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In Vivo Confocal Microscopy of the Corneal Sub-Basal Nerve plexus in Medically Controlled Glaucoma

Published online by Cambridge University Press:  07 January 2022

Luca Agnifili Open the ORCID record for Luca Agnifili [Opens in a new window] ,
Lorenza Brescia ,
Edoardo Villani ,
Giada D'Onofrio ,
Michele Figus ,
Francesco Oddone ,
Paolo Nucci  and
Rodolfo Mastropasqua
Luca Agnifili*
Affiliation:
Ophthalmology Clinic, Department of Medicine and Ageing Science, University “G. D'Annunzio” of Chieti-Pescara, Chieti66100, Italy
Lorenza Brescia
Affiliation:
Ophthalmology Clinic, Department of Medicine and Ageing Science, University “G. D'Annunzio” of Chieti-Pescara, Chieti66100, Italy
Edoardo Villani
Affiliation:
Department of Clinical Sciences and Community Health, University of Milan & Eye Clinic San Giuseppe Hospital, IRCCS Multimedica, Milan20123, Italy
Giada D'Onofrio
Affiliation:
Ophthalmology Clinic, Department of Medicine and Ageing Science, University “G. D'Annunzio” of Chieti-Pescara, Chieti66100, Italy
Michele Figus
Affiliation:
Ophthalmology Unit, Department of Surgery, Medicine, Molecular and Emergency, University of Pisa, Pisa56124, Italy
Francesco Oddone
Affiliation:
IRCCS-Fondazione Bietti, Rome00198, Italy
Paolo Nucci
Affiliation:
Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
Rodolfo Mastropasqua
Affiliation:
Institute of Ophthalmology, University of Modena and Reggio Emilia, Modena41125, Italy
*
*Corresponding author: Luca Agnifili, E-mail: l.agnifili@unich.it
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Abstract

The present study investigated the corneal sub-basal nerve plexus (SNP) modifications in glaucoma. Ninety-five glaucomatous patients were enrolled and divided into Group 1 and 2, preserved and preservative-free mono-therapy (30 and 28 patients), and Group 3, multi-therapy (37). Thirty patients with dry eye disease (DED) and 32 healthy subjects (HC) served as controls. In vivo confocal microscopy evaluated the nerve fibers density (CNFD), length (CNFL), thickness (CNFT), branching density (CNBD), and dendritic cell density (DCD). CNFD, CNFL, and CNBD were reduced in Group 3 and DED compared to HC (p < 0.05). CNFL was reduced in Group 3 compared to Group 2 (p < 0.05), and in Group 1 compared to HC (p < 0.001). CNFD, CNBD, and CNFT did not differ between glaucomatous groups. DCD was higher in Group 3 and DED compared to HC and Group 2 (p < 0.01). Group 3 showed worse ocular surface disease index (OSDI) scores compared to Group 1, 2, and HC (p < 0.05). CNFL and DCD correlated with OSDI score in Group 3 (r = −0.658, p < 0.001; r = 0.699, p = 0.002). Medical therapy for glaucoma harms the corneal nerves, especially in multi-therapy regimens. Given the relations with the OSDI score, SNP changes seem features of glaucoma therapy-related OSD and negatively affects the patient's quality of life.

Keywords

corneal nerve fibersglaucoma therapyin vivo confocal microscopyocular surface diseasequality of life
Type
Biological Applications
Information
Microscopy and Microanalysis , Volume 28 , Issue 2 , April 2022 , pp. 496 - 503
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Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of the Microscopy Society of America

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Footnotes

†

LA and LB equally contributed to this paper and share primary authorship.

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