CORNEAL SUBBASAL NERVE PLEXUS EVALUATION BY IN VIVO CONFOCAL MICROSCOPY IN MULTIPLE SCLEROSIS

  • Diogo Hipólito Fernandes Ophthalmology Department, Lisbon Central Hospital Centre, Lisbon, Portugal
  • Maria Elisa Luís Ophthalmology Department, Lisbon Central Hospital Centre, Lisbon, Portugal
  • Joana Cardigos Ophthalmology Department, Lisbon Central Hospital Centre, Lisbon, Portugal
  • Joana Cardigos Ophthalmology Department, Lisbon Central Hospital Centre, Lisbon, Portugal
  • Miguel Vieira Ophthalmology Department, Lisbon Central Hospital Centre, Lisbon, Portugal
  • Marta Alves 1 - Epidemiology and Statistics Unit, Research Centre, Lisbon Central Hospital Centre, Lisbon, Portugal; 2 - 4- CEAUL (Centre of Statistics and its Applications), Lisbon University, Lisbon, Portugal
  • Ana Luísa Papoila 1 - Epidemiology and Statistics Unit, Research Centre, Lisbon Central Hospital Centre, Lisbon, Portugal; 2 - NOVA Medical School/Faculdade de Ciências Médicas, Nova Lisbon University, Lisbon, Portugal; 3 -CEAUL (Centre of Statistics and its Applications), Lisbon University, Lisbon, Portugal
  • Ana Luísa Papoila 1 - Epidemiology and Statistics Unit, Research Centre, Lisbon Central Hospital Centre, Lisbon, Portugal; 2 - NOVA Medical School/Faculdade de Ciências Médicas, Nova Lisbon University, Lisbon, Portugal; 3 -CEAUL (Centre of Statistics and its Applications), Lisbon University, Lisbon, Portugal
  • João Paulo Cunha 1 - Ophthalmology Department, Lisbon Central Hospital Centre, Lisbon, Portugal; 2- NOVA Medical School/Faculdade de Ciências Médicas, Nova Lisbon University, Lisbon, Portugal
  • Joana Tavares Ferreira 1 - Ophthalmology Department, Lisbon Central Hospital Centre, Lisbon, Portugal; 2- NOVA Medical School/Faculdade de Ciências Médicas, Nova Lisbon University, Lisbon, Portugal

Resumo

PURPOSE

Multiple Sclerosis (MS) is the most frequent cause of neurologic disability in young adults, characterized by demyelination and axonal degeneration. Monitoring this last component remains an important challenge. Our study aims to access corneal subbasal nerve plexus morphology by in vivo confocal microscopy (CCM) and explore the possibility of using this noninvasive technology to obtain a biomarker of axonal degeneration.

METHODS

            In this cross-sectional study 30 patients with MS and 22 healthy controls were included. All participants underwent full ophthalmology standard evaluation, CCM and optical coherence tomography (OCT). The following corneal subbasal nerve plexus morphology parameters were analysed: corneal nerve fibre density (CNFD), corneal nerve branch density (CNBD), corneal nerve fibre length (CNFL) and corneal nerve fibre tortuosity (CNFT). Neurological disability of MS patients was accessed using Expanded Disability Status Scale (EDSS) and MS Severity Score (MSSS).

 

RESULTS

            Compared to controls, MS patients have lower CNFD, CNBD and CNFL (p<0.001) but no significant difference was found related to CNFT (p=0.108). No significant differences were found related to corneal subbasal plexus parameters between MS patients with or without optic neuritis (MSON vs MSNON). CNFD and temporal-inferior peripapillary retinal nerve fibre layer (ppRNFL) showed inverse association both with EDSS (rS=-0.62, p<0.001 for CNFD; rS=-0.53, p=0.003 for temporal-inferior ppRNFL) and MSSS (rS=-0.44, p=0.018 for CNFD; rS=-0.49, p=0.009 for temporal-inferior ppRNFL) scores.

CONCLUSIONS

            CNFD, CNBD and CNFL are decreased in MS patients, suggesting axonal degeneration. Further longitudinal studies are needed to confirm whether CNFD could be a promising imaging parameter in MS severity evaluation.

Keywords: multiple sclerosis, axonal degeneration, optical coherence tomography, corneal confocal microscopy, expanded disability status scale.

Publicado
2019-10-23
Secção
Artigos originais