Doctoral dissertation

Towards better and more personalized treatment of ocular diseases with the study of tear fluid

Ocular surface disease (OSD) is one of the most common reasons to visit an ophthalmologist and the number of patients is increasing due to e.g., population aging, worsened air quality and increased use of digital devices. In addition to the treatment of OSD, the state of the ocular surface has an effect on the treatment of other ophthalmic conditions, such as glaucoma, and the outcomes of ophthalmic surgeries.

The causes of OSDs, similar to the signs and symptoms experienced by the patients, can vary from person to person, making treatment selection challenging. The analysis of proteins in the tear fluid, i.e. tear fluid proteomics, allows the study of ocular surface state, which can in the future enable more precise diagnostics and more efficient treatment of patients suffering from ocular diseases.

Diagnosis and selection of effective treatment for OSDs can be challenging due to the lack of a wider clinical examination, which is not always performed to patients. In addition, clinical signs rarely correlate with the symptoms experienced by the patients. The state of the ocular surface also has an effect on the treatment of other ocular diseases, such as glaucoma, as well as the outcomes of ophthalmic surgeries.

A thin layer of tear film protects the ocular surface and by analyzing the proteins found in the tear fluid, it is possible to evaluate carefully the condition of the ocular surface. Approximately 1,000 proteins can be quantified from 2 μl tear fluid samples with the current mass spectrometry and proteomics methods. By analyzing these tear fluid proteomics results with bioinformatics, further information about the factors affecting OSDs can be obtained. It is also possible to identify biomarkers, which can be implemented for better and more personalized treatment of OSDs and other ocular diseases in the future. The aforementioned methods are also important in the development of new diagnostic and personalized treatment methods.

In her dissertation Janika Nättinen, MSc, studied the effects of dry eye disease and glaucoma treatment as well as environment to the tear fluid protein expression levels among patients suffering from OSD. In addition, other factors affecting the tear fluid proteomics results, such as age and tear fluid sampling effects, were also studied. The findings presented in the dissertation provide further information on the proteins and biological functions connected to various OSDs and display what type of bioinformatics analysis could be performed on tear fluid proteomics data.

The doctoral dissertation of MSc Janika Nättinen in the field of Ophthalmology titled Towards Personalized Ocular Surface Diagnosis and Treatment with Tear Fluid Proteomics and Bioinformatics will be publicly examined in the Faculty of Medicine and Health Technology at Tampere University at 12 o’clock on Friday 13th of December 2019 in Arvo building’s Yellow Hall F025, Arvo Ylpön katu 34. The Opponent will be professor Steffen Heegaard from University of Copenhagen, Denmark. The Custos will be professor Hannu Uusitalo from the Faculty of Medicine and Health Technology.

The dissertation is available online at