title: Reduced Corneal Endothelial Cell Density in Patients With Dry Eye Disease.
abstract: OBJECTIVE
  To evaluate corneal endothelial cell density (ECD) in patients with dry eye disease (DED) compared to an age-matched control group.
  
  
  METHODS
  Cross-sectional, controlled study.
  
  
  METHODS
  This study included 90 eyes of 45 patients with moderate to severe DED (aged 53.7 ± 9.8 years) and 30 eyes of 15 normal controls (aged 50.7 ± 9.8 years). All subjects had a complete ophthalmic evaluation including symptom assessment using the Ocular Surface Disease Index (OSDI) and corneal fluorescein staining. In addition, laser scanning in vivo confocal microscopy was performed to measure the density of the following parameters in the central cornea: endothelial cells, subbasal nerves, and subbasal immune dendritic cells.
  
  
  RESULTS
  Corneal ECD was significantly lower in the DED group (2595.8 ± 356.1 cells/mm(2)) than in the control group (2812.7 ± 395.2 cells/mm(2), P = .046). The DED group showed significantly lower corneal subbasal nerve density (17.1 ± 6.9 mm/mm(2)) compared to the control group (24.7 ± 4.4 mm/mm(2), P < .001). Dendritic cell density was significantly higher in the DED group than in the controls (111.7 ± 137.3 vs 32.0 ± 24.4 cells/mm(2), respectively, P = .002). There were statistically significant correlations between corneal ECD and dry eye severity parameters including the OSDI score (rs = -0.26, P = .03), and corneal fluorescein staining (rs = -0.28, P = .008).
  
  
  CONCLUSIONS
  There is a significant reduction in corneal ECD in DED that correlates with clinical severity of the disease.
authors.affiliation: Cornea and Refractive Surgery Service, Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Kheirkhah
authors.affiliation: Cornea and Refractive Surgery Service, Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts.
authors.forename: Ujwala S
authors.initials: US
authors.lastname: Saboo
authors.affiliation: Cornea and Refractive Surgery Service, Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts.
authors.forename: Tulio B
authors.initials: TB
authors.lastname: Abud
authors.affiliation: Cornea and Refractive Surgery Service, Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts.
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Dohlman
authors.affiliation: Cornea and Refractive Surgery Service, Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Arnoldner
authors.affiliation: Cornea and Refractive Surgery Service, Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts.
authors.forename: Pedram
authors.initials: P
authors.lastname: Hamrah
authors.affiliation: Cornea and Refractive Surgery Service, Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts. Electronic address: Reza_Dana@meei.harvard.edu.
authors.forename: Reza
authors.initials: R
authors.lastname: Dana
mesh_terms: D000328:Adult; D000368:Aged; D002452:Cell Count; D003315:Cornea / Q000294:innervation; D055954:Corneal Endothelial Cell Loss / Q000175:diagnosis / Q000209:etiology*; D003430:Cross-Sectional Studies; D003713:Dendritic Cells / Q000473:pathology; D015352:Dry Eye Syndromes / Q000150:complications* / Q000175:diagnosis; D004728:Endothelium, Corneal / Q000473:pathology*; D005260:Female; D015590:Fluorophotometry; D006801:Humans; D008297:Male; D018613:Microscopy, Confocal; D008875:Middle Aged; D009882:Ophthalmic Nerve / Q000473:pathology; D011795:Surveys and Questionnaires; D014792:Visual Acuity / Q000502:physiology