| In Vivo Confocal Microscopy Analysis of Corneal Microstructural Changes in Neurosurgically-Induced Neurotrophic Keratitis. |
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Dong Hyun Lee, Eun Young Choi, Eung Kweon Kim, Hyung Keun Lee |
1Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea. shadik@yuhs.ac
2Institute of Corneal Dystrophy Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea. |
| 신경외과 수술로 인한 신경영양각막염 환자에서 동일초점현미경을 이용한 각막미세구조 변화 분석 |
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이동현1*⋅최은영1*⋅김응권1,2⋅이형근1,2 |
Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine1, Seoul, Korea
Institute of Corneal Dystrophy Research, Department of Ophthalmology, Yonsei University College of Medicine2, Seoul, Korea |
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| Abstract |
PURPOSE
To investigate the changes of the corneal microstructure of neurosurgically-induced neurotrophic keratitis patients compared to normal human corneas using in vivo confocal microscope (IVCM). METHODS: Ten eyes in the normal control group and 11 eyes in the neurosurgically-induced neurotrophic keratitis patient group were included in the present study. After corneal sensitivity tests were performed, thickness of each layer and number of endothelial cells and stromal keratocytes in the cornea were assessed using IVCM. Morphological characteristics of the corneal nerves were measured by ImageJ software. RESULTS: After analysis of corneal thickness layer by layer, the Bowman's layer was significantly reduced in the neurosurgically-induced neurotrophic keratitis patient group compared with the normal control group (p = 0.016) and the portion of Bowman's layer was significantly reduced in the neurosurgically-induced neurotrophic keratitis patient group compared with the control group (p = 0.024). The nerve fiber length per square-millimeter became significantly shorter compared to the normal control group (p = 0.042). The nerve fiber length per square millimeter showed significant correlations with the number of fibers, number of beading, branching patterns, and nerve tortuosity (p = 0.002, 0.002, 0.013 and 0.034, respectively). The number of endothelial cells and stromal keratocytes, the number of nerve fibers and beading, and the pattern of branching and nerve tortuosity showed no significant differences between the normal and neurosurgically-induced neurotrophic keratitis patient groups. CONCLUSIONS: Our results showed that decreased thickness of Bowman's layer may be related to the decreased corneal nerve distribution, secondary to the dysfunction of trigeminal nerve branch innervating the cornea. The microstructural changes of Bowman's layer can help diagnose the disease and evaluate the current status in neurosurgically-induced neurotrophic keratitis patients. |
| Key Words:
Confocal microscopy;Corneal nerve;Corneal thickness;Neurosurgery;Neurosurgically-induced neurotrophic keratitis |
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