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Zeina Salem, Gabriela Dieckmann, Adam Tanaka, Paula Kataguiri, Shruti Aggarwal, Rodrigo T Muller, Bernardo Cavalcanti, Andrea Cruzat, Ahmad Kheirkhah, Pedram Hamrah; Patients with Dry Eye Disease Demonstrate Significant Decrease In Central and Peripheral Corneal Nerve Density. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2658. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
Dry eye disease (DED) is a condition that causes ocular surface discomfort. In vivo confocal microscopy (IVCM) allows corneal nerve visualization. The purpose of this study was to assess corneal nerve changes in the center and peripheral corneal quadrants in DED patients as compared to normal controls.
This is a prospective, cross-sectional, case-control study of 46 patients diagnosed with DED, and 20 age and sex-matched normal controls (P>0.05). IVCM images were taken in the central cornea and 4 peripheral quadrants. Three representative images were selected for each area and main trunk, branch and total nerve densities analyzed by two masked observers. DED were further stratified into mixed (Schirmer’s test £10 mm; TBUT<10’’) and evaporative (TBUT<10’’; Schirmer’s >10 mm) subtypes. A P value <0.05 was considered statistically significant.
In the DED group, main trunk, branch and total nerve densities were significantly lower as compared to the control group (P<0.001) for the central cornea and all peripheral quadrants. There were no significant differences in the peripheral corneal nerve density between the 2 subtypes of DED. In the DED group, the total nerve density was significantly higher in the central cornea (17.07±7.03mm/mm2) than in the nasal (11.55±5.42) and inferior (11.26±5.98) quadrants (P<0.01). Similarly, the branch density in the central cornea (10.61±4.41) was significantly higher than in the nasal (7.28±3.45) and the inferior (7.09±3.92) quadrants (P<0.01). In addition, the main trunk density in the central cornea (1.24±0.75) was significantly lower than in the nasal (2.10±1.80) and the temporal (2.06±1.51) quadrants (P<0.03).
Patients with DED demonstrate a significant reduction in nerve density in both the central and peripheral corneal quadrants as demonstrated by IVCM.
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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