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Corneal Nerve Abnormalities in Painful Dry Eye Disease Patients

Background: This study aimed to compare the corneal nerve structural abnormalities detected using in vivo confocal microscopy (IVCM) in patients with neuropathic corneal pain (NCP) secondary to primary meibomian gland dysfunction (MGD) or autoimmune dry eye (AIDE). Methods: A two-stage retrospective...

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Autores principales: Guerrero-Moreno, Adrian, Liang, Hong, Moreau, Nathan, Luzu, Jade, Rabut, Ghislaine, Melik Parsadaniantz, Stéphane, Labbé, Antoine, Baudouin, Christophe, Réaux-Le Goazigo, Annabelle
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8533181/
https://www.ncbi.nlm.nih.gov/pubmed/34680542
http://dx.doi.org/10.3390/biomedicines9101424
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author Guerrero-Moreno, Adrian
Liang, Hong
Moreau, Nathan
Luzu, Jade
Rabut, Ghislaine
Melik Parsadaniantz, Stéphane
Labbé, Antoine
Baudouin, Christophe
Réaux-Le Goazigo, Annabelle
author_facet Guerrero-Moreno, Adrian
Liang, Hong
Moreau, Nathan
Luzu, Jade
Rabut, Ghislaine
Melik Parsadaniantz, Stéphane
Labbé, Antoine
Baudouin, Christophe
Réaux-Le Goazigo, Annabelle
author_sort Guerrero-Moreno, Adrian
collection PubMed
description Background: This study aimed to compare the corneal nerve structural abnormalities detected using in vivo confocal microscopy (IVCM) in patients with neuropathic corneal pain (NCP) secondary to primary meibomian gland dysfunction (MGD) or autoimmune dry eye (AIDE). Methods: A two-stage retrospective nested case–control study was conducted. First, data from patients with either MGD or AIDE were assessed, selecting only cases with no corneal pain (VAS = 0) or severe pain (VAS ≥ 8). Ocular signs and symptoms of the 238 selected patients were compared between painful and painless cases. Next, painful patients with no corneal damage (Oxford score ≤ 1) were selected within each study group, defining the cases with NCP (i.e., “pain without stain”). IVCM images from all groups were compared with prospectively-recruited healthy controls, focusing on dendritiform cell density and nerve abnormalities (density, tortuosity, microneuromas). Results: AIDE patients had more ocular signs/symptoms than MGD patients. Compared with healthy controls, AIDE-related NCP patients showed increased nerve tortuosity and number of neuromas, whereas MGD-related NCP patients had reduced nerve density and increased number, perimeter, and area of microneuromas. Microneuromas were also observed in healthy controls. Furthermore, a higher number of microneuromas was found in MGD-related NCP compared to AIDE-related NCP or painless MGD. Conclusions: MGD-related NCP was associated with significantly more corneal nerve abnormalities than AIDE-related NCP or healthy controls. Although IVCM can be useful to detect NCP-related corneal nerve changes in such patients, the diagnosis of dry eye disease-related NCP will require an association of several IVCM-based criteria without relying solely on the presence of microneuromas.
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spelling pubmed-85331812021-10-23 Corneal Nerve Abnormalities in Painful Dry Eye Disease Patients Guerrero-Moreno, Adrian Liang, Hong Moreau, Nathan Luzu, Jade Rabut, Ghislaine Melik Parsadaniantz, Stéphane Labbé, Antoine Baudouin, Christophe Réaux-Le Goazigo, Annabelle Biomedicines Article Background: This study aimed to compare the corneal nerve structural abnormalities detected using in vivo confocal microscopy (IVCM) in patients with neuropathic corneal pain (NCP) secondary to primary meibomian gland dysfunction (MGD) or autoimmune dry eye (AIDE). Methods: A two-stage retrospective nested case–control study was conducted. First, data from patients with either MGD or AIDE were assessed, selecting only cases with no corneal pain (VAS = 0) or severe pain (VAS ≥ 8). Ocular signs and symptoms of the 238 selected patients were compared between painful and painless cases. Next, painful patients with no corneal damage (Oxford score ≤ 1) were selected within each study group, defining the cases with NCP (i.e., “pain without stain”). IVCM images from all groups were compared with prospectively-recruited healthy controls, focusing on dendritiform cell density and nerve abnormalities (density, tortuosity, microneuromas). Results: AIDE patients had more ocular signs/symptoms than MGD patients. Compared with healthy controls, AIDE-related NCP patients showed increased nerve tortuosity and number of neuromas, whereas MGD-related NCP patients had reduced nerve density and increased number, perimeter, and area of microneuromas. Microneuromas were also observed in healthy controls. Furthermore, a higher number of microneuromas was found in MGD-related NCP compared to AIDE-related NCP or painless MGD. Conclusions: MGD-related NCP was associated with significantly more corneal nerve abnormalities than AIDE-related NCP or healthy controls. Although IVCM can be useful to detect NCP-related corneal nerve changes in such patients, the diagnosis of dry eye disease-related NCP will require an association of several IVCM-based criteria without relying solely on the presence of microneuromas. MDPI 2021-10-09 /pmc/articles/PMC8533181/ /pubmed/34680542 http://dx.doi.org/10.3390/biomedicines9101424 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Guerrero-Moreno, Adrian
Liang, Hong
Moreau, Nathan
Luzu, Jade
Rabut, Ghislaine
Melik Parsadaniantz, Stéphane
Labbé, Antoine
Baudouin, Christophe
Réaux-Le Goazigo, Annabelle
Corneal Nerve Abnormalities in Painful Dry Eye Disease Patients
title Corneal Nerve Abnormalities in Painful Dry Eye Disease Patients
title_full Corneal Nerve Abnormalities in Painful Dry Eye Disease Patients
title_fullStr Corneal Nerve Abnormalities in Painful Dry Eye Disease Patients
title_full_unstemmed Corneal Nerve Abnormalities in Painful Dry Eye Disease Patients
title_short Corneal Nerve Abnormalities in Painful Dry Eye Disease Patients
title_sort corneal nerve abnormalities in painful dry eye disease patients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8533181/
https://www.ncbi.nlm.nih.gov/pubmed/34680542
http://dx.doi.org/10.3390/biomedicines9101424
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