{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T00:23:56Z","timestamp":1760660636735,"version":"build-2065373602"},"reference-count":18,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2015,10,24]],"date-time":"2015-10-24T00:00:00Z","timestamp":1445644800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microscopy Res &amp; Technique"],"published-print":{"date-parts":[[2015,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Sjogren's syndrome (SS) is a progressive autoimmune condition mainly affecting the salivary and lacrimal glands with an incidence of primary SS between 1\/100 and 1\/1,000. SS implies an alteration in the epithelium and subepithelium innervation, with consequent reduction of corneal sensitivity. It is necessary to have noninvasive quantitative methods to characterize the status of the corneal nerve fibers of the patients in order to choose and follow the best therapy. Entropy (information dimension) of the nerve corneal fibers distribution observed by confocal microscopy was evaluated in patients with primary SS (<jats:italic>n<\/jats:italic>\u2009=\u200930, 6 males, 24 females, 21\u201381 years), diagnosed by biopsy of salivary gland and blood tests and in sex\u2010 age\u2010matched healthy subjects (<jats:italic>n<\/jats:italic>\u2009=\u200912). Corneal nerve fiber density, Langerhans cell count, and cell density in the nerve plexus images were also evaluated. In selected patients salivary gland atrophy degree was also evaluated. Nerve corneal distribution observed by confocal microscopy is fractal. Entropy of the corneal nerve distribution statistically distinguishes between SS patients and healthy subjects: patients present a lower value of information dimension of the corneal nerve fibers distribution than healthy individuals (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Percentage of grouped cases classified by entropy according to the subjects (selected patients vs. healthy) showed a 100% sensitivity and 96% specificity, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001 with a low value of coefficient of variation among the individuals (6\u20137 times lower than the other morphometric indexes). Entropy correlated with the severity of the disease (salivary gland atrophy degree, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01). Evaluation of entropy of the corneal nerve distribution observed by a laser confocal microscopy appears to quantitatively and noninvasively characterize an aspect of the SS patients in relation to the recognition of an impairment of their ocular surface, giving us for the first time a method to objectively and precisely characterize the corneal innervation status in the SS patients. <jats:italic>Microsc. Res. Tech. 78:1069\u20131074, 2015<\/jats:italic>. \u00a9 2015 Wiley Periodicals, Inc.<\/jats:p>","DOI":"10.1002\/jemt.22586","type":"journal-article","created":{"date-parts":[[2015,10,24]],"date-time":"2015-10-24T05:58:00Z","timestamp":1445666280000},"page":"1069-1074","source":"Crossref","is-referenced-by-count":10,"title":["Entropy of corneal nerve fibers distribution observed by laser scanning confocal microscopy: A noninvasive quantitative method to characterize the corneal innervation in <scp>S<\/scp>jogren's syndrome patients"],"prefix":"10.1002","volume":"78","author":[{"given":"Giorgio","family":"Bianciardi","sequence":"first","affiliation":[{"name":"Department of Medical Biotechnologies University of Siena Siena Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Eugenia","family":"Latronico","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences Surgery and Neurosciences University of Siena Siena Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudio","family":"Traversi","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences Surgery and Neurosciences University of Siena Siena Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,10,24]]},"reference":[{"doi-asserted-by":"publisher","key":"e_1_2_6_2_1","DOI":"10.1016\/j.exer.2010.07.008"},{"doi-asserted-by":"publisher","key":"e_1_2_6_3_1","DOI":"10.2174\/1574893608666131217234443"},{"doi-asserted-by":"publisher","key":"e_1_2_6_4_1","DOI":"10.2174\/1574893611308030011"},{"doi-asserted-by":"publisher","key":"e_1_2_6_5_1","DOI":"10.1097\/01.ico.0000214802.40313.fa"},{"doi-asserted-by":"publisher","key":"e_1_2_6_6_1","DOI":"10.1016\/S1542-0124(12)70043-5"},{"volume-title":"Fractal geometry: Mathematical foundations and applications","year":"1990","author":"Falconer K","key":"e_1_2_6_7_1"},{"key":"e_1_2_6_8_1","first-page":"2457","article-title":"The application of in vivo laser scanning confocal microscopy as a tool of conjunctival in vivo cytology in the diagnosis of dry eye ocular surface desease","volume":"16","author":"Kojima T","year":"2010","journal-title":"Mol Vis"},{"key":"e_1_2_6_9_1","first-page":"174","article-title":"Self\u2010similarity and fractal irregularity in pathologic tissues","volume":"9","author":"Losa GA","year":"1996","journal-title":"Mod Pathol"},{"doi-asserted-by":"publisher","key":"e_1_2_6_10_1","DOI":"10.1146\/annurev.bioeng.6.040803.140100"},{"doi-asserted-by":"publisher","key":"e_1_2_6_11_1","DOI":"10.1016\/j.survophthal.2011.11.003"},{"doi-asserted-by":"publisher","key":"e_1_2_6_12_1","DOI":"10.1001\/archopht.122.3.369"},{"doi-asserted-by":"publisher","key":"e_1_2_6_13_1","DOI":"10.1167\/iovs.06-0127"},{"doi-asserted-by":"publisher","key":"e_1_2_6_14_1","DOI":"10.1097\/00003226-200007000-00015"},{"doi-asserted-by":"publisher","key":"e_1_2_6_15_1","DOI":"10.1103\/PhysRevB.39.7097"},{"key":"e_1_2_6_16_1","first-page":"2609","article-title":"Conjunctival T\u2010cell subpopulations in Sjogren's and non Sjogren's patients with dry\u2010eye","volume":"43","author":"Stern ME","year":"2002","journal-title":"IOVS"},{"doi-asserted-by":"publisher","key":"e_1_2_6_17_1","DOI":"10.1111\/j.1442-9071.2008.01766.x"},{"doi-asserted-by":"publisher","key":"e_1_2_6_18_1","DOI":"10.1167\/iovs.06-1129"},{"key":"e_1_2_6_19_1","first-page":"1","article-title":"Tear dynamic and corneal confocal microscopy of subjects with mild self reported office dry eye","volume":"20","author":"Zhang X","year":"2010","journal-title":"Ophthalmology"}],"container-title":["Microscopy Research and Technique"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fjemt.22586","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/analyticalsciencejournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jemt.22586","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T14:26:30Z","timestamp":1760624790000},"score":1,"resource":{"primary":{"URL":"https:\/\/analyticalsciencejournals.onlinelibrary.wiley.com\/doi\/10.1002\/jemt.22586"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,10,24]]},"references-count":18,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2015,12]]}},"alternative-id":["10.1002\/jemt.22586"],"URL":"https:\/\/doi.org\/10.1002\/jemt.22586","archive":["Portico"],"relation":{},"ISSN":["1059-910X","1097-0029"],"issn-type":[{"type":"print","value":"1059-910X"},{"type":"electronic","value":"1097-0029"}],"subject":[],"published":{"date-parts":[[2015,10,24]]}}}