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Ocular surface evaluation using as‐oct and in vivo confocal microscopy in patients with primary sjögren’s syndrome
Author(s) -
Luís Maria Elisa,
Cardigos Joana,
Barcelos Filipe,
Carvalho Helena,
Hipólito Diogo,
Crisóstomo Sara,
VazPatto José,
Alves Nuno
Publication year - 2019
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2019.5436
Subject(s) - medicine , ophthalmology , optical coherence tomography , confocal microscopy , in vivo , confocal , pathology , optics , physics , microbiology and biotechnology , biology
Dry eye disease severity is classically obtained through an evaluation of tear film stability and tear production, lid margin disease, ocular surface damage and tear osmolarity. Other parameters for severity classification are know being used for a more accurate follow‐up and managing. The purpose of this study is to evaluate the tear meniscus (TM) and corneal sub‐basal nerve plexus (SBNP) in a population with pSS, using anterior segment optical coherence tomography (AS‐OCT) and in vivo Confocal Microscopy (ivCM). Material and Methods Observational cross‐sectional study of 50 patients with pSS and 20 healthy controls. All patients were submitted to Schirmer test I without anaesthesia, tear break‐up time and corneal fluorescein staining evaluation. Anterior segment optical coherence tomography (AS‐OCT) was used for TM height and area analysis. In vivo Confocal Microscopy (IVCM) was performed for corneal SBNP density, length and tortuosity. Differences in pSS ophthalmic features were analyzed according to phenotype profile. Results TM height was significantly lower in pSS in contrast to healthy controls (p < 0.001). Corneal SBNP density and length were significantly lower and tortuosity significantly higher in pSS patients (p < 0.001, p = 0.004 and p = 0.001, respectively). Conclusion The diagnosis of Primary Sjögren’s Syndrome (pSS) is sometimes challenging, taking into account the clinical heterogeneity and diagnostic criteria fulfillment variability. AS‐OCT and IVCM may be useful in additional evaluation of lachrymal unit dysfunction in pSS.