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Age-related differences in the normal human cornea: a laser scanning in vivo confocal microscopy study
  1. Rachael L Niederer, MBChB (dr_rachnz{at}yahoo.co.nz),
  2. Divya Perumal, BOptom(Hon,
  3. Trevor Sherwin, PhD,
  4. Charles NJ McGhee, PhD FRCS F (c.mcghee{at}auckland.ac.nz)
  1. University of Auckland, New Zealand
  2. University of Auckland, New Zealand
  3. University of Auckland, New Zealand
  4. University of Auckland, New Zealand

    Abstract

    Background/aims: To quantify and establish base- line normative data for age-related differences in cellular and innervation density in the normal, healthy, human cornea using laser scanning in vivo confocal microscopy.

    Methods: Cross-sectional study of 85 normal subjects assessed via corneal topography and laser scanning in vivo confocal microscopy.

    Results: Mean age was 38 ± 16 years (range 18 to 87 years) and 60% of subjects were female. Anterior keratocyte density declined by 0.9% per year (r=-0.423, p < 0.001), posterior keratocyte density declined by 0.3% per year (r=-0.250, p = 0.021) and endothelial cell density declined by 0.5% per year (r=-0.615, p < 0.001). Sub-basal nerve fibre density declined by 0.9% per year (r=-0.423, p < 0.001). No association was observed between age and basal epithelial cell density, or between age and central corneal thickness, corneal astigmatism or horizontal corneal diameter (p > 0.05). No association was observed between subject gender and corneal cell or innervation density.

    Conclusion: Using laser scanning in vivo confocal microscopy this study highlights a significant, and relatively linear, reduction in keratocyte and endothelial cell density with increasing subject age. Interestingly, corneal sub-basal nerve fibre density also significantly decreases with increasing age. In vivo laser scanning confocal microscopy provides a safe, non-invasive method for the establishment of normative data and assessment of alterations in human corneal microstructure following surgery or disease processes.

    • age
    • corneal nerves
    • endothelium
    • in vivo confocal microscopy
    • keratocytes

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