Corneal Confocal Microscopy Detects Small-Fibre Neuropathy in Burning Mouth Syndrome: a cross-sectional study

O'Neill, FE ORCID: 0000-0002-6009-1026, Marshall, Andrew ORCID: 0000-0001-8273-7089, Ferdousi, Maryam and Malik, Rayaz (2019) Corneal Confocal Microscopy Detects Small-Fibre Neuropathy in Burning Mouth Syndrome: a cross-sectional study. Journal of Oral and Facial Pain and Headache, 33 (3). pp. 337-341.

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Abstract

<h4>Aims</h4>To assess the utility of corneal confocal microscopy in identifying small fiber damage in patients with burning mouth syndrome (BMS).<h4>Methods</h4>A prospective cross-sectional cohort study was conducted at two United Kingdom dental hospitals between 2014 and 2017. A total of 17 consecutive patients with idiopathic BMS aged between 18 and 85 years and 14 healthy age-matched control subjects were enrolled in this study. Corneal subbasal nerve plexus measures were quantified in images acquired using a laser-scanning in vivo corneal confocal microscope. The main outcome measures were corneal nerve fiber density, nerve branch density, nerve fiber length, and Langerhans cell density.<h4>Results</h4>Of the 17 patients with BMS, 15 (88%) were women, and the mean (standard deviation) age of the sample was 61.7 (6.5) years. Of the healthy controls, 7 (50%) were women, and the mean (standard deviation) age was 59.3 (8.68) years. Corneal nerve fiber density (no./mm²) (BMS: 29.27 ± 6.22 vs controls: 36.19 ± 5.9; median difference = 6.71; 95% CI: 1.56 to 11.56; P = .007) and corneal nerve fiber length (mm/mm²) (BMS: 21.06 ± 4.77 vs controls: 25.39 ± 3.91; median difference = 4.5; 95% CI: 1.22 to 6.81; P = .007) were significantly lower in BMS patients compared to controls, and Langerhans cell density (no./mm²) (BMS: 74.04 ± 83.37 vs controls: 29.17 ± 45.14; median difference = -21.27; 95% CI: -65.35 to -2.91; P = .02) was significantly higher.<h4>Conclusion</h4>Using a rapid noninvasive ophthalmic imaging technique, this study provides further evidence for small fiber damage in BMS and has potential utility for monitoring disease progression and/or response. Furthermore, this technique shows a hitherto undocumented increased density of immune cells in this group of patients.

Item Type:	Article
Uncontrolled Keywords:	burning mouth syndrome, corneal confocal microscopy
Depositing User:	Symplectic Admin
Date Deposited:	05 Dec 2018 10:04
Last Modified:	19 Jan 2023 01:10
DOI:	10.11607/ofph.2338
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3029474