Viral keratitis: clinical characterisation and study with confocal microscopy

Session Details

Session Title: Inflammation in Ocular Infections

Session Date/Time: Wednesday 17/09/2014 | 08:00-09:30

Paper Time: 08:54

Venue: Capital Hall A

First Author: : P.Leon ITALY

Co Author(s): :    G. Saviane   A. Perrotta   A. Cuna   M. Pastore   A. Zanei   D. Tognetto

Abstract Details

Purpose:

To evaluate the modification of corneal sub-basal nerve sensibility, clinical appearance and corneal histological morphology between HZO eyes and controls, using in vivo confocal microscopy (IVCM).

Setting:

University Eye Clinic of Trieste

Methods:

Seven eyes with the diagnosis of HZO with corneal involvement and their controlateral clinically unaffected eyes, 19 eyes with the diagnosis of HZO without corneal involvement and their controlateral clinically unaffected eyes were studied and compared with normal controls (n = 17). In vivo confocal microscopy (Confoscan 4; Nidek Technologies, Gamagori, Japan) were performed bilaterally in all patients and controls. Corneal esthesiometry (Cochet-Bonnet; Luneau Ophthalmologie, Chartres, France) of the central cornea, BUT, meniscus tear and IOP (Goldmann applanation tonometry) were performed bilaterally in all patients. Changes in corneal nerve density, total nerve number, main nerve trunks, branching and tortuosity, superficial and basal epithelial cells density, as well as anterior and posterior stromal keratocytes density were evaluated after IVCM and were correlated to corneal sensation.

Results:

Eyes with HZO with corneal involvement had a significant (P<0.01) decrease in total nerve length number of nerves and number of main nerve trunks as compared with controls. In the controlateral clinically unaffected eyes, total nerve length (694,41 ± 35,35 μm/frame) also were decreased, but not so significantly as the controlateral affected eyes (P=0.05). Eyes with HZO without corneal involvement and their controlateral eyes had a significant (P<0.01) decrease in total nerve length, number of nerves and number of nerve branching as compared with controls. There was a gradual decrease in the density of superficial epithelial cells (1265,26 ± 457,46; 1245,96 ± 258,07; 1418,79 ± 507,77; 1218,18 ± 295,31 vs. 1846,87 ± 351,96 cells/mm2) in both eyes of patients with HZO (P<0.05) and there was also a decrease in the density of stromal anterior keratocytes (675,62 ± 109,51 vs. 769,51 ± 92,39) in eyes of patients with HZO without corneal involvement (P=0.02) as compared with controls.

Conclusions:

Unilateral HZO with or without corneal involvement causes a bilateral loss in corneal sub-basal nerve plexus and induces changes in the superficial epithelial cells, as demonstrated by the use of in vivo confocal microscopy. This study demonstrated that these changes correlates strongly with changes in corneal sensation.

Financial Interest:

NONE