Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 May 12;21(1):211.
doi: 10.1186/s12886-021-01967-7.

Corneal nerve structure in patients with primary Sjögren's syndrome in China

Fangting Li #  1   2 , Qin Zhang #  1 , Xin Ying  1 , Jing He  3 , Yuebo Jin  3 , Huiwen Xu  4   5 , Yaobin Cheng  3 , Mingwei Zhao  6
Affiliations

Corneal nerve structure in patients with primary Sjögren's syndrome in China

Fangting Li et al. BMC Ophthalmol. .

Abstract

Background: The aim of this study was to evaluate the in vivo confocal microscopic morphology of corneal subbasal nerves and its relationship with clinical parameters in patients with primary Sjögren's syndrome in China.

Methods: This was a case control study of 22 dry eye disease (DED) patients with primary Sjögren's syndrome (pSS) and 20 control subjects with non-Sjögren dry eye disease (NSDE). Each patient underwent an evaluation of ocular surface disease using the tear film break-up time (TBUT), noninvasive tear film break-up time (NIKBUT), noninvasive tear meniscus height (NIKTMH), corneal staining (National Eye Institute scale, NEI), Schirmer I test, meibography, and corneal subbasal nerve analysis with in vivo confocal microscopy (IVCM). The right eye of each subject was included in this study.

Results: SS patients showed a shorter TBUT (P = 0.009) and Schirmer I test results (P = 0.028) than the NSDE group. However, there was no significant difference in NIKBUT between the two groups (P = 0.393). The nerve density of subbasal nerves, number of nerves and tortuosity of the SS group were significantly lower than those of the NSDE group (P = 0.001, P < 0.001 and P = 0.039, respectively). In the SS group, the mean nerve length was correlated with age and the Schirmer I test (r = - 0.519, P = 0.013 and r = 0.463, P = 0.035, respectively). Corneal staining was correlated with nerve density and the number of nerves (r = - 0.534, P = 0.013 and r = - 0.487, P = 0.025, respectively).

Conclusions: Sjögren syndrome dry eye (SSDE) patients have more severe clinical dry eye parameters than non-Sjögren dry eye disease (NSDE) patients. Compared with NSDE patients, we found that SSDE patients showed decreased corneal subbasal nerve density and numbers.

Keywords: Corneal nerve; Dry eye disease; In vivo confocal microscopy (IVCM); Sjögren’s syndrome.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
IVCM images of corneal subbasal nerves in the NSDE group a and in the SSDE group c. Images b and d are their respective subbasal nerve tracings using NeuronJ software
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Patel R, Shahane A. The epidemiology of Sjögren’s syndrome. Clin Epidemiol. 2014;30(6):247–255. - PMC - PubMed
    1. Craig JP, Nelson JD, Azar DT, Belmonte C, Bron AJ, Chauhan SK, de Paiva CS, Gomes JAP, Hammitt KM, Jones L, Nichols JJ, Nichols KK, Novack GD, Stapleton FJ, Willcox MDP, Wolffsohn JS, Sullivan DA. TFOS DEWS II report executive summary. Ocul Surf. 2017;15(4):802–812. doi: 10.1016/j.jtos.2017.08.003. - DOI - PubMed
    1. Solomon A, Dursun D, Liu Z, Xie Y, Macri A, Pflugfelder SC. Pro- and anti-inflammatory forms of interleukin-1 in the tear fluid and conjunctiva of patients with dry-eye disease. Invest Ophthalmol Vis Sci. 2001;42(10):2283–2292. - PubMed
    1. Tincani A, Andreoli L, Cavazzana I, Doria A, Favero M, Fenini M, et al. Novel aspects of Sjogren’s syndrome in 2012. BMC Med. 2013;4(11):93. doi: 10.1186/1741-7015-11-93. - DOI - PMC - PubMed
    1. Shimazaki J, Goto E, Ono M, Shimmura S, Tsubota K. Meibomian gland dysfunction in patients with Sjogren syndrome. Ophthalmology. 1988;105(8):1485–1488. doi: 10.1016/S0161-6420(98)98033-2. - DOI - PubMed