Purpose

To evaluate corneal subbasal nerve alterations in evaporative and aqueous-deficient dry eye disease (DED) as compared to controls.

Methods

In this retrospective, cross-sectional, controlled study, eyes with a tear break-up time of less than 10 s were classified as DED. Those with an anesthetized Schirmer's strip of less than 5 mm were classified as aqueous-deficient DED. Three representative in vivo confocal microscopy images were graded for each subject for total, main, and branch nerve density and numbers.

Results

Compared to 42 healthy subjects (42 eyes), the 70 patients with DED (139 eyes) showed lower total (18,579.0 ± 687.7 μm/mm² vs. 21,014.7 ± 706.5, p = 0.026) and main (7,718.9 ± 273.9 vs. 9,561.4 ± 369.8, p < 0.001) nerve density, as well as lower total (15.5 ± 0.7/frame vs. 20.5 ± 1.3, p = 0.001), main (3.0 ± 0.1 vs. 3.8 ± 0.2, p = 0.001) and branch (12.5 ± 0.7 vs. 16.5 ± 1.2, p = 0.004) nerve numbers. Compared to the evaporative DED group, the aqueous-deficient DED group showed reduced total nerve density (19,969.9 ± 830.7 vs. 15,942.2 ± 1,135.7, p = 0.006), branch nerve density (11,964.9 ± 749.8 vs. 8,765.9 ± 798.5, p = 0.006), total nerves number (16.9 ± 0.8/frame vs. 13.0 ± 1.2, p = 0.002), and branch nerve number (13.8 ± 0.8 vs. 10.2 ± 1.1, p = 0.002).

Conclusions

Patients with DED demonstrate compromised corneal subbasal nerves, which is more pronounced in aqueous-deficient DED. This suggests a role for neurosensory abnormalities in the pathophysiology of DED.

中文翻译：

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不同亚型干眼病角膜神经的改变：体内共聚焦显微镜研究

目的

与对照组相比，评估蒸发性和缺水性干眼病 (DED) 中的角膜基底神经改变。

方法

在这项回顾性、横断面、对照研究中，泪液破裂时间小于 10 秒的眼睛被归类为 DED。那些被麻醉的 Schirmer 条小于 5 毫米的人被归类为缺水型 DED。对每个受试者的三个具有代表性的体内共聚焦显微镜图像进行总、主要和分支神经密度和数量的分级。

结果

与 42 名健康受试者（42 只眼）相比，70 名 DED 患者（139 只眼）的总数较低（18,579.0 ± 687.7 μm/mm ² vs. 21,014.7 ± 706.5, p = 0.026）和主要（7,718.9 ± 273.9 vs. 9,561.4 ± 369.8, p < 0.001) 神经密度，以及较低的总神经密度 (15.5 ± 0.7/帧 vs. 20.5 ± 1.3, p = 0.001)、主要 (3.0 ± 0.1 vs. 3.8 ± 0.2, p = 0.001) 和分支 (12.5 ± 0.7 vs. 16.5 ± 1.2, p = 0.004) 神经数。与蒸发性 DED 组相比，缺水 DED 组的总神经密度降低（19,969.9 ± 830.7 对 15,942.2 ± 1,135.7，p = 0.006），分支神经密度（11,964.9 ± 749.8 对 8,765.9 ± 798.5，p = 0.006） 、总神经数（16.9 ± 0.8/帧 vs. 13.0 ± 1.2，p = 0.002）和分支神经数（13.8 ± 0.8 vs. 10.2 ± 1.1，p = 0.002）。

结论

DED 患者表现出角膜基底神经受损，这在缺水型 DED 中更为明显。这表明神经感觉异常在 DED 的病理生理学中的作用。