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Tudor Tepelus, Gloria B. Chiu, Jianyan Huang, Ping Huang, Srinivas R Sadda, Olivia L Lee; Correlation between corneal changes by confocal microscopy and symptomatology in patients with dry eye syndromes. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2847.
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© 2017 Association for Research in Vision and Ophthalmology.
To evaluate the corneal innervation and inflammatory cell infiltration by in vivo confocal microscopy (IVCM) and to correlate these confocal parameters with subjective symptoms of dry eye as measured by Ocular Surface Disease Index (OSDI) in patients with non-Sjögren's (NSDE) and Sjögren’s syndrome dry eyes (SSDE).
Central cornea images were prospectively captured from 10 age matched healthy control eyes, 24 eyes with clinically diagnosed NSDE and 43 eyes with clinically diagnosed SSDE, using In Vivo Laser Scanning Confocal Microscopy (HRT III RCM, Heildelberg, Germany). Characteristics of corneal nerves (density, tortuosity and reflectivity), presence of inflammatory dendritic cells (DCs) and OSDI scores were evaluated.
Images obtained by IVCM from 77 eyes were analyzed. The density of nerve fibers was 1562±996 µm/frame in the SSDE group, 2150±1015 µm/frame in the NSDE group and 2725±687 µm/frame in the control group (p<0.05, ANOVA). In comparison to control group, the density of nerve fibers was decreased in the SSDE (p<0.001, t-test) and the NSDE groups (p=0.06, t-test), with increased nerve tortuosity and decreased reflectivity (both p<0.05, t-test). The density of dendritic cells was 71.65±72.54 cells/mm2 in the SSDE group, 40.33±31.63 cells/mm2 in the NSDE group and 27.53±5.58 cells/mm2 in the control group (p<0.05, ANOVA). In comparison to control group, the density of dendritic cells was decreased in the SSDE (p<0.001, t-test) and the NSDE groups (p=0.07, t-test). Significant correlations were found between the nerve density and dendritic cell density (p<0.001), between the nerve density and OSDI scores (p<0.001) and between the dendritic cell density and OSDI scores (p=0.01, Pearson p).
The corneas of eyes affected with NSDE and SSDE are characterized by alterations in corneal innervation and infiltration of inflammatory dendritic cells. These quantitative measures are correlated with severity of subjective symptoms of dry eye as measured with OSDI.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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