Clinical Implication of Patchy Pattern Corneal Staining in Dry Eye Disease.

Seitaro Komai,Yukiko Sonomura,Shigeru Kinoshita,Chie Sotozono,Norihiko Yokoi,Hiroaki Kato,Aoi Komuro

doi:10.3390/diagnostics11020232

Seitaro Komai, Yukiko Sonomura + Show 5 more

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https://doi.org/10.3390/diagnostics11020232

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Abstract

Corneal fluorescein staining in a form that is commonly called a “patchy pattern (PP)” is sometimes seen with or without superficial punctate keratopathy (SPK) in dry-eye diseases (DEDs). Here, we investigated the differences in the clinical features of DED patients with and without PP corneal staining (PPCS). This study involved 35 DEDs with PPCS (PPCS group) and 30 DEDs with SPK and without PPCS (non-PPCS group). The tear meniscus radius (TMR, mm), spread grade (SG) of the tear-film lipid layer (i.e., SG 1–5, 1 being best), noninvasive breakup time (NIBUT, seconds), fluorescein breakup time (FBUT, seconds), corneal epithelial damage (CED, 15 points maximum), conjunctival epithelial damage (CjED, six points maximum), the Schirmer’s 1 test (ST1, mm), and the prevalence of Sjögren’s syndrome (SS) were examined, and then compared between the two groups. Our findings revealed that between the groups (PPCS vs. non-PPCS), there was a statistically significant difference (p < 0.05) in CjED (3.1 ± 1.9 vs. 1.3 ± 1.6), ST1 (5.6 ± 7.4 vs. 14.8 ± 11.4), and the prevalence of SS (60.0% vs. 16.7%). Our findings suggest that DEDs and dry-eye patients with PPCS may indicate not only SS itself, but also the ophthalmological characteristics compatible with SS.

Highlights

Received: 31 December 2020Superficial punctate keratopathy (SPK) is a corneal epithelial abnormality clinically characterized by the punctate staining of the corneal surface when observed via fluoresceinassisted slit-lamp biomicroscopy
This study involved subjects who were enrolled from the Kyoto Prefectural University of Medicine (KPUM) Dry Eye Clinic between May 2013 and May 2015, with the inclusion criteria being patients diagnosed with dry eye diseases (DEDs) and who underwent fluorescein corneal staining
65 subjects, 35 eyes were classified as DED with patchy pattern (PP) corneal staining (PPCS) (PPCS group) and 30 eyes as DED

Summary

Introduction

Superficial punctate keratopathy (SPK) is a corneal epithelial abnormality clinically characterized by the punctate staining of the corneal surface when observed via fluoresceinassisted slit-lamp biomicroscopy. SPK is observed in a variety of ocular surface diseases, such as dry eye diseases (DEDs) [1], the eyes of contact lens wearers [2,3], drug-induced epithelial keratopathy [4], and ocular trauma, as well as in normal eyes [5]. Corneal fluorescein staining in a form that is commonly called a “patchy pattern (PP)” (Figure 1) is sometimes observed with or without SPK in patients afflicted with DED. Similar to PP corneal staining (PPCS), corneal mucus plaques (CMPs) are sometimes seen in patients with relatively severe ATDDEs [15,16]. CMPs are aggregates of various sizes and shapes that attach to the corneal surface, and they are mainly composed of mucus, Accepted: 1 February 2021

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