Abstract
Purpose: :
To investigate the density of Langerhans cells in the central corneal epithelium of patients with dry eye syndrome under topical anti-inflammatory therapy with cyclosporine A 0.05% eye drops.
Methods: :
31 patients (age 21-85 years) with severe keratokonjunctivitis sicca were enrolled in the trial. For Langerhans cell counts, patients were examined in vivo with the combination of the Heidelberg Retina Tomograph II and the Rostock Cornea Module prior to and after 3 months of treatment with cyclosporine A 0.05% eye drops twice daily. In addition, tear film osmolarity, break up time (BUT), Schirmer test with anaesthesia and meibomian gland dysfunction were evaluated in each patient. Statistical analyses were performed using StatisticaTM software, p-values < 0.05 *, < 0.001** were considered significant.
Results: :
There was a significant reduction in Langerhans cell density in the central corneal epithelium after anti-inflammatory treatment from 110±12 cells/mm² to 56±10 cells/mm². Tear break up time increased significantly from 6.9 seconds (range 3-12 seconds) to 15.0 seconds (range 10-26 seconds). Tear film osmolarity, Schirmer test with anesthesia and meibomian gland dysfunction did not show significant changes.
Conclusions: :
Evaluation of Langerhans cell density in the central corneal epithelium by in vivo confocal microscopy could be an effective objective diagnostic feature in monitoring anti-inflammatory therapy in patients with dry eye disease or other ocular surface pathologies.
Clinical Trial: :
www.drks-neu.uniklinik-freiburg.de/, DRKS00003269
Keywords: cornea: tears/tear film/dry eye • cornea: epithelium