Abstract
Purpose :
Choroidal sympathetic innervation is impaired in CSCR throughout mineralocorticoid receptor (1-2). We hypothesize that the CSCR condition modifies the entire eyeball innervation system including corneal nerves. Nerves shape is easily observed within cornea by in vivo confocal microscopy (IVCM)(3). We explored corneal nerves morphology throughout 2 groups of patients with CSCR and without CSCR (CTRL), using IVCM.
Methods :
We quantified choroid thickness in both groups by OCT-EDI mode (Spectralis; Heidelberg). Patients were free from corneal disease. We explored the central, mid-peripheral, paralimbal and limbal corneal areas of patients with and without CSCR by IVCM (HRT3; Heidelberg). We proceeded with the multilayer module of acquisition and systematically analyzed the subepithelial area (SE), Bowman’s layer (BL), anterior (AS; Depth<50µm), intermediate (IS; 50≤D<150µm), deep stroma (DS; D≥150µm) and endothelium. We semi-quantified as absent (0), rare (1) or common (2) the morphological corneal nerves abnormalities from both groups.
Results :
We compared 10 CSCR to 8 CTRL. While 5 CTRL showed canonic corneal nerves, rare abnormalities were detected in 3 CTRL, located in the SE, BL and AS layers. All CSCR displayed nerve abnormalities, commonly in 1 layer at least, and in more than 2 layers for 4 CSCR . CSCR nerves were noticeably altered across the SE/BL/SEP and AS layers compared to CTRL (Mann-Whitney; p≤ 0.005). Endothelium appeared normal in both groups.
Conclusions :
The thin nerve network and subepithelial plexus are altered in cornea of CSCR patients, especially within anterior layers of cornea.
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2-Leclercq B, Weiner A, Zola M, Mejlacowicz D, Lassiaz P, Jonet L, Gélizé E, Perrot J, Viengchareun S, Zhao M, Behar-Cohen F. The choroidal nervous system: a link between mineralocorticoid receptor and pachychoroid. Acta Neuropathol. 2023 Nov;146(5):747-766.
3-Mastropasqua L, Nubile M, Lanzini M, Calienno R, Dua HS. In vivo microscopic and optical coherence tomography classification of neurotrophic keratopathy. J Cell Physiol. 2019 May;234(5):6108-6115.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.