Bucsan Radu, Coroleucă Ruxandra, Garhöfer Gerhard, Popa-Cherecheanu Alina, Schmetterer Leopold, Iancu Raluca
Department of Ophthalmology, University of Medicine and Pharmacy Carol Davila, 050747 Bucharest, Romania.
Department of Ophthalmology, Emergency University Hospital Bucharest, 050098 Bucharest, Romania.
Diagnostics (Basel). 2024 Jul 26;14(15):1613. doi: 10.3390/diagnostics14151613.
In vivo confocal microscopy (IVCM) is a vital tool in studying dry eye disease (DED), providing insights into morphological changes at ocular surface unit levels. This review presents the main differences in corneal structure between aqueous-deficient dry eye disease (AD-DED) and normal eyes.
A comprehensive search of PubMed, Web of Science, Embase, and MEDLINE databases from January 2000 to December 2023 was conducted. The study selection process, as well as data selection and examination, were independently performed by two members of the review team.
The review reveals a consistent decrease in corneal surface epithelial cell density in AD-DED cases compared to a control group, but conflicting data on basal epithelial cell density. Notably, the abnormal hyperreflectivity of keratocytes in patients with Sjogren's syndrome was recorded, and there was a significant keratocyte density in AD-DED subjects compared to evaporative DED and control groups. Studies also found a decrease in sub-basal nerve density, increased tortuosity, and the fragmentation of nerve fibers. Dendritic cell density and dendritic cell dendrites increase in AD-DED patients compared to healthy subjects.
IVCM is a powerful tool for enhancing our understanding of the pathophysiological mechanisms underlying DED. However, the review underscores the urgent need to standardize the terminology, analysis, and units used for accurate interpretation, a crucial step in advancing our knowledge of DED.
共聚焦显微镜检查（IVCM）是研究干眼病（DED）的重要工具，可深入了解眼表单位水平的形态学变化。本综述介绍了水液缺乏型干眼病（AD-DED）与正常眼睛在角膜结构上的主要差异。
对2000年1月至2023年12月期间的PubMed、Web of Science、Embase和MEDLINE数据库进行了全面检索。研究筛选过程以及数据选择和审查由综述团队的两名成员独立进行。
该综述显示，与对照组相比，AD-DED病例的角膜表面上皮细胞密度持续降低，但关于基底上皮细胞密度的数据存在矛盾。值得注意的是，记录了干燥综合征患者角膜细胞的异常高反射性，与蒸发型DED和对照组相比，AD-DED受试者的角膜细胞密度显著增加。研究还发现基底神经密度降低、弯曲度增加以及神经纤维断裂。与健康受试者相比，AD-DED患者的树突状细胞密度和树突状细胞树突增加。
IVCM是增强我们对DED潜在病理生理机制理解的有力工具。然而，该综述强调迫切需要规范用于准确解释的术语分析和单位，这是推进我们对DED认识的关键一步。
