In vivo confocal microscopic study of corneal innervation in Sjögren's Syndrome with or without small fiber neuropathy

Jade Luzu; Antoine Labbé; Annabelle Réaux-Le Goazigo; Ghislaine Rabut; Hong Liang; Bénédicte Dupas; Benjamin Blautain; Damien Sène; Christophe Baudouin

doi:10.1016/j.jtos.2022.07.003

In vivo confocal microscopic study of corneal innervation in Sjögren's Syndrome with or without small fiber neuropathy

Ocul Surf. 2022 Jul:25:155-162. doi: 10.1016/j.jtos.2022.07.003. Epub 2022 Jul 22.

Authors

Jade Luzu¹, Antoine Labbé², Annabelle Réaux-Le Goazigo³, Ghislaine Rabut⁴, Hong Liang², Bénédicte Dupas⁴, Benjamin Blautain⁴, Damien Sène⁵, Christophe Baudouin²

Affiliations

¹ Department of Ophthalmology III, CHNO des Quinze-Vingts, IHU FOReSIGHT, 28 rue de Charenton, F-75012, Paris, France. Electronic address: jluzu@15-20.fr.
² Department of Ophthalmology III, CHNO des Quinze-Vingts, IHU FOReSIGHT, 28 rue de Charenton, F-75012, Paris, France; Sorbonne Université, INSERM, CNRS, Institut de la Vision, IHU FOReSIGHT, 17 rue Moreau, F-75012, Paris, France.
³ Sorbonne Université, INSERM, CNRS, Institut de la Vision, IHU FOReSIGHT, 17 rue Moreau, F-75012, Paris, France.
⁴ Department of Ophthalmology III, CHNO des Quinze-Vingts, IHU FOReSIGHT, 28 rue de Charenton, F-75012, Paris, France.
⁵ Departement of Internal Medecine, Lariboisière Hospital, 2 rue Ambroise Paré, F-75010, Paris, France.

PMID: 35872076
DOI: 10.1016/j.jtos.2022.07.003

Abstract

Purpose: To study changes in the subbasal nerve plexus by In vivo confocal microscopy (IVCM) in Sjögren's Syndrome (SS) with or without associated Small Fiber Neuropathy (SFN), in order to prevent diagnostic delay.

Methods: Seventy-one patients with SS, including 19 with associated SFN, 20 healthy volunteers and 20 patients with Meibomian gland dysfunction (MGD) were included in this retrospective case-control study. IVCM was used to investigate subbasal nerve plexus density and morphology.

Results: Corneal sensitivity as evaluated with the Cochet-Bonnet aesthesiometer was significantly reduced in the SS group versus the control group (P = 0.026) and the MGD group (P = 0.037). The number of inflammatory cells was significantly increased in the SS group to 86.2 ± 82.1 cells/mm² compared to the control group (P < 0.001). The density of the subbasal nerve plexus was significantly reduced to 16.7 ± 6.5 mm/mm² in the SS group compared to the control group (P < 0.005) and the MGD group (P = 0.042). The tortuosity of the nerves in the SS group was significantly increased compared to the control group (P < 0.001) and the MGD group (P = 0.025). The average number of subbasal nerve plexus neuromas was significantly increased in the SS group compared to the control group (P = 0.001), with a significant increase in the average number of neuromas in SS patients with associated SFN compared to SS patients without SFN (P = 0.008).

Conclusion: IVCM can be useful to detect corneal nerve changes in SS patients and may allow earlier diagnosis of the disease and to consider new therapeutic approaches.

Keywords: Confocal; Corneal innervation; Microscopy; Neuroma; Sjogren's syndrome; Small fiber neuropathy.

MeSH terms

Case-Control Studies
Cornea / innervation
Delayed Diagnosis
Humans
Microscopy, Confocal
Neuroma* / complications
Ophthalmic Nerve
Retrospective Studies
Sjogren's Syndrome* / complications
Sjogren's Syndrome* / diagnosis
Small Fiber Neuropathy* / complications