Corneal nerve structure and function in patients with non‐Sjögren dry eye

Abstract

AbstractPurpose To evaluate the relationship between the in vivo morphology of subbasal corneal nerves and clinical parameters in patients with non‐Sjögren dry eye disease (NSDD).Methods Forty‐three patients with NSDD and 14 healthy age‐ and gender‐matched control subjects were included. Each patient underwent an evaluation of ocular surface disease symptoms using the Ocular Surface Disease Index (OSDI), tear film break‐up time (TBUT), corneal and conjunctival staining (Oxford scale), the Schirmer test, corneal sensation testing using the Cochet‐Bonnet esthesiometer and corneal subbasal nerve analysis with IVCM. One eye of each subject was included in the study.Results Corneal sensitivity was significantly lower in the dry eye group as compared to the control group (P=0.001). Corneal subbasal nerves showed significant changes in dry eye patients as compared to normal subjects: lower density (P<0.001), increased tortuosity (P<0.001), number of beadings (P<0.001) and width (P=0.014). In patients with dry eye, corneal subbasal nerve density was correlated to age (r=−0.335, P=0.028), the Oxford scale (r=−0.562, P<0.001) and central corneal sensitivity (r=0.305, P=0.047). The maximum length of nerve fibers within a frame (MaxL) was correlated to the OSDI (r=−0.332, P=0.030) and the Oxford scale (r=−0.321, P=0.036). In multivariate analysis corneal subbasal nerve density remained correlated to the Oxford score (P<0.001). The Oxford score was also correlated to central corneal sensitivity (r=−0.317, P=0.039).Conclusion NSDD patients presented significant alterations of subbasal corneal nerve structure and function. In NSDD, subbasal nerve alterations were correlated to ocular surface tissue damage.