Abstract | 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-functional unit. This confocal integrated approach may be useful in both research and clinical settings.
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Authors | Edoardo Villani, Fabrizio Magnani, Francesco Viola, Alessandro Santaniello, Raffaella Scorza, Paolo Nucci, Roberto Ratiglia |
Journal | Optometry and vision science : official publication of the American Academy of Optometry
(Optom Vis Sci)
Vol. 90
Issue 6
Pg. 576-86
(Jun 2013)
ISSN: 1538-9235 [Electronic] United States |
PMID | 23670123
(Publication Type: Journal Article)
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Topics |
- Adult
- Aged
- Case-Control Studies
- Cell Count
- Conjunctiva
(pathology)
- Dry Eye Syndromes
(pathology)
- Epithelial Cells
(pathology)
- Epithelium, Corneal
(pathology)
- Eyelids
(pathology)
- Female
- Humans
- Male
- Microscopy, Confocal
- Middle Aged
- Prospective Studies
- Young Adult
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