Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami, Miami, Florida, USA.
Department of Ophthalmology, Miami Veterans Administration Medical Center, Miami, Florida, USA.
Clin Exp Ophthalmol. 2021 May;49(4):373-387. doi: 10.1111/ceo.13924. Epub 2021 Apr 13.
Many studies utilised in vivo confocal microscopy (IVCM) to associate variations in corneal structures with dry eye disease (DED). However, DED is an umbrella term that covers various aetiologies and presentations. This review analyses populations by DED aetiology to determine the relationships between IVCM parameters and specific DED sub-types. It focuses on the most commonly examined structures, sub-basal nerves and dendritic cells. Across the literature, most studies found individuals with immune-mediated DED had lower sub-basal nerve fibre number and density than controls, with smaller differences between non-immune DED and controls. However, wide ranges of values reported across studies demonstrate considerable overlap between DED sub-types and controls, rendering these metrics less helpful when diagnosing an individual patient. Dendritic cell density was considerably higher in individuals with immune-mediated DED than in non-immune DED or controls. As such, dendritic cell density may be a better indicator of DED associated with a systemic immune-mediated process.
许多研究使用活体共聚焦显微镜（IVCM）将角膜结构的变化与干眼疾病（DED）联系起来。然而，DED 是一个涵盖各种病因和表现的总称。本综述通过 DED 的病因对人群进行分析，以确定 IVCM 参数与特定 DED 亚型之间的关系。它重点分析了最常检查的结构，即基底下神经和树突状细胞。在文献中，大多数研究发现免疫介导的 DED 患者的基底下神经纤维数量和密度低于对照组，而非免疫介导的 DED 与对照组之间的差异较小。然而，研究报告的数值范围很广，表明 DED 亚型和对照组之间有很大的重叠，这使得这些指标在诊断个别患者时帮助不大。免疫介导的 DED 患者的树突状细胞密度明显高于非免疫介导的 DED 或对照组。因此，树突状细胞密度可能是与全身性免疫介导过程相关的 DED 的更好指标。
