PT - JOURNAL ARTICLE AU - Harrison Dermer AU - Jodi Hwang AU - Rhiya Mittal AU - Adam K Cohen AU - Anat Galor TI - Corneal sub-basal nerve plexus microneuromas in individuals with and without dry eye AID - 10.1136/bjophthalmol-2020-317891 DP - 2022 May 01 TA - British Journal of Ophthalmology PG - 616--622 VI - 106 IP - 5 4099 - http://bjo.bmj.com/content/106/5/616.short 4100 - http://bjo.bmj.com/content/106/5/616.full SO - Br J Ophthalmol2022 May 01; 106 AB - Background/aim An objective marker is needed to detect when corneal nerve abnormalities underlie neuropathic corneal pain (NCP), as symptoms often overlap with those of dry eye (DE). This study evaluated microneuroma (MN) frequency in various populations and investigated relationships between MN presence and DE clinical features in individuals with DE symptoms but without a history of refractive surgery, in order to eliminate refractive surgery as a potential confounder of nerve abnormalities.Methods This was a retrospective study that included individuals with and without DE symptoms who underwent a clinical evaluation for DE (symptom surveys and ocular surface evaluation) and in vivo confocal microscopy imaging. DE clinical features (including those suggestive of neuropathic pain) were compared based on MN presence using t-tests, χ2 analyses and Pearson’s correlation coefficients with 0.05 alpha level.Results MN frequencies did not significantly differ between individuals with DE symptoms (Dry Eye Questionnaire 5 score ≥6) and a history of refractive surgery (n=1/16, 6%), individuals with DE symptoms without a history of refractive surgery (n=26/119, 22%) and individuals without DE symptoms (n=2/18, 11%, p=0.22). Among individuals with DE symptoms without a history of refractive surgery, DE clinical features, including those indicative of NCP (burning sensation and sensitivity to light, wind and extreme temperatures), did not significantly differ based on MN presence (p>0.05).Conclusion MN frequencies did not significantly differ between individuals with and without DE symptoms. Their presence alone could not distinguish between DE subtypes, including features of NCP in our study population.All data relevant to the study are included in the article or uploaded as supplementary information.