Abstract
Purpose :
Dry Eye (DE) is a prevalent disease in the US and considerably impacts quality of life. Given its heterogeneous nature, biomarkers are needed in DE that can identify underlying contributors to disease. One potential biomarker is the presence of activated dendritic cells (aDCs) in the central cornea, which can be quantified using In-Vivo Confocal Microscopy (IVCM). The purpose of this study was to examine whether aDCs could serve as a biomarker for DE that is associated with a systemic immune disorder.
Methods :
Retrospective chart review of 128 individuals with DE symptoms (DE Questionnaire-5≥6) who underwent IVCM between October 2018- July 2020 at the Miami Veterans Administration Medical Center. Exclusion criteria included corneal scarring and history of previous ocular infections. All individuals underwent a standardized ocular surface examination. IVCM images were analyzed with ACCmetrics software, aDCs were manually quantified based on presence of ≥3 dendrites that were of the same size or longer than the body of the cell. A receiver operating curve (ROC) analysis was used to examine relationships between aDCs number and systemic immune disease. Based on this analysis, individuals were grouped into categories by aDCs number (≥2 versus < 2) and demographic and DE parameters were examined.
Results :
The mean age of the study population was 57.1±15.0 years; 71.1% were male, 53.1% self-identified as white and 24.2% as Hispanic. The mean number of aDCs in the cornea was 1.28±2.16 cells/mm2. ROC analysis found that the presence ≥2aDCs in the central cornea had a sensitivity of 60% and specificity of 77% for the diagnosis of a systemic immune disorder. Individuals were thus grouped by aDCs number (≥2 versus < 2); those with aDC≥2 were more likely to be black, have Secondary Sjogren’s, use autologous serum tears, have a higher nerve fiber area, higher nerve fractal dimension, and lower nasal and middle conjunctivochalasis scores.
Conclusions :
The presence of ≥2 aDC in the central cornea suggests a systemic immune disorder in individuals with DE symptoms. Further longitudinal research is needed to evaluate our finding in more diverse populations and to evaluate if changes in aDC number correlate with changes in clinical symptoms and signs of disease.
This is a 2021 ARVO Annual Meeting abstract.