Nguyen Brian J, Gupta Angela S, He Jocelyn, Ying Gui-Shuang, Bunya Vatinee Y, Macchi Ilaria, Massaro-Giordano Mina
Department of Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA, USA.
Department of Ophthalmology, Center for Preventive Ophthalmology and Biostatistics, University of Pennsylvania, Philadelphia, PA, USA.
Clin Ophthalmol. 2024 Jul 30;18:2175-2182. doi: 10.2147/OPTH.S456621. eCollection 2024.
This study was to assess corneal epithelial thickness (CET) in patients with Sjogren's disease (SjD).
A retrospective chart review was conducted of SjD patients from September 2021 to January 2022. Patient demographics, unanesthetized Schirmer's test, serologic markers, and symptoms as measured by the Ocular Surface Disease Index (OSDI) were reviewed. Epithelial thickness from both eyes was measured using anterior segment OCT at the central 3mm and concentric 5mm, 7mm, and 9mm zones for the superior, temporal, inferior, and nasal corneal quadrants. Associations between corneal epithelial thickness with patient demographics, clinical characteristics, and symptoms were evaluated using regression models.
Fifteen SjD patients (100% female) were included with a mean age of 58.4 years. Patients with Sjogren's disease had a significantly thinner superior corneal epithelium compared to the inferior epithelium (mean 47.7mm vs 53.1mm, p = 0.001). The epithelial thickness mean standard deviation (MSD) was significantly inversely correlated with the unanesthetized Schirmer test (r=-0.39, p = 0.005), suggesting that an overall variability of CET correlates with decreased aqueous tear production. SS-A, SS-B, ANA, and RF positivity were not associated with any measures of CET.
This pilot study suggests that there is significant superior versus inferior thinning of corneal epithelium in Sjogren's patients. There was a significant correlation between variability of corneal epithelial thickness and decreased tear production in Sjogren's patients. Further larger studies are needed to understand the relationship of CET with objective and subjective measurements of ocular surface disease.
本研究旨在评估干燥综合征（SjD）患者的角膜上皮厚度（CET）。
对2021年9月至2022年1月期间的SjD患者进行回顾性病历审查。审查了患者的人口统计学资料、未麻醉状态下的泪液分泌试验、血清学标志物以及通过眼表疾病指数（OSDI）测量的症状。使用眼前节光学相干断层扫描（OCT）测量双眼在中央3mm以及角膜上、颞、下、鼻象限同心的5mm、7mm和9mm区域的上皮厚度。使用回归模型评估角膜上皮厚度与患者人口统计学资料、临床特征和症状之间的关联。
纳入15例SjD患者（100%为女性），平均年龄58.4岁。干燥综合征患者角膜上半部分的上皮明显比下半部分薄（平均47.7mm对53.1mm，p = 0.001）。上皮厚度平均标准差（MSD）与未麻醉状态下的泪液分泌试验显著负相关（r = -0.39，p = 0.005），这表明CET的总体变异性与泪液分泌减少相关。SS - A、SS - B、抗核抗体（ANA）和类风湿因子（RF）阳性与CET的任何测量指标均无关联。
这项初步研究表明，干燥综合征患者角膜上皮存在明显的上半部分比下半部分变薄的情况。干燥综合征患者角膜上皮厚度的变异性与泪液分泌减少之间存在显著相关性。需要进一步开展更大规模的研究来了解CET与眼表疾病客观和主观测量指标之间的关系。
