Department of Ophthalmology, University of Pecs, Rakoczi u. 2, 7623, Pecs, Hungary.
Department of Ophthalmology, Faculty of Medicine, University of Debrecen, Nagyerdei krt. 98, 4032, Debrecen, Hungary.
Sci Rep. 2021 May 27;11(1):11111. doi: 10.1038/s41598-021-90594-9.
To investigate corneal microstructure of systemic sclerosis (SSc) patients using in vivo confocal microscopy (IVCM). 33 patients with SSc and 30 age-matched healthy subjects were recruited. All participants underwent comprehensive ophthalmic examination including IVCM (Heidelberg Retina Tomograph III, Heidelberg Engineering GmbH, Heidelberg, Germany) and ocular surface evaluation. Subbasal nerve plexus morphology was investigated using automated software analysis (ACCMetrics V3; University of Manchester, Manchester, UK). Keratocyte cell densities in the anterior stroma were significantly lower in patients with SSc compared to controls (P < 0.0001). In 7 SSc patients no keratocyte nuclei were identified in the anterior stroma and in most patients scattered hyperreflective punctate material were observed in the anterior stroma. Significantly lower subbasal nerve fiber parameters were found in patients with SSc compared to healthy subjects (P < 0.05). There were no significant correlations between the duration of SSc and any of the corneal cell density values. Tear break-up time values (4.82 ± 3.15 s) and Ocular Surface Disease Index scores (33.27 ± 30.11) were abnormal, Schirmer values (6.78 ± 5.82 mm) were borderline in SSc patients. In SSc, corneal morphological changes and accumulation of punctate material in the stroma was detected with confocal microscopy. Severe ocular surface disease was observed in SSc patients with significant impairment in subbasal nerve plexus morphology resembling peripheral neuropathy.
使用活体共聚焦显微镜（IVCM）研究系统性硬化症（SSc）患者的角膜微观结构。招募了 33 名 SSc 患者和 30 名年龄匹配的健康受试者。所有参与者均接受全面眼科检查，包括 IVCM（海德堡视网膜断层扫描仪 III，海德堡工程有限公司，海德堡，德国）和眼表面评估。使用自动软件分析（ACCMetrics V3；曼彻斯特大学，曼彻斯特，英国）研究基底神经丛形态。与对照组相比，SSc 患者的前基质中神经细胞密度明显降低（P<0.0001）。在 7 名 SSc 患者的前基质中未发现神经细胞核，并且在大多数患者的前基质中观察到散在的高反射点状物质。与健康受试者相比，SSc 患者的基底神经纤维参数明显降低（P<0.05）。SSc 患者的角膜细胞密度值与疾病持续时间之间无显著相关性。泪膜破裂时间值（4.82±3.15 s）和眼表面疾病指数评分（33.27±30.11）异常，Schirmer 值（6.78±5.82 mm）在 SSc 患者中处于边缘状态。在 SSc 中，通过共聚焦显微镜检测到角膜形态变化和基质中点状物质的积聚。在 SSc 患者中观察到严重的眼表面疾病，基底神经丛形态明显受损，类似于周围神经病。
