Changes in Corneal Subbasal Nerve Morphology and Sensitivity During Orthokeratology: Onset of Change

Lum, Edward; Golebiowski, Blanka; Swarbrick, Helen A.

doi:10.1016/j.jtos.2016.07.005

Cited by 15 publications

(36 citation statements)

References 33 publications

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“…In contrast, no mid-peripheral changes were observed. This finding is in line with previous results in OK wearers 20,28 in studies in which it was speculated that changes in corneal sensitivity would be limited to the central cornea while the peripheral cornea would be unaffected.…”

Section: Discussionsupporting

confidence: 92%

“…Further study would be needed to confirm this theory. In line with this idea, other authors 20 have noted the recovery of corneal sensitivity 3 months after the removal of OK lenses. This finding is consistent with our observations, given the significant increase in central corneal sensitivity observed between 1 year of treatment and 1 month post-treatment (p=0.045).…”

Section: Discussionmentioning

confidence: 53%

“…Patel et al 8 correlated SBNP nerve density, SBNP nerve tortuosity and corneal sensitivity in a large population of non-contact lens wearers. More recently, Lum et al reported a reduction in corneal sensitivity and SBNP nerve density over both short-term 20 and long-term 21 periods of OK lens wear. However, correlations between SBNP nerve density, nerve tortuosity and corneal sensitivity have not yet been detected in the healthy corneas of OK users in the long term.…”

Section: Introductionmentioning

confidence: 99%

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Long-Term Impacts of Orthokeratology Treatment on Sub-Basal Nerve Plexus and Corneal Sensitivity Responses and Their Reversibility

Nombela-Palomo

Felipe-Marquez

Teus

et al. 2018

Eye &Amp; Contact Lens: Science &Amp; Clinical Practice

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Abstract:PURPOSE: To examine the effects of 1 year of overnight orthokeratology (OK) treatment on the sub-basal nerve plexus (SBNP) and corneal sensitivity and to assess the reversibility of these effects 1 month after treatment interruption.METHODS: 32 subjects with low-moderate myopia underwent OK treatment for one year. 15 non-contact lens wearers served as controls. At the time points baseline, 1 year of treatment, and 1 month after removing the OK lenses, two tests were conducted: corneal sensitivity (Cochet-Bonnet esthesiometer) and SBNP imaging by in vivo confocal microscopy.RESULTS: In participants wearing OK lenses, significant reductions over the year were produced in SBNP nerve density (p=0.001 and p=0.006) and number of nerves (p<0.001 and p=0.001) in the central and mid-peripheral cornea respectively. Differences over the year were also detected in central objective tortuosity (p=0.002). Following lens removal, baseline values of nerve density (p=0.024 and p=0.001) and number of nerves (p=0.021 and p<0.001) for the central and mid-peripheral cornea respectively were not recovered. At 1 month post-treatment, a difference was observed from 1 year values in central corneal sensitivity (p=0.045) and mid-peripheral Langerhans cell density (p=0.033), and from baseline in mid-peripheral objective tortuosity (p=0.049). Direct correlation was detected at 1 year between nerve density and tortuosity both in the central (p<0.01; r= 0.69) and mid-peripheral cornea (p<0.01; r= 0.76).CONCLUSIONS: Long term OK treatment led to reduced SBNP nerve density and this was directly correlated with corneal tortuosity. After 1 month of treatment interruption, nerve density was still reduced. Powered by Editorial Manager® and ProduXion Manager® from Aries Systems Corporation

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 53%

Section: Introductionmentioning

confidence: 99%

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Long-Term Impacts of Orthokeratology Treatment on Sub-Basal Nerve Plexus and Corneal Sensitivity Responses and Their Reversibility

Nombela-Palomo

Felipe-Marquez

Teus

et al. 2018

Eye &Amp; Contact Lens: Science &Amp; Clinical Practice

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“…23 In recent studies of contact lens wear, mosaics consisting of six fields of view were used. 24,25 In a single earlier study, 4 depth correction for SBP variation in the axial plane was performed whereas in other studies it is not performed. ''Depth correction'' here refers to the projection of subbasal nerve paths from a volume of imaged tissue onto a single plane for further analysis.…”

Section: Resultsmentioning

confidence: 99%

Reduced Corneal Nerve Fiber Density in Type 2 Diabetes by Wide-Area Mosaic Analysis

Lagali

Allgeier

Guimarães

et al. 2017

Invest. Ophthalmol. Vis. Sci.

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Citation: Lagali NS, Allgeier S, Guimarães P, et al. Reduced corneal nerve fiber density in type 2 diabetes by wide-area mosaic analysis. Invest Ophthalmol Vis Sci. 2017;58:6318-6327. DOI:10.1167/iovs.17-22257 PURPOSE. To determine if corneal subbasal nerve plexus (SBP) parameters derived from widearea depth-corrected mosaic images are associated with type 2 diabetes. METHODS.One hundred sixty-three mosaics were produced from eyes of 82 subjects by laserscanning in vivo confocal microscopy (IVCM). Subjects were of the same age, without (43 subjects) or with type 2 diabetes (39 subjects). Mosaic corneal nerve fiber length density (mCNFL) and apical whorl corneal nerve fiber length density (wCNFL) were quantified and related to the presence and duration of diabetes (short duration < 10 years and long duration ‡ 10 years).RESULTS. In mosaics with a mean size of 6 mm 2 in subjects aged 69.1 6 1.2 years, mCNFL in type 2 diabetes was reduced relative to nondiabetic subjects (13.1 6 4.2 vs. 15.0 6 3.2 mm/ mm 2 , P ¼ 0.018). Also reduced relative to nondiabetic subjects was mCNFL in both shortduration (14.0 6 4.0 mm/mm 2 , 3.2 6 3.9 years since diagnosis) and long-duration diabetes (12.7 6 4.2 mm/mm 2 , 15.4 6 4.2 years since diagnosis; ANOVA P ¼ 0.023). Lower mCNFL was associated with presence of diabetes (P ¼ 0.032) and increased hemoglobin A1c (HbA1c) levels (P ¼ 0.047). By contrast, wCNFL was unaffected by diabetes or HbA1c (P > 0.05). Global SBP patterns revealed marked degeneration of secondary nerve fiber branches outside the whorl region in long-duration diabetes.CONCLUSIONS. Wide-area mosaic images provide reference values for mCNFL and wCNFL and reveal a progressive degeneration of the SBP with increasing duration of type 2 diabetes.

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“…29 Compared with our early work reporting nerve fibre orientation in orthokeratology, the variation of nerve fibre orientation at the central cornea was higher after LASIK (43.5°) than both orthokeratology (34.3°), which is purely mechanical, and in healthy controls (29.8°). 12 These results may indicate that the nerve plexus after LASIK surgery has become more randomly arranged compared to controls and contact lens wearers. It has been speculated that the wavier/random pattern could be due to the faster re-epithelialization compared to nerve regeneration.…”

Section: Discussionmentioning

confidence: 90%

Alteration of the pattern of regenerative corneal subbasal nerves after laser in‐situ keratomileusis surgery

Chao

Lum

Golebiowski

et al. 2020

Ophthalmic Physiologic Optic

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Purpose Corneal nerves exhibit high plasticity, which allows successful reinnervation after nerve damage caused by laser in‐situ keratomileusis (LASIK) surgery. This study aimed to examine corneal subbasal nerve orientation during regeneration after LASIK. Methods This study involved 20 healthy, myopic subjects who had undergone bilateral Femto‐LASIK 12–16 months prior with a superior hinge position. The corneal subbasal nerve plexus at the central, mid‐temporal and mid‐superior cornea on the right eye were imaged using in vivo confocal microscopy. Global nerve fibre orientation (indicating the overall pattern) and variation of nerve fibre orientation (indicating the consistency of the orientation) was determined using customised MATLAB™ software (http://www.mathworks.com/products/matlab.html). Differences in nerve orientation variables between groups were examined using the Mann‐Whitney U test. Linear mixed models with Bonferroni adjustment were conducted to examine differences between corneal regions, and over time, after LASIK. Results There were no differences between post‐LASIK and control groups in global nerve orientation at any of the examined corneal regions. The post‐LASIK subjects had a greater variation of nerve orientation at the central (p = 0.007) and temporal (p = 0.049) cornea than the controls. There was a difference in global nerve fibre orientation between corneal regions (p < 0.001) in the controls but not in the post‐LASIK group. The variation of nerve fibre orientation was higher at the central, compared to the temporal and superior cornea after LASIK (p < 0.001), although there were no differences between corneal regions in controls. Conclusions Our results demonstrate that there was an increased variability in the corneal subbasal innervation patterns following LASIK when compared to controls.

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Changes in Corneal Subbasal Nerve Morphology and Sensitivity During Orthokeratology: Onset of Change

Abstract: Alterations in corneal nerve morphology occur rapidly with commencement of OK lens wear and appear to underpin functional sensitivity loss. Nerve fiber orientation can provide a useful index for changes in corneal nerve morphology.

Cited by 15 publications

References 33 publications

Long-Term Impacts of Orthokeratology Treatment on Sub-Basal Nerve Plexus and Corneal Sensitivity Responses and Their Reversibility

Long-Term Impacts of Orthokeratology Treatment on Sub-Basal Nerve Plexus and Corneal Sensitivity Responses and Their Reversibility

Reduced Corneal Nerve Fiber Density in Type 2 Diabetes by Wide-Area Mosaic Analysis

Alteration of the pattern of regenerative corneal subbasal nerves after laser in‐situ keratomileusis surgery

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