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M. Marenco, F. De Gregorio, S. Lupo, E. M. Vingolo, A. Missiroli, F. Missiroli; Sub Epithelial Nerve Plexus Analysis as an Early Predictor Factor of Keratocunus Development. Invest. Ophthalmol. Vis. Sci. 2009;50(13):5106.
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to determine whether the analysis of corneal basal nerve plexus by means of confocal microscopy can be considered a predictor factor in diagnosis of keratoconus.
Twenty-three patients (male/female=14/9; mean age = 23 years old) at risk of developing keratoconus due to familiar predisposition were recruited and followed up for 4 years. At baseline, all the patients underwent to a complete ophthalmologic examination including best corrected visual acuity (BCVA), slit lamp examination, applanation tonometry, corneal topography (Keratron Scout 4.1.0), ultrasound pachimetry, confocal microscopy (Confoscan 3.0, Nidek Technology, Japan). Patients wearing contact lenses and with any corneal diseases were excluded from the study. Student's t test and Fisher's test were applied for statistical purposes.
Patients with no corneal nerve plexus changes, as evaluated by confocal microscopy , had no astigmatic progression as measured by corneal topography (change in simK at the end of the 4 years follow-up: 0.27 + 0.87 dioptres ; p=n.s.), whereas patients presenting nerve plexus changes showed progression (change in simK at the end of the 4 years follow-up: 3.72 + 1.18 dioptres; p<0.001).Conculusion: Among the clinical parameters considered in this study, the analysis of the corneal subepitelial nerve plexus by means of Confocal Microscopy appeared be a predictive factors of keratatokonus development or progression. If confirmed by larger prospective studies, the analysis of the corneal subepitelial nerve plexus might be helpful to select patients who could take benefit from an early cross-linking treatment .
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