Effects of corneal nerve density on the response to treatment in dry eye disease.
Effects of corneal nerve density on the response to treatment in dry eye disease.
复制标题
DOI：
10.1016/j.ophtha.2014.11.006
复制
发表时间：
2015-04
期刊：
影响因子：
13.7
通讯作者：
Dana, Reza
中科院分区：
文献类型：
--
作者：
Kheirkhah, Ahmad;Dohlman, Thomas H.;Amparo, Francisco;Arnoldner, Michael A.;Jamali, Arsia;Hamrah, Pedram;Dana, Reza
评估干眼症（DED）患者角膜基底下神经纤维长度（SNFL）水平是否可以预测治疗后体征和症状的改善水平。IV期、双盲、随机临床试验。60例与睑板腺功能障碍相关的DED患者和27例年龄匹配的对照。DED患者随机接受局部人工泪液、氯替泼诺0.5%或氯替泼诺0.5%/妥布霉素0.3%，每日两次，持续4周。在基线时，在双眼中进行中央角膜的体内共焦显微镜检查。DED患者分为2个亚组，基线SNFL较低的患者和基线SNFL接近正常的患者（截止点：对照组的平均SNFL减去2个标准差）。在所有治疗组中，比较了低SNFL和接近正常SNFL亚组之间基线和治疗4周后的临床体征和症状。症状问卷、角膜荧光素染色（CFS）、丽丝胺绿色结膜染色、泪膜破裂时间、Schirmer试验和SNFL。DED患者的基线SNFL（17.06 ± 5.78 mm/mm 2）显著低于对照组（23.68 ± 3.42，P=0.001）。在人工泪液和氯替泼诺组中，尽管基线SNFL低（<16.84 mm/mm 2）的患者的任何体征或症状均无显著改善，但基线SNFL接近正常（≥16.84 mm/mm 2）的受试者的症状和角膜荧光素染色（CFS）评分均显示出显著改善（均P<0.05）。在氯替泼诺/妥布霉素组中，基线SNFL低或接近正常的任何亚组的任何体征或症状均无明显变化。DED治疗后CFS和患者屈光状态的显著改善仅在角膜SNFL接近正常的亚组中明显。因此，SNFL的考虑可能有助于解释患者对DED治疗反应的变异性。
To evaluate whether levels of corneal subbasal nerve fiber length (SNFL) in dry eye disease (DED) could prognosticate the level of improvement in signs and symptoms after treatment. Phase IV, double-masked, randomized clinical trial. Sixty patients with meibomian gland dysfunction-associated DED and 27 age-matched controls. Patients with DED were randomized to receive topical artificial tears, loteprednol etabonate 0.5%, or loteprednol etabonate 0.5%/tobramycin 0.3% twice daily for 4 weeks. At baseline, in vivo confocal microscopy of central cornea was performed in both eyes. Patients with DED were divided into 2 subgroups, those with low baseline SNFL and those with near-normal baseline SNFL (the cut-off point: mean SNFL in controls minus 2 standard deviations). Clinical signs and symptoms at baseline and after 4 weeks of treatment were compared between the subgroups with low and near-normal SNFL for all therapeutic groups. Symptom questionnaires, corneal fluorescein staining (CFS), conjunctival staining with lissamine green, tear break-up time, Schirmer’s test, and SNFL. In patients with DED, baseline SNFL (17.06 ± 5.78 mm/mm2) was significantly lower than in controls (23.68 ± 3.42, P=0.001). In the artificial tear and loteprednol groups, although no significant improvement in any sign or symptom was noted in patients with low baseline SNFL (<16.84 mm/mm2), subjects with near-normal baseline SNFL (≥16.84 mm/mm2) showed significant improvement in both symptoms and corneal fluorescein staining (CFS) score (all P<0.05). In the loteprednol/tobramycin group, no significant change was evident for any sign or symptom in either subgroup of low or near-normal baseline SNFL. Significant improvements in CFS and patient symptomatology after DED treatment were evident only in the subgroup with near-normal corneal SNFL. Consideration of SNFL may thus assist in explaining the variability of patients’ response to DED therapy.
登录
查看更多内容
影响因子：
4.4
作者：
Villani, Edoardo;Galimberti, Daniela;Ratiglia, Roberto
通讯作者：
Ratiglia, Roberto
影响因子：
3.9
作者：
Bonini, S;Rama, P;Lambiase, A
通讯作者：
Lambiase, A
影响因子：
7.4
作者：
ROZSA, AJ;BEUERMAN, RW
通讯作者：
BEUERMAN, RW
影响因子：
13.7
作者：
Sall, K;Stevenson, OD;Reis, BL
通讯作者：
Reis, BL
影响因子：
2.3
作者：
Chen, Minjie;Gong, Lan;Zhong, Xingwu
通讯作者：
Zhong, Xingwu