Ocular Microbiology and Immunology Group
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2025 OMIG Abstract

Exploring the Relationship Between Serum Autoantibodies and Longitudinal Changes in Dry Eye Disease

Shyamal Raolji¹, Gurnoor Gill³, Pragnya Rao Donthineni^1,2, Chloe Sheilds¹, Anat Galor<sup>1,4

1</sup>Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida; ²Shantilal Shanghvi Cornea Institute, L.V Prasad Eye Institute, Hyderabad, India; ³FAU College of Medicine, Florida Atlantic University, Boca Raton, Florida; ⁴Miami Veterans Administration Medical Center, Miami, Florida

Purpose: To explore whether baseline serum levels of the autoantibodies to carbonic anhydrase 6 (CA6), parotid secretory protein (PSP), and salivary gland protein-1 (SP-1) are associated with changes in dry eye disease (DED) symptoms and signs over time.

Methods: A retrospective analysis was conducted on 67 individuals with DED who underwent baseline antibody testing and had follow-up data available within a 1-year window (±6 months). Longitudinal change in DED symptoms was defined as an increase in either DEQ-5 by ≥3 points (n=17) or OSDI by ≥10 points. Changes in DED signs were defined as an increase in InflammaDry score by ≥1 an increase in corneal staining by ≥2, or a decrease in Schirmer score by ≥3 mm. Associations between quantitative antibody levels and clinical progression were assessed using correlation and stepwise regression analyses.

Results: Baseline antibody levels were significantly associated with subsequent worsening of both dry eye symptoms and signs. Overall, 43% (n=29) of individuals experienced worsening in symptoms, and 82% (n=55) experienced worsening in at least one sign. In stepwise Cox models, higher PSP IgM levels were predictive of worsening in OSDI scores (HR=1.014, 95% CI: 1.001–1.026, p=0.03) and InflammaDry scores (HR=1.018, 95% CI: 1.006–1.031, p=0.003). For tear production, higher CA6 IgM levels were associated with increased risk of Schirmer worsening (HR=1.045, 95% CI: 1.008–1.083, p=0.016), while higher CA6 IgG levels were protective (HR=0.958, 95% CI: 0.925–0.993, p=0.018).

Conclusions: Baseline serum autoantibody levels—particularly PSP IgM and CA6 isotypes—were associated with an increased risk of worsening dry eye symptoms and signs over time. These findings suggest a potential role for antibody profiling in identifying patients at risk for disease progression and guiding future approaches to personalized management in DED