May 2008
Volume 49, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2008
In vivo Confocal Microscopy of Corneal Nerve Fibres in Hiv+ Patients
Author Affiliations & Notes
  • L. Sabato
    Luigi Sacco Hospital, University of Milan, Milano, Italy
    Clinical Science Luigi Sacco, Eye Clinic,
  • L. Bertazzi
    Luigi Sacco Hospital, University of Milan, Milano, Italy
    Clinical Science Luigi Sacco, Eye Clinic,
  • M. Pellegrini
    Luigi Sacco Hospital, University of Milan, Milano, Italy
    Clinical Science Luigi Sacco, Eye Clinic,
  • S. V. Luccarelli
    Luigi Sacco Hospital, University of Milan, Milano, Italy
    Clinical Science Luigi Sacco, Eye Clinic,
  • L. Meroni
    Luigi Sacco Hospital, University of Milan, Milano, Italy
    Clinical Science Luigi Sacco, Institute of Infectious and Tropical Disease,
  • G. Staurenghi
    Luigi Sacco Hospital, University of Milan, Milano, Italy
    Clinical Science Luigi Sacco, Eye Clinic,
  • Footnotes
    Commercial Relationships  L. Sabato, None; L. Bertazzi, None; M. Pellegrini, None; S.V. Luccarelli, None; L. Meroni, None; G. Staurenghi, Travel Grant, R.
  • Footnotes
    Support  None.
Investigative Ophthalmology & Visual Science May 2008, Vol.49, 2804. doi:https://doi.org/
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      L. Sabato, L. Bertazzi, M. Pellegrini, S. V. Luccarelli, L. Meroni, G. Staurenghi; In vivo Confocal Microscopy of Corneal Nerve Fibres in Hiv+ Patients. Invest. Ophthalmol. Vis. Sci. 2008;49(13):2804. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : To relieve differences in the corneal sub-basal nerve plexus between HIV+ and HIV- patients, using corneal confocal microscopy. Nerve Fibre Lenght (NFL) was assumed as an index to evaluate the compromise of the peripheral nervous system.

Methods: : We scanned the cornea from both eyes of 20 HIV+ patients and 20 HIV- patients and collected images of the nerve plexus contained in the Bowman’s layer.Corneal confocal laser scanning microscopy was performed using a Rodstock Cornea Module attached to a Heidelberg Retina Tomograph II.2 images per eye were analyzed, using a custom software program, to determine NFL (total nerve lenght [µm] within a confocal image [area = 160000 µm²]).Inclusion criteria were HIV seropositivity, being on highly active antiretroviral therapy (HAART), age 25-65 years, CD4+ T lymphocytes < 500/ microL. Exclusion criteria were diabetes, neuropathies other then DSP, chronic renal failure, Sjogren’s sindrome, connective disorders, corneal pathology, previous eye surgery.

Results: : Corneal Nerve Fibre Lengh (µm/µm2) was reduced in HIV+ patients (0.0194, SD=0.047) compared with HIV- patients (0.0236, SD=0.034).NFL was significantly different among the two groups (0.042, 95% CI of mean 0.024-0.060, p<0.001, t test).

Conclusions: : The results suggest that HIV+ patients show alterations in corneal innervations consisting in Nerve Fibre Lenght reduction.All HIV+patients in our study had a reduced NFL, even if only 3 of them had clinical diagnosis of DSP, confirmed by electromyography.Corneal confocal microscopy is a rapid, non-invasive in vivo clinical examinationtechnique, that could act as a surrogate measure of distal neuropathy in HIV+ patients.Further prospective clinical studies are needed to evaluate a larger number of patients and a long-term follow up.

Keywords: nerve fiber layer • microscopy: confocal/tunneling • AIDS/HIV 
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