In vivo confocal microscopic study of corneal innervation in Sjögren's Syndrome with or without small fiber neuropathy,The Ocular Surface

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In vivo confocal microscopic study of corneal innervation in Sjögren's Syndrome with or without small fiber neuropathy
The Ocular Surface ( IF 6.4 ) Pub Date : 2022-07-22 , DOI: 10.1016/j.jtos.2022.07.003
Jade Luzu ₁ , Antoine Labbé ₂ , Annabelle Réaux-Le Goazigo ₃ , Ghislaine Rabut ₁ , Hong Liang ₂ , Bénédicte Dupas ₁ , Benjamin Blautain ₁ , Damien Sène ₄ , Christophe Baudouin ₂

Affiliation

Purpose

To study changes in the subbasal nerve plexus by In vivo confocal microscopy (IVCM) in Sjögren's Syndrome (SS) with or without associated Small Fiber Neuropathy (SFN), in order to prevent diagnostic delay.

Methods

Seventy-one patients with SS, including 19 with associated SFN, 20 healthy volunteers and 20 patients with Meibomian gland dysfunction (MGD) were included in this retrospective case-control study. IVCM was used to investigate subbasal nerve plexus density and morphology.

Results

Corneal sensitivity as evaluated with the Cochet-Bonnet aesthesiometer was significantly reduced in the SS group versus the control group (P = 0.026) and the MGD group (P = 0.037). The number of inflammatory cells was significantly increased in the SS group to 86.2 ± 82.1 cells/mm² compared to the control group (P < 0.001). The density of the subbasal nerve plexus was significantly reduced to 16.7 ± 6.5 mm/mm² in the SS group compared to the control group (P < 0.005) and the MGD group (P = 0.042). The tortuosity of the nerves in the SS group was significantly increased compared to the control group (P < 0.001) and the MGD group (P = 0.025). The average number of subbasal nerve plexus neuromas was significantly increased in the SS group compared to the control group (P = 0.001), with a significant increase in the average number of neuromas in SS patients with associated SFN compared to SS patients without SFN (P = 0.008).

Conclusion

IVCM can be useful to detect corneal nerve changes in SS patients and may allow earlier diagnosis of the disease and to consider new therapeutic approaches.

中文翻译：

有或没有小纤维神经病变的干燥综合征角膜神经支配的体内共聚焦显微镜研究

目的

通过体内共聚焦显微镜(IVCM) 在伴有或不伴有相关小纤维神经病变 (SFN) 的干燥综合征 (SS) 中研究基底下神经丛的变化，以防止诊断延误。

方法

这项回顾性病例对照研究纳入了 71 名 SS 患者，包括 19 名伴有 SFN 的患者、20 名健康志愿者和 20 名睑板腺功能障碍（MGD）患者。IVCM用于研究基底下神经丛的密度和形态。

结果

SS 组与对照组 ( P = 0.026) 和 MGD 组 ( P = 0.037)相比，使用 Cochet-Bonnet 感觉仪评估的角膜敏感性显着降低。与对照组相比， SS组炎症细胞数显着增加至86.2±82.1个/mm ²（P < 0.001）。与对照组（ P < 0.005）和MGD组（P = 0.042）相比，SS组基底下神经丛密度显着降低至16.7±6.5 mm/mm ^{2 。}SS组神经迂曲度较对照组（P < 0.001）和MGD组（P = 0.025）。与对照组相比，SS组基底下神经丛神经瘤的平均数量显着增加（P = 0.001），与无SFN的SS患者相比，伴有SFN的SS患者的平均神经瘤数量显着增加（P = 0.008)。