Corneal Confocal Microscopy Identifies and Differentiates Patients With Multiple Sclerosis and Epilepsy.

Area of Science:

• Ophthalmology
• Neurology
• Biomarker Discovery

Background:

• Multiple sclerosis (MS) and epilepsy are neurological conditions with potential ocular manifestations.
• Corneal nerve structure alterations may serve as indicators of neurological disease.

Purpose of the Study:

• To evaluate the utility of corneal confocal microscopy (CCM) in identifying and differentiating patients with MS from those with epilepsy.
• To analyze specific corneal nerve parameters for diagnostic potential.

Main Methods:

• Corneal confocal microscopy (CCM) was performed on 83 MS patients, 50 epilepsy patients, and 20 healthy controls (HCs).
• Quantification included automated corneal nerve fiber length (ACNFL), automated corneal nerve fractal dimension (ACNFrD), and the ACNFrD/ACNFL ratio.

Main Results:

• Patients with MS and epilepsy showed significantly reduced ACNFL and ACNFrD, and increased ACNFrD/ACNFL ratio compared to HCs.
• Distinct patterns in corneal nerve parameters were observed between MS and epilepsy patients.
• ACNFL demonstrated high diagnostic utility for MS identification (AUC 0.90), while ACNFrD was most useful for epilepsy identification (AUC 0.76) and differentiating MS from epilepsy (AUC 0.70).

Conclusions:

• Corneal neurodegeneration exhibits distinct patterns in MS and epilepsy.
• CCM can identify and differentiate patients with MS and epilepsy, suggesting its potential as a diagnostic tool.
• Further validation with larger sample sizes is recommended.