In vivo confocal microscopy of corneal nerve fiber damage in early course of multiple sclerosis

To evaluate the corneal nerve fiber morphology in patients with multiple sclerosis (MS) by in vivo corneal confocal microscopy (CCM).

Retinal nerve fiber layer thickness (RNFLT), central macular thickness (CMT), corneal nerve fiber length (CNFL), corneal nerve fiber density (CNFD), corneal nerve branch density (CNBD) and corneal nerve fiber tortuosity (CNFT) were measured. Correlation of corneal nerve findings with duration and clinical severity of MS was calculated.

CNFL (9.50 ± 0.60 vs. 11.20 ± 0.57 mm/mm², P = 0.046) and CNBD (57.46 ± 5.04 vs. 77.65 ± 3.41 no/mm², P = 0.001) were significantly lower with no significant difference in CNFD (21.24 ± 1.20 vs. 23.62 ± 0.95 no/mm², P = 0.125), CNFT (2.00 ± 0.15 vs. 1.73 ± 0.12, P = 0.180), CMT (269.57 ± 12.53 vs. 271.10 ± 18.84 μm, P = 0.716) or RNFLT (102.82 ± 6.98 vs. 105.33 ± 12.70 μm, P = 0.351) between patients with RRMS compared to controls. There was no significant correlation between CCM parameters with EDSS and duration of disease in MS patients.

The current study demonstrated that a decrease in CNFL, CNFD and CNBD in CCM analysis in the early course of MS.