ESCRS - FP15.09 - Neuropathic Corneal Pain: Corneal Confocal Microscopy Findings

Neuropathic Corneal Pain: Corneal Confocal Microscopy Findings

Published 2024 - 42nd Congress of the ESCRS

Reference: FP15.09 | Type: Free paper | DOI: 10.82333/vy2k-vb42

Authors: Betul Kubat* 1 , Gamze Ozkan 2 , Canan Sanal Toprak 3 , Merve Demirci 4 , Semra Akkaya Turhan 2

1Department of Opthalmology,Yunus Emre State Hospital,Eskisehir,Türkiye, 2Department of Opthalmology,Marmara University, School of Medicine,Istanbul,Türkiye, 3Department of Physical Therapy and Rehabilitation,Marmara University, School of Medicine,Istanbul,Türkiye, 4Department of Physical Therapy and Rehabilitation,Zonguldak Ataturk State Hospital,Zonguldak,Türkiye

Purpose

To evaluate clinical and corneal confocal microscopy (CCM) findings in fibromyalgia (FMS) patients with neuropathic corneal pain (NCP).

Setting

Marmara University, School of Medicine, Department of Opthalmology

Methods

Fourteen FMS patients with ocular pain without ocular surface findings, and 25 healthy controls were included in this case-controlled observational study. Dry Eye Questionnaire-5 (DEQ-5) and CCM were performed. Corneal nerve fiber density (CNFD), corneal nerve branch density (CNBD), corneal total branch density (CTBD), corneal nerve fiber length (CNFL), and corneal nerve fractal dimension (CNFrD) were obtained using the ACCMetrics. Oliveira-Soto scale was used to grade tortuosity. Dendritic cell (DC) density was measured with ImageJ software. Microneuromas were manually counted and analyzed according to their morphological types.

Results

DEQ-5 score was higher in FMS group (12.50 ± 4.03) than control (2.40 ± 1.78) (p<0.001). CNFD, CNBD, and CNFrD values were lower in the FMS group (p=0.004, p=0.011, p=0.029, respectively). CNFL and CTBD values were similar between groups (p=0.060, p=0.245, respectively). Tortuosity grade was higher in the FMS group (p<0.001). Microneuromas and mature DC density were higher in FMS (p=0.001, p=0.001, respectively), while immature DC density was similar between groups (p=0.425). A total of 19 microneuromas were identified in the FMS group, of which 84.21% (n = 16) were lateral, 10.52% (n = 2) were stump, and 5.26% (n = 1) were spindle.

Conclusions

NCP and corneal nerve fiber pathologies were more common in FMS patients compared to healthy controls. CCM features such as dendritic cells, tortuosity, and microneuromas can provide better classification of the disease and contribute to individualized treatment planning when there is a discordance between ocular surface pain and clinical findings.