In vivo confocal scanning laser microscopy in patients with primary Sjögren's syndrome: A monocentric experience

Gabbriellini, Gianluca; Baldini, Chiara; Varanini, Valentina; Notarstefano, Chiara; Pepe, Pasquale; Fanucci, F; Ferro, Francesco; Luciano, N.; Mosca, Marta; Nardi, Marco; Bombardieri, Stefano

doi:10.3109/14397595.2014.979523

Cited by 10 publications

(4 citation statements)

References 19 publications

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“…In terms of corneal subbasal nerve morphology, controversial results have been demonstrated in several studies among different DED types [ 12 – 15 ]. Previous study investigated the corneal nerve morphology of SSDE concluded that SSDE has more corneal nerve density and number than non-Sjögren dry eye disease (NSDE) in China, which is contrary to studies in western populations [ 13 , 15 ]. The purpose of this study was therefore to investigate the morphology of corneal subbasal nerves and its relationship with clinical parameters in patients with primary SSDE and NSDE based on a Chinese population.…”

Section: Introductionmentioning

confidence: 86%

Corneal nerve structure in patients with primary Sjögren’s syndrome in China

Zhang

Ying

et al. 2021

BMC Ophthalmol

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Background The aim of this study was to evaluate the in vivo confocal microscopic morphology of corneal subbasal nerves and its relationship with clinical parameters in patients with primary Sjögren’s syndrome in China. Methods This was a case control study of 22 dry eye disease (DED) patients with primary Sjögren’s syndrome (pSS) and 20 control subjects with non-Sjögren dry eye disease (NSDE). Each patient underwent an evaluation of ocular surface disease using the tear film break-up time (TBUT), noninvasive tear film break-up time (NIKBUT), noninvasive tear meniscus height (NIKTMH), corneal staining (National Eye Institute scale, NEI), Schirmer I test, meibography, and corneal subbasal nerve analysis with in vivo confocal microscopy (IVCM). The right eye of each subject was included in this study. Results SS patients showed a shorter TBUT (P = 0.009) and Schirmer I test results (P = 0.028) than the NSDE group. However, there was no significant difference in NIKBUT between the two groups (P = 0.393). The nerve density of subbasal nerves, number of nerves and tortuosity of the SS group were significantly lower than those of the NSDE group (P = 0.001, P < 0.001 and P = 0.039, respectively). In the SS group, the mean nerve length was correlated with age and the Schirmer I test (r = − 0.519, P = 0.013 and r = 0.463, P = 0.035, respectively). Corneal staining was correlated with nerve density and the number of nerves (r = − 0.534, P = 0.013 and r = − 0.487, P = 0.025, respectively). Conclusions Sjögren syndrome dry eye (SSDE) patients have more severe clinical dry eye parameters than non-Sjögren dry eye disease (NSDE) patients. Compared with NSDE patients, we found that SSDE patients showed decreased corneal subbasal nerve density and numbers.

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Section: Introductionmentioning

confidence: 86%

Corneal nerve structure in patients with primary Sjögren’s syndrome in China

Zhang

Ying

et al. 2021

BMC Ophthalmol

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“…Twelve studies used either the SSCM or LSCM to examine sub‐basal nerves in patients with DED related to SS 24,25,27‐36 . Six of these studies compared nerve fibre number and morphology of individuals with SS‐associated DED to non‐Sjögren's‐associated DED (non‐SS) and healthy controls.…”

Section: Corneal Nervesmentioning

confidence: 99%

Can in vivo confocal microscopy differentiate between sub‐types of dry eye disease? A review

Hwang

Dermer

2021

Clinical Exper Ophthalmology

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Many studies utilised in vivo confocal microscopy (IVCM) to associate variations in corneal structures with dry eye disease (DED). However, DED is an umbrella term that covers various aetiologies and presentations. This review analyses populations by DED aetiology to determine the relationships between IVCM parameters and specific DED sub‐types. It focuses on the most commonly examined structures, sub‐basal nerves and dendritic cells. Across the literature, most studies found individuals with immune‐mediated DED had lower sub‐basal nerve fibre number and density than controls, with smaller differences between non‐immune DED and controls. However, wide ranges of values reported across studies demonstrate considerable overlap between DED sub‐types and controls, rendering these metrics less helpful when diagnosing an individual patient. Dendritic cell density was considerably higher in individuals with immune‐mediated DED than in non‐immune DED or controls. As such, dendritic cell density may be a better indicator of DED associated with a systemic immune‐mediated process.

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“…In fact, in vivo confocal microscopy has demonstrated corneal nerve alterations in the setting of corneal surgery [70] and Sjögren’s syndrome (a condition in which chronic corneal staining is a hallmark) [71]. Electrophysiologically, peripheral corneal nerves have been found to sensitize when subjected to an inflammatory milieu and after lacrimal gland transection [72, 73].…”

Section: Shared Neurophysiological Abnormalities Between Ocular Drynementioning

confidence: 99%

Neuropathic symptoms of the ocular surface: dryness, pain, and itch

Andersen

Yosipovitch

2017

Current Opinion in Allergy &Amp; Clinical Immunology

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Purpose of review To describe recent findings on epidemiology, pathophysiology and management of neuropathic symptoms of the ocular surface, with a focus on potential similarities between sensations of dry eye, pain and itch. Recent findings A narrative review of the literature was undertaken. Key references from research in dry eye, neuropathic symptoms of the ocular surface, ocular pain and itch as well as general references on itch and pain neurobiology were included. Recent findings suggest aspects of DE, chronic ocular pain, and itch symptomatology is driven by neuropathic pain mechanisms involving peripheral and central sensitization processes. Summary Ocular dryness, pain, and itch are prevalent complaints with several of shared features. Multiple lines of evidence suggest that peripheral and central neuronal sensitization processes are involved in generating and maintaining ocular sensory symptoms. Research is warranted on the epidemiology of ocular sensations, molecular mechanisms involved in nociception and pruriception in the eye, electrophysiological alterations in animal models of eye conditions, and therapeutic modalities that can alleviate unpleasant ocular sensations.

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In vivo confocal scanning laser microscopy in patients with primary Sjögren's syndrome: A monocentric experience

Abstract: CSLM might be a useful novel tool in the assessment of the involvement of the lachrymal functional unit in pSS.

Cited by 10 publications

References 19 publications

Corneal nerve structure in patients with primary Sjögren’s syndrome in China

Corneal nerve structure in patients with primary Sjögren’s syndrome in China

Can in vivo confocal microscopy differentiate between sub‐types of dry eye disease? A review

Neuropathic symptoms of the ocular surface: dryness, pain, and itch

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