Article Text

other Versions

PDF
Ex vivo confocal microscopy of human corneal nerves
  1. Mouhamed A Al-Aqaba,
  2. Thaer Alomar,
  3. Ammar Miri,
  4. Usama Fares,
  5. Ahmad Muneer Otri,
  6. Harmnider S Dua
  1. Division of Ophthalmology and Visual Sciences, Queen's Medical Centre, University of Nottingham, Nottingham, UK
  1. Correspondence to Professor Harminder S Dua, Division of Ophthalmology and Visual Sciences, B Floor, Eye and ENT Centre, Queen's Medical Centre, University Hospital, Derby Road, Nottingham NG7 2UH, UK; Harminder.dua{at}nottingham.ac.uk

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/mm2, 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.

  • Ex-vivo confocal microscopy
  • corneal nerves
  • limbal nerves
  • cornea
  • anatomy
  • imaging

Statistics from Altmetric.com

Footnotes

  • Funding MAA is funded for his studentship by the Ministry of Higher Education, Government of Iraq.

  • Competing interest None.

  • Ethics approval This study was conducted with the approval of the Nottingham ethics committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Linked Articles

  • At a glance
    Harminder S Dua Arun D Singh