Purchase this article with an account.
C. Jacobi, K. Gottschalk, C. Cursiefen, F.E. Kruse, L.J. Muller; Organization of the Subbasal Nerves in a Large Group of Control Human Corneas Visualized With the Heidelberg Retinal Tomograph (HRT II) . Invest. Ophthalmol. Vis. Sci. 2005;46(13):878.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Purpose: To establish in vivo the orientation of the subbasal nerves (SBN) in the apex as well as nasal, temporal, superior and inferior periphery of intact human corneas. Methods: Subbasal nerves of 110 eyes of 61 healthy volunteers (aged between 20 and 84) were recorded with the Rostock cornea module attached to the HRT II. The resolution of this apparatus is higher than that of other in vivo confocal microscopes and the relatively large contact plane prevents disturbances of the recordings due to blinking. Thick as well as thin SBN in the apex, mid–periphery and periphery were easily visualized. Also the presence of dendritic cells and of loops in the SBN were scored. Results: Semi–quantitative observations did not show differences in density of SBN and loops in the apex with age and no relation between the density of SBN and dendritic cells. In the apex thick SBN of most pairs of eyes had a preferred 6–12 orientation. In addition, eyes had a second preferred orientation which was for right eyes in the 5–11 and 6–11 direction and for left eyes in the 7–1, 8–2 and 9–3 direction, indicating a second preference towards the temporal side. In the periphery screening was performed in the 12, 3, 6 and 9 o’clock position and thin SBN ran in the 6–12 direction at the superior and inferior location and in the 3–9 direction at the nasal and temporal location. Because such findings had not been observed in previous publications one person was scanned along every clock hour and these thin SBN appeared to be radially organized along the circumference. In the mid–periphery close to the radial fibers many passages of stromal nerves through Bowman's layer as well as small curved stromal nerves below the epithelium (subepithelial nerves) were frequently observed. Conclusions: This is the first time that important details of the corneal nerves outside the apex were studied in vivo with confocal microscopy. Besides the 6–12 orientation pattern of SBN, there is a second one towards the temporal side. These observations are of relevance concerning possible changes caused by diseases or after surgical intervention such as refractive surgery.
This PDF is available to Subscribers Only