title: Diffusion tensor magnetic resonance imaging of trigeminal nerves in relapsing herpetic keratouveitis.
abstract: BACKGROUND
  Corneal hypoesthesia is the landmark of HSV and VZV keratitis and can lead to neurotrophic keratitis. Diffusion tensor imaging (DTI) is a new magnetic resonance imaging (MRI) derived technique, which offers possibilities to study axonal architecture. We aimed at assessing the potential impact of recurrent HSV or VZV-related keratitis on the axonal architecture of trigeminal nerves using DTI.
  
  
  METHODS
  Prospective non-interventional study.
  
  
  METHODS
  Twelve patients and 24 controls.
  
  
  METHODS
  DTI using MRI of the trigeminal fibers and corneal esthesiometry using the Cochet-Bonnet esthesiometer were acquired for patients affected by unilateral and recurrent HSV or VZV-related keratitis (3 months after the last corneal inflammatory event), and control subjects with no history of ocular or neuronal disease affecting the trigeminal pathways.
  
  
  METHODS
  Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were compared between the 2 eyes of both patients and controls, and correlated with corneal esthesiometry.
  
  
  RESULTS
  FA was lower in the trigeminal fibers ipsilateral to the affected eye compared to the non-affected side (0.39±0.02 versus 0.46±0.04, P=0.03). This difference was more important than the intra-individual variability observed in controls. Concomitantly, the asymmetry in ADC results was significantly correlated with the loss of corneal sensitivity in the affected eye.
  
  
  CONCLUSIONS
  Corneal hypoesthesia related to HSV and VZV keratitis is associated with persistent modifications in the architecture and functionality of the trigeminal fibers. These results add further explanation to the pathogenesis of HSV and VZV-induced neurotrophic keratitis, which may occur despite an apparent quiescence of the disease.
authors.affiliation: Department of Ophthalmology, Bicêtre Hospital, Assistance Publique-Hôpitaux de Paris, Paris-Sud University, Le Kremlin-Bicêtre, France.
authors.forename: Antoine
authors.initials: A
authors.lastname: Rousseau
authors.affiliation: Department of Neuroradiology, Bicêtre Hospital, Assistance Publique-Hôpitaux de Paris, Paris-Sud University, Le Kremlin-Bicêtre, France.
authors.forename: Ghaïdaa
authors.initials: G
authors.lastname: Nasser
authors.affiliation: Department of Ophthalmology, Grenoble University Hospital, Grenoble, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Chiquet
authors.affiliation: Department of Ophthalmology, Bicêtre Hospital, Assistance Publique-Hôpitaux de Paris, Paris-Sud University, Le Kremlin-Bicêtre, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Barreau
authors.affiliation: Department of Ophthalmology, Bicêtre Hospital, Assistance Publique-Hôpitaux de Paris, Paris-Sud University, Le Kremlin-Bicêtre, France.
authors.forename: Gael
authors.initials: G
authors.lastname: Gendron
authors.affiliation: Department of Ophthalmology, Bicêtre Hospital, Assistance Publique-Hôpitaux de Paris, Paris-Sud University, Le Kremlin-Bicêtre, France.
authors.forename: Godefroy
authors.initials: G
authors.lastname: Kaswin
authors.affiliation: Department of Ophthalmology, Bicêtre Hospital, Assistance Publique-Hôpitaux de Paris, Paris-Sud University, Le Kremlin-Bicêtre, France.
authors.forename: Mohamed
authors.initials: M
authors.lastname: M'Garrech
authors.affiliation: Department of Neuroradiology, Bicêtre Hospital, Assistance Publique-Hôpitaux de Paris, Paris-Sud University, Le Kremlin-Bicêtre, France.
authors.forename: Farida
authors.initials: F
authors.lastname: Benoudiba
authors.affiliation: Department of Neuroradiology, Bicêtre Hospital, Assistance Publique-Hôpitaux de Paris, Paris-Sud University, Le Kremlin-Bicêtre, France.
authors.forename: Denis
authors.initials: D
authors.lastname: Ducreux
authors.affiliation: Department of Ophthalmology, Bicêtre Hospital, Assistance Publique-Hôpitaux de Paris, Paris-Sud University, Le Kremlin-Bicêtre, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Labetoulle
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D006987:Hypesthesia / Q000821:virology; D016849:Keratitis, Herpetic / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014276:Trigeminal Nerve / Q000473:pathology* / Q000821:virology; D014605:Uveitis / Q000473:pathology* / Q000821:virology; D055815:Young Adult
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