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2020 OMIG Abstract

Corneal Microneuromas and Dry Eye

Jodi Hwang BS1, Harrison Dermer MD1, Rhiya Mittal BS1, Adam Karp Cohen2, Anat Galor MD, MSPH2,3
1Miller School of Medicine, University of Miami, Miami, FL; 2Miami Veterans Affairs Medical Center,
Miami, FL; 3Bascom Palmer Eye Institute, University of Miami, Miami, FL

Purpose: Neuropathic corneal pain (NCP) may present similarly, or concomitantly, with dry eye (DE), and an objective marker is needed to detect when corneal nerve abnormalities underlie DE symptoms. Microneuromas (MN) have been suggested as markers of nerve damage. This study evaluated MN frequency in populations with and without DE symptoms and investigated relationships between MN presence and DE clinical features.

Methods: Retrospective study of 34 individuals without and 77 individuals with DE symptoms. Main outcome measure was MN frequency in various populations. Secondary outcome measures were comparisons of DE clinical features, including NCP features, in individuals with DE symptoms grouped by MN presence.

Results: 26 healthy individuals (mean age 26 years + 4.5), 77 with DE symptoms (Dry Eye Questionnaire-5 (DEQ-5)>6, mean age 58 years + 13.5), and 8 with DE signs but no symptoms (DEQ-5<6, mean age 71 years + 9) were examined. MN frequency was lowest in young individuals without DE symptoms (11.5%) and highest in older individuals without DE symptoms (37.5%). MN were observed in 27% of symptomatic individuals. Examining symptomatic individuals without a history of refractive surgery, DE symptoms and signs, including NCP features (sensitivity to wind and light), were not different by MN status. Individuals with a history of cataract or glaucoma surgery (n=12) had increased corneal nerve fiber width (0.06 + 0.14mm/mm2) compared to those with no surgical history (n=54, 0.02 + 0.002mm/mm2, p=0.03).

Conclusion: MN were found in individuals with and without DE symptoms. Their presence alone could not distinguish between DE sub-types, including features of NCP.

Disclosure: N

Support Supported by the Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Clinical Sciences R&D (CSRD) I01 CX002015 (A Galor) and Biomedical Laboratory R&D (BLRD) Service I01 BX004893 (A Galor), Department of Defense Gulf War Illness Research Program (GWIRP) W81XWH-20-1-0579 (A Galor) and Vision Research Program (VRP) W81XWH-20-1-0820 (A Galor), National Eye Institute R01EY026174 (A Galor) and R61EY032468 (A Galor), NIH Center Core Grant P30EY014801 (institutional) and Research to Prevent Blindness Unrestricted Grant (institutional).



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