Seeliger Tabea, Gehlhaar Marten A, Oluwatoba-Popoola Irene, Konen Franz F, Haar Melanie, Donicova Emilia, Wachsmann Marija, Pielen Amelie, Gingele Stefan, Prenzler Nils K, Ernst Diana, Witte Torsten, Framme Carsten, Bajor Anna, Skripuletz Thomas
Department of Neurology, Hannover Medical School, 30625 Hannover, Germany.
Department of Ophthalmology, Hannover Medical School, 30625 Hannover, Germany.
J Clin Med. 2022 Aug 1;11(15):4484. doi: 10.3390/jcm11154484.
Patients with Sjögren's syndrome and polyneuropathy more frequently develop cranial nerve affection when compared to patients with chronic inflammatory demyelinating polyneuropathy (CIDP). We therefore aimed to analyze trigeminal corneal nerve fibre characteristics in both patient groups.
A total of 26 patients with Sjögren's syndrome associated neuropathy and 29 patients with CIDP were recruited at our university hospital and compared to 6 healthy controls. Dry eye symptoms and signs were assessed via clinical examination and the Ocular Disease Surface Index questionnaire. Trigeminal corneal nerve fibres were analyzed via corneal confocal microscopy (CCM) as a non-invasive in vivo microscopy.
CCM revealed significantly reduced corneal nerve fibre density and corneal nerve fibre main branch density in the Neuro-Sjögren group when compared with healthy controls. There were no significant group differences between the Neuro-Sjögren and the CIDP group for any of the microscopic parameters. Dry eye assessment showed similarly reduced scores for both patient groups, while healthy controls showed better results for objective dry eye signs. There was no correlation between microscopic parameters of the corneal confocal microscopy and parameters of dry eye assessment.
Our data revealed trigeminal corneal nerve affection in patients with neuropathy associated with Sjögren's syndrome and patients with CIDP detected by CCM. No difference was found between both neuropathy groups indicating that CCM is not able to distinguish between both entities.
与慢性炎症性脱髓鞘性多发性神经病（CIDP）患者相比，干燥综合征合并多发性神经病患者更常出现颅神经受累。因此，我们旨在分析这两组患者的三叉神经角膜神经纤维特征。
在我们大学医院招募了26例干燥综合征相关性神经病患者和29例CIDP患者，并与6名健康对照者进行比较。通过临床检查和眼表疾病指数问卷评估干眼症状和体征。通过角膜共焦显微镜（CCM）作为一种非侵入性活体显微镜分析三叉神经角膜神经纤维。
与健康对照者相比，CCM显示神经干燥综合征组的角膜神经纤维密度和角膜神经纤维主支密度显著降低。在任何微观参数方面，神经干燥综合征组和CIDP组之间均无显著组间差异。干眼评估显示两组患者的得分同样降低，而健康对照者在客观干眼体征方面表现更好。角膜共焦显微镜的微观参数与干眼评估参数之间无相关性。
我们的数据显示，通过CCM检测到，干燥综合征相关性神经病患者和CIDP患者存在三叉神经角膜神经受累。两组神经病患者之间未发现差异，表明CCM无法区分这两种疾病。
