Purchase this article with an account.
Jiucheng He, Haydee E. P. Bazan; Altered Corneal Nerve Architecture in Epithelial Basement Membrane Dystrophy. Invest. Ophthalmol. Vis. Sci. 2012;53(14):1802.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Epithelial basement membrane dystrophy (EBMD), also known as Cogan’s microcystic epithelial dystrophy or map-dot-fingerprint dystrophy, is by far the most common corneal dystrophy, with estimates of prevalence ranging from 2-43% of the general population. Patients with EBMD often suffer painful recurrent corneal erosions, photophobia and decreased vision. Morphologic abnormalities in epithelial cells and basement membrane associated with EBMD have been well studied by light, electron and more recently by in vivo confocal microscopes (IVCM), but little is known about the change in corneal innervations. In this study, we used a newly developed method of immunofluorescence staining and imaging (Exp Eye Res 2010; 91: 513) to study the corneal nerve architecture in EBMD eyes.
Two fresh eyes from a 56-year-old male donor were obtained from the National Disease Research Interchange (NDRI). The right eye of the donor was diagnosed with EBMD, while the left eye was normal. After slit lamp examination, the corneas were fixed in 4% paraformaldehyde and stained with mouse monoclonal anti-β-tublin III antibody. Images were acquired with a Nikon fluorescence microscope equipped with a digital camera using the MetaVue imaging software in time-lapse mode. Corneal epithelial nerve density was calculated based on the whole view of the corneal nerves. Differences between the left and the right corneas in epithelial nerve densities were compared by paired-samples t test.
The left cornea appeared normal as observed by a portable digital slit lamp. In the right eye, broad illumination showed that numerous irregular geographic shaped, faint gray-white patches were present in the central area and inferior quadrant of the cornea. Retroillumination showed that these irregular pathologic foci were located in the basement membrane and had sharp borders. Immunofluorescence showed that there was no obvious difference in the stromal nerve distribution between the two eyes, but there were numerous areas without epithelial innervations in the EBMD cornea. Around the pathological areas, the epithelial nerve bundles showed more tortuous courses and fewer divisions than in the normal cornea. Quantitative analysis of corneal nerve distribution based on the whole mount images showed there was a significant decrease (P<0.05) in epithelial nerve density in the right eye.
We show for the first time the detailed nerve architecture in an EBMD cornea. Our results suggest that the altered epithelial nerve architecture and decreased nerve density may contribute to the pathomechanisms of EBMD.
This PDF is available to Subscribers Only