Corneal nerve regeneration is affected by scar location in herpes simplex keratitis: A longitudinal in vivo confocal microscopy study

Simple item page
dc.catalogadorgjm
dc.contributor.authorPosarelli, Matteo
dc.contributor.authorChirapapaisan, Chareenun
dc.contributor.authorMüller, Rodrigo
dc.contributor.authorAbbouda, Alessandro
dc.contributor.authorPondelis, Nicholas
dc.contributor.authorCruzat Corssen, Andrea
dc.contributor.authorCavalcanti, Bernardo M.
dc.contributor.authorCox, Stephanie M.
dc.contributor.authorJamali, Arsia
dc.contributor.authorPavan-Langston, Deborah
dc.contributor.authorHamrah, Pedram
dc.date.accessioned2023-07-18T16:24:26Z
dc.date.available2023-07-18T16:24:26Z
dc.date.issued2023
dc.description.abstractPurpose: To assess the effect of corneal scar location on corneal nerve regeneration in patients with herpes simplex virus (HSV) keratitis in their affected and contralateral eyes over a 1-year period by in vivo confocal microscopy (IVCM), and to correlate these findings to corneal sensation measured by Cochet-Bonnet Esthesiometer. Methods: Prospective, longitudinal, case-control study. Bilateral corneal nerve density and corneal sensation were analyzed centrally and peripherally in 24 healthy controls and 23 patients with unilateral HSV-related corneal scars using IVCM. Results: In the central scar (CS) group, total nerve density in the central cornea remained significantly lower compared to controls at follow-up (11.05 ± 1.97mm/mm2, p < 0.001), and no significant nerve regeneration was observed (p = 0.090). At follow-up, total nerve density was not significantly different from controls in the central and peripheral cornea of the peripheral scar (PS) group (all p > 0.05), but significant nerve regeneration was observed in central corneas (16.39 ± 2.39mm/mm2, p = 0.007) compared to baseline. In contralateral eyes, no significant corneal nerve regeneration was observed in central or peripheral corneas of patients with central scars or peripheral scars at 1-year follow-up, compared to baseline (p > 0.05). There was a positive correlation between corneal nerve density and sensation in both central (R = 0.53, p < 0.0001) and peripheral corneas (R = 0.27, p = 0.0004). In the CS group, the corneal sensitivity was <4 cm in 4 (30.8%) and 7 (53.8%) patients in the central and peripheral corneas at baseline, and in 5 (38.5%) and 2 subjects (15.4%) at follow-up, whereas in the PS group only 1 patient (10%) showed a corneal sensation < 4 cm in the central cornea at baseline, and only 1 (10.0%), 3 (30.0%) and 1 (10.0%) patients at follow-up in the central, affected and opposite area of the cornea, respectively. Conclusion: The location of HSV scarring in the cornea affects the level of corneal nerve regeneration. Eyes with central corneal scar have a diminished capacity to regenerate nerves in central cornea, show a more severe reduction in corneal sensation in the central and peripheral corneas that persist at follow-up, and have a reduced capability to restore the corneal sensitivity above the cut-off of 4 cm. Thus, clinicians should be aware that CS patients would benefit from closer monitoring for potential complications associated with neurotrophic keratopathy, as they have a lower likelihood for nerve regeneration.
dc.description.funderDPL
dc.description.funderJohnstone Fund
dc.description.funderStevens Fund
dc.description.funderNIH
dc.description.funderResearch to Prevent Blindness
dc.description.funderFalk Medical Research Trust
dc.description.funderLions Club International Foundation
dc.fechaingreso.objetodigital2023-07-18
dc.identifier.doi10.1016/j.jtos.2023.01.003
dc.identifier.eissn1937-5913
dc.identifier.issn1542-0124
dc.identifier.pubmedidPMID: 36646165
dc.identifier.scopusidSCOPUS_ID:85147432247
dc.identifier.urihttps://doi.org/10.1016/j.jtos.2023.01.003
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/74204
dc.identifier.wosidWOS:000964039200001
dc.information.autorucEscuela de Medicina; Cruzat Corssen, Andrea; 0000-0002-3724-7037; 159755
dc.language.isoen
dc.nota.accesoContenido parcial
dc.pagina.final52
dc.pagina.inicio42
dc.revistaOcular Surface
dc.rightsacceso restringido
dc.subject.ods03 Good health and well-being
dc.subject.odspa03 Salud y bienestar
dc.titleCorneal nerve regeneration is affected by scar location in herpes simplex keratitis: A longitudinal in vivo confocal microscopy study
dc.typeartículo
dc.volumen28
sipa.codpersvinculados159755
sipa.indexScopus
sipa.trazabilidadSCOPUS;02-03-2023
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
corneal_nerve_regeneration.pdf
Size:
106.55 KB
Format:
Adobe Portable Document Format
Description:
Download
Collections
Artículos de revistas