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YUQING DENG, Jianhua Wang, Hong Jiang, Wan Chen, Jin Yuan; Conjunctival microvascular alterations in dry eye patients and their responses to anti-inflammation treatment. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4902. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
This study aimed to characterize the microvasculature and microcirculation of the bulbar conjunctiva in patients with dry eye disease (DED) as well as their responses to anti-inflammation treatment.
Twenty-five patients with DED (20 females and 5 males, aged 48.4 ± 16.8 years, mean ± standard deviation), 25 age- and gender-matched healthy subjects (20 females and 5 males, aged 49.1±16.7 years) were recruited and filled out the ocular surface disease index (OSDI). The conjunctival blood flow velocities (BFVs) and vessel diameters were measured using Functional Slit-lamp Biomicroscopy (FSLB). The repeat measurements were performed in DED group at 30 and 60 days during anti-inflammation treatment. Other clinical measurements were also administrated in the follow-up of DED group, including the noninvasive tear-film break-up times (NI-fBUT and NI-avBUT, respectively), the hyperemia index (HI) of the bulbar conjunctiva, OSDI, Schirmer I test (ST) scores and corneal fluorescein staining scores.
The bulbar BFV, vessel diameter and OSDI in DED group were significantly higher than control group, (P < 0.05 respectively). 60 days after anti-inflammatory therapy, significant decreases in BFV, HI, vessel diameter, OSDI, and corneal fluorescein staining score were found (all P < 0.05) (Figure 1). Moreover, significant increases in NI-fBUT and NI-avBUT were observed. The corneal staining score was related to BFV (r = 0.48, P < 0 .0001) and HI (r = 0.30，P =0.009). HI was also related to BFV (r = 0.28, P = 0.014).
Increased bulbar BFV and larger vessel diameter were found in bulbar conjunctiva of DED patients, which may indicate underlying chronic inflammation. The decreases in BFV, vessel diameter and HI may be useful in noninvasive efficacy evaluations of dry eye treatments.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
Figure 1: Bulbar conjunctival microvascular, ocular symptoms and signs alterations in dry eye patients. Average BFV and vessel diameter were significantly higher in DED group than control (P < 0.001, A). Compared to the baseline values, BFV, vessel diameter and HI were decreased at 30 and 60 days during anti-inflammatory therapy (B). A typical case of a patient with Sjögren's syndrome and severe DED with recovery of the microvascular parameters and tear-film stability (C).The measurements at baseline and at 30 and 60 days after treatment are presented on the right.
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