Skip to main content

Advertisement

SpringerLink
Log in

Differential contributions of impaired corneal sensitivity and reduced tear secretion to corneal epithelial disorders

  • Clinical Investigation
  • Published:
Japanese Journal of Ophthalmology Aims and scope Submit manuscript

Abstract

Background/aims

To determine the possible roles of impaired corneal sensitivity and reduced tear secretion in various types of corneal epithelial disorders.

Methods

A total of 99 patients (179 eyes) with corneal epithelial disorders classified as persistent epithelial defects (PED), corneal erosion, or superficial punctate keratopathy (SPK) and 115 individuals (230 eyes) without apparent ocular surface disorders (controls) were enrolled in a prospective study. Corneal sensitivity was measured with a Cochet-Bonnet esthesiometer, and tear secretion was measured by the Schirmer test in each subject.

Results

Corneal sensitivity of eyes in the PED and corneal erosion groups was significantly lower than that in the control group. Schirmer test values for eyes in the SPK group were significantly reduced compared with those in the control group.

Conclusion

A loss of corneal sensitivity may contribute to the development of PED and corneal erosion, whereas reduced tear secretion may be a contributing factor for SPK. Both results indicate the importance of corneal sensory innervation to the maintenance of corneal integrity.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Nishida T. Saika S. Cornea and sclea: anatomy and physiology. In: Krachmer JH, Mannis MJ, Holland EJ, editors. Cornea, 3rd ed. St. Louis: Mosby; 2010. p. 3–24.

  2. Gipson IK, Joyce NC, Zieske JD. The anatomy and cell biology of the human cornea, limbus, counjunctiva, and adnexa. In: Foster CS, Azar DT, Dohlman CH, editors. Smolin and Thoft’s the cornea. Scientific foundation and clinical practice. 4th ed. Philadelphia: Lippincott Williams & Wilkins; 2005. p. 1–35.

    Google Scholar 

  3. Nishida T. The cornea: stasis and dynamics. Nippon Ganka Gakkai zasshi. 2008;112:179–212. (in Japanese).

    PubMed  CAS  Google Scholar 

  4. Cohen EJ, Rapuano CJ. Corneal changes from ocular surgery. In: Kaufman HE, Barron BA, Dohlman CH, editors. The cornea. 2nd ed. Newton: Butterworth-Heinemann; 1998. p. 673–96.

    Google Scholar 

  5. Faulkner WJ, Varley GA. Corneal diagnostic techniques. In: Krachmer JH, Mannis MJ, Holland EJ, editors. Cornea, 3rd ed. St Louis: Mosby; 2010. p. 131–8.

  6. Gulati A, Dana R. Keratoconjunctivitis sicca: clinical aspects. In: Foster CS, Azar DT, Dohlman CH, editors. Smolin and Thoft’s the cornea. Scientific foundation and clinical practice. 4th ed. Philadelphia: Lippincott Williams & Wilkins; 2005. p. 603–27.

    Google Scholar 

  7. Kenyon KR, Ghinelli E, Chaves HV. Morphology and pathologic response in corneal and conjunctival disease. In: Foster CS, Azar DT, Dohlman CH, editors. Smolin and Thoft’s the cornea. Scientific foundation and clinical practice. 4th ed. Philadelphia: Lippincott Williams & Wilkins; 2005. p. 103–40.

    Google Scholar 

  8. Parrish CM, Chandler JW. Corneal trauma. In: Kaufman HE, Barron BA, Dohlman CH, editors. The cornea. 2nd ed. Newton: Butterworth-Heinemann; 1998. p. 633–71.

    Google Scholar 

  9. Watkins A, Macaluso DM, Feldman ST. Pathogenesis of sterile corneal erosions and ulcerations. In: Krachmer JH, Mannis MJ, Holland EJ, editors. Cornea, 2nd ed. St Louis: Mosby; 2005. p. 151–64.

  10. Nishida T, Tanaka T. Extracellular matrix and growth factors in corneal wound healing. Curr Opin Ophthalmol. 1996;7:2–11.

    Article  PubMed  CAS  Google Scholar 

  11. Zieske JD. Extracellular matrix and wound healing. Curr Opin Ophthalmol. 2001;12:237–41.

    Article  PubMed  CAS  Google Scholar 

  12. Chang BH, Groos EBJ. Neurotrophic keratitis. In: Krachmer JH, Mannis MH, Holland EJ, editors. Cornea, 3rd ed. St Louis: Mosby; 2010. p. 1101–9.

  13. Nishida T. Neurotrophic mediators and corneal wound healing. Ocul Surf. 2005;3:194–202.

    PubMed  Google Scholar 

  14. Nishida T, Yanai R. Advances in treatment for neurotrophic keratopathy. Curr Opin Ophthalmol. 2009;20:276–81.

    Article  PubMed  Google Scholar 

  15. Yamada M, Ogata M, Kawai M, Mashima Y. Decreased substance P concentrations in tears from patients with corneal hypesthesia. Am J Ophthalmol. 2000;129:671–2.

    Article  PubMed  CAS  Google Scholar 

  16. Dogru M, Katakami C, Inoue M. Tear function and ocular surface changes in noninsulin-dependent diabetes mellitus. Ophthalmology. 2001;108:586–92.

    Article  PubMed  CAS  Google Scholar 

  17. Jones LT. The lacrimal secretory system and its treatment. J All India Ophthalmol Soc. 1966;14:191–6.

    PubMed  CAS  Google Scholar 

  18. Sawa M, Miyata K, Nishida T, Mishima H, Otori T. A nationwide survey on the incidence and modes of treatment of corneal epithelial disorders. Ganka. 1993;35:1507–12.

    Google Scholar 

  19. Davies MS. Corneal anaesthesia after alcohol injection of the trigeminal sensory root. Examination of 100 anaesthetic corneae. Br J Ophthalmol. 1970;54:577–86.

    Article  PubMed  CAS  Google Scholar 

  20. Mackie IA. Role of the corneal nerves in destructive disease of the cornea. Trans Ophthalmol Soc UK. 1978;98:343–7.

    PubMed  CAS  Google Scholar 

  21. Onofrio BM. Radiofrequency percutaneous Gasserian ganglion lesions: results in 140 patients with trigeminal pain. J Neurosurg. 1975;42:132–9.

    Article  PubMed  CAS  Google Scholar 

  22. Cavanagh HD, Pihlaja D, Thoft RA, Dohlman CH, et al. The pathogenesis and treatment of persistent epithelial defects. Trans Sect Ophthalmol Am Acad Ophthalmol Otolaryngol. 1976;81:754–69.

    PubMed  CAS  Google Scholar 

  23. Cobo LM. Corneal complications of herpes zoster ophthalmicus. Prevention and treatment. Cornea. 1988;7:50–6.

    Article  PubMed  CAS  Google Scholar 

  24. Liesegang TJ. Corneal complications from herpes zoster ophthalmicus. Ophthalmology. 1985;92:316–24.

    PubMed  CAS  Google Scholar 

  25. Liesegang TJ. Ocular herpes simplex infection: pathogenesis and current therapy. Mayo Clin Proc. 1988;63:1092–105.

    PubMed  CAS  Google Scholar 

  26. Hyndiuk RA, Kazarian EL, Schultz RO, Seideman S. Neurotrophic corneal ulcers in diabetes mellitus. Arch Ophthalmol. 1977;95:2193–6.

    Article  PubMed  CAS  Google Scholar 

  27. Lockwood A, Hope-Ross M, Chell P. Neurotrophic keratopathy and diabetes mellitus. Eye. 2006;20:837–9.

    Article  PubMed  CAS  Google Scholar 

  28. Rosenwasser GOD. Complications of topical ocular anesthetics. Int Ophthalmol Clin. 1989;29:153–8.

    Article  PubMed  CAS  Google Scholar 

  29. Rosenwasser GOD, Holland S, Pflugfelder SC, Lugo M, Heidemann DG, Culbertson WW, et al. Topical anesthetic abuse. Ophthalmology. 1990;97:967–72.

    PubMed  CAS  Google Scholar 

  30. Yamada N, Yanai R, Inui M, Nishida T. Sensitizing effect of substance P on corneal epithelial migration induced by IGF-1, fibronectin, or interleukin-6. Invest Ophthalmol Vis Sci. 2005;46:833–9.

    Article  PubMed  Google Scholar 

  31. Nishida T, Nakagawa S, Manabe R. Clinical evaluation of fibronectin eyedrops on epithelial disorders after herpetic keratitis. Ophthalmology. 1985;92:213–6.

    PubMed  CAS  Google Scholar 

  32. Tsubota K, Goto E, Shimmura S, Shimazaki J. Treatment of persistent corneal epithelial defect by autologous serum application. Ophthalmology. 1999;106:1984–9.

    Article  PubMed  CAS  Google Scholar 

  33. Young AL, Cheng ACO, Ng HK, Cheng LL, Leung GYS, Lam DSC. The use of autologous serum tears in persistent corneal epithelial defects. Eye. 2004;18:609–14.

    Article  PubMed  CAS  Google Scholar 

  34. Wilczynski M. The use of autologous serum in the treatment of the ocular surface diseases. Klin Oczna. 2009;111:363–8.

    PubMed  Google Scholar 

  35. Jeng BHMD, Dupps WJJMDP. Autologous serum 50% eyedrops in the treatment of persistent corneal epithelial defects. Cornea. 2009;28:1104–8.

    Article  PubMed  Google Scholar 

  36. Chikama T-I, Fukuda K, Morishige N, Nishida T. Treatment of neurotrophic keratopathy with substance-P-derived peptide (FGLM) and insulin-like growth factor I. Lancet. 1998;351:1783–4.

    Article  PubMed  CAS  Google Scholar 

  37. Yamada N, Matsuda R, Morishige N, Yanai R, Chikama T-I, Nishida T, et al. Open clinical study of eye-drops containing tetrapeptides derived from substance P and insulin-like growth factor-1 for treatment of persistent corneal epithelial defects associated with neurotrophic keratopathy. Br J Ophthalmol. 2008;92:896–900.

    Article  PubMed  CAS  Google Scholar 

  38. Nishida T, Chikama TI, Morishige N, Yanai R, Yamada N, Saito J. Persistent epithelial defects due to neurotrophic keratopathy treated with a substance P-derived peptide and insulin-like growth factor 1. Jpn J Ophthalmol. 2007;51:442–7.

    Article  PubMed  CAS  Google Scholar 

  39. Lambiase A, Rama P, Bonini S, Caprioglio G, Aloe L. Topical treatment with nerve growth factor for corneal neurotrophic ulcers. N Engl J Med. 1998;338:1174–80.

    Article  PubMed  CAS  Google Scholar 

  40. Dunn SP, Heidemann DG, Chow CYC, Crockford D, Turjman N, Angel J, et al. Treatment of chronic nonhealing neurotrophic corneal epithelial defects with thymosin beta 4. Arch Ophthalmol. 2010;128:636–8.

    Article  PubMed  Google Scholar 

  41. Sosne G, Qiu P, Kurpakus-Wheater M, Matthew H. Thymosin beta4 and corneal wound healing: visions of the future. Ann N Y Acad Sci. 2010;1194:190–8.

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

We wish to thank the following for their clinical contribution to the study: Nobuhiko Chikamoto (Yamaguchi University Hospital, currently Chikamoto EYE Clinic); Keiko Muromoto (Nihon University Itabashi Hospital, currently Saito Eye Clinic); Yasuhiko Okajima (Nihon University Itabashi Hospital, currently Okajima Eye Clinic); Takashi Miyai (Miyata Eye Hospital, currently The University of Tokyo); Ryohei Nejima, and Daisuke Harada (Miyata Eye Hospital, currently Mine Municipal Mitou Hospital); Yuji Kumano (Ohshima Hospital of Ophthalmology); and Akira Sakimoto (Choshi General City Hospital, currently Department of General Pediatrics, Nerima Hikarigaoka Hospital, Nihon University School of Medicine). We also thank the nurses and paramedical staff at the participating hospitals.

Author information

Author notes

  1. Teruo Nishida

    Present address: Yamaguchi University, 1677-1 Yoshida, Yamaguchi, 753-8511, Japan

  2. Tai-Ichiro Chikama

    Present address: Hiroshima University Hospital, Hiroshima, Hiroshima, Japan

  3. Kyoko Shigeta

    Present address: Tokyo Womens Medical University Yachiyo Medical Center, Yachiyo, Chiba, Japan

Authors and Affiliations

  1. Department of Ophthalmology, Yamaguchi University Hospital, Ube, Yamaguchi, Japan

    Teruo Nishida & Tai-Ichiro Chikama

  2. Department of Ophthalmology, Nihon University Itabashi Hospital, Tokyo, Japan

    Mitsuru Sawa

  3. Miyata Eye Hospital, Miyakonojyo, Miyazaki, Japan

    Kazunori Miyata

  4. Ohshima Hospital of Ophthalmology, Fukuoka, Japan

    Takaaki Matsui

  5. Department of Ophthalmology, Choshi General City Hospital, Choshi, Chiba, Japan

    Kyoko Shigeta

Authors
  1. Teruo Nishida
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tai-Ichiro Chikama
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mitsuru Sawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kazunori Miyata
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Takaaki Matsui
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Kyoko Shigeta
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Teruo Nishida.

About this article

Cite this article

Nishida, T., Chikama, TI., Sawa, M. et al. Differential contributions of impaired corneal sensitivity and reduced tear secretion to corneal epithelial disorders. Jpn J Ophthalmol 56, 20–25 (2012). https://doi.org/10.1007/s10384-011-0105-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10384-011-0105-4

Keywords

Search

Navigation