Ex vivo confocal microscopy of human corneal nerves. Issue 9 (27th June 2010)

• Record Type: Journal Article
• Authors: Al-Aqaba, Mouhamed A; Alomar, Thaer; Miri, Ammar; Fares, Usama; Otri, Ahmad Muneer; Dua, Harmnider S
• Is Part Of: British journal of ophthalmology. Volume 94:Issue 9(2010)
• Page Start: 1251
• Page End: 1257
• Publication Date: 2010-06-27
• Subjects: Ex-vivo confocal microscopy -- corneal nerves -- limbal nerves -- cornea -- anatomy -- imaging; Ophthalmology -- Periodicals; 617.7
• DOI: 10.1136/bjo.2009.178244
• Languages: English
• ISSNs: 0007-1161

Abstract

Abstract : Aims: To evaluate the distribution, morphometry and the postmortem changes of the central and peripheral human corneal nerves by exvivo laser-scanning confocal microscopy (EVCM). Methods: 24 eyes from 14 cadavers were retrieved at different time intervals after death and examined by EVCM. Five regions were examined in each eye: central, superior, inferior, temporal and nasal. In each region, corneal nerve images were categorised according to their anatomical location in the cornea into sub-basal, stromal and limbal nerves. Five nerve parameters were measured: density, orientation, diameter, numbers and branching pattern. Results: Exvivo confocal scanning of a motionless eye allows high quality imaging and tracking of corneal and limbal nerves. Stromal nerves from the sub-Bowman's plexus perforate the Bowman's zone and terminate in bulb-like structures, from each of which a leash of sub-basal nerves arises. Following death, sub-basal nerve parameters showed significant changes. The density decreased from 9.23±4.48 to 0.45±0.07 mm/mm 2, the diameter from 4.01±0.81 to 2.08±0.20 μm, the numbers from 8.3 to 1.0 and branching pattern from 39.38% to 0% (p<0.05) from day 1 to day 5 postmortem. Stromal and limbal nerves showed no significant changes in their density and diameter. Conclusions: This study establishes a direct link between sub-basal nerves and the sub-Bowman's nerves via distinct terminal bulbs. Limbal nerves are the thickest, are seen in all quadrants and can be traced to the corneal centre. The sub-basal nerve plexus rapidly degenerates after death but stromal and limbal nerves survive during the first five days after death.