title: Corneal confocal microscopy alterations in Sjögren's syndrome dry eye.
abstract: OBJECTIVE
  To evaluate light backscattering (LB) in corneal layers in patients with primary Sjögren's syndrome dry eye (SSDE) utilizing in vivo corneal confocal microscopy (IVCM) and to determine the eventual association with the lacrimal functional test values.
  
  
  METHODS
  A complete ophthalmic evaluation, Schirmer test with and without stimulation, break-up time (BUT) and IVCM were performed on 55 patients affected by SSDE and in an age- and sex-matched cohort of healthy participants (HP). Light backscattering, measures as light reflectivity unit (LRU), detected by IVCM at Bowman's membrane (BM) at 50 μm, at 100 μm and at 200 μm deeper than BM was compared in the two groups. The correlations between LB values and lacrimal function results were evaluated.
  
  
  RESULTS
  In patients affected by SSDE, LB was significantly higher (p < 0.001) in each corneal layer examined (+14 ± 6.33 LRU at BM), compared with HP. A good reverse correlation between the light reflectivity measures at BM with Schirmer test with (r = -0.91) and without (r = -0.90) stimulation and BUT (r = -0.88) was found. Correlations were lower in the deeper corneal layers.
  
  
  CONCLUSIONS
  Even if our results should be confirmed in further studies with a larger population, these findings show that IVCM is a device able to detect alterations in corneal layers in SSDE patients related to the lacrimal function. Light backscattering (LB) could be very useful for clinical diagnosis and management of SSDE.
authors: Multidisciplinary Department of Medical, Surgical and Dental Sciences, Second University of Napoli, Napoli, Italy.
authors: Michele
authors: M
authors: Lanza
authors: University Study Center "Grandi Apparecchiature" Second University of Napoli, Napoli, Italy.
authors: Stefania
authors: S
authors: Iaccarino
authors: Department of Translational Medical Sciences, Division of Clinic Immunology and Allergy, University of Naples Federico II University, Napoli, Italy.
authors: Gilda
authors: G
authors: Varricchi
authors: Rheumatology Unit, "Santa Maria del Popolo degli Incurabili" Hospital, Napoli, Italy.
authors: Tito
authors: T
authors: D'Errico
authors: Multidisciplinary Department of Medical, Surgical and Dental Sciences, Second University of Napoli, Napoli, Italy.
authors: Ugo Antonello
authors: UA
authors: Gironi Carnevale
authors: Multidisciplinary Department of Medical, Surgical and Dental Sciences, Second University of Napoli, Napoli, Italy.
authors: Mario
authors: M
authors: Bifani
mesh_terms: D000328:Adult; D000368:Aged; D003315:Cornea / Q000378:metabolism / Q000473:pathology*; D015352:Dry Eye Syndromes / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D018613:Microscopy, Confocal / Q000379:methods*; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012859:Sjogren's Syndrome / Q000150:complications* / Q000175:diagnosis / Q000378:metabolism; D013666:Tears / Q000378:metabolism; D055815:Young Adult
keywords: Sjögren's Syndrome; confocal microscopy; cornea; corneal surface; early diagnosis