The corneal nerve density in the sub‐basal plexus decreases with increasing myopia: a pilot study

Harrison, William L.; Putnam, Nicole; Shukis, Christine; Nguyen, Evelyn T.; Reinard, Kristen; Hundelt, Elizabeth; Vardanyan, Galina; Gabai, Celine; Yevseyenkov, Vladimir

doi:10.1111/opo.12366

Cited by 7 publications

(5 citation statements)

References 26 publications

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“…Besides, the refractive error of the participants was not recorded in this study. Given that Harrison et al 21 reported that corneal nerve density in the subbasal nerve plexus decreased with increasing myopia, the refractive error would give significant information.…”

Section: Discussionmentioning

confidence: 99%

Technical Report: Automatic Measurement of Corneal Nerve Fiber Area Using Versatile Software

Shinji

Chikama²,

Kiuchi

2022

Optom Vis Sci

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In vivo confocal microscopy has become a popular method to observe the details of corneal structures. We consider the area of corneal structures to be a versatile index and have measured the areas of various corneal structures using a commercially available software.PURPOSE: This study aimed to evaluate the accuracy of software used to measure the corneal nerve fiber area. METHODS:The corneal structures of 11 healthy volunteers were visualized using in vivo confocal microscopy. The image that most clearly depicted the corneal nerve fibers of each participant was selected for analysis. The corneal nerve fiber area was automatically measured by the software. An experienced ophthalmologist then manually measured the corneal nerve fiber area in each image assessed by the software. The Pearson correlation test was used to determine the correlation coefficient between the corneal nerve fiber areas measured automatically and those measured manually. The correlation between the corneal nerve fiber area and the participant's age was also evaluated. RESULTS:A strong correlation was found between the corneal nerve fiber area measured automatically and the corneal nerve fiber area measured manually (r = 0.98, P = 2.4 Â 10 −7 ). The corneal nerve fiber area was not correlated with participant age, regardless of whether the area was measured automatically (r = −0.26, P = .44) or manually (r = −0.13, P = .71). CONCLUSIONS:The software used in this study automatically measures the corneal nerve fiber area with accuracy similar to that of manual measurement by an experienced ophthalmologist. This software has potential for use in quantifying the areas of various corneal structures.

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Section: Discussionmentioning

confidence: 99%

Technical Report: Automatic Measurement of Corneal Nerve Fiber Area Using Versatile Software

Shinji

Chikama²,

Kiuchi

2022

Optom Vis Sci

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“…Harrison et al using the same confocal system but different software, showed a negative correlation between myopia and nerve density but they did not perform regression analysis between other corneal parameters 32 . In this study we measured spherical power and not axial length, but as Harrison et al showed, the spherical power is a much better predictor of SBNP density.…”

Section: Discussionmentioning

confidence: 99%

Impact of corneal parameters, refractive error and age on density and morphology of the subbasal nerve plexus fibers in healthy adults

Roszkowska

Wylęgała

Gargano

et al. 2021

Sci Rep

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The purpose of this study was to analyze corneal sub-basal nerve plexus (SBNP) density and morphology and their relationships with corneal parameters and refractive status. In this single center study, in vivo confocal microscopy (IVCM) was performed in 76 eyes of 38 healthy subjects aged 19–87 (mean age 34.987 ± 1.148). Nerve fiber analysis was performed using Confoscan 4 microscope with semi-automated software (Nidek Technologies, Italy) The nerve fiber length (NFL) µm/mm2, nerve fiber density (NFD) no./mm2, tortuosity coefficient (TC), and nerve beadings density (NBD) no./mm were considered. Relationship between SBNP parameters and corneal curvature, thickness, diameter, and refraction were analyzed. Additionally, the association with gender, laterality and age were determined. NFL was inversely correlated with age (r = − 0.528, p < 0.001), myopic refractive error (spherical value) (r = − 0.423, p < 0.001), and cylindrical power (r = − 0.340, p = 0.003). NFD was inversely correlated with age (r = − 0.420, p < 0.001) and myopic refractive error (r = − 0.341, p = 0.003). NBD showed a low inverse correlation with cylindrical power (r = − 0.287, p = 0.012) and a slight positive correlation with K (r = 0.230, p = 0.047). TC showed a significant negative correlation between age (r = − 0.500, p < 0.001) and myopic refractive error (r = − 0.351, p = 0.002). Additionally, there were strong positive correlations between NFL and NFD (r = 0.523, p < 0.001), NFL and TI (r = 0.603, p < 0.001), and NFD and TC (r = 0.758, p < 0.001). Multiple regression analysis revealed age to be the most significant factor affecting SBNP density (B = − 0.467, p = 0.013) and length (B = − 61.446, p < 0.001); myopic refractive error reduced both SBNP density (B = − 2.119, p = 0.011) and length (B = − 158.433, p = 0.016), while gender and laterality had no significant effects (p > 0.005). SBNP fiber length decreases with age, myopic refractive error and cylindrical power. SBNP fiber density reduces with age and myopic refractive error. Corneal nerve parameters are not influenced by gender or laterality.

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“…Second, corneal characteristics may differ based on ethnicity, so our results may not be generalizable for Western populations. For instance, Asians have smaller anterior segments and higher prevalence of myopia 34 – 36 , both of which may affect the SCNP parameters 37 . The reported values of normal SCNP measurements also varied across different ethnicities in past reports 24 , 38 , 39 .…”

Section: Discussionmentioning

confidence: 99%

Comparing the results of manual and automated quantitative corneal neuroanalysing modules for beginners

Hsieh

et al. 2021

Sci Rep

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This study aimed to evaluate the reliability of in vivo confocal microscopic neuroanalysis by beginners using manual and automated modules. Images of sub-basal corneal nerve plexus (SCNP) from 108 images of 18 healthy participants were analyzed by 7 beginner observers using manual (CCMetrics, [CCM]) and automated (ACCMetrics, [ACCM]) module. SCNP parameters analyzed included corneal nerve fiber density (NFD), corneal nerve branch density (NBD), corneal nerve fiber length (NFL), and tortuosity coefficient (TC). The intra-observer repeatability, inter-observer reliability, inter-module agreement, and left–right eye symmetry level of SCNP parameters were examined. All observers showed good intra-observer repeatability using CCM (intraclass correlation coefficient [ICC] > 0.60 for all), except when measuring TC. Two observers demonstrated especially excellent repeatability in analyzing NFD, NBD, and NFL using manual mode, indicating the quality of interpretation may still be observer-dependent. Among all SCNP parameters, NFL had the best inter-observer reliability (Spearman’s rank-sum correlation coefficient [SpCC] and ICC > 0.85 for the 3 original observers) and left–right symmetry level (SpCC and ICC > 0.60). In the additional analysis of inter-observer reliability using results by all 7 observers, only NFL showed good inter-observer reliability (ICC = 0.79). Compared with CCM measurements, values of ACCM measurements were significantly lower, implying a poor inter-module agreement. Our result suggested that performance of quantitative corneal neuroanalysis by beginners maybe acceptable, with NFL being the most reliable parameter, and automated method cannot fully replace manual work.

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The corneal nerve density in the sub‐basal plexus decreases with increasing myopia: a pilot study

Abstract: Corneal nerve density in the sub-basal plexus decreased with increasing myopia. This could have implications for corneal surgery and contact lens wear in this patient population.

Cited by 7 publications

References 26 publications

Technical Report: Automatic Measurement of Corneal Nerve Fiber Area Using Versatile Software

Technical Report: Automatic Measurement of Corneal Nerve Fiber Area Using Versatile Software

Impact of corneal parameters, refractive error and age on density and morphology of the subbasal nerve plexus fibers in healthy adults

Comparing the results of manual and automated quantitative corneal neuroanalysing modules for beginners

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