Altered Corneal Nerves in Chinese Thyroid-Associated Ophthalmopathy Patients Observed by In Vivo Confocal Microscopy

Wu, Lianqun; Mou, Pei; Chen, Zi-Yu; Cheng, Jin-Wei; Le, Qihua; Cai, Jun; Wei, Rui-Li

doi:10.12659/msm.912310

Cited by 20 publications

(18 citation statements)

References 30 publications

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“…Additionally, AMPA receptor antagonists decrease neuronal damage (43). Recently, our research group reported that the central corneal sub-basal nerve plexus of patients with TAO was significantly decreased compared with those of control subjects, suggesting that nerve degeneration is associated with the disease (44). In the present study, trafficking of AMPA receptor signaling was enriched in orbital decompression.…”

Section: Discussionsupporting

confidence: 59%

“…In addition to inflammation, the pathogenesis of TAO involves apoptosis, ECM component accumulation, neurodegeneration, orbital fibroblasts and increased fat volume ( 33 , 38 , 44 , 45 ). The potentially complex interaction among mononuclear cells, fat cells and orbital fibroblasts may underlie the unusual tissue reactivity and remodeling that occurs in patients with TAO.…”

Section: Discussionmentioning

confidence: 99%

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Tear proteomics of orbital decompression for disfiguring exophthalmos in inactive thyroid‑associated ophthalmopathy

et al. 2020

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The progress and achievements that have been made in tear proteomics in thyroid-associated ophthalmopathy (TAO) are critical for exploring the pathogenesis of TAO and investigating potential therapeutic targets. However, the tear proteomics of orbital decompression for disfiguring exophthalmos in inactive TAO have yet to be properly investigated. In the present study, orbital decompression was performed to repair disfiguring exophthalmos in patients with inactive TAO. Tears were collected before and after orbital decompression in patients with inactive TAO. Liquid chromatography with tandem mass spectrometry (LC-MS/MS) was performed to explore the changes in tear proteomics. Bioinformatics analyses were then employed to analyze the functions of the differentially expressed proteins (DEPs) identified by LC-MS/MS. The palpebral fissure height and exophthalmia area were significantly restored after 1 month of orbital decompression such that they approached the normal levels identified in healthy eyeballs. Among the 669 proteins identified by LC-MS/MS, 83 proteins were changed significantly between the preoperative and postoperative stages in inactive TAO patients and healthy control individuals. The DEPs were predicted to be involved in numerous signaling pathways. Bioinformatics analyses revealed that pathways associated with the immune system, metabolism, programmed cell death, vesicle-mediated transport, neuronal system and extracellular matrix organization may fulfill significant roles in orbital decompression in patients with inactive TAO. Taken together, these results provided a preliminary understanding of the mechanism of orbital decompression for disfiguring exophthalmos in inactive TAO patients.

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Section: Discussionsupporting

confidence: 59%

Section: Discussionmentioning

confidence: 99%

Tear proteomics of orbital decompression for disfiguring exophthalmos in inactive thyroid‑associated ophthalmopathy

et al. 2020

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“…IVCM has been recently applied to the armament of modalities used in the examination of MGs in patients with MGD, as well as many other ocular diseases (e.g., Sjogren’s syndrome [ 41 ], atopic keratoconjunctivitis [ 45 ] and primary blepharospasm [ 40 ]), providing a new noninvasive tool with which to study morphological changes in MGs. IVCM has been used by several researchers to investigate the effects of GO on the human cornea and bulbar conjunctiva at a cellular level [ 6 , 18 , 46 ]. Their observations suggested that GO induced changes in the bulbar conjunctiva, including reduced epithelial cell density and goblet cell density, increased Langerhans cell density, and higher degree of squamous metaplasia.…”

Section: Discussionmentioning

confidence: 99%

In vivo confocal microscopy assessment of meibomian glands microstructure in patients with Graves’ orbitopathy

Cheng

Chen

et al. 2021

BMC Ophthalmol

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Background To evaluate microstructural changes in the meibomian glands (MGs) in patients with active and inactive Graves’ orbitopathy (GO), using in vivo confocal microscopy (IVCM), and to investigate the correlations between clinical and confocal findings. Methods Forty patients (80 eyes) with GO (34 eyes with active GO, 46 eyes with inactive GO), and 31 age- and sex-matched control participants (62 eyes) were enrolled consecutively. A researcher recorded the clinical activity score (CAS) for each patient. A complete ophthalmic examination was then performed, including external eye, ocular surface and MGs. IVCM of the MGs was performed to determine the MG acinar density (MAD), MG longest and shortest diameters (MALD and MASD), MG orifice area (MOA), MG acinar irregularity (MAI), meibum secretion reflectivity (MSR), acinar wall inhomogeneity (AWI), acinar periglandular interstices inhomogeneity (API), and severity of MG fibrosis (MF). Results All confocal microscopy assessments of MGs significantly differed among groups (all P = 0.000). Compared to controls, GO groups showed lower MOA (1985.82 ± 1325.30 μm2 in active GO and 2021.59 ± 1367.45 μm2 in inactive GO vs. 3896.63 ± 891.90 μm2 in controls, all P = 0.000) and MAD (87.21 ± 32.69 /mm2 in active GO and 80.72 ± 35.54 /mm2 in inactive GO vs. 114.69 ± 34.90 /mm2 in controls, P = 0.001 and 0.000, respectively); greater MALD (118.11 ± 30.23 μm in active GO and 120.58 ± 27.64 μm in inactive GO vs. 58.68 ± 20.28 μm in controls, all P = 0.000) and MASD (44.77 ± 19.16 μm in active GO and 46.02 ± 20.70 μm in inactive GO vs. 27.80 ± 9.90 μm in controls, all P = 0.000); and higher degrees of MAI, MSR, and MF (all P<0.05). Eyes with active GO had higher degrees of MAI (P = 0.015), AWI (P = 0.000), and API (P = 0.000), while eyes with inactive GO had higher degrees of MSR (P = 0.000) and MF (P = 0.017). In GO groups, AWI and API were positively correlated with CAS (r = 0.640, P = 0.000; r = 0.683, P = 0.000, respectively), and MF was negatively correlated with CAS (r = − 0.228, P = 0.042). Conclusions IVCM effectively revealed microstructural changes of MGs in eyes with GO and provided strong in vivo evidence for the roles of obstruction and inflammation in the ocular surface disease process. Furthermore, it revealed discernible patterns of MG abnormalities in eyes with active GO and inactive GO, which are not easily distinguishable by typical clinical examinations.

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“…IVCM has been recently applied to the armament of modalities used in the examination of MGs in patients with MGD, as well as many other ocular diseases (e.g., Sjogren's syndrome [37], atopic keratoconjunctivitis [41] and primary blepharospasm [36]), providing a new noninvasive tool with which to study morphological changes in MGs. IVCM has been used by several researchers to investigate the effects of GO on the human cornea and bulbar conjunctiva at a cellular level [6,18,42]. Their observations suggested that GO induced changes in the bulbar conjunctiva, including reduced epithelial cell density and goblet cell density, increased Langerhans cell density, and higher degree of squamous metaplasia.…”

Section: Discussionmentioning

confidence: 99%

In vivo confocal microscopy assessment of meibomian glands microstructure in patients with Graves’ orbitopathy

Cheng

Chen

et al. 2020

Preprint

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Background: To evaluate microstructural changes in the meibomian glands (MGs) in patients with active and inactive Graves’ orbitopathy (GO), using in vivo confocal microscopy (IVCM), and to investigate the correlations between clinical and confocal findings.Methods: Forty patients (80 eyes) with GO (34 eyes with active GO, 46 eyes with inactive GO), and 31 age- and sex-matched control participants (62 eyes) were enrolled consecutively. Each participant completed an Ocular Surface Disease Index (OSDI) questionnaire and underwent a full eye examination, including assessments of clinical activity score (CAS), proptosis, palpebral fissure height (PFH), lagophthalmos, lipid layer thickness (LLT), partial blinking rate, noninvasive first breakup time (NIF-BUT), average breakup time (NIAvg-BUT), tear film breakup area (TBUA), corneal fluorescein staining (CFS), Schirmer I Test (SIT), meibum quality and MG expressibility. IVCM of the MGs was performed to determine the MG acinar density (MAD), MG longest and shortest diameters (MALD and MASD), MG orifice area (MOA), MG acinar irregularity (MAI), meibum secretion reflectivity (MSR), acinar wall inhomogeneity (AWI), acinar periglandular interstices inhomogeneity (API), and severity of MG fibrosis (MF).Results: All parameters demonstrated statistically significant differences among groups (all P＜0.05), except OSDI, LLT and NIAvg-BUT (P＞0.05). Compared to controls, GO groups showed lower MOA and MAD; greater MALD and MASD; and higher degrees of MAI, MSR, AWI, API, and MF (all P＜0.05). Eyes with active GO had higher degrees of MAI, AWI, and API, while eyes with inactive GO had higher degrees of MSR and MF (all P＜0.05). In GO groups, the two measured confocal signs of inflammation (AWI and API) were significantly correlated with CAS, proptosis, PFH, lagophthalmos, OSDI, NIF-BUT, CFS, SIT, meibum quality, and MG expressibility (all P＜0.05). MF was significantly correlated with CAS, OSDI, meibum quality, and MG expressibility (all P＜0.05). Conclusions: IVCM effectively revealed microstructural changes of MGs in eyes with GO and provided strong in vivo evidence for the roles of obstruction and inflammation in the ocular surface disease process. Furthermore, it revealed discernible patterns of MG abnormalities in eyes with active GO and inactive GO, which are not easily distinguishable by typical clinical examinations.

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Altered Corneal Nerves in Chinese Thyroid-Associated Ophthalmopathy Patients Observed by In Vivo Confocal Microscopy

Cited by 20 publications

References 30 publications

Tear proteomics of orbital decompression for disfiguring exophthalmos in inactive thyroid‑associated ophthalmopathy

Tear proteomics of orbital decompression for disfiguring exophthalmos in inactive thyroid‑associated ophthalmopathy

In vivo confocal microscopy assessment of meibomian glands microstructure in patients with Graves’ orbitopathy

In vivo confocal microscopy assessment of meibomian glands microstructure in patients with Graves’ orbitopathy

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