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: 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.

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