Corneal Sensation And Subbasal Nerve Density Are Reduced In Eyes With Limbal Stem Cell Deficiency.
Published 2023 - 41st Congress of the ESCRS
Reference: FP22.06 | Type: Free paper | DOI: 10.82333/b1as-8427
Authors: Clémence Bonnet* 1 , Duangratn Niruthisard 2 , Rutuja Unhale 3 , Sophie Deng 3
1Ophthalmology,Cochin Hospital,Paris,France;Cornea,Stein Eye Institute,Los Angeles,United States, 2Cornea,Department of Ophthalmology, Banphaeo General Hospital, ,Samut Sakhon,Thailand, 3Cornea,Stein Eye Institute,Los Angeles,United States
Purpose
To evaluate corneal sensation and characterize subbasal nerve plexus in eyes with limbal stem cell deficiency (LSCD).
Setting
Monocentric prospective cross sectional comparative study performed at the University of California, Los Angeles Stein Eye Institute.
Methods
Forty-six eyes (35 subjects) with LSCD and 14 normal control eyes (14 subjects) were recruited between 2019-22. The central corneal sensation was measured by Cochet-Bonnet esthesiometer and subbasal nerve plexus was imaged at the central cornea and 4 limbal regions (superior, inferior, nasal and temporal) using in vivo confocal microscopy. Characteristics of subbasal nerve plexus namely subbasal nerve density (SND), subbasal nerve branch density (SNBD), and tortuosity coefficient (TC) were quantified using CCMetrics (University of Manchester) by 2 masked examiners. The severity of LSCD was graded using a previously published composite grading system. Statistical analyses were performed using the Kruskal-Wallis test and Pearson correlation.
Results
Seven, 18 and 21 eyes were classified as stage I, II and III LSCD, respectively. The mean sensation (mm+SD) at the central cornea and limbus were 29.2+21.5 and 33.5+15.1 in the LSCD group and 57.6+5.8 and 54.3+4.7 in the control group (all p<0.001), respectively. All parameters of subbasal nerve plexus were significantly decreased at the central and limbal regions in the LSCD group compared to the control (p<0.05). The central corneal and limbal sensation had moderate negative correlation with the LSCD composite scores (rho=-0.64), p<0.001) and had moderate positive correlation with SND (rho=0.63, p<0.001), SNBD (rho=0.57, p<0.001), and TC (rho=0.41, p=0.001).
Conclusions
Corneal sensation, SND, and SNBD were reduced in LSCD at both central cornea and limbal regions. The reduction of central corneal and limbal sensation had a positive correlation with the reduction in SND and the severity of LSCD. This study demonstrated the co-existing neurotropic element in the pathophysiology of LSCD.