title: In vivo confocal scanning laser microscopy in patients with primary Sjögren's syndrome: A monocentric experience.
abstract: OBJECTIVE
  (i) To analyze the in vivo corneal structure and sub-basal plexus nerves in patients with primary Sjögren's syndrome (pSS) and no-SS dry eye by confocal scanning laser microscopy (CSLM) and (ii) to correlate CSLM findings with tear function tests and with patients' subjective dryness.
  
  
  METHODS
  Seventeen patients with pSS, 16 no-SS dry eye, and 20 healthy volunteers were included. CSLM parameters taken into consideration included: basal epithelial integrity, corneal thickness, epithelial cellular density, keratocyte activation, and sub-basal plexus morphology. Statistical analysis was carried out using SPSS-13 (Chicago IL, USA).
  
  
  RESULTS
  CSLM pachymetric data and the superficial epithelium cell density were significantly lower in pSS versus no-SS dry eye (p < 0.0001); keratocyte activation and sub-basal nerve abnormalities were also more frequent in pSS patients (p < 0.0001). CSLM findings well correlated with both the ocular test results and the patients' perception of ocular dryness at the baseline and over the follow-up.
  
  
  CONCLUSIONS
  CSLM might be a useful novel tool in the assessment of the involvement of the lachrymal functional unit in pSS.
authors.affiliation: Ophthalmology Unit, University of Pisa , Pisa , Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Gabbriellini
authors.forename: Chiara
authors.initials: C
authors.lastname: Baldini
authors.forename: Valentina
authors.initials: V
authors.lastname: Varanini
authors.forename: Chiara
authors.initials: C
authors.lastname: Notarstefano
authors.forename: Pasquale
authors.initials: P
authors.lastname: Pepe
authors.forename: Francesca
authors.initials: F
authors.lastname: Fanucci
authors.forename: Francesco
authors.initials: F
authors.lastname: Ferro
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Luciano
authors.forename: Marta
authors.initials: M
authors.lastname: Mosca
authors.forename: Marco
authors.initials: M
authors.lastname: Nardi
authors.forename: Stefano
authors.initials: S
authors.lastname: Bombardieri
mesh_terms: D002452:Cell Count; D003315:Cornea / Q000473:pathology*; D003316:Corneal Diseases / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D018613:Microscopy, Confocal / Q000379:methods; D008875:Middle Aged; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D012859:Sjogren's Syndrome / Q000473:pathology*
keywords: Confocal scanning laser microscopy; Dry eye; Keratoconjunctivitis sicca; Lachrymal functional unit; Sjögren's syndrome