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2014 Agenda and Abstracts | < Previous | Next >

2014 OMIG Abstract 17

Patients with Herpes Zoster Ophthalmicus Demonstrate Progressive
Corneal Nerve Damage by In Vivo Confocal Microscopy

Ahmad Kheirkhah, Rodrigo Muller, Deborah Pavan-Langston, Andrea Cruzat,
Mohammad Dastjerdi, Pedram Hamrah

Cornea and Refractive Surgery Service, Massachusetts Eye and Ear Infirmary,
Department of Ophthalmology, Harvard Medical School, Boston, MA

Purpose: To evaluate the long-term alterations in corneal nerves after keratitis due to herpes zoster ophthalmicus (HZO) using in vivo confocal microscopy (IVCM).

Methods: This prospective longitudinal study included 14 patients (mean age: 63 ± 12 years) who had HZO with corneal involvement at 1-21 years (median: 5 years) prior to enrollment. Slit-scanning IVCM of the central cornea was performed bilaterally using Confoscan 4 (Nidek). The imaging was repeated after a follow-up of 39.6 ± 6.8 months (range, 29.5-53.0 months). Total nerve density in the corneal subbasal layer was measured by two masked observers using NeuronJ and was compared to 15 eyes of an age-matched normal control group (59 ± 17 years).

Results: At baseline, the subbasal nerve density was significantly lower in the affected eyes (4.34 ± 3.73 mm/mm2) as well as in contralateral unaffected eyes (7.62 ± 3.64) compared to the normal control group (14.23 ± 6.23), with P<0.001 and P=0.002, respectively. At the end of follow-up, the mean subbasal nerve density in the affected eyes declined to 2.94 ± 2.64 mm/mm2 (P=0.04) with a median decrease of 53% (range, 20-657%) in 9 eyes. In the contralateral unaffected eyes, although the mean nerve density also decreased to 6.08 ± 2.45 mm/mm2, the difference was not statistically significant (P=0.09).

Conclusion: Patients with HZO demonstrate profound and progressive reduction in corneal nerves during long-term follow-up, requiring continued close monitoring for the complications of neurotrophic keratopathy.

Funding: NIH K08 EYE020575 (to PH), Falk Medical Research Trust (to PH), New England Corneal Transplant Research Fund (to PH).

Financial Disclosure: AK (N), RM (N), DPL (N), AC (N), MD (N), PH (S)

2014 Agenda and Abstracts | < Previous | Next >