title: Corneal confocal microscopy is efficient, well-tolerated, and reproducible.
abstract: In order to develop an efficient, reproducible, and well-tolerated protocol for assessing corneal innervation, 11 normal subjects underwent corneal confocal microscopy (CCM) using a Heidelberg Retinal Tomography III microscope. Five standardized locations were sampled in the left eye and one centrally in the right. The protocol was repeated 1-4 weeks later. A blinded technician measured nerve fiber length (NFL) and tortuosity coefficient (TC). The relationship between image location and NFL and TC was assessed using one-way analysis of variance, and reproducibility determined using relative intertrial variability and intraclass correlation coefficients. NFL reproducibility was maximized by averaging four or more images from the left eye, or one central image from both eyes. TC was less reproducible. CCM is a rapid, well-tolerated, and reproducible method for assessing corneal innervation.
authors.affiliation: Department of Neurology, University of Utah, Salt Lake City, UT 84132, USA. gordon.smith@hsc.utah.edu
authors.forename: Albert Gordon
authors.initials: AG
authors.lastname: Smith
authors.forename: Gene
authors.initials: G
authors.lastname: Kim
authors.forename: Michael
authors.initials: M
authors.lastname: Porzio
authors.forename: Blaine
authors.initials: B
authors.lastname: Allen
authors.forename: Margaret
authors.initials: M
authors.lastname: Koach
authors.forename: Mark
authors.initials: M
authors.lastname: Mifflin
authors.forename: Kathleen
authors.initials: K
authors.lastname: Digre
authors.forename: Bonnie M
authors.initials: BM
authors.lastname: Keung
authors.forename: John Robinson
authors.initials: JR
authors.lastname: Singleton
mesh_terms: D000328:Adult; D003315:Cornea / Q000294:innervation*; D005260:Female; D006801:Humans; D008297:Male; D018613:Microscopy, Confocal; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology; D010523:Peripheral Nervous System Diseases / Q000175:diagnosis* / Q000473:pathology; D015203:Reproducibility of Results