Relation between Corneal Dendritic Cell Density and Tear film Stability in Patients with Epidemic Keratoconjunctivitis associated Dry Eye.

Purpose To clarify the ocular surface features of patients with recent history of epidemic keratoconjunctivitis (EKC) and the relation between corneal dendritic cells (DCs) and ocular discomfort. Methods Normal controls (NC) and dry eye (DE) patients without EKC were recruited. Patients with recent EKC history (onset >4 weeks, but <20 weeks) were recruited as EKC + DE group (with dry eye) or EKC-DE group (without dry eye). Ocular Surface Disease Index (OSDI) questionnaire, tear film parameters including lipid layer thickness, first tear break-up time (fBUT), average tear break-up time (aBUT), tear meniscus height and Schirmer I test, meibomian gland parameters, and in vivo corneal confocal microscopy were evaluated. Results 50 subjects in the NC group, 83 patients in the DE group, 76 patients in the EKC + DE group, and 38 patients in the EKC-DE group were included. Compared with the NC, DE, and EKC-DE groups, the EKC + DE group represented higher OSDI, lid margin, and meibum score ( P  < 0.05). In the EKC + DE group, the tear volume (10.5 ± 3.7mm) was significantly higher than in the DE group (8.1 ± 2.8mm, P  < 0.001). The DC density in the EKC + DE group (29.98 ± 15.38 cells/image) was significantly higher than in NC, DE, and EKC-DE groups (4.68 ± 4.05 cells/image) ( P  < 0.001). The DC density was positively correlated with OSDI, lid margin, and meibum score (all P  < 0.01) while inversely correlated with fBUT, aBUT (all P  < 0.001) in the EKC + DE group. Conclusions Corneal DC density significantly correlates to ocular discomfort and tear film instability in patients with recent EKC history who suffer from DE without aqueous tear deficiency.