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Mariana C. Navarro, Regina Velasco, Oscar Baca, Alejandro Babayan, Oscar Fernandez, Ruben Suarez, Gloria Cortes, Mauricio Cedillo; Corneal findings by confocal microscopy in patients with Sjogren syndrome. Invest. Ophthalmol. Vis. Sci. 2012;53(14):88.
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Epithelial changes in these patients are not justified by the glandular damage and secondary aqueous deficiency. Corneal innervation compromise could have a negative impact by diminishing blinking frequency and lachrymal reflex therefore affecting the epithelium itself. Confocal microscopy allows us to get a morphological view similar to a histological but in a more secure, faster and repeatable way.Determine corneal morphological findings by confocal microscopy (epithelial and subbasal plexus analysis) in patients with Sjogren syndrome, compare them with a control group. And study its relationship with the clinical evaluation.
It is an observational prospective, comparative, transversal case series study between two groups (1.-with Sjogren who met American-European Consensus Group, 2.-control) the variables were: lachrymal film breakup time (BUT), Schirmer, Van Bijsterveld (VB) score, superficial and basal cellular densities, anterior and posterior stroma cellular densities, number of nerve fibers, tortuosity and reflectiveness (evaluated by Oliveira-Soto L, Efron system).
Ten eyes with SS and 10 control subjects were studied with a mean age of 43.2 years (±6.7) with 65% women. There was a statistically significant difference in all variables between groups. Correlation in SS group was found demonstrating that a lower BUT was associated with worse VB score, more nerve reflectiveness and tortuosity. That a higher VB score came along with worse superficial cell density; and with less number of nerve fibers there was a higher cell density in posterior stroma.
We obtained a qualitative and quantitative study in SS patients who had morphological changes in both nerve subbasal plexus and epithelium reflected in the clinical findings.
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