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Sjogren`s syndrome and ocular surface changes by laser-scanning in vivo confocal microscopy

Teodora Marinova, Yana Manolova, Christina Grupcheva

Abstract

Introduction: Dry eye disease (DED) and ocular allergy are common conditions in the eye practice. They have more than 20% of prevalence and that fact increases healthcare problems and affects life quality. Rheumatologic diseases such as Sjogren`s syndrome (SS) are often associated with ophthalmic findings, and belong to the dry eye but with decreased tear film production.

Material and Methods: The laser-scanning confocal microscopy (LSCM) was performed to 16 eyes of 8 patients with subjective complains and objective clinical signs of DED and SS. The results of examinations were compared with control group of 28 eyes of 14 healthy patients. The qualitative analysis was performed to calculate the cell density in all cornea layers. The presence and distribution of Langerhans cells (LCs) in cornea was estimated. The quantitative survey understood monitoring of inflammation signs and corneal changes such as a presence of leukocytes. Changes in subbasal nerve plexus (SNP) and Meibomian glands (MGs) were evaluated over time.

Results: The quantitative analysis presented calculations of cell density of all cornea layers. The most important finding was the reduction of epithelium cell density. In healthy patients it was 5048.6±56 cells/mm2 compared to 4603±70 cells/mm2 in DED-SS patients, but also the keratocyte number was significantly lower. The density of corneal LCs was compared to the healthy patients: 71±8 cells/mm2 and 19±3cells/mm2 respectively. The quantitative observation showed visible changes in SNP especially in tortuosity and destiny of sub-basal nerves.

Conclusion: The ability of LSCM technology to examine different components of the ocular surface has opened new doors for studying the physiology and pathology. LSCM allows understanding the pathological changes of DED and SS. Our study proved that these diseases affect all structures of the anterior ocular surface.

Keywords

dry eye disease; Sjogren`s syndrome; laser-scanning confocal microscopy; cornea

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References

Villani E, F Mantelli, P Nucci. In-vivo confocal microscopy of the ocular surface: ocular allergy and dry eye. Current Opinion in Allergy and Clinical unology, 2013;13(5): 569-576.

Enrıquez-de-Salamanca A, Bonini S, Calonge M. Molecular and cellular biomarkers in dry eye disease and ocular allergy. Curr Opin Allergy Clin Immunol, 2012;12:523-53.

Kari O, Saari KM. Diagnostics and new developments in the treatment of ocular allergies. Curr Allergy Asthma Rep, 2012;12:232-239.

Miljanovic B, Dana R, Sullivan DA, Schaumberg DA. Impact of dry eye syndrome on vision-related quality of life. Am J Ophthalmol, 2007;143:409-415.

Poole TR, Graham EM. Ocular manifestations of rheumatologic disorders. Curr Opin Ophthalmol, 1999;10(6): 458-63.

Machetta F, Fea AM, Actis AG, de Sanctis U, Dalmasso P, Grignolo FM. In Vivo Confocal Microscopic Evaluation of Corneal Langerhans Cells in Dry Eye Patients, The Open Ophthalmology Journal, 2014;8:51-59.

A Zhivov. In Vivo Confocal Microscopic Evaluation of Langerhans Cell Density and Distribution in the Corneal Epithelium of Healthy Volunteers and Contact Lens Wearers. Cornea, 2007;1.

Villani E, Baudouin C, Efron N, et al. In vivo confocal microscopy of the ocular surface: from bench to bedside. Curr Eye Res, 2013;11 DOI: 10.3109/027 13683.2013.842592.

Villani E, Magnani F, Viola F, et al. In vivo confocal evaluation of the ocular surface morphofunctional unit in dry eye. Optom Vis Sci, 2013; 90:576-586.

Lemp M, Baudouin C, Baum J, et al. The definition and classification of dry eye disease: report of the Definition and Classification Subcommittee of the International Dry Eye Workshop. Ocul Surf, 2007;5:75-92.

Villani E, Mantellid F, Nuccia P, In-vivo confocal microscopy of the ocular surface: Ocular allergy and dry eye. Curr Opin Allergy Clinical Immunol, 2013:5:569-576.

Alhatem A, Cavalcanti B, Hamrah P. In vivo confocal microscopy in dry eye disease and related conditions. Semin Ophthalmol, 2012;27:138-148.

Engelmann TW. Ãœber die Hornhaut des Auges, Leipzig. In: Virchow H, ed. Graefe-Saemisch Handbuch der Gesamten Augenheilkunde. 2nd ed. Leipzig: Engelmann 1867; pp. 30.1. 14. Rosenberg ME, Tervo TM, Muller LJ, et al. In vivo confocal microscopic after herpes keratitis. Cornea, 2002;21(3):265-9.

Zhivov A, Stave J, Vollmar B, Guthoff R. In vivo confocal microscopic evaluation of Langerhans cell density and distribution in the corneal epithelium of healty volunteers and conctact lens wearers. Cornea, 2007;26(1):47-54.

Zhivov A, Stave J, Vollmar B, Guthoff R. In vivo confocal microscopic evaluation of Langerhans cell density and distribution in the normal human corneal epithelium. Graefes Arch Clin Exp Ophthalmol, 2005;243(10):1056-61.

Villani E, Beretta S, Galimberti D, et al. In vivo confocal microscopy of conjunctival roundish bright objects: young, older, and Sjogren subjects. Invest Ophthalmol Vis Sci, 2011;52:4829-4832.

Ibrahim OM, Matsumoto Y, Dogru M, et al. The efficacy, sensitivity, and specificity of in vivo laser confocal microscopy in the diagnosis of Meibomian gland dysfunction. Ophthalmology, 2010;117:665-672.

Villani E, Viola F, Sala R, et al. Corneal involvement in Graves` orbitopathy: an in vivo confocal study. Invest Ophthalmol Vis Sci, 2010;51:4574-4578.

Villani E, Beretta S, De Capitani M, et al. In vivo confocal microscopy of Meibomian glands in Sjogren`s syndrome. Invest Ophthalmol Vis Sci, 2011;52:933-939.

Labbe A, Alalwani H, Van Went C, et al. The relationship between sub-basal nerve morphology and corneal sensation in ocular surface disease. Invest Ophthalmol Vis Sci, 2012;53:4926-4931.




DOI: http://dx.doi.org/10.14748/ssm.v46i4.1015

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About The Authors

Teodora Marinova
Medical University of Varna
Bulgaria

Department of Ophthalmology and Visual Science
Specialised Eye Hospital - Varna, Bulgaria

Yana Manolova
Medical University of Varna
Bulgaria

Department of Ophthalmology and Visual Science
Specialised Eye Hospital - Varna, Bulgaria

Christina Grupcheva
Medical University of Varna
Bulgaria

Department of Ophthalmology and Visual Science
Specialised Eye Hospital - Varna, Bulgaria

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