Fan Wang, Yue Li, Zhaowei Zhang, Qiuchen Lu, Cancan Shi, Xiaofan Yu, Fen Hu, Mingxin Li, Jianxin Guo, Zhenhao Zhang, He Wang
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引用次数: 0
Abstract
Objective: This study aimed to examine the bilateral stability of the tear film in patients with unilateral neurotrophic keratitis and to observe changes in corneal nerve and immune cells under confocal microscopy.
Methods: A prospective cross-sectional study included 63 patients with confirmed neurotrophic keratitis (NK) and 40 normal controls of similar sex and age. NK patients were divided into stage 1 and stage 2 based on the severity of the disease. Tear meniscus height (TMH), first non-invasive tear film break-up time (NIBUT-f), and corneal fluorescein staining were assessed. Corneal sensitivity was assessed using a Cochet-Bonnet esthesiometer. The corneal subbasal nerve plexus (SNP) and dendritic cells (DCs) were imaged using in vivo confocal microscopy (IVCM), and the SNP was analyzed using the fully automated corneal nerve analysis software "ACCmetric."
Results: Eyes with NK stage 2 showed worse performance in TMH, NIBUT-f, corneal fluorescein staining score, corneal sensitivity examination, SNP parameters, and DC density compared to NK stage 1 (all p < 0.001). The contralateral eyes of NK patients had significantly shorter NIBUT-f and higher dendritic cell density than controls (p < 0.001).
Conclusion: The contralateral eyes of NK patients are more prone to dry eye signs than those of normal subjects and should be monitored and treated promptly. Increased dendritic cell numbers in the contralateral eyes of NK patients suggest bilateral immune alterations in unilateral disease.
目的：观察单侧神经营养性角膜炎患者双侧泪膜的稳定性，并在共聚焦显微镜下观察角膜神经和免疫细胞的变化。方法：一项前瞻性横断面研究包括63例确诊的神经营养性角膜炎（NK）患者和40例性别和年龄相似的正常对照。NK患者根据病情严重程度分为1期和2期。观察撕裂半月板高度（TMH）、首次无创撕裂膜破裂时间（NIBUT-f）和角膜荧光素染色。使用Cochet-Bonnet感受器评估角膜敏感度。使用体内共聚焦显微镜（IVCM）对角膜基底下神经丛（SNP）和树突状细胞（DCs）进行成像，并使用全自动角膜神经分析软件“ACCmetric”对SNP进行分析。结果：NK 2期眼的TMH、NIBUT-f、角膜荧光素染色评分、角膜敏感性检查、SNP参数、DC密度等指标均较NK 1期差（p均 p ）。结论：NK患者对侧眼较正常人更易出现干眼体征，应及时监测和治疗。NK患者对侧眼睛树突状细胞数量增加提示单侧疾病的双侧免疫改变。
期刊介绍：
Frontiers in Medicine publishes rigorously peer-reviewed research linking basic research to clinical practice and patient care, as well as translating scientific advances into new therapies and diagnostic tools. Led by an outstanding Editorial Board of international experts, this multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide.
In addition to papers that provide a link between basic research and clinical practice, a particular emphasis is given to studies that are directly relevant to patient care. In this spirit, the journal publishes the latest research results and medical knowledge that facilitate the translation of scientific advances into new therapies or diagnostic tools. The full listing of the Specialty Sections represented by Frontiers in Medicine is as listed below. As well as the established medical disciplines, Frontiers in Medicine is launching new sections that together will facilitate
- the use of patient-reported outcomes under real world conditions
- the exploitation of big data and the use of novel information and communication tools in the assessment of new medicines
- the scientific bases for guidelines and decisions from regulatory authorities
- access to medicinal products and medical devices worldwide
- addressing the grand health challenges around the world
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