However, only recently have associations of the gut microbiome with ocular diseases been realized.2,3,4 In this study, we investigated whether there is a connection between the bacterial diversity of the gut microbiome and dry eye disease.
Methods : We performed retrospective chart review of patients presenting to FishmanVision (Palo Alto, CA) that had been prescribed the SmartGut microbiome screening test (uBiome, San Francisco, CA). Using 16S rRNA gene sequencing based stool test, we compared levels (low, normal, high) of 26 bacterial organisms for patients diagnosed with dry eye disease vs. “normals.”1
Results : The uBiome analysis was carried out on 17 patients (13 diagnosed with dry eye disease and 4 without dry eye). No patient had high level of any bacteria and no patient reported low level for 11 organisms. Bacteroides fragilis, Alistipes, and Collinsella were normal (0/4) in non-dry eye patients, but they were low in 8% (1/13), 8% (1/13), and 46% (6/13) of dry eye patients. Prevotella, Odoribacteria, Bifidobacterium, Barnesellia, and Akkermansia muciniphila were all low in 25% (1/4) of non-dry eye patients, while they were low in 23% (3/13), 31% (4/13), 38% (5/13), 54% (7/13), and 77% (10/13) of dry eye patients. Lactobacillus was low in 75% (3/4) of non-dry eye patients and in only 62% (8/13) of dry eye patients. Anaerotruncus colihominis was low in 50% (2/4) of non-dry eye patients and in 77% (10/13) of dry eye patients. Methanobrevibacter smithii and Oxalobacter formigenes were low in 100% (4/4) of non-dry eye patients and in 85% (11/13) of dry eye patients. Butyrivibrio crossotus, Ruminococcus albus, and Dialister invisus were low in 100% (4/4) of non-dry eye patients and 92% (12/13) of dry eye patients. These observations are illustrated in Figure 1.
Conclusions : Collinsella, Barnesellia, Akkermansia muciniphila were lower in dry eye patients compared to normal patients. Lower gut microbiome diversity in dry eye patients may have important clinical ramifications in the treatment of dry eye disease.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 – May 2, 2019.