Luzu Jade, Labbé Antoine, Réaux-Le Goazigo Annabelle, Rabut Ghislaine, Liang Hong, Dupas Bénédicte, Blautain Benjamin, Sène Damien, Baudouin Christophe
Department of Ophthalmology III, CHNO des Quinze-Vingts, IHU FOReSIGHT, 28 rue de Charenton, F-75012, Paris, France.
Department of Ophthalmology III, CHNO des Quinze-Vingts, IHU FOReSIGHT, 28 rue de Charenton, F-75012, Paris, France; Sorbonne Université, INSERM, CNRS, Institut de la Vision, IHU FOReSIGHT, 17 rue Moreau, F-75012, Paris, France.
Ocul Surf. 2022 Jul;25:155-162. doi: 10.1016/j.jtos.2022.07.003. Epub 2022 Jul 22.
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.
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.
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/mm compared to the control group (P < 0.001). The density of the subbasal nerve plexus was significantly reduced to 16.7 ± 6.5 mm/mm 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).
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.
通过体内共聚焦显微镜（IVCM）研究伴有或不伴有小纤维神经病变（SFN）的干燥综合征（SS）患者的基底神经丛变化，以防止诊断延误。
本回顾性病例对照研究纳入了71例SS患者，其中19例伴有SFN，20名健康志愿者和20例睑板腺功能障碍（MGD）患者。采用IVCM研究基底神经丛密度和形态。
与对照组（P = 0.026）和MGD组（P = 0.037）相比，SS组使用Cochet-Bonnet眼压计评估的角膜敏感性显著降低。与对照组相比，SS组炎症细胞数量显著增加至86.2±82.1个细胞/mm（P < 0.001）。与对照组（P < 0.005）和MGD组（P = 0.042）相比，SS组基底神经丛密度显著降低至16.7±6.5 mm/mm。与对照组（P < 0.001）和MGD组（P = 0.025）相比，SS组神经的曲折度显著增加。与对照组相比，SS组基底神经丛神经瘤的平均数量显著增加（P = 0.001），与无SFN的SS患者相比，伴有SFN的SS患者神经瘤平均数量显著增加（P = 0.008）。
IVCM有助于检测SS患者的角膜神经变化，可能有助于疾病的早期诊断并考虑新的治疗方法。
