Ocular Microbiology and Immunology Group
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2014 OMIG Abstract 14

Alterations in Corneal Nerve Density and Function in Herpes Zoster Ophthalmicus Associated with Central vs. Peripheral Corneal Involvement
Rodrigo Muller, Deborah Pavan-Langston, Ahmad Kheirkhah, Bernardo Cavalcanti, Andrea Cruzat,
Clara Colon, Monique Trinidad, Pedram Hamrah
Ocular Surface Imaging Center, Cornea Service, Massachusetts Eye and Ear Infirmary, Boston, MA

Purpose: We have previously demonstrated decreased corneal nerves and sensation in patients with herpes zoster ophthalmicus (HZO). This study aimed to compare corneal sensation and subbasal nerve changes using in vivo confocal microscopy (IVCM) in patients with central (CCS) vs. peripheral corneal scars (PCS) due to HZO.

Methods: This prospective, cross-sectional study included 38 patients with HZO with either CCS (n=19) or PCS (n=19), as well as 18 age-matched normal controls. Subbasal corneal nerve density was measured by IVCM (HRT3/RCM), in addition to corneal sensation (by Cochet-Bonnet esthesiometer), in the center and peripheral quadrants of the cornea, depending upon the location of the scar.

Results: Patients with CCS showed a significantly decreased central subbasal nerve density (4.1±3.6 mm/mm²) compared to patients with PCS (13.1±7.3, p<0.001) and controls (20.2±4.1, p<0.001), although, no difference was found in the corneal sensation between HZO groups (3.1±2.3 and 3.9±2.2 cm, p=0.5). Both the peripheral areas in the CCS group (5.3±5.4), as well as the affected area of the PCS group (2.2±3.5, p=0.1) demonstrated significantly lower nerve density as compared to controls (8.8±1.8; p<0.05 for all), while the contralateral area to the peripheral scar (8.4±5.1, p=0.1) did not show a significant difference. Moreover, there was a significant decrease of nerve density in the affected area compared to the contralateral area of patients with PCS (p<0.001). However, the peripheral cornea of patients with CCS showed no significant difference compared to the area of the scar in patients with PCS (p=0.1). There was no significant difference comparing the peripheral corneal sensation in patients with CCS (2.7±2.2), affected (3.2±2.1) and contralateral areas (4.0±2.2) of patients with PCS, although all were lower compared to normal controls.

Conclusions: There is differential corneal nerve damage in patients with HZO keratitis depending upon the location of the focal corneal scar. Although the decrease in the central and peripheral corneal sensation was similar between the groups with CCS and PCS, IVCM showed profound loss of subbasal nerves that was more pronounced in patients with CCS, suggesting that this group may require closer clinical follow-up.

Funding Support: NIH R01-EY022695 (PH), Research to Prevent Blindness Career Development Award (PH), Falk Medical Research Trust (PH), MEEI Foundation (PH).

Disclosure: S

2014 Agenda and Abstracts | < Previous | Next >