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Vannarut Satitpitakul, Ahmad Kheirkhah, Pedram Hamrah, Reza Dana; Patients with Dry Eye Disease and Low Subbasal Nerve Density are at High Risk for Progressive Corneal Endothelial Cell Loss. Invest. Ophthalmol. Vis. Sci. 2016;57(12):5272.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the changes in corneal endothelial cell density (CECD) over time in patients with dry eye disease (DED)
This retrospective study included 40 eyes of 20 patients with mild to moderate DED (60.4 ± 12.3 years old). Laser in vivo confocal microscopy was performed of the central cornea in both eyes and was repeated after a mean follow-up of 33.2 ± 10.2 months (range, 21-57 months). The densities of corneal endothelial cells and subbasal nerves were measured using the variable-frame method and NeuronJ tracing, respectively, and compared with 13 eyes of age-matched controls (56.8 ± 4.8 years old).
At the initial visit, the DED group had lower densities of CECD (2619.9 ± 385.6 cells/mm2) and subbasal nerves (17.8 ± 7.5 mm/mm2) compared to the control group (2861.0 ± 292.3 cells/mm2 and 22.8 ± 3.0 mm/mm2, with P=0.07 and P=0.01, respectively). At the last follow-up, although the subbasal nerve density remained similar (16.7 ± 7.2 mm/mm2, P=0.43), the mean CECD decreased to 2465.1 ± 391.2 cells/mm2 (P=0.01), with a mean corneal endothelial loss of 2.1 ± 3.6% per year. The endothelial cell loss showed a statistically significant negative correlation with initial subbasal nerve density (Rs= -0.55, P=0.02). Although the initial CECD had significant correlation with age (Rs= -0.60, P=0.01), the endothelial cell loss over time did not correlate with age.
Patients with DED have increased progressive corneal endothelial cell loss compared to age-matched controls. Lower subbasal nerve density is a risk factor for increased endothelial cell loss over time.
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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