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Despite the absence of visible signs of inflammation, tear fluid changes confirm the role of inflammation in the pathogenesis of keratoconus. Significant correlations between clinical study findings and tear levels of markers of these metabolic processes allow their use as biomarkers for detecting early stages of keratoconus, assessing disease severity, predicting progression, identifying therapeutic targets, and objectively evaluating treatment effectiveness, including after corneal cross-linking.<\/jats:p>","DOI":"10.17116\/oftalma202614204199","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:38:57Z","timestamp":1787031537000},"page":"99","source":"Crossref","is-referenced-by-count":0,"title":["Biomarkers in tear fluid in keratoconus"],"prefix":"10.17116","volume":"142","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7856-8005","authenticated-orcid":false,"given":"N.B.","family":"Chesnokova","sequence":"first","affiliation":[{"name":"Helmholtz National Medical Research Center of Eye Diseases","place":["Moscow, Russia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8032-4248","authenticated-orcid":false,"given":"T.A.","family":"Pavlenko","sequence":"additional","affiliation":[{"name":"Helmholtz National Medical Research Center of Eye Diseases","place":["Moscow, Russia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7557-4955","authenticated-orcid":false,"given":"O.V.","family":"Beznos","sequence":"additional","affiliation":[{"name":"Helmholtz National Medical Research Center of Eye Diseases","place":["Moscow, Russia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"6743","reference":[{"key":"key-10.17116\/oftalma202614204199-1","doi-asserted-by":"publisher","DOI":"10.3389\/fbioe.2019.00066"},{"key":"key-10.17116\/oftalma202614204199-2","doi-asserted-by":"publisher","DOI":"10.3341\/kjo.2025.0093"},{"key":"key-10.17116\/oftalma202614204199-3","doi-asserted-by":"publisher","DOI":"10.1097\/ICO.0000000000002150"},{"key":"key-10.17116\/oftalma202614204199-4","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.63.5.12"},{"key":"key-10.17116\/oftalma202614204199-5","doi-asserted-by":"publisher","DOI":"10.17116\/oftalma202313903211"},{"key":"key-10.17116\/oftalma202614204199-6","unstructured":"Avetisov SE, Mamikonian VR, Novikov IA. 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