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Changes in the tarsal conjunctiva viewed by in vivo confocal microscopy are associated with ocular symptoms and contact lens wear
Author(s) -
Lópezde la Rosa Alberto,
Alghamdi Waleed M,
Kunnen Carolina ME,
Lazon de la Jara Percy,
GonzálezGarcía María J,
Markoulli Maria,
Papas Eric B
Publication year - 2019
Publication title -
ophthalmic and physiological optics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.147
H-Index - 66
eISSN - 1475-1313
pISSN - 0275-5408
DOI - 10.1111/opo.12638
Subject(s) - contact lens , ophthalmology , interquartile range , medicine , asymptomatic , eyelid , confocal microscopy , surgery , optics , physics
Purpose To investigate the effect of soft contact lens ( CL ) wear on the morphology of the epithelial‐lamina propria junction as well as the possible association with symptoms of discomfort. Methods Ninety‐two subjects were recruited, including 60 soft CL wearers, 16 previous wearers, and 16 non‐wearers. Additionally, subjects were classified as symptomatic or asymptomatic using the Contact Lens Dry Eye Questionnaire 8 for the CL wearers (a score ≥ 12 was considered symptomatic) and the Dry Eye Questionnaire 5 for the previous wearers and non‐wearers (a score ≥ 5 was considered symptomatic). In vivo confocal microscopy of the tarsal conjunctiva was performed on a single occasion. Papillae density, shortest diameter, longest diameter, area, circularity, lumen/wall brightness ratio, irregularity, reflectivity, inhomogeneous appearance of wall and inhomogeneous appearance of rete ridges were evaluated. Effects of CL wear, symptoms and their interaction were analysed using two‐way analysis of variance. Correlations were investigated using Spearman's coefficient. Data are presented as mean (standard deviation) or median [interquartile range]. Results Contact lens wearers, compared to previous wearers and non‐wearers, showed higher circularity [0.65 (0.08) vs 0.59 (0.10) vs 0.57 (0.11), p = 0.003]. Subjects with symptoms, compared to asymptomatic participants, showed higher circularity [0.64 (0.08) vs 0.61 (0.10), p < 0.001] and lower irregularity (1.0 [0.7–2.0] vs 1.3 [1.0–2.3], p = 0.009). For previous wearers, those with symptoms showed greater density (135.4 [107.3–183.3] vs 87.5 [85.4–116.7], p = 0.013) and circularity [0.64 (0.07) vs 0.54 (0.10), p = 0.016]. For non‐wearers, those with symptoms showed higher circularity [0.65 (0.08) vs 0.50 (0.08), p < 0.001]. DEQ ‐5 correlated with circularity (ρ = 0.55, p = 0.001). Conclusions Soft CL wear modifies papillae of the epithelial‐lamina propria junction into a more rounded shape; however, CL cessation appears to resolve this alteration. Additionally, a more rounded papillae shape is associated with ocular symptoms in subjects not actively wearing CL s.