TY - JOUR
T1 - Corneal nerve regeneration after herpes simplex keratitis
T2 - A longitudinal in vivo confocal microscopy study
AU - Moein, Hamid Reza
AU - Kheirkhah, Ahmad
AU - Muller, Rodrigo T.
AU - Cruzat, Andrea C.
AU - Pavan-Langston, Deborah
AU - Hamrah, Pedram
N1 - Publisher Copyright:
© 2018 Elsevier Inc.
PY - 2018/4
Y1 - 2018/4
N2 - Purpose: To evaluate the long-term alterations of corneal nerves in patients with herpes simplex virus (HSV) keratitis using in vivo confocal microscopy (IVCM). Design: Prospective, longitudinal, cross sectional. Methods: This study included 16 patients with a history of HSV keratitis and 15 age-matched normal controls. Slit-scanning IVCM was performed in all subjects at baseline and then after a mean follow-up of 37.3 ± 1.7 months in the patient group. Corneal subbasal nerve density and corneal sensation were compared between groups at baseline and follow-up. Results: At baseline, the mean subbasal nerve density was significantly lower in both affected eyes (1.4 ± 0.6 mm/mm 2 ) and contralateral unaffected eyes (6.4 ± 0.7 mm/mm 2 ) compared with the controls (14.1 ± 1.6 mm/mm 2 ; all P <.001). At the end of follow-up, the mean nerve density in affected eyes increased to 2.8 ± 0.7 mm/mm 2 (P =.006), with no significant change in contralateral unaffected eyes (6.5 ± 1.0 mm/mm 2 , P =.72). However, both eyes had lower nerve density than controls (all P <.001). Corneal sensation was significantly lower in affected eyes (2.6 ± 0.6 cm) than in the control group (6.0 ± 0.0, P <.001) and showed no significant change at the end of follow-up (2.5 ± 0.6 cm, P =.80). Corneal sensation in contralateral unaffected eyes was not different in comparison with controls at both baseline and follow up (all p >.05). Conclusions: Our results demonstrate that although corneal nerve regeneration occurs in patients with HSV keratitis, this change is not clinically significant and does not results in changes of corneal sensation. Therefore, these patients need to be followed closely for complications of neurotrophic keratopathy and might benefit from neuro-regenerative therapies.
AB - Purpose: To evaluate the long-term alterations of corneal nerves in patients with herpes simplex virus (HSV) keratitis using in vivo confocal microscopy (IVCM). Design: Prospective, longitudinal, cross sectional. Methods: This study included 16 patients with a history of HSV keratitis and 15 age-matched normal controls. Slit-scanning IVCM was performed in all subjects at baseline and then after a mean follow-up of 37.3 ± 1.7 months in the patient group. Corneal subbasal nerve density and corneal sensation were compared between groups at baseline and follow-up. Results: At baseline, the mean subbasal nerve density was significantly lower in both affected eyes (1.4 ± 0.6 mm/mm 2 ) and contralateral unaffected eyes (6.4 ± 0.7 mm/mm 2 ) compared with the controls (14.1 ± 1.6 mm/mm 2 ; all P <.001). At the end of follow-up, the mean nerve density in affected eyes increased to 2.8 ± 0.7 mm/mm 2 (P =.006), with no significant change in contralateral unaffected eyes (6.5 ± 1.0 mm/mm 2 , P =.72). However, both eyes had lower nerve density than controls (all P <.001). Corneal sensation was significantly lower in affected eyes (2.6 ± 0.6 cm) than in the control group (6.0 ± 0.0, P <.001) and showed no significant change at the end of follow-up (2.5 ± 0.6 cm, P =.80). Corneal sensation in contralateral unaffected eyes was not different in comparison with controls at both baseline and follow up (all p >.05). Conclusions: Our results demonstrate that although corneal nerve regeneration occurs in patients with HSV keratitis, this change is not clinically significant and does not results in changes of corneal sensation. Therefore, these patients need to be followed closely for complications of neurotrophic keratopathy and might benefit from neuro-regenerative therapies.
KW - Corneal nerve regeneration
KW - Corneal sensation
KW - Herpes simplex keratitis
KW - In vivo confocal microscopy
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U2 - 10.1016/j.jtos.2017.12.001
DO - 10.1016/j.jtos.2017.12.001
M3 - Article
C2 - 29305292
AN - SCOPUS:85041233205
SN - 1542-0124
VL - 16
SP - 218
EP - 225
JO - Ocular Surface
JF - Ocular Surface
IS - 2
ER -