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Corneal Confocal Microscopy Features and Tear Molecular Profile in Study Participants with Discordance between Ocular Surface Disease Clinical Signs and Discomfort

Various ocular surface conditions such as dry eye disease can present with severe discomfort and pain. However, it is clinically challenging to establish etiology and prescribe correct treatment in patients who have a lot of discordance between symptoms and signs. To understand the basis of such dis...

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Autores principales: D’Souza, Sharon, Shetty, Rohit, Nair, Archana Padmanabhan, Agrawal, Ruchika, Dickman, Mor M., Khamar, Pooja, Nuijts, Rudy M. M. A., Ghosh, Arkasubhra, Sethu, Swaminathan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9099769/
https://www.ncbi.nlm.nih.gov/pubmed/35566533
http://dx.doi.org/10.3390/jcm11092407
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author D’Souza, Sharon
Shetty, Rohit
Nair, Archana Padmanabhan
Agrawal, Ruchika
Dickman, Mor M.
Khamar, Pooja
Nuijts, Rudy M. M. A.
Ghosh, Arkasubhra
Sethu, Swaminathan
author_facet D’Souza, Sharon
Shetty, Rohit
Nair, Archana Padmanabhan
Agrawal, Ruchika
Dickman, Mor M.
Khamar, Pooja
Nuijts, Rudy M. M. A.
Ghosh, Arkasubhra
Sethu, Swaminathan
author_sort D’Souza, Sharon
collection PubMed
description Various ocular surface conditions such as dry eye disease can present with severe discomfort and pain. However, it is clinically challenging to establish etiology and prescribe correct treatment in patients who have a lot of discordance between symptoms and signs. To understand the basis of such discordance, we stratified subjects with ocular surface pain based on concordance between the severity of signs and symptoms and evaluated corneal structural features and tear molecular factors. All subjects underwent slit lamp examination, dry eye evaluation, and ocular surface disease index (OSDI) scoring. Subjects were stratified into group 1—without symptoms or clinical signs; group 2—without symptoms but with signs; group 3—with similar severity of symptoms and signs; and group 4—with symptom severity greater than that of the signs. Laser scanning in vivo confocal microscopy (IVCM) and tear fluid analysis for soluble factors by multiplex ELISA was performed for all subjects. Patients with a higher grade of symptoms and signs showed increased corneal dendritic cell (cDC) density (p < 0.05) which was more pronounced in subjects with discordance between the symptoms and signs (group 4). A significantly higher proportion of microneuroma-like structures and cDC were observed in group 4. IL-17A levels were significantly elevated in the tears of subjects with more discomfort. Our results demonstrate that corneal IVCM and the measurement of tear film factors can help clinicians improve diagnosis and treatment choice. Stratifying patients with ocular surface discomfort on the basis of discordance between symptoms and clinical signs may help identify patients who need additional adjunctive targeted therapy to resolve their condition.
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spelling pubmed-90997692022-05-14 Corneal Confocal Microscopy Features and Tear Molecular Profile in Study Participants with Discordance between Ocular Surface Disease Clinical Signs and Discomfort D’Souza, Sharon Shetty, Rohit Nair, Archana Padmanabhan Agrawal, Ruchika Dickman, Mor M. Khamar, Pooja Nuijts, Rudy M. M. A. Ghosh, Arkasubhra Sethu, Swaminathan J Clin Med Article Various ocular surface conditions such as dry eye disease can present with severe discomfort and pain. However, it is clinically challenging to establish etiology and prescribe correct treatment in patients who have a lot of discordance between symptoms and signs. To understand the basis of such discordance, we stratified subjects with ocular surface pain based on concordance between the severity of signs and symptoms and evaluated corneal structural features and tear molecular factors. All subjects underwent slit lamp examination, dry eye evaluation, and ocular surface disease index (OSDI) scoring. Subjects were stratified into group 1—without symptoms or clinical signs; group 2—without symptoms but with signs; group 3—with similar severity of symptoms and signs; and group 4—with symptom severity greater than that of the signs. Laser scanning in vivo confocal microscopy (IVCM) and tear fluid analysis for soluble factors by multiplex ELISA was performed for all subjects. Patients with a higher grade of symptoms and signs showed increased corneal dendritic cell (cDC) density (p < 0.05) which was more pronounced in subjects with discordance between the symptoms and signs (group 4). A significantly higher proportion of microneuroma-like structures and cDC were observed in group 4. IL-17A levels were significantly elevated in the tears of subjects with more discomfort. Our results demonstrate that corneal IVCM and the measurement of tear film factors can help clinicians improve diagnosis and treatment choice. Stratifying patients with ocular surface discomfort on the basis of discordance between symptoms and clinical signs may help identify patients who need additional adjunctive targeted therapy to resolve their condition. MDPI 2022-04-25 /pmc/articles/PMC9099769/ /pubmed/35566533 http://dx.doi.org/10.3390/jcm11092407 Text en © 2022 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
D’Souza, Sharon
Shetty, Rohit
Nair, Archana Padmanabhan
Agrawal, Ruchika
Dickman, Mor M.
Khamar, Pooja
Nuijts, Rudy M. M. A.
Ghosh, Arkasubhra
Sethu, Swaminathan
Corneal Confocal Microscopy Features and Tear Molecular Profile in Study Participants with Discordance between Ocular Surface Disease Clinical Signs and Discomfort
title Corneal Confocal Microscopy Features and Tear Molecular Profile in Study Participants with Discordance between Ocular Surface Disease Clinical Signs and Discomfort
title_full Corneal Confocal Microscopy Features and Tear Molecular Profile in Study Participants with Discordance between Ocular Surface Disease Clinical Signs and Discomfort
title_fullStr Corneal Confocal Microscopy Features and Tear Molecular Profile in Study Participants with Discordance between Ocular Surface Disease Clinical Signs and Discomfort
title_full_unstemmed Corneal Confocal Microscopy Features and Tear Molecular Profile in Study Participants with Discordance between Ocular Surface Disease Clinical Signs and Discomfort
title_short Corneal Confocal Microscopy Features and Tear Molecular Profile in Study Participants with Discordance between Ocular Surface Disease Clinical Signs and Discomfort
title_sort corneal confocal microscopy features and tear molecular profile in study participants with discordance between ocular surface disease clinical signs and discomfort
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9099769/
https://www.ncbi.nlm.nih.gov/pubmed/35566533
http://dx.doi.org/10.3390/jcm11092407
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