Conjunctival in vivo confocal scanning laser microscopy in patients with sjögren syndrome

Tais Hitomi Wakamatsu, Enrique Adan Sato, Yukihiro Matsumoto, Osama M.A. Ibrahim, Murat Dogru, Minako Kaido, Reiko Ishida, Kazuo Tsubota

Research output: Contribution to journalArticlepeer-review

76 Citations (Scopus)


PURPOSE. To demonstrate the conjunctival alterations in patients with Sjögren's (SSDE) and non-Sjögren's syndrome dry eye (NSSDE) using a new generation confocal microscope (HRTII/ RCM; Heidelberg Engineering, Heidelberg, Germany), in a prospective controlled study. METHODS. Twenty-eight right eyes of 28 patients with SSDE (28 women; mean age, 58.2 ± 14.3 years), 7 right eyes of patients with NSSDE (7 women; mean age, 66.1 ± 14.4 years), and 14 right eyes of 14 age- and sex-matched control subjects were studied. All subjects underwent the Schirmer test, tear film breakup time (BUT), vital staining, and confocal microscopy of the temporal bulbar conjunctiva. The density of conjunctival epithelial cells, epithelial microcysts, and conjunctival and corneal inflammatory infiltrates were also assessed. RESULTS. The tear quantity, stability, and vital staining scores were significantly worse in patients with SSDE or NSSDE than in control subjects (P < 0.001 and P < 0.05, respectively). Eyes of the patients with SSDE or NSSDE had a significantly higher density of conjunctival and corneal inflammatory infiltrates than did the control eyes (P < 0.001). Conjunctival inflammatory cell densities showed a negative correlation with tear stability and tear quantity and a positive correlation with the vital staining scores. Conjunctival epithelial cell densities were significantly lower in SSDE and NSSDE compared with control subjects (P < 0.05). The density of epithelial cysts was significantly higher in SS than in healthy control eyes (P < 0.001). CONCLUSIONS. Confocal scanning laser microscopy was an efficient and a noninvasive tool for the quantitative assessment of the conjunctival inflammation and epithelial cell densities as well as evaluation of conjunctival morphologic alterations, such as microcysts in patients with SSDE and NSSDE dry eye disease.

Original languageEnglish
Pages (from-to)144-150
Number of pages7
JournalInvestigative Ophthalmology and Visual Science
Issue number1
Publication statusPublished - 2010 Jan

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience


Dive into the research topics of 'Conjunctival in vivo confocal scanning laser microscopy in patients with sjögren syndrome'. Together they form a unique fingerprint.

Cite this