Sjögren sendromuna bağlı gelişen kuru göz hastalığında meydana gelen oküler yüzey değişikliklerinin konfokal mikroskopi ile değerlendirilmesi

Hüseyin Cem Şimşek; Cansu Kaya; Murat Kaşıkcı; Sabahattin Sül; Aylin Karalezli

doi:10.19161/etd.1086117

EN TR

Evaluation of ocular surface changes in dry eye disease due to Sjögren's syndrome by confocal microscopy

Abstract

Aim: To evaluate the ocular surface alterations in dry eye disease related to Sjögren's syndrome. Materials and Methods: The data of 25 patients followed up in our clinic with dry eye disease due to Sjögren's syndrome and 25 healthy control groups were evaluated prospectively. In order to evaluate the ocular surface, the ocular surface diseases index, Schirmer 1 test, tear film break-up time, corneal fluorescein staining, strip meniscometry test and confocal microscopy results were evaluated. Results: In patients with Sjögren's syndrome, Schirmer 1 test was 2.41.1 mm, tear film break-up time was 3.10.9 seconds, corneal fluorescein staining score was 4.12.2, strip meniscometry score was 1.80.8 mm, ocular surface diseases index score was 22.111.6, dendritic cell density 3811.3 cells/mm2 and subbasal nerve density 950375 μm/mm2 In the healthy control group, Schirmer 1 test was 15.16.2 mm, tear film break-up time was 12.23.4 seconds, corneal fluorescein staining score was 2.2±1.8, strip meniscometry score was 5.72.1 mm, ocular surface diseases index score was 4.32.5, dendritic cell density was 8.32.7 cells/mm2 and subbasal nerve density was evaluated as 1077320 μm/mm2. Dendritic cell density was found to be significantly higher and subbasal nerve density was found to be significantly lower in patients with Sjögren's syndrome compared to the control group (p<0.001). Conclusion: Laser scanning in vivo confocal microscopy is a useful method for evaluating structures such as corneal cell morphology, inflammatory cell density, and nerve fiber density in patients with Sjögren's syndrome. For this reason, detailed analysis of confocal microscope results together with ocular surface evaluation guides the diagnosis and treatment of patients.

Keywords

Sjögren sendromuna bağlı gelişen kuru göz hastalığında meydana gelen oküler yüzey değişikliklerinin konfokal mikroskopi ile değerlendirilmesi

Öz

Amaç: Sjögren sendromuna bağlı olarak gelişen kuru göz hastalığında meydana gelen oküler yüzey değişikliklerini oküler yüzey testleri ve konfokal mikroskopi ile değerlendirmek. Gereç ve Yöntem: Kliniğimizde Sjögren sendromuna bağlı kuru göz hastalığı ile takip edilen 25 hastanın ve 25 sağlıklı kontrol grubunun verileri prospektif olarak değerlendirildi. Tüm hastalara genel sistemik hastalık sorgusu ile birlikte tam oftalmik muayene yapıldı. Oküler yüzeyi değerlendirmek için çalışmaya katılan bireylerde oküler yüzey hastalıkları indeksi, Schirmer 1 testi, gözyaşı kırılma zamanı, korneal flöresein boyanma, strip meniskometri testi ve konfokal mikroskopi sonuçları değerlendirildi. Bulgular: Sjögren sendromlu olgularda Schirmer 1 testi 2,41,1 mm, gözyaşı kırılma zamanı 3,10,9 saniye, korneal flöresein boyanma skoru 4,12,2, strip meniskometri skoru 1,80,8 mm, oküler yüzey hastalıkları indeksi skoru 22,111,6, dendritik hücre yoğunluğu 3811,3 hücre/mm2 ve subbazal sinir yoğunluğu 950375 μm/mm2 olarak değerlendirilmiştir. Sağlıklı kontrol grubunda ise Schirmer 1 testi 15,16,2 mm, gözyaşı kırılma zamanı 12,23,4 saniye, korneal flöresein boyanma skoru 2,2±1,8, strip meniskometri skoru 5,72,1 mm, oküler yüzey hastalıkları indeksi skoru 4,32,5, dendritik hücre yoğunluğu 8,32,7 hücre/mm2 ve subbazal sinir yoğunluğu 1077320 μm/mm2 olarak değerlendirildi. Sjögren sendromlu olgularda dendritik hücre yoğunluğu kontrol grubuna göre anlamlı olarak yüksek, subbazal sinir yoğunluğu anlamlı derecede düşük olarak değerlendirildi (p<0,001). Sonuç: Lazer tarayıcı in vivo konfokal mikroskopi, Sjögren sendromu olan hastalarda kornea hücreleri morfolojisi, inflamatuar hücre yoğunluğu ve sinir lifi yoğunluğu gibi yapıların değerlendirilmesi için yararlı bir yöntemdir. Bu nedenle oküler yüzey değerlendirmesi ile birlikte konfokal mikroskopi sonuçlarının detaylı analiz edilmesi hastaların tanı ve tedavisinde yol gösterici olmaktadır.

Anahtar Kelimeler

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Details

Primary Language

Turkish

Subjects

Health Care Administration

Journal Section

Research Article

Authors

Hüseyin Cem Şimşek
0000-0001-8003-745X
Türkiye

Cansu Kaya ^*
0000-0002-2230-3008
Türkiye

Murat Kaşıkcı
0000-0002-2748-9702
Türkiye

Sabahattin Sül
0000-0003-4812-7636
Türkiye

Aylin Karalezli
0000-0003-1316-4656
Türkiye

Publication Date

March 15, 2022

Submission Date

September 16, 2021

Acceptance Date

November 26, 2021

Published in Issue

Year 2022 Volume: 61 Number: 1

DOI

https://doi.org/10.19161/etd.1086117

IZ

https://izlik.org/JA37WU92WD

Cite

RIS / Bibtex

Vancouver

1.Hüseyin Cem Şimşek, Cansu Kaya, Murat Kaşıkcı, Sabahattin Sül, Aylin Karalezli. Sjögren sendromuna bağlı gelişen kuru göz hastalığında meydana gelen oküler yüzey değişikliklerinin konfokal mikroskopi ile değerlendirilmesi. EJM. 2022 Mar. 1;61(1):80-6. doi:10.19161/etd.1086117