Clinical applications of corneal confocal microscopy

Tavakoli, Mitra; Hossain, Parwez; Malik, Rayaz A.

doi:10.2147/opth.s1490

Cited by 47 publications

(11 citation statements)

References 100 publications

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“…48 Generally, the SSCM is considered user-friendly as it can be conveniently operated in either an automatic or semi-automatic mode to quickly achieve 500× confocal images of scanned objects with 26 µm axial resolution. 49 The device uses a halogen lamp as the light source, which provides a broad beam and adjustable brightness during corneal scanning. With this slightly wide field of illumination, the SSCM induces the magnitude of the backscattering of the projected light when it hits the intracorneal structures, especially the opaque areas.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of Corneal Subbasal Nerves in Different Age Groups: An in vivo Confocal Microscopic Analysis

Chirapapaisan¹,

Thongsuwan²,

Chirapapaisan³

et al. 2021

OPTH

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Purpose: To determine the normative characteristics of corneal subbasal nerves in different age groups using laser scanning in vivo confocal microscopy (IVCM). Patients and Methods: This descriptive observational study recruited healthy subjects (aged 20-60 years) from Siriraj Health-Screening Center. Excluded were individuals who had abnormal ocular symptoms, previous ocular surgery, a history of any diseases related to systemic and/or corneal neuropathy, or abnormal corneal sensitivity. Corneal IVCM (HRT3/ Rostock Corneal Module) was performed at the central cornea to analyze the subbasal nerve plexus. The corneal nerve characteristics, comprising the number and density of nerves (main nerve trunks, branches, and total nerves) were analyzed using the NeuronJ program, and the corneal nerve tortuosity was graded. The correlations between the subbasal nerve density, tortuosity and age were then analyzed. Results: Eighty subjects were enrolled, with twenty in each of four age groups (20-30, >30-40, >40-50, and >50-60 years). Overall, the mean number and density of main nerve trunks were 27.93±0.81/mm 2 and 11.22±0.30 mm/mm 2 , respectively. As of the nerve branches, the average number and density were 103.56±2.37/mm 2 and 9.15±0.30 mm/mm 2 , respectively. The total nerve density was 20.37±0.39 mm/mm 2 . There were no significant differences between subbasal nerve parameters of the four age groups. It is noteworthy that 65% of the subjects aged over 40 years revealed high-grade nerve tortuosity. Conclusion:The corneal subbasal nerve numbers and densities were not significantly different among a healthy population aged 20-60 years. However, there was a trend towards high tortuosity of the corneal nerve in people aged over 40 years.

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Section: Discussionmentioning

confidence: 99%

Characteristics of Corneal Subbasal Nerves in Different Age Groups: An in vivo Confocal Microscopic Analysis

Chirapapaisan¹,

Thongsuwan²,

Chirapapaisan³

et al. 2021

OPTH

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“…Due to this arrangement, sub-basal nerves in the superior and human apical cornea are oriented vertically. In contrast, subbasal nerves in other corneal regions may be orientated horizontally or obliquely, consistent with their locations within the whorl-like plexus (157) Corneal confocal microscopy (CCM) is a non-invasive, in vivo ophthalmic imaging technique that allows a detailed examination of the cornea, at high magnification, on a cellular level (Figure 1J) (158). By capturing multiple two-dimensional images at different depths, CCM imaging can delineate the corneal layers of the cornea (158), providing superior magnification compared to standard slit-lamp biomicroscopy.…”

Section: Corneal Nerves As a Biomarker For Dpnmentioning

confidence: 97%

Advances in Screening, Early Diagnosis and Accurate Staging of Diabetic Neuropathy

Carmichael

Fadavi

Ishibashi³

et al. 2021

Front. Endocrinol.

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The incidence of both type 1 and type 2 diabetes is increasing worldwide. Diabetic peripheral neuropathy (DPN) is among the most distressing and costly of all the chronic complications of diabetes and is a cause of significant disability and poor quality of life. This incurs a significant burden on health care costs and society, especially as these young people enter their peak working and earning capacity at the time when diabetes-related complications most often first occur. DPN is often asymptomatic during the early stages; however, once symptoms and overt deficits have developed, it cannot be reversed. Therefore, early diagnosis and timely intervention are essential to prevent the development and progression of diabetic neuropathy. The diagnosis of DPN, the determination of the global prevalence, and incidence rates of DPN remain challenging. The opinions vary about the effectiveness of the expansion of screenings to enable early diagnosis and treatment initiation before disease onset and progression. Although research has evolved over the years, DPN still represents an enormous burden for clinicians and health systems worldwide due to its difficult diagnosis, high costs related to treatment, and the multidisciplinary approach required for effective management. Therefore, there is an unmet need for reliable surrogate biomarkers to monitor the onset and progression of early neuropathic changes in DPN and facilitate drug discovery. In this review paper, the aim was to assess the currently available tests for DPN’s sensitivity and performance.

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“…IVCM is also getting popularity in ophthalmology, and the IVCM can be used in almost all lesions involving the ocular surface to observe the microstructure change of the ocular surface resulted from the lesions. The concept of confocal microscopy was first patented by Marvin Minsky in 1957 to study the brain neural cells [10]. The first in vivo images of the human cornea were obtained by Cavanaugh et al in 1989.…”

Section: Discussionmentioning

confidence: 99%

In Vivo Confocal Microscopy of Cornea in Patients with Terrien’s Marginal Corneal Degeneration

Chen

Tang

et al. 2019

Journal of Ophthalmology

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This study was aimed at observing the morphological changes of the cornea with ocular in vivo confocal microscopy (IVCM) in patients with Terrien’s marginal degeneration (TMD). Ten patients (20 eyes) with TMD treated in the Department of Ophthalmology, Xiangya Hospital, and 10 healthy controls (20 eyes) were included in the current study. A detailed slit lamp microscopy, anterior segment photography, and corneal IVCM examination were performed for each eye. The density of central and marginal corneal epithelial cells, stromal cells, and subepithelial nerve fibers was compared between the two groups using the Wilcoxon rank sum test. Compared with the control group, the corneal epithelial and endothelial cells in the TMD group showed granular highly reflective substances and thinner subepithelial nerve fibers. The uneven dot-like highly reflective substances without cell structures appeared in the stromal layer of the cornea. The density of central and marginal corneal epithelial cells, stromal cells, and subepithelial nerve fibers was lower in the TMD group (p<0.05), and they were negatively correlated with severity of the disease (p<0.05). Our study demonstrated that the density of corneal epithelial cells, stromal cells, and sensory plexus nerve fibers was significantly reduced in the TMD group. The pathological changes were more obvious in the marginal cornea, and it is correlated with severity of the disease.

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Clinical applications of corneal confocal microscopy

Cited by 47 publications

References 100 publications

Characteristics of Corneal Subbasal Nerves in Different Age Groups: An in vivo Confocal Microscopic Analysis

Characteristics of Corneal Subbasal Nerves in Different Age Groups: An in vivo Confocal Microscopic Analysis

Advances in Screening, Early Diagnosis and Accurate Staging of Diabetic Neuropathy

In Vivo Confocal Microscopy of Cornea in Patients with Terrien’s Marginal Corneal Degeneration

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