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Corneal Nerve Abnormalities in Painful Dry Eye Disease Patients

Institut de la Vision, INSERM, CNRS, Sorbonne Université, 17 rue Moreau, 75012 Paris, France
CHNO des Quinze-Vingts, INSERM-DGOS CIC 1423, 17 rue Moreau, 75012 Paris, France
Department of Ophthalmology, Ambroise Paré Hospital, AP-HP, University of Versailles Saint-Quentin-en-Yvelines, 9 Avenue Charles de Gaulle, 92100 Boulogne-Billancourt, France
Author to whom correspondence should be addressed.
These authors contributed equally to this study.
Academic Editor: Stefania Raimondo
Biomedicines 2021, 9(10), 1424;
Received: 18 August 2021 / Revised: 28 September 2021 / Accepted: 7 October 2021 / Published: 9 October 2021
(This article belongs to the Section Neurobiology and Neurologic Disease)
Background: This study aimed to compare the corneal nerve structural abnormalities detected using in vivo confocal microscopy (IVCM) in patients with neuropathic corneal pain (NCP) secondary to primary meibomian gland dysfunction (MGD) or autoimmune dry eye (AIDE). Methods: A two-stage retrospective nested case–control study was conducted. First, data from patients with either MGD or AIDE were assessed, selecting only cases with no corneal pain (VAS = 0) or severe pain (VAS ≥ 8). Ocular signs and symptoms of the 238 selected patients were compared between painful and painless cases. Next, painful patients with no corneal damage (Oxford score ≤ 1) were selected within each study group, defining the cases with NCP (i.e., “pain without stain”). IVCM images from all groups were compared with prospectively-recruited healthy controls, focusing on dendritiform cell density and nerve abnormalities (density, tortuosity, microneuromas). Results: AIDE patients had more ocular signs/symptoms than MGD patients. Compared with healthy controls, AIDE-related NCP patients showed increased nerve tortuosity and number of neuromas, whereas MGD-related NCP patients had reduced nerve density and increased number, perimeter, and area of microneuromas. Microneuromas were also observed in healthy controls. Furthermore, a higher number of microneuromas was found in MGD-related NCP compared to AIDE-related NCP or painless MGD. Conclusions: MGD-related NCP was associated with significantly more corneal nerve abnormalities than AIDE-related NCP or healthy controls. Although IVCM can be useful to detect NCP-related corneal nerve changes in such patients, the diagnosis of dry eye disease-related NCP will require an association of several IVCM-based criteria without relying solely on the presence of microneuromas. View Full-Text
Keywords: neuropathic pain; nerve abnormalities; cornea; dry eye; microneuroma neuropathic pain; nerve abnormalities; cornea; dry eye; microneuroma
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MDPI and ACS Style

Guerrero-Moreno, A.; Liang, H.; Moreau, N.; Luzu, J.; Rabut, G.; Melik Parsadaniantz, S.; Labbé, A.; Baudouin, C.; Réaux-Le Goazigo, A. Corneal Nerve Abnormalities in Painful Dry Eye Disease Patients. Biomedicines 2021, 9, 1424.

AMA Style

Guerrero-Moreno A, Liang H, Moreau N, Luzu J, Rabut G, Melik Parsadaniantz S, Labbé A, Baudouin C, Réaux-Le Goazigo A. Corneal Nerve Abnormalities in Painful Dry Eye Disease Patients. Biomedicines. 2021; 9(10):1424.

Chicago/Turabian Style

Guerrero-Moreno, Adrian, Hong Liang, Nathan Moreau, Jade Luzu, Ghislaine Rabut, Stéphane Melik Parsadaniantz, Antoine Labbé, Christophe Baudouin, and Annabelle Réaux-Le Goazigo. 2021. "Corneal Nerve Abnormalities in Painful Dry Eye Disease Patients" Biomedicines 9, no. 10: 1424.

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