June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
In Vivo Confocal Microscopy Demonstrates Intranasal Neurostimulation-Induced Goblet Cell Alterations in Patients with Dry Eye Disease
Author Affiliations & Notes
  • Gabriela Dieckmann
    Ophtalmology, Tufts Medical center, Brookline, Massachusetts, United States
    Center for Translational Ocular Immunology, Tufts Medical Center, Boston, Massachusetts, United States
  • Paula Kataguiri
    Ophtalmology, Tufts Medical center, Brookline, Massachusetts, United States
    Center for Translational Ocular Immunology, Tufts Medical Center, Boston, Massachusetts, United States
  • Nicholas Pondelis
    Ophtalmology, Tufts Medical center, Brookline, Massachusetts, United States
  • Arsia Jamali
    Ophtalmology, Tufts Medical center, Brookline, Massachusetts, United States
    Center for Translational Ocular Immunology, Tufts Medical Center, Boston, Massachusetts, United States
  • Alessandro Abbouda
    Ophtalmology, Tufts Medical center, Brookline, Massachusetts, United States
    Center for Translational Ocular Immunology, Tufts Medical Center, Boston, Massachusetts, United States
  • zeina salem
    Ophtalmology, Tufts Medical center, Brookline, Massachusetts, United States
    Center for Translational Ocular Immunology, Tufts Medical Center, Boston, Massachusetts, United States
  • Manfred Franke
    Allergan, Irvine, California, United States
  • Michelle Senchyna
    Allergan, Irvine, California, United States
  • Pedram Hamrah
    Ophtalmology, Tufts Medical center, Brookline, Massachusetts, United States
    Center for Translational Ocular Immunology, Tufts Medical Center, Boston, Massachusetts, United States
  • Footnotes
    Commercial Relationships   Gabriela Dieckmann, None; Paula Kataguiri, None; Nicholas Pondelis, None; Arsia Jamali, None; Alessandro Abbouda, None; zeina salem, None; Manfred Franke, Allegan (E); Michelle Senchyna, Allergan (E); Pedram Hamrah, Alcon (F), Allergan (C), Allergan (F), Bausch&Lomb (C), Dompe (F), Dompe (C), Eyegate pharmaceutical (C), GlaxoSmithKline (F), GlaxoSmithKline (C), Heidelberg Engineering (C), Jade pharmaceuticals (C), Novabay (C), Santen INC (C), Tissue-Tech (F), Tissue-Tech (C), Valeant (C)
  • Footnotes
    Support  Allergan, Inc., Irvine, CA; NIH R01-EY022695, Massachusetts Lions Eye Foundation
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 2694. doi:
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      Gabriela Dieckmann, Paula Kataguiri, Nicholas Pondelis, Arsia Jamali, Alessandro Abbouda, zeina salem, Manfred Franke, Michelle Senchyna, Pedram Hamrah; In Vivo Confocal Microscopy Demonstrates Intranasal Neurostimulation-Induced Goblet Cell Alterations in Patients with Dry Eye Disease. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2694.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Goblet cells (GCs), found in the conjunctival epithelium, are specialized mucin secreting cells that contribute to maintenance of tear film stability and ocular surface lubrication. The Intranasal Tear Neurostimulator (ITN) delivers a small electrical current to sensory neurons of the nasal cavity that stimulate the nasolacrimal reflex and induce tear production. This study compared morphological GC changes before and after use of the ITN by means of laser in vivo corneal confocal microscopy (IVCM).

Methods : This was a single center, single-arm, study that included 15 dry eye subjects (22 eyes). Laser IVCM images were taken before and after approximately three minutes of ITN application at the inferonasal area of the bulbar conjunctiva. GC were analyzed and measured by ImageJ™ software. Three images from each patient were selected according to their quality and accuracy to be further analyzed by two masked observers. GCs were selected according to the following criteria: 50<area<150 mm2, round or oval shaped, highlighted from the background, well defined borders. All data are shown as mean±SD. Mean data were compared using a paired t-test. P values <0.05 were considered statistically.

Results : Morphological analysis was performed for a total of 755 GCs pre- and 712 GCs post-application of the ITN. Mean pre- and post-GC areas were 67.52±40.03mm2 and 58.72±31.16mm2, respectively. The mean change in area, 8.8±8.8 µm, representing a 13.03% reduction following use of the ITN, was statistically significant (p<0.001). Mean pre- and post-stimulation GC perimeters were 48.78±21.84mm and 42.79±19.25µm, respectively. The mean change in perimeter, 5.99±2.59µm, representing a 12.27% reduction following use of the ITN, was statistically significant (p<0.001).

Conclusions : The ITN significantly reduced GCs area and perimeter within three minutes of stimulation, demonstrating a direct effect on GCs. Laser IVCM is a reliable tool to assess morphological GC changes.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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