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Ziyuan Liu, Wei Wang; Confocal analysis of corneal nerves reflecting a primary peripheral neural change in normal tension glaucoma. Invest. Ophthalmol. Vis. Sci. 2019;60(9):5543. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the morphological features of corneal subbasal nerve plexus (CSNP) and Langerhans cells (LCs) in normal tension glaucoma (NTG) and primary open angle glaucoma (POAG)
Ten eyes with NTG, 23 eyes with POAG and 31 eyes of healthy subjects were recruited. CSNP and LCs were assessed by corneal confocal microscopy (CCM) and peripapillary retinal nerve fiber layer (RNFL) was measured with optical coherence tomography (OCT). CCM parameters including nerve fiber length (FL), branch number (BN), nerve width (NW), nerve reflectivity (NR), total and local nerve tortuosity (NT) as well as type 1 and type 2 LCs were compared between the POAG and NTG, as well as between the topical medication treated POAG and the nontreated. The CCM parameters were also analyzed for correlations with medication duration and the RNFL thickness.
The NTG had the longest FL, most BN, thinnest NW, lowest reflectivity and most tortuosity. The POAG had similar CSNP to the normal. Both NTG and POAG had significantly more type 2 LCs than the normal. The treated POAG had longer FL, more BN, FW, FR, more NT than the nontreated but with no significant difference. The anti-glaucoma medication duration had no significant correlations with CCM parameters in POAG, but the CCM parameters had correlations with RNFL thickness in both NTG and POAG.
The NTG had characteristic CSNP which is associated with RNFL supporting the idea of it being a neurodegenerative condition independent of intraocular pressure (IOP). The cause for the corneal alterations in treated POAG should be further distinguished from a primary neurodegenerative progress.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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