TY - JOUR
T1 - In vivo confocal evaluation of the ocular surface morpho-functional unit in dry eye
AU - Villani, Edoardo
AU - Magnani, Fabrizio
AU - Viola, Francesco
AU - Santaniello, Alessandro
AU - Scorza, Raffaella
AU - Nucci, Paolo
AU - Ratiglia, Roberto
PY - 2013/6
Y1 - 2013/6
N2 - PURPOSE: To study, by a new, integrated, laser scanning confocal microscopy approach, the ocular surface morpho-functional unit in patients with primary Sjogren syndrome (SSI), non-Sjogren syndrome dry eye (non-SSDE), and meibomian gland disease (MGD). METHODS: Patients and age- and sex-matched control subjects (N = 60; 15 each) were consecutively enrolled in a prospective case-control study. Laser scanning confocal microscopy was used to obtain simultaneous optical sampling of the ocular surface components: cornea, bulbar and tarsal conjunctiva, MGs, and eyelid margin. RESULTS: For all superficial epithelia, except eyelid margins, there were reduced cell densities in each group compared with that in controls (p <0.001). The lowest cell densities were in the SSI group (p <0.001). Eyelid margin superficial cell density was decreased only in MGD (p <0.001). Basal epithelial cell density at the corneal apex was increased in both SSI and non-SSDE compared with that in controls (p <0.01). In the conjunctiva, it was decreased in each group compared with that in controls (p <0.01). Subbasal dendritic cell density was significantly increased in both SSI and MGD compared with that in controls (p <0.01). Conjunctival inflammatory cell density and MG inflammation were increased in each group compared with those in controls (p <0.001), with the highest values in SSI. Subbasal nerve plexi had fewer fibers and higher bead density in each group compared with those in controls (p <0.001). There was increased tortuosity in both SSI and MGD (p <0.001). Patients with MGD had the lowest MG acinar density, the largest diameter of acini and acinar orifices, and the highest secretion reflectivity (p <0.001). CONCLUSIONS: Laser scanning confocal microscopy can provide an in vivo, noninvasive, high-resolution overview of the ocular surface morpho-funcional unit. This confocal integrated approach may be useful in both research and clinical settings.
AB - PURPOSE: To study, by a new, integrated, laser scanning confocal microscopy approach, the ocular surface morpho-functional unit in patients with primary Sjogren syndrome (SSI), non-Sjogren syndrome dry eye (non-SSDE), and meibomian gland disease (MGD). METHODS: Patients and age- and sex-matched control subjects (N = 60; 15 each) were consecutively enrolled in a prospective case-control study. Laser scanning confocal microscopy was used to obtain simultaneous optical sampling of the ocular surface components: cornea, bulbar and tarsal conjunctiva, MGs, and eyelid margin. RESULTS: For all superficial epithelia, except eyelid margins, there were reduced cell densities in each group compared with that in controls (p <0.001). The lowest cell densities were in the SSI group (p <0.001). Eyelid margin superficial cell density was decreased only in MGD (p <0.001). Basal epithelial cell density at the corneal apex was increased in both SSI and non-SSDE compared with that in controls (p <0.01). In the conjunctiva, it was decreased in each group compared with that in controls (p <0.01). Subbasal dendritic cell density was significantly increased in both SSI and MGD compared with that in controls (p <0.01). Conjunctival inflammatory cell density and MG inflammation were increased in each group compared with those in controls (p <0.001), with the highest values in SSI. Subbasal nerve plexi had fewer fibers and higher bead density in each group compared with those in controls (p <0.001). There was increased tortuosity in both SSI and MGD (p <0.001). Patients with MGD had the lowest MG acinar density, the largest diameter of acini and acinar orifices, and the highest secretion reflectivity (p <0.001). CONCLUSIONS: Laser scanning confocal microscopy can provide an in vivo, noninvasive, high-resolution overview of the ocular surface morpho-funcional unit. This confocal integrated approach may be useful in both research and clinical settings.
KW - conjunctiva
KW - cornea
KW - dry eye
KW - imaging
KW - in vivo confocal microscopy
KW - inflammation
KW - meibomian glands
KW - ocular surface
KW - Sjogren syndrome
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U2 - 10.1097/OPX.0b013e318294c184
DO - 10.1097/OPX.0b013e318294c184
M3 - Article
C2 - 23670123
AN - SCOPUS:84878928527
VL - 90
SP - 576
EP - 586
JO - Optometry and Vision Science
JF - Optometry and Vision Science
SN - 1040-5488
IS - 6
ER -