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Author Spotlight: Establishing a Practical and Cost-Effective Protocol for Corneal Sensitivity Testing in Clinical Settings
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Structural changes in the corneal subbasal nerve plexus in keratoconus.

Elias Flockerzi1, Loay Daas1, Berthold Seitz1

  • 1Department of Ophthalmology, Saarland University Medical Center, Homburg, Germany.

Acta Ophthalmologica
|April 11, 2020
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Summary
This summary is machine-generated.

Keratoconus (KC) patients show significantly reduced corneal nerve fiber length (CNFL) and increased subbasal nerve plexus (SNP) tortuosity compared to healthy individuals. These findings suggest a neurodegenerative component in KC progression.

Keywords:
corneal confocal microscopycorneal nerve fibre lengthkeratoconussubbasal nerve plexus

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Area of Science:

  • Ophthalmology
  • Neuroscience
  • Medical Imaging

Background:

  • Corneal confocal microscopy (CCM) enables visualization of subtle changes in the corneal subbasal nerve plexus (SNP).
  • Previous CCM studies suggested reduced corneal nerve fiber length (CNFL) in keratoconus (KC) based on limited image analysis.

Purpose of the Study:

  • To investigate and quantify alterations in corneal nerve structure in KC patients using CCM.
  • To compare CNFL and SNP tortuosity between KC patients and healthy controls.

Main Methods:

  • Examined the SNP of 23 KC patients and 16 controls using 10 CCM images per eye.
  • Calculated CNFL per frame area and quantified SNP tortuosity via amplitude and area under the curve (AUC).

Main Results:

  • KC patients exhibited significantly lower CNFL (16.4 mm/mm²) compared to healthy controls (23.8 mm/mm²).
  • SNP tortuosity, measured by amplitude and AUC, was significantly increased in KC patients.
  • No significant difference in CNFL was found between contact lens-wearing and non-wearing KC patients.

Conclusions:

  • CCM reveals significantly reduced CNFL and increased SNP tortuosity in KC.
  • These findings support a potential neurodegenerative aspect of KC and may serve as markers for disease severity and progression.