An in vivo confocal microscopy study: correlation between morphological changes of corneal subbasal nerve and clinical symptoms of Sjögren syndrome

AIM: To observe the morphological changes of corneal subbasal nerve (SBN) plexus in patients with Sjögren syndrome (SS) by in vivo confocal microscopy (IVCM) study and analyze its correlation with clinical symptoms. METHODS: We collected 22 cases (44 eyes) patients with SS (observation group) and 22 cases (44 eyes) healthy people with the same age (control group) for observation of central corneal SBN fibers diameter, number of beads, and tortuosity, and recorded tear film break up time (BUT), Schirmer’s I test (SIT), tear meniscus height (TMH), dendritic cell (DC) density, the results were applied to perform statistical analysis. RESULTS: Under IVCM observation, the diameter of corneal SBN fibers in the observation group became thinner, the number of beads and the degree of nerve fiber tortuosity were increased compared with the control group, and the difference was statistically significant (P<0.05). Pearson correlation analysis: the diameter of corneal SBN fibers in the observation group was significantly correlated with BUT (r=0.472, P<0.01), SIT (r=0.562, P<0.01), TMH (r=0.246, P=0.02) and DC density (r=-0.636, P<0.01). The number of nerve fiber beads was correlated with BUT (r= -0.621, P<0.01), SIT (r=-0.688, P<0.01), TMH (r=-0.438, P<0.01) and DC density (r=0.528, P<0.01). There was a significant correlation between nerve fiber tortuosity and BUT (r=-0.634, P<0.01), SIT (r=-0.713, P<0.01), TMH (r= -0.384, P<0.01) and DC density (r=0.604, P<0.01). CONCLUSION: IVCM can effectively observe the morphology of corneal nerve plexus. In SS patients, the diameter of corneal SBN fibers becomes thinner, the number of beads increases, and the tortuosity of nerve fiber increases. Moreover, the degree of nerve fiber lesions is correlated with the severity of dry eye clinical symptoms.

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Effect of Autologous Serum Eye Drops in Patients with Sjögren Syndrome-related Dry Eye: Clinical and In Vivo Confocal Microscopy Evaluation of the Ocular Surface

In Vivo ◽

10.21873/invivo.11016 ◽

2016 ◽

Vol 30 (6) ◽

pp. 931-938 ◽

Cited By ~ 15

Author(s):

FRANCESCO SEMERARO ◽

ELIANA FORBICE ◽

GIUSEPPE NASCIMBENI ◽

MARCO TAGLIETTI ◽

VITO ROMANO ◽

...

Keyword(s):

Confocal Microscopy ◽

Dry Eye ◽

Ocular Surface ◽

Sjögren Syndrome ◽

Autologous Serum ◽

Sjogren Syndrome ◽

Eye Drops ◽

In Vivo Confocal Microscopy ◽

Serum Eye Drops

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Cellular morphological changes detected by laser scanning in vivo confocal microscopy associated with clinical outcome in fungal keratitis

Scientific Reports ◽

10.1038/s41598-019-44833-9 ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 1

Author(s):

Jaya D. Chidambaram ◽

Namperumalsamy V. Prajna ◽

Srikanthi Palepu ◽

Shruti Lanjewar ◽

Manisha Shah ◽

...

Keyword(s):

Confocal Microscopy ◽

Clinical Outcome ◽

Laser Scanning ◽

Morphological Changes ◽

Fungal Keratitis ◽

In Vivo Confocal Microscopy

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An in vivo confocal microscopy study of corneal changes in pseudoexfoliation syndrome

European Journal of Ophthalmology ◽

10.1177/1120672118803850 ◽

2018 ◽

Vol 29 (5) ◽

pp. 555-560 ◽

Cited By ~ 2

Author(s):

Luca Terracciano ◽

Michela Cennamo ◽

Eleonora Favuzza ◽

Litasova Julia ◽

Orsola Caporossi ◽

...

Keyword(s):

Confocal Microscopy ◽

Anterior Segment ◽

Senile Cataract ◽

Nerve Plexus ◽

Pseudoexfoliation Syndrome ◽

Control Group ◽

In Vivo Confocal Microscopy ◽

Corneal Sensitivity ◽

Corneal Layer

Purpose: To evaluate, through the in vivo confocal microscopy, the pathological changes of each corneal layer in eyes affected by pseudoexfoliation syndrome. Methods: We studied 40 eyes of 40 patients with diagnosis of unilateral senile cataract associated with pseudoexfoliation syndrome and 40 eyes of 40 control subjects with senile cataract without pseudoexfoliation syndrome. All patients underwent a complete ophthalmic examination including best corrected visual acuity, slit-lamp examination, corneal sensitivity measurement using a Cochet-Bonnet nylon thread esthesiometer, and anterior segment optical coherence tomography (Visante OCT, Carl Zeiss Meditec AG, Germany); in vivo confocal microscopy of corneal sections (endothelium, stroma, sub-basal nerve plexus, and superficial and basal epithelium) was performed with the ConfoScan 4.0 (Nidek, Japan). Results: In pseudoexfoliation syndrome group, the mean corneal sensitivity was 44.1 ± 1.3 mm and in the control group was 55.6 ± 4.7 mm. The corneas of the eyes with pseudoexfoliation syndrome were significantly less sensitive than those of control group eyes (p < 0.001). Pseudoexfoliation syndrome eyes had a lower nerve density and less nerve beadings and a higher degree of tortuosity in sub-basal plexus compared to the control group. The cell density of epithelial and endothelial layers was significantly lower in pseudoexfoliation syndrome eyes than controls. In 80% of pseudoexfoliation syndrome eyes, we found activated keratocytes and inflammatory cells in the anterior stroma. Conclusion: Our study demonstrates the morpho-structural corneal alterations in eyes affected by pseudoexfoliation syndrome, using corneal in vivo confocal microscopy as a non-invasive and high-reproducible technique to evaluate pathophysiology of each corneal layer; the sub-basal nerve plexus alterations are correlated with the lower corneal sensitivity.

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Role of Fractalkine in the Pathogenesis of Primary Sjögren Syndrome: Increased Serum Levels of Fractalkine, Its Expression in Labial Salivary Glands, and the Association with Clinical Manifestations

The Journal of Rheumatology ◽

10.3899/jrheum.130892 ◽

2014 ◽

Vol 41 (12) ◽

pp. 2425-2438 ◽

Cited By ~ 7

Author(s):

Jae Ho Lee ◽

Seung-Ki Kwok ◽

Seung Min Jung ◽

Jennifer Lee ◽

Jae-Seon Lee ◽

...

Keyword(s):

Epithelial Cells ◽

Confocal Microscopy ◽

Salivary Glands ◽

Proinflammatory Cytokines ◽

Sjögren Syndrome ◽

Control Group ◽

Sjogren Syndrome ◽

Clinical Effects ◽

Extraglandular Manifestations ◽

Primary Sjögren Syndrome

Objective.To investigate the expression of fractalkine and identify the clinical effects of fractalkine and its receptor (CX3CR1) in patients with primary Sjögren syndrome (pSS).Methods.Serum fractalkine levels were determined by ELISA. Immunohistochemical staining was done to compare the expression of fractalkine and CX3CR1 between salivary glands (SG) of patients with SS and controls. The cells to be merged with fractalkine were evaluated by confocal microscopy. Type of CX3CR1-expressing cells among infiltrating lymphocytes in SG was analyzed by confocal microscopy. Further, associations among fractalkine, proinflammatory cytokines, and clinical profiles were investigated.Results.Serum fractalkine levels in patients with pSS were higher than those in the control group (p = 0.026). SG expression of fractalkine and its receptor was upregulated in patients with pSS compared to that in the controls by immunohistochemistry. Higher histological grade was associated with more fractalkine-positive cells per total epithelial cells. Epithelial cells were the main fractalkine-expressing cell type in the SG. Serum fractalkine levels were significantly correlated with proinflammatory cytokines levels (interleukin 17: r = 0.685, p = 0.029; tumor necrosis factor-α: r = 0.444, p = 0.003), antinuclear antibody (r = 0.349, p = 0.022), and immunoglobulin G levels (r = 0.325, p = 0.044). Serum fractalkine levels in patients with extraglandular manifestations of pSS were significantly higher than in those without extraglandular manifestations (p = 0.026).Conclusion.Fractalkine and CX3CR1 may play a role in the pathogenesis of pSS, including extraglandular manifestations.

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Subbasal nerve fiber regeneration after LASIK and LASEK assessed by noncontact esthesiometry and in vivo confocal microscopy: Prospective study

Journal of Cataract & Refractive Surgery ◽

10.1016/j.jcrs.2007.05.023 ◽

2007 ◽

Vol 33 (9) ◽

pp. 1515-1521 ◽

Cited By ~ 57

Author(s):

Taym Darwish ◽

Arun Brahma ◽

Clare OʼDonnell ◽

Nathan Efron

Keyword(s):

Confocal Microscopy ◽

Prospective Study ◽

Nerve Fiber ◽

In Vivo Confocal Microscopy

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The influence of pseudoexfoliative syndrome on corneal morphology based on in vivo confocal microscopy

Ophthalmology journal ◽

10.17816/ov10249-55 ◽

2017 ◽

Vol 10 (2) ◽

pp. 49-55 ◽

Cited By ~ 2

Author(s):

Vitaly V Potemkin ◽

Tatyana S Varganova ◽

Evgeniy L Akopov ◽

Elena V Ageeva

Keyword(s):

Dendritic Cells ◽

Confocal Microscopy ◽

Real Time ◽

Cell Density ◽

In Vivo Imaging ◽

Morphological Changes ◽

In Vivo Confocal Microscopy ◽

Examination Method ◽

Mode A

Confocal microscopy is a modern examination method, which provides in real-time mode a noninvasive in vivo imaging of the cornea, limb, and conjunctiva. Purpose. To evaluate main morphological changes observed by confocal microscopy in patients with pseudoexfoliation (PEX) syndrome. Methods. 21 patients were examined. 12 patients with PEX syndrome were enrolled as the main group, and 9 patients without PEX - as controls. Results. In patients with PEX, there was a decreased cell density in the epithelium and the stroma of the cornea, as well as a lot of hyperreflective intercellular microdeposits and dendritic cells (p < 0.05).

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