Joana Cardigos1, Filipe Barcelos2,3,4, Helena Carvalho5, Diogo Hipólito1, Sara Crisóstomo1, José Vaz-Patto3, Nuno Alves1,6. 1. Department of Ophthalmology, Centro Hospitalar de Lisboa Central, Lisbon, Portugal. 2. CEDOC, Chronic Diseases Research Center, Immunology, NOVA Medical School FCM, Universidade Nova de Lisboa, Lisbon, Portugal. 3. Department of Rheumatology, Instituto Português de Reumatologia, Lisbon, Portugal. 4. Department of Rheumatology, Hospital Cuf Descobertas, Lisbon, Portugal. 5. Centre for Research and Studies in Sociology (CIES-IUL), Instituto Universitário de Lisboa (ISCTE-IUL), Lisboa, Portugal. 6. Department of Ophthalmology, Hospital Cuf Descobertas, Lisbon, Portugal.
Abstract
PURPOSE: To evaluate lower tear meniscus and corneal sub-basal nerve plexus in primary Sjögren's syndrome (pSS) and Sicca syndrome patients. METHODS: Cross-sectional study of 116 patients with Sicca syndrome associated with pSS and not associated with Sjögren's syndrome (non-SS Sicca) and 20 normal control subjects. Tear meniscus height and area were measured using anterior segment optical coherence tomography; corneal sub-basal nerve plexus density, length, and tortuosity were evaluated using in vivo confocal microscopy. Data analysis was performed using IBM-SPSS Statistics 24.0. RESULTS: Corneal sub-basal nerve plexus density and length were significantly lower, and tortuosity was significantly higher in pSS and non-SS Sicca groups than in normal control subjects (P < 0.001; P = 0.018, respectively). Corneal sub-basal nerve plexus presented a strong association with Schirmer test I and tear breakup time. Cutoff values of sub-basal nerve plexus density (36.5 nerve/mm) and length (12.5 mm/mm) presented 80.2% to 81.9% sensitivity and 85% specificity for detecting Sicca syndrome patients. No significant differences were found between the 3 groups regarding tear meniscus height and area. CONCLUSIONS: Corneal sub-basal nerve plexus in vivo confocal microscopy may be a useful tool in the assessment of dry eye disease in Sicca syndrome, complementing the information provided by the conventional modalities used in dry eye disease evaluation.
PURPOSE: To evaluate lower tear meniscus and corneal sub-basal nerve plexus in primary Sjögren's syndrome (pSS) and Sicca syndromepatients. METHODS: Cross-sectional study of 116 patients with Sicca syndrome associated with pSS and not associated with Sjögren's syndrome (non-SS Sicca) and 20 normal control subjects. Tear meniscus height and area were measured using anterior segment optical coherence tomography; corneal sub-basal nerve plexus density, length, and tortuosity were evaluated using in vivo confocal microscopy. Data analysis was performed using IBM-SPSS Statistics 24.0. RESULTS: Corneal sub-basal nerve plexus density and length were significantly lower, and tortuosity was significantly higher in pSS and non-SS Sicca groups than in normal control subjects (P < 0.001; P = 0.018, respectively). Corneal sub-basal nerve plexus presented a strong association with Schirmer test I and tear breakup time. Cutoff values of sub-basal nerve plexus density (36.5 nerve/mm) and length (12.5 mm/mm) presented 80.2% to 81.9% sensitivity and 85% specificity for detecting Sicca syndromepatients. No significant differences were found between the 3 groups regarding tear meniscus height and area. CONCLUSIONS: Corneal sub-basal nerve plexus in vivo confocal microscopy may be a useful tool in the assessment of dry eye disease in Sicca syndrome, complementing the information provided by the conventional modalities used in dry eye disease evaluation.
Authors: Tabea Seeliger; Marten A Gehlhaar; Irene Oluwatoba-Popoola; Franz F Konen; Melanie Haar; Emilia Donicova; Marija Wachsmann; Amelie Pielen; Stefan Gingele; Nils K Prenzler; Diana Ernst; Torsten Witte; Carsten Framme; Anna Bajor; Thomas Skripuletz Journal: J Clin Med Date: 2022-08-01 Impact factor: 4.964