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2020 OMIG Abstract

Comparison of Corneal Nerve Alterations in Patients with Autoimmune-Mediated Neuropathic Corneal Pain

Leyla Yavuz-Saricay, MD1,2, Betul N. Bayraktutar, MD1,2, Vanessa Atocha2, Pedram Hamrah, MD1,2,3
1Center for Translational Ocular Immunology, Department of Ophthalmology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA; 2Cornea Service, New England Eye Center, Department of Ophthalmology, Tufts Medical School, Tufts University School of Medicine, Boston, MA; 3Department of Neuroscience, Tufts University School of Medicine, Boston, MA

Purpose: Our aim was to compare corneal nerve alterations in patients with neuropathic corneal pain (NCP) and positive serology autoimmune antibodies (Ab) with and without IgM against neuronal trisulfated heparin disaccharide (TS-HDS) and fibroblast growth factor receptor 3 (FGFR3).

Methods:: Retrospective chart review of NCP patients (n=35) with positive autoimmune Ab (those having a positive result for ANA, SS-A, SS-B, RR, c-ANCA, p -ANCA, anti-gliadin IgA/IgG, anti-TS-HDS and/or anti-FGFR3 IgM were included into the study). Laser in vivo confocal microscopy (HRT3/RCM) images were analyzed using corneal nerve alterations using Neuron J in a masked fashion, comparing patients with or without anti-neuronal TS-HDS and FGFR-3 IgM. The healthy control group consisted of an age- and sex-matched subjects (n=35) from a reference normative database.

Results: The mean age was 50.3 19.0 years for patients without anti-neuronal Abs (n=19, 4 males, 15 females) and 48.1 18.7 for patients with anti-TS-HDS/FGFR-3 IgM (n=16, 1 male, 15 females), and 47.3+15.5 (n=35, 5 males, 30 female) for controls. The mean total, main and branch subbasal corneal nerve densities in patients with anti-TS-HDS/FGFR-3 IgM were 9,944.71,085.0 mm/mm2, 6,542.7 563.2, and 3,402.0 579.2, and were significantly lower (p=0.01, p=0.01, p=0.03 respectively) compared to patients without anti-neuronal antibodies with 14,406.7 1,192.1, 9,046.2 684.8, and 5,360.6 592.9, and healthy controls (20,935.8 697.4, 9,138.2 460.6, and 11,527.6 564.4, respectively (p=0.001, p=0.005, p<0.001 respectively).

Conclusion: NCP patients with underlying autoimmune conditions demonstrate reduced nerve density compared to controls. NCP patients with anti-neuronal IgM against TS-HDS and/or FGFR-3 demonstrate significant corneal nerve fiber loss compared to other autoimmune-mediated NCP patients.

Disclosure: N (L YavuzSaricay, BN Bayraktuar, V Atocha); C,S (P Hamrah)



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