A Study Of Ocular Surface Abnormality, Corneal Sensation Changes, Facial Perceptivity Changes And Their Relationships In Systemic Lupus Erythematosus

Objective To investigate ocular surface abnormality,corneal sensation changes, facial perceptivity changes and to study the relationships of corneal hypesthesia and ocular surface abnormality and facial perception changes in systemic lupus erythematosus(SLE) subjects.Methods A prospective case-controlled study was adopted. Seventy SLE subjects(140 eyes) and 62 non- rheumatic diseases subjects (132 eyes) were recruited. Central corneal sensation(CCS) and facial perceptivity changes were measured with a Cochet-Bonnet aesthesiometer. At the same time, Schirmer'sⅠtest(sIt),tear film Break Up Time(BUT), corneal fluorescein staining and conjunctival Impression cytology(IC) analysis were used to examine all the subjects. The relationships between corneal hypesthesia and ocular surface abnormality or facial perception changes in systemic lupus erythemaitosus subjects were studied.Results Compared with control subjects, the incidence of keratoconjunctivitis sicca(KCS) among the patients of SLE increased(P<0.01), and the incidence of KCS in active phase wre more than that in nonactive phase(P<0.05); The average Schirmer's I test value decreased in patients with SLE(t=-5.49,P<0.01); the mean BUT value was significantly shorter than that in the controls(t=-6.54,P<0.01); the positive rate of corneal fluorescein staining was significantly increased in SLEs than that in normal controls (χ2=82.563,P<0.001); Eyes of patients of SLE demonstrated a significantly higher grade of squamous metaplasia compared with the control subjects(χ2=44.725,P<0.001);The CCS declined in patients with SLEs(t=-4.492,P<0.001), and in active phase they were more lower than those in nonactive phase(P<0.05); The facial perceptivity decreased(t=-7.563,P<0.001), and in active phase they were significantly reduced compared with those in nonactive phase(P<0.05); CCS was correlated with sIt ,BUT ,the positive rate of corneal fluorescein staining , the grade of squamous metaplasia and facial perception(r=0.331,P≈0.00;r=0.244,P≈0.00;r= -0.396,P≈0.00, r=-0.362,P≈0.00;r=0.608,P<0.001); There were eighteen patients of KCS among thirty-five patients with skin lesion(51.4%), and there were three patients of that among thirty-five patients without skin lesion(8.6%), and the incidences of KCS among patients with skin lesion were significantly higher than that among without skin lesion(P<0.001); In SLE subjects, CCS and facial perceptivity among the patients with skin lesion that was no less than 2 years were significantly reduced compared with the patients with skin lesion that was less than 2 years and the patients without skin lesion,and their CCS was correlate with their facial perception (r=0.589,P=0.00).Conclusion Patients of SLE have significantly reduced corneal sensation and are prone to have abnormalities of ocular surface. Corneal hypesthesia is one of the factors related to ocular surface abnormality, such as corneal epithelial disorder and dry eye. The patients with KCS whose ocular surface were severitily damage among SLE subjects have not fell unwell like dryness of eye may because the corneal perceptivity was decreased. CCS among patients of SLE accorded with facial skin lension and facial perceptivity.