Abstract
Purpose :
Corneal neuro-immune crosstalk has been of interest given advances in in vivo confocal microscopy (IVCM) imaging, given that IVCM is able to capture the presence of both immune cells and nerves. However, correlations between nerve alterations and dendritiform immune cell (DC) parameters in dry eye disease (DED) have not been investigated to date, which is the aim of the current study.
Methods :
This retrospective cross-sectional cohort study included 105 patients with DED. Patients were included in the study if they had symptoms of DED, a tear break-up time (TBUT) of less than 10 seconds and/or corneal fluorescein staining score of at least 1 on the Oxford scale. Three representative images were selected for the study eye for analysis using ImageJ. Morphological alterations of DCs per image was quantified by Image J. NeuronJ was used to quantify corneal nerve density for each image for main and total nerves.
Results :
The average age of the patients was 58.8 ± 1.7 years, and 76.2% of them were female. The average DC size was 108.54 ± 5.70 µm2, and the average number of dendrites was 0.59 ± 0.08 per immune cell. The mean immune cell density was 47.73 ± 5.43/mm2. Main, total, and branch nerve densities were 8,011.58 ± 269.74 mm/mm2, 12,516.58 ± 450.89, and 4504.99 ± 264.20, respectively. DC size was inversely correlated to total nerve density (rho = -0.339, p = 0.001) and branch nerve density (rho = -0.386, p<0.001). In addition, number of dendrites had an inverse correlation to total nerve density (rho = -0.212, p = 0.035) and branch nerve density (rho = -0.211, p = 0.036). The inverse correlation of DC size and dendrite number and nerve density suggest that larger, more mature DCs are associated with nerve loss or vice versa.
Conclusions :
IVCM reveals an increased density and morphologic changes of corneal DCs in DED. There is a strong and significant correlation between the increase in DC size and number of dendrites and the decreased subbasal corneal nerves, suggesting a potential interaction between the immune and nervous system in the cornea during DED.
This is a 2021 ARVO Annual Meeting abstract.