Abstract
Purpose :
To evaluate the corneal sub-basal nerve plexus and the distribution and morphology of the dendritic cells (DCs) in the cornea of patients with multiple sclerosis (MS) using in vivo confocal microscopy (IVCM).
Methods :
This was a single-center cross-sectional comparative study. All MS patients were clinically scored using the EDSS score (Expanded Disability Status Scale) which ranges form 0 to 10 (higher score indicate grater disability). Patients underwent ophthalmological examination and then cornea was analyzed by IVCM Heidelberg Retina Tomograph (HRT III) in combination with Rostock Cornea Module. Five sectors (central, nasal, temporal, inferior and superior) were analyzed in both patient eyes; one image for each sector was analyzed using the manual cell counting system of the HRT software and ImageJ program. Nerve fibers number (NFN) expressed in number/frame, nerve fibers density (NFD) expressed in μm/frame, DCs density (cell/mm2) and DCs size (µm2) were considered for the analyses. Difference between the two groups and correlation between nerve fibers, DCs, MS type and EDSS score were analyzed by SPSS statistical program.
Results :
From July 2017 to July 2018 we enrolled 44 consecutive patients: 23 with MS (age 48 ±7 years (mean ±SD)) and 21 healthy subjects (age 39 ±17years). A statistically significant (p<0.05) decrease was found for NFN in patients with MS compared with healthy subjects in each sector analyzed. The NFD showed a significant (p<0.05) decrease in the central sector in MS patients. Moreover, an inverse correlation (r:-0.2; p<0.05) was found between NFN and EDSS. No significant (p<0.01) difference for morphologic parameters of DCs was found between the two groups.
Conclusions :
IVCM showed a difference in corneal morphological parameters, moreover, these changes appear to be related to the degree of illness. Further longitudinal studies are needed to confirm this significant link and use these parameters in clinical practice.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.