Center for Translational Ocular Immunology, Department of Ophthalmology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA; Cornea Service, New England Eye Center, Department of Ophthalmology, Tufts Medical School, Tufts University School of Medicine, Boston, MA, USA.
Cornea Service, New England Eye Center, Department of Ophthalmology, Tufts Medical School, Tufts University School of Medicine, Boston, MA, USA; Ocular Surface Imaging Center, Cornea and Refractive Surgery Service, Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA.
Ocul Surf. 2020 Oct;18(4):641-650. doi: 10.1016/j.jtos.2020.07.006. Epub 2020 Jul 22.
To compare the clinical characteristics and in vivo confocal microscopy (IVCM) findings of patients with neuropathic corneal pain (NCP) due to refractive surgery (RS-NCP) and herpetic eye disease (H-NCP) to controls.
Sixteen patients with RS-NCP and 7 patients with H-NCP, and 37 healthy reference age- and sex-matched healthy controls were included to the study. The medical records were reviewed for demographic features, detailed disease history, ocular surface disease index (OSDI), ocular pain assessment survey (OPAS) scores. IVCM images of patients were analyzed and compared to reference controls by two masked observers.
The mean pain intensity score for the last 24 h (5.1 ± 2.4 vs. 3.9 ± 1.2; p = 0.27), last 2 weeks (6.1 ± 2.5 vs. 4.8 ± 2.3; p = 0.13) for RS-NCP vs. H-NCP respectively, and quality of life scores (p = 0.23) were similar in both groups. Quality of life, especially mood (p = 0.06) and enjoying life/relations to others (p = 0.10) were affected in both groups, but were not statistically significant between groups. The mean total nerve density was lower in RS-NCP (5,702.4 ± 4,599.0 μm/mm) compared to their respective controls (26,422.8 ± 4,491.0; p < 0.001) and in the H-NCP group (2,149.5 ± 2,985.9) compared to their respective controls (22,948.8 ± 3,169.0; p < 0.001). Alterations in DC density were similar between all groups (38.3 ± 48.0 cells/mm in RS-NCP, 61.0 ± 76.9 in H-NCP, p = 0.95).
Neuropathic corneal pain patients due to refractive surgery show similar clinical characteristics, pain levels, quality of life impact, and IVCM findings as patients with NCP due to herpetic eye disease.
比较因屈光手术（RS-NCP）和疱疹性眼病（H-NCP）引起的神经性角膜痛（NCP）患者的临床特征和活体共焦显微镜（IVCM）检查结果与对照组。
纳入 16 例 RS-NCP 患者、7 例 H-NCP 患者和 37 名年龄、性别匹配的健康对照者。回顾性分析其临床资料，包括人口统计学特征、详细病史、眼表疾病指数（OSDI）、眼痛评估量表（OPAS）评分。两名观察者对患者的 IVCM 图像进行分析，并与参考对照组进行比较。
RS-NCP 患者组最近 24 小时（5.1±2.4 对 3.9±1.2；p=0.27）和最近 2 周（6.1±2.5 对 4.8±2.3；p=0.13）的平均疼痛强度评分相似，H-NCP 患者组分别为 5.1±2.4 和 3.9±1.2，两组的生活质量评分（p=0.23）相似。两组的生活质量，特别是情绪（p=0.06）和享受生活/与他人的关系（p=0.10）均受到影响，但组间无统计学差异。RS-NCP 患者的总神经密度（5702.4±4599.0 μm/mm）明显低于各自的对照组（26422.8±4491.0 μm/mm，p<0.001）和 H-NCP 组（2149.5±2985.9 μm/mm），与各自的对照组相比（22948.8±3169.0 μm/mm，p<0.001）。所有组之间的 DC 密度变化相似（RS-NCP 组 38.3±48.0 个细胞/mm，H-NCP 组 61.0±76.9 个细胞/mm，p=0.95）。
因屈光手术引起的神经性角膜痛患者的临床特征、疼痛水平、生活质量影响和 IVCM 检查结果与疱疹性眼病引起的 NCP 患者相似。
