title: In vivo confocal microscopy evaluation of ocular and cutaneous alterations in patients with rosacea.
abstract: The physiopathology of rosacea and the correlation between ocular and cutaneous rosacea remains unclear. This study analysed ocular and cutaneous rosacea with in vivo confocal microscopy (IVCM).
  
  
  
  Thirty-four eyes of 34 patients with confirmed rosacea-associated meibomian gland dysfunction-related evaporative dry eye were enrolled in the study. The ophthalmological investigations included dry eye ocular surface disease index (OSDI), the Schirmer test, tear osmolarity, tear break up time, the Oxford score, infrared meibography for meibomian gland (MG) analysis and IVCM investigation for cornea, MG and skin analysis (cheek, hand). Presences ofDemodexin the MG and in the cheek were also investigated. We established scores for quantifying the MG alterations in the MG (IVCM-MG) and cheek (IVCM-Cheek), and scores forDemodexquantification in the MG and cheek (IVCM-MG-Dex and IVCM-Cheek-Dex).
  
  
  
  IVCM was relevant for analysing the cornea and MG structures and was also suitable for cutaneous analysis. Exposed skin explorations presented the epidermal and dermal layers clearly. In patients with rosacea, the IVCM-MG alteration scores were correlated with IVCM-Cheek (R2=0.27 and p=0.0006) and IVCM-MG-Dex was correlated with IVCM-Cheek-Dex (R2=0.70 and p<0.0001). However, no correlation was found between the IVCM-MG or IVCM-Cheek and the break up time, Schirmer, Oxford and osmolarity evaluations.
  
  
  
  IVCM could be a safe, effective and reliable tool to quantify alterations of the cornea, MG and cheek glands in patients with rosacea combined with quantification ofDemodexinfections. As a valuable tool for investigating the pathophysiology of the disease, it could be used to assess the effectiveness of therapy.
authors.affiliation: Department of Ophthalmology III, Quinze-Vingts National Ophthalmology Hospital, Paris, France.|DHU View Maintain, INSERM-DHOS, Center of Clinical Investigations (CIC) 1423, Quinze-Vingts National Ophthalmology Hospital, Paris, France.|INSERM, U968, Paris, France.|UMR S 968, Institut de la Vision, UPMC University Paris 06, Paris, France.|CNRS, UMR 7210, Paris, France.
authors.forename: Hong
authors.initials: H
authors.lastname: Liang
authors.affiliation: Department of Ophthalmology III, Quinze-Vingts National Ophthalmology Hospital, Paris, France.|DHU View Maintain, INSERM-DHOS, Center of Clinical Investigations (CIC) 1423, Quinze-Vingts National Ophthalmology Hospital, Paris, France.
authors.forename: Matthieu
authors.initials: M
authors.lastname: Randon
authors.affiliation: Department of Ophthalmology III, Quinze-Vingts National Ophthalmology Hospital, Paris, France.|DHU View Maintain, INSERM-DHOS, Center of Clinical Investigations (CIC) 1423, Quinze-Vingts National Ophthalmology Hospital, Paris, France.
authors.forename: Sylvain
authors.initials: S
authors.lastname: Michee
authors.affiliation: Department of Ophthalmology III, Quinze-Vingts National Ophthalmology Hospital, Paris, France.|DHU View Maintain, INSERM-DHOS, Center of Clinical Investigations (CIC) 1423, Quinze-Vingts National Ophthalmology Hospital, Paris, France.
authors.forename: Rachid
authors.initials: R
authors.lastname: Tahiri
authors.affiliation: Department of Ophthalmology III, Quinze-Vingts National Ophthalmology Hospital, Paris, France.|DHU View Maintain, INSERM-DHOS, Center of Clinical Investigations (CIC) 1423, Quinze-Vingts National Ophthalmology Hospital, Paris, France.|INSERM, U968, Paris, France.|UMR S 968, Institut de la Vision, UPMC University Paris 06, Paris, France.|CNRS, UMR 7210, Paris, France.|Department of Ophthalmology, Ambroise Paré Hospital, APHP, University of Versailles Saint-Quentin-en-Yvelines, Versailles, France.
authors.forename: Antoine
authors.initials: A
authors.lastname: Labbe
authors.affiliation: Department of Ophthalmology III, Quinze-Vingts National Ophthalmology Hospital, Paris, France.|DHU View Maintain, INSERM-DHOS, Center of Clinical Investigations (CIC) 1423, Quinze-Vingts National Ophthalmology Hospital, Paris, France.|INSERM, U968, Paris, France.|UMR S 968, Institut de la Vision, UPMC University Paris 06, Paris, France.|CNRS, UMR 7210, Paris, France.|Department of Ophthalmology, Ambroise Paré Hospital, APHP, University of Versailles Saint-Quentin-en-Yvelines, Versailles, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Baudouin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003228:Conjunctiva / Q000000981:diagnostic imaging / Q000473:pathology; D003315:Cornea / Q000000981:diagnostic imaging / Q000473:pathology; D015352:Dry Eye Syndromes / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005141:Eyelid Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008537:Meibomian Glands / Q000000981:diagnostic imaging / Q000473:pathology; D018613:Microscopy, Confocal / Q000379:methods*; D008875:Middle Aged; D012393:Rosacea / Q000000981:diagnostic imaging* / Q000503:physiopathology; D013666:Tears / Q000737:chemistry / Q000378:metabolism
keywords: Eye Lids; Imaging; Inflammation; Ocular surface