Masked Study Of Corneal Nerves In Dry Eye Patients Using Confocal Microscopy

Abstract

Abstract: : Purpose: The ocular surface, the main lacrimal gland and the interconnecting neural reflex loops comprise a functional unit. An alteration in corneal innervation has been described in dry eye (DE) associated with diabetes mellitus, contact lens use and lasik. The purpose of this study was to evaluate if DE not related with Sjogren's syndrome (NSDE) and DE related to this syndrome (SSDE) are associated with an alteration of the corneal nerves. Methods: Group healthy volunteers less 60 yo (HVl60)(10 females and 1 male) aged 30.7 SD 2.6, group healthy volunteers more 60 yo (HVm60)(8 females and 2 males) aged 68.7 SD 7.1, group SSDE (10 females and 1 male) aged 52.9 SD 8.7 and group NSDE (8 females and 2 males) aged 65.8 SD 5.3 yo. Patients were examined with a Confoscan model P4 (Tomey, Germany). Results: Sub–basal nerve density: HVl60 = 769 SD 88, HVm60 = 624 SD 86, SSDE = 508 SD 128 and NSDE = 593 SD 127 microns/mm2 (p<0.000, ANOVA). There was a statistically significant difference between HVl60 and the other groups (HVm60 p<0.05, SSDE p<0.000 and NSDE p<0.005, Bonferroni). Number of beadings: HVl60 = 198 SD 66, HVm60 = 182 SD 63, SSDE = 387 SD 62 and NSDE = 323 SD 64 /mm (p<0.000, ANOVA). There was a statistically significant difference between healthy volunteers groups and DE groups (p<0.000, Bonferroni). Conclusions: SSDE and NSDE patients exhibit corneal innervation abnormalities.

Keywords: aging • cornea: clinical science • innervation: sensation