Avetisov S E, Surnina Z V
Krasnov Research Institute of Eye Diseases, Moscow, Russia.
Sechenov First Moscow State Medical University, Moscow, Russia.
Vestn Oftalmol. 2023;139(3. Vyp. 2):38-45. doi: 10.17116/oftalma202313903238.
This article presents the results of confocal microscopy of the corneal nerve fibers (CNF). The transparency of the cornea provides a unique potential for visualization of thin unmyelinated nerve fibers at the level close to morphological study. Modern software eliminates the need for manual tracing of the confocal image fragments, allows objectifying the process of assessment of CNF structure based on quantitative indicators characterizing the length, density and tortuosity of the main nerve trunks. Clinical application of structural analysis of the CNF has two potential directions associated with immediate tasks of ophthalmology, as well as with interdisciplinary affairs. In terms of ophthalmology, this primarily concerns various surgical interventions potentially affecting the state of the cornea, and chronic pathological processes in the cornea of different nature. Such studies could analyze the degree of changes in the CNF, or the particularities of corneal reinnervation. The potential for interdisciplinary studies lies in using CNF as biomarkers of systemic polyneuropathies. Relative simplicity, high level of direct visualization of the thin nerve fibers, and the obtained results allow recommending corneal confocal microscopy as a tool for primary screening and consequent monitoring of neuropathies in addition to the conventional methods.
本文介绍了角膜神经纤维(CNF)共聚焦显微镜检查的结果。角膜的透明度为在接近形态学研究的水平上可视化细无髓神经纤维提供了独特的潜力。现代软件消除了对共聚焦图像片段进行手动追踪的需要,允许基于表征主要神经干长度、密度和曲折度的定量指标,客观化CNF结构的评估过程。CNF结构分析的临床应用有两个潜在方向,一个与眼科的直接任务相关,另一个与跨学科事务相关。在眼科方面,这主要涉及可能影响角膜状态的各种手术干预,以及不同性质的角膜慢性病理过程。此类研究可以分析CNF的变化程度,或角膜再支配的特殊性。跨学科研究的潜力在于将CNF用作系统性多发性神经病的生物标志物。相对简单、对细神经纤维的直接可视化程度高以及所获得的结果,使得除了传统方法外,还可推荐角膜共聚焦显微镜作为神经病学初步筛查和后续监测的工具。