Ophthalmology Department, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal.
Epidemiology and Statistics Unit, Research Centre, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal.
Curr Eye Res. 2021 Oct;46(10):1452-1459. doi: 10.1080/02713683.2021.1904509. Epub 2021 Apr 6.
: Our study aims to evaluate corneal subbasal nerve plexus morphology by corneal confocal microscopy (CCM) in Multiple Sclerosis (MS) patients and to explore its potential ability to distinguish between MS patients and healthy subjects.: Cross-sectional study, including 60 MS patients and 22 healthy subjects. Expanded Disability Status Scale (EDSS) was used to assess neurological disability. All participants underwent full ophthalmology evaluation, CCM and optical coherence tomography (OCT). Corneal nerve fibre density (CNFD), branch density (CNBD), fibre length (CNFL) and fibre tortuosity (CNFT) were analysed. Generalized additive regression models were used to analyse the data.: Compared to controls, MS patients had lower CNFD, CNBD and CNFL ( < .001) and higher CNFT ( = .002). The area under the ROC curve to distinguish MS patients from healthy controls with CNFD and CNBD was 0.84 (95%CI: 0.75 to 0.93; 95%CI: 0.75 to 0.92, respectively). A nonlinear association between EDSS and CNFD was found, with an initial density increase followed by a significant decrease until more severe disability status. EDSS was associated with CNFL and CNBD, with values being significantly lower for patients with an EDSS > 2.5 (-2.06 mm/mm2; 95%CI: -3.84 to -0.28; = .027 and -8.70 branches/mm2; 95%CI: -14.69 to -2.71; = .006, respectively). An optic neuritis (ON) history did not influence CCM parameters.: Our results confirm CCM parameters' potential to differentiate MS patients from healthy subjects, not being influenced by a previous ON history. A significant relationship between patient's disability and corneal nerve morphology was also found.
: 我们的研究旨在通过角膜共聚焦显微镜（CCM）评估多发性硬化症（MS）患者的角膜基质神经丛形态，并探讨其区分 MS 患者和健康受试者的潜在能力。: 横断面研究，包括 60 例 MS 患者和 22 例健康受试者。扩展残疾状况量表（EDSS）用于评估神经功能障碍。所有参与者均接受全面眼科评估、CCM 和光学相干断层扫描（OCT）检查。分析角膜神经纤维密度（CNFD）、分支密度（CNBD）、纤维长度（CNFL）和纤维扭曲度（CNFT）。使用广义加性回归模型分析数据。: 与对照组相比，MS 患者的 CNFD、CNBD 和 CNFL 较低（<0.001），CNFT 较高（=0.002）。用 CNFD 和 CNBD 区分 MS 患者和健康对照者的 ROC 曲线下面积为 0.84（95%CI：0.75 至 0.93；95%CI：0.75 至 0.92）。发现 EDSS 与 CNFD 之间存在非线性关联，最初密度增加，随后显著下降，直到残疾状态更严重。EDSS 与 CNFL 和 CNBD 相关，EDSS>2.5 的患者 CNFL 和 CNBD 值明显较低（-2.06 mm/mm2；95%CI：-3.84 至-0.28；=0.027 和-8.70 个分支/mm2；95%CI：-14.69 至-2.71；=0.006）。视神经炎（ON）病史不影响 CCM 参数。: 我们的研究结果证实了 CCM 参数区分 MS 患者和健康受试者的潜力，不受先前 ON 病史的影响。还发现患者残疾与角膜神经形态之间存在显著关系。
