Ocular surface evaluation using as‐oct and in vivo confocal microscopy in patients with primary sjögren’s syndrome

Abstract

AbstractIntroductionDry eye disease severity is classically obtained through an evaluation of tear film stability and tear production, lid margin disease, ocular surface damage and tear osmolarity. Other parameters for severity classification are know being used for a more accurate follow‐up and managing. The purpose of this study is to evaluate the tear meniscus (TM) and corneal sub‐basal nerve plexus (SBNP) in a population with pSS, using anterior segment optical coherence tomography (AS‐OCT) and in vivo Confocal Microscopy (ivCM).Material and MethodsObservational cross‐sectional study of 50 patients with pSS and 20 healthy controls. All patients were submitted to Schirmer test I without anaesthesia, tear break‐up time and corneal fluorescein staining evaluation. Anterior segment optical coherence tomography (AS‐OCT) was used for TM height and area analysis. In vivo Confocal Microscopy (IVCM) was performed for corneal SBNP density, length and tortuosity. Differences in pSS ophthalmic features were analyzed according to phenotype profile.ResultsTM height was significantly lower in pSS in contrast to healthy controls (p < 0.001). Corneal SBNP density and length were significantly lower and tortuosity significantly higher in pSS patients (p < 0.001, p = 0.004 and p = 0.001, respectively).ConclusionThe diagnosis of Primary Sjögren’s Syndrome (pSS) is sometimes challenging, taking into account the clinical heterogeneity and diagnostic criteria fulfillment variability. AS‐OCT and IVCM may be useful in additional evaluation of lachrymal unit dysfunction in pSS.