Assessing the sub‐basal nerve plexus of the living healthy human cornea by in vivo confocal microscopy

The purpose of the study was to perform quantitative analysis of the sub‐basal epithelial nerve plexus of healthy, living human cornea, using real time in vivo confocal microscopy and the analySIS software system. The study was based on in vivo confocal microstructural analysis of 50 eyes of 50 subjects, divided into two age groups: group 1 (n = 25) 25 ± 5 years of age, and group 2 (n = 25) 70 ± 5 years of age. All subjects exhibited clinically healthy corneas. The overall nerve density was 632.35 ± 287.57 µm/mm2 for group 1 and 582.39 ± 327.13 µm/mm2 for group 2. The mean fibre diameter was measured at 0.52 ± 0.23 µm for group 1 and at 0.56 ± 0.27 µm for group 2. Beadings of the nerve fibres were recorded at a density of 213 ± 123/mm for group 1 and 201 ± 192/mm for group 2. Establishing standards for normal nerve density and morphology of the living human cornea at different ages may be beneficial, both in early detection and follow up of various corneal diseases and in post‐surgical management following corneal surgery.

[1]  T. Tervo,et al.  Corneal wound healing and nerve morphology after excimer laser in situ keratomileusis in human eyes. , 1996, Journal of refractive surgery.

[2]  N Efron,et al.  Morphology of Corneal Nerves Using Confocal Microscopy , 2001, Cornea.

[3]  J. Marshall,et al.  Loss and recovery of corneal sensitivity following photorefractive keratectomy for myopia. , 1999, Journal of refractive surgery.

[4]  L. Hesse,et al.  Corneal reinnervation after photorefractive keratectomy and laser in situ keratomileusis: an in vivo study with a confocal videomicroscope. , 1996, German journal of ophthalmology.

[5]  D. Ertoy,et al.  Postoperative topical mitomycin C in conjunctival squamous cell neoplasia. , 1999, Cornea.

[6]  R. Guthoff,et al.  Corneal reinnervation following penetrating keratoplasty--correlation of esthesiometry and confocal microscopy. , 1996, German journal of ophthalmology.

[7]  G. Vrensen,et al.  Ultrastructural organization of human corneal nerves. , 1996, Investigative ophthalmology & visual science.

[8]  S. Kaufman,et al.  Differential diagnosis of linear corneal images on confocal microscopy. , 1999, Cornea.

[9]  T. Sherwin,et al.  Differential diagnosis of corneal oedema assisted by in vivo confocal microscopy , 2001, Clinical & experimental ophthalmology.

[10]  W. Petroll,et al.  In vivo confocal microscopy of patients with corneal recurrent erosion syndrome or epithelial basement membrane dystrophy. , 2000, Ophthalmology.

[11]  T. Tervo,et al.  Real-time confocal microscopic observations on human corneal nerves and wound healing after excimer laser photorefractive keratectomy. , 1997, Current eye research.

[12]  I. Immonen,et al.  Corneal structure and sensitivity in type 1 diabetes mellitus. , 2000, Investigative ophthalmology & visual science.

[13]  W. Petroll,et al.  Comparison of in vivo and ex vivo cellular structure in rabbit eyes detected by tandem scanning microscopy , 1992, Journal of microscopy.

[14]  J. Auran,et al.  Scanning slit confocal microscopic observation of cell morphology and movement within the normal human anterior cornea. , 1995, Ophthalmology.

[15]  W. Wiegand,et al.  In vivo observation of corneal nerve regeneration after photorefractive keratectomy with a confocal videomicroscope. , 1996, German journal of ophthalmology.

[16]  G F Vrensen,et al.  Architecture of human corneal nerves. , 1997, Investigative ophthalmology & visual science.

[17]  B. Masters,et al.  In vivo human corneal confocal microscopy of identical fields of subepithelial nerve plexus, basal epithelial, and wing cells at different times , 1994, Microscopy research and technique.

[18]  T. Tervo,et al.  Recovery of corneal nerve morphology following laser in situ keratomileusis. , 1998, Experimental eye research.