Corneal confocal microscopy is efficient, well-tolerated, and reproducible

Area of Science:

• Ophthalmology
• Neuroscience
• Medical Imaging

Background:

• Assessing corneal innervation is crucial for diagnosing neurological conditions.
• Standardized and reproducible methods are needed for corneal nerve evaluation.

Purpose of the Study:

• To develop and validate an efficient, reproducible protocol for corneal innervation assessment using corneal confocal microscopy (CCM).

Main Methods:

• 11 healthy subjects underwent CCM using a Heidelberg Retinal Tomography III microscope.
• Standardized locations were sampled, and the protocol was repeated after 1-4 weeks.
• Nerve fiber length (NFL) and tortuosity coefficient (TC) were measured by a blinded technician.

Main Results:

• Reproducibility of NFL was maximized by averaging four or more images from one eye or one central image from both eyes.
• TC measurements showed lower reproducibility compared to NFL.
• CCM proved to be a rapid and well-tolerated procedure.

Conclusions:

• CCM is a viable and reproducible technique for quantifying corneal innervation.
• The developed protocol enhances the reliability of corneal nerve fiber length assessment.
• Further refinement may improve the reproducibility of tortuosity coefficient measurements.