ESCRS - PP12.04 - Corneal Surface And Sub-Basal Nerve Plexus Changes In Patients With Suspected Small Nerve Fiber Neuropathy

Corneal Surface And Sub-Basal Nerve Plexus Changes In Patients With Suspected Small Nerve Fiber Neuropathy

Published 2023 - 41st Congress of the ESCRS

Reference: PP12.04 | DOI: 10.82333/jn4k-xk42

Authors: Josef Storm* 1 , Marcela Minarikova 2 , Veronika Potockova 3 , Radim Mazanec 3 , Gabriela Mahelkova 4

1Department of Ophthalmology,UH Motol,Prague,Czech Republic, 2Department of Physiology,2nd faculty of medicine,Prague,Czech Republic, 3Department of Neurology,UH Motol,Prague,Czech Republic, 4Department of Ophthalmology,UH Motol,Prague,Czech Republic;Department of Physiology,2nd faculty of medicine,Prague,Czech Republic

Ocular surface disease is a multifactorial disorder. Intact corneal innervation is viewed as a significant factor in maintaining corneal surface homeostasis. It is presumed that afferent nerve fiber damage disrupts tear production resulting in tear film instability and inflammation.

Our aim was to verify the relation of corneal nerve fibers to the state of the ocular surface and tear film.

Department of Ophthalmology and Department of Neurology at the Motol University Hospital, Department of Physiology at the 2nd Faculty of Medicine, Prague, Czech Republic

The study involved patients referred for corneal nerve fiber evaluation for suspected small fiber neuropathy. We’ve included patients with no clinically significant ophthalmological findings only. The examinations were performed using in-vivo corneal confocal microscope (IVCM; HRT3, Heidelberg Engineering, Germany). Corneal nerve fiber density (CNFD), branch density (CNBD) and fiber length (CNFL) were evaluated using ACCMetrics (Weill Cornell, Doha, Qatar). Detailed evaluation of the ocular surface was performed (OSDI questionnaire, sensitivity, TBUT, Oxford staining score), tear osmolarity measured (TearLab) and a tear sample was collected from which MMP-9 levels were measured, using the commercially available MMP-9 Human Elisa kit.

102 patients in total underwent the examination. As per available normative databases a certain degree of nerve fiber damage was found in 56 patients, whereas 46 patients showed none. There was no significant difference in age or gender between the two groups. No statistically significant difference was found in any of the ocular surface parameters when comparing each group. Tear film osmolarity or MMP-9 levels did not show statistically different differences either.

We have not found any ocular surface differences between patients with corneal nerve fiber damage and patients without. To better understand the effect of corneal nerve fiber damage on the ocular surface further studies are necessary.