title: Corneal nerves alterations in various types of systemic polyneuropathy, identified by in vivo confocal microscopy.
abstract: BACKGROUND
  In vivo confocal microscopy (IVCM) is a newly developed application to assess corneal nerve morphology. The purpose of the study is to evaluate the role of IVCM in the assessment of various types of polyneuropathy, and to define alterations of corneal nerves in such conditions.
  
  
  METHODS
  Eighteen patients with various types of polyneuropathy were characterized by clinical neurological and ophthalmic examinations, as well as by electroneuromyography (ENMG). Full thickness IVCM of corneal nerves was carried out on all patients and 15 age-matched eyes using Heidelberg Retina Tomograph II (HRT II). The subbasal nerve plexus were statistically analysed regarding long nerve fiber density, nerve branch density, nerve thickness, nerve bead number and nerve tortuosity.
  
  
  RESULTS
  In subbasal nerve plexus, the following three parameters were significantly reduced in patients with polyneuropathy compared to controls: long nerve fibre density (p < 0.01), nerve branch density (p < 0.001), and nerve bead number (p = 0.001). In addition, the average grade of nerve tortuosity was 2.87 +/- 0.97 in the polyneuropathic group and 1.17 +/- 0.68 in the control group (p < 0.0001).
  
  
  CONCLUSIONS
  IVCM allows a non-invasive, in vivo study of corneal nerves with high resolution. It therefore appears invaluable in clinical investigations. IVCM appears to be valuable in a large variety of polyneuropathic conditions.
authors.affiliation: Ophthalmology Clinic, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland.
authors.forename: C
authors.initials: C
authors.lastname: Zhao
authors.forename: S
authors.initials: S
authors.lastname: Lu
authors.forename: A
authors.initials: A
authors.lastname: Truffert
authors.forename: N
authors.initials: N
authors.lastname: Tajouri
authors.forename: K
authors.initials: K
authors.lastname: Zhao
authors.forename: A
authors.initials: A
authors.lastname: Mateo Montoya
authors.forename: A
authors.initials: A
authors.lastname: Dosso
authors.forename: T
authors.initials: T
authors.lastname: Landis
authors.forename: A B
authors.initials: AB
authors.lastname: Safran
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003315:Cornea / Q000294:innervation* / Q000473:pathology*; D003389:Cranial Nerve Diseases / Q000473:pathology*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008297:Male; D018613:Microscopy, Confocal / Q000379:methods*; D008875:Middle Aged; D011115:Polyneuropathies / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity