CORNEAL SENSITIVITY IN A PREVIOUSLY DIAGNOSED MILD DRY EYE DISEASE POPULATION COMPARED TO NON-DRY EYE CONTROLS
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Abstract
Background and Objective
To identify whether a measurable difference in corneal sensitivity exists between patients previously diagnosed with mild dry eye disease and non-dry eye controls using a novel in-office esthesiometry kit.
Material and Methods
This was a consecutive, single-visit, single-center, comparative observational study. Forty patients (20 dry eye patients and 20 non-dry eye controls) were screened for study inclusion. Thirty-six were included in the analysis set (17 dry eye, 19 non-dry eye). Patients completed a dry eye symptom questionnaire (OSDI), tear film break-up time (TBUT) evaluation, Schirmer’s I test, and vital dye staining for corneal and conjunctival integrity, and corneal sensitivity measurements in the central and inferior cornea.
Results
Comparison between the two groups revealed statistically significant differences in age, TBUT, conjuncti-val and corneal staining scores, and central corneal and inferior corneal sensitivity. There were no differ-ences in OSDI score and Schirmer’s I score between the two groups. Corneal staining score was inversely correlated with a decrease in central (−0.78) and inferior (−0.77) corneal sensitivity. Corneal sensitivity measurements were more strongly correlated to corneal staining score than age (−0.58; z = −2.20).
Conclusion
Patients with a previous diagnosis of mild dry eye disease exhibited higher corneal and conjunctival staining scores, which correlated with reduced corneal sensitivity in both central and inferior regions compared to non-dry eye controls. A stronger correlation existed between reduced sensitivity to corneal staining and age in this study. This demonstrates a decrease in the neurosensory function in the presence of reduced
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References
1. Stapleton F, Alves M, Bunya VY, Jalbert I, Lekhanont K, Malet F, et al. TFOS DEWS II Epidemiology Report. Ocul Surf. 2017;15(3): 334–75. https://doi.org/10.1016/j.jtos.2017.05.003
2. Bradley JL, Özer Stillman I, Pivneva I, Guerin A, Evans AM, Dana R. Dry eye disease ranking among common reasons for seeking eye care in a large US claims database. Clin Ophthalmol. 2019;13:225–32. https://doi.org/10.2147/OPTH.S188314
3. Sacchetti M, Lambaise A. Diagnosis and management of neurotrophic keratitis. Clin Ophthalmol. 2014;8:571–9. https://doi.org/10.1016/ j.jtos.2017.06.003
4. Dua HS, Said DG, Messmer EM, Rolando M, Benitez-Del-Castillo JM, Hossain PN, et al. Neurotrophic keratopathy. Prog Retin Eye Res. 2018;66:102–20. https://doi.org/10.1016/j. preteyeres.2018.04.003
5. Cruzat A, Qazi Y, Hamrah P. In-vivo confocal microscopy of corneal nerves in health and dis-ease. Ocul Surf. 2017;15(1):15–47. https://doi. org/10.1016/j.jtos.2016.09.004
6. Xu KP, Yagi Y, Tsubota K. Decrease in cor-neal sensitivity and change in tear function in dry eye. Cornea. 1996;15(3):235–9. https://doi. org/10.1097/00003226-199605000-00002
7. Hosal BM, Ornek N, Zilelioğlu G, Elhan AH. Morphology of corneal nerves and corneal sensa-tion in dry eye: A preliminary study. Eye (Lond). 2005;19(12):1276–9. https://doi.org/10.1038/sj.eye. 6701760
8. Benitez-Del-Castillo JM, Acosta MC, Wassfi MA, Díaz-Valle D, Gegúndez JA, Fernandez C, et al. Relation between corneal innervation with confocal microscopy and corneal sensitivity with noncontact esthesiometry in patients with dry eye. Invest Ophthalmol Vis Sci. 2007;48(1):173–81. https://doi.org/10.1167/iovs.06-0127
9. De Paiva CS, Pflugfelder SC. Corneal epithe-liopathy of dry eye induced hyperesthesia to mechanical air jet stimulation. Am J Ophthalmol. 2004;137(1):109–15. https://doi.org/10.1016/s0002-9394(03)00897-3
10. Tuisku IS, Konttinen YT, Konttinen LM, Tervo TM. Alterations in corneal sensitivity and nerve mor-phology in patients with primary Sjogren’s syn-drome. Exp Eye Res. 2008;86(6):879–85. https:// doi.org/10.1016/j.exer.2008.03.002
11. Dana R, Farid M, Gupta PK, Hamrah P, Karpecki P, McCabe CM, et al. Expert consensus on the identification, diagnosis, and treatment of neurotrophic keratopathy. BMC Ophthalmol. 2021;21(1):327. https://doi.org/10.1186/s12886-021-02092-1
12. Mirzajan A, Khezri F, Jafarzadehpur E, Karimian F, Khabazkhoob M. Normal corneal sensitivity and its changes with age in Tehran, Iran. Clin Exp Optom. 2015;98(1):54–57. https:// doi.org/10.1111/cxo.12214
13. Nepp J, Wirth M. Fluctuations of corneal sensitivity in dry eye syndrome—A longitudinal pilot study. Cornea. 2015;34(10):1221–6. https://doi. org/10.1097/ICO.0000000000000566 14. Stapleton F, Marfurt C, Golebiowski B, Rosenblatt M, Bereiter D, Begley C, et al. The TFOS International Workshop on Contact Lens Discomfort: Report of the subcommittee on neurobiology. Invest Ophthalmol Vis Sci. 2013;54(11):TFOS71-97. https://doi.org/10.1167/iovs.13-13226
15. Lum E, Golebiowski B, Gunn R, Babhoota M, Swarbrick H. Corneal sensitivity with contact lenses of different mechanical properties. Optom Vis Sci. 2013;90(9):954–60. https://doi.org/10.1097/OPX.0000000000000016 16. Murphy PJ, Patel S, Marshall J. The effect of long term, daily contact lens wear on corneal sensitivity. Cornea. 2001;20(3):264–9. https://doi. org/10.1097/00003226-200104000-00006
17. Patel SV, McLaren JW, Hodge DO, Bourne WM. Confocal microscopy in vivo in corneas of long-term contact lens wearers. Invest Ophthalmol Vis Sci. 2002;43(4):995–1003.