Evaluation of the Relationship Between Objective Corneal Sensitivity and Subjective Symptoms Using a Dry Eye-Specific Functional Test in Dry Eye Disease
Project no. 27393 · Status: Kapanmış · 2023
Summary
<p><br></p><p><strong>Purpose:</strong> It was aimed to define the relationship between the severity of dry eye disease and corneal sensitivity and the correlation of this relationship with dry eye parameters.</p><p><strong>Methods:</strong> Sixty-two eyes of 31 healthy volunteers who applied for routine ophthalmologic examination and 150 eyes of 75 dry eye patients with dry eye severity ranging from 1-5 were included in the study. Detailed eye examination, Shirmer-1 test, tear film break-up time (T-BUT) test, Oxford and ocular surface disease index (OSDI) tests were applied to all participants in this cross-sectional study, which was performed after local ethics committee approval. In addition, an ocular surface pain score (OSPS) for dry eye was generated using the OSDI questionnaire by excluding the vision-related questions. Corneal sensitivities of all eyes were measured in 5 corneal regions (central, superior, inferior, nasal, and temporal) with a Cochet-Bonnet esthesiometer. All groups were compared in terms of corneal sensitivity and dry eye parameters.</p><p><strong>Results: </strong>There was no significant difference between the dry eye and control groups in terms of mean age (p=0.162). Of the patient group, 32(42.7%) were male and 43(57.3%) were female, 19(61.3%) of the control group were male and 12(38.7%) were female. The rate of women was found to be significantly higher in the patient group (p=0.014). Schirmer-1 test, T-BUT, central, superior, inferior, nasal and temporal corneal sensitivity values were found to be significantly lower in the patient group (p<0.001). We found a correlation between OSPS and OSDI (<em>r= </em>0.983, p<0.001).<em> </em>OSDI, OSPS and Oxford Scale results were statistically significantly higher in the patient group (p<0.001). When the patient group was compared according to the dry eye stages, it was found that corneal sensitivity decreased significantly as the severity increased up to the grade 4 (p<0.001). Although grade 5 corneal sensitivity was lower than grade 4, this difference was not as significant for all quadrants as in other stages (p<0.001). While there was a moderate positive correlation between Schirmer-1 test, T-BUT and central corneal sensitivity (<em>r</em> =0.583, 0.657, p<0.001 for both, respectively), there was a negative between Oxford scale and central, superior, inferior, nasal, temporal corneal sensitivity (<em>r</em> =-637, -548, -560, -619, -588, p<0.001 for all parameters, respectively). And there was a negative correlation between central, superior, inferior, nasal, temporal corneal sensitivity and OSPS (r = -0.631, -0.562, -0.565, -0.613, -0.593, p< 0.001 for all parameters, respectively). </p><p><strong>Conclusion: </strong>In the present study, it was determined that as the severity of dry eye disease increased, dry eye parameters worsened, and corneal sensitivity decreased. Despite decreased corneal sensitivity, the increase in OSPS in patients with advanced dry eye may suggest the development of neurogenic pain due to neurodegeneration.</p><p><strong>Keywords: </strong>Dry eye, corneal sensitivity, neuropathic pain </p>