Corneal nerve parameters may help assess multiple sclerosis stages, severity
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Key takeaways:
- Patients with MS had lower corneal nerve fiber density, corneal nerve branch density and corneal nerve fiber length.
- Corneal nerve fiber morphology correlated with Multiple Sclerosis Severity Score.
The corneal nerve parameters of patients with multiple sclerosis could be used to evaluate and monitor the stages of the disease, according to a poster presented at the Women in Ophthalmology Summer Symposium.
Previously, in vivo corneal confocal microscopy was used to demonstrate that increased corneal immune cell density and corneal nerve fiber loss are features of multiple sclerosis (MS), according to Emma Grace Orekovi, MD, of Svjetlost Eye Clinic in Zagreb, Croatia, and colleagues.
Image: Adobe Stock
They theorized that by examining patient corneal alterations that correlate with neurological disability severity, the high-quality imaging resolution of in vivo corneal confocal microscopy could allow for the monitoring and evaluation of MS across stages.
A cross-sectional study included 20 women with relapsing-remitting or secondary-progressive MS aged 18 to 65 years who had experienced an episode of optic neuritis and 20 healthy control participants.
The Heidelberg Retina Tomograph 3 with the Rostock cornea module was used to achieve 800-fold magnification, and the ACCMetrics corneal nerve fiber analyzer measured corneal nerve fiber parameters. MS severity and disability status were measured using the Multiple Sclerosis Severity Score and the Expanded Disability Status Scale.
All corneal confocal microscopy parameters were significantly different between patients with MS and controls.
Compared with the controls, patients with MS had lower corneal nerve fiber density (32.15 ± 6.5 fibers/mm2 vs. 38.85 ± 5.3 fibers/mm2; P < .04), lower corneal nerve branch density (48.5 ± 12.1 branches/mm2 vs. 62.75 ± 10.95 branches/mm2; P < .03) and lower corneal nerve fiber length (18.75 ± 3.55 mm/mm2 vs. 21.1 ± 2.15 mm/mm2; P < .01). Further, corneal nerve fiber morphology directly correlated with the Multiple Sclerosis Severity Score and the Expanded Disability Status Scale, with an inverse correlation between corneal nerve fiber density and the Expanded Disability Status Scale.
“Corneal nerve parameters could reflect MS patient disability status, with different impacts observed based on disability severity and current treatment effects,” Orekovi and colleagues wrote.
Future studies could investigate longitudinal corneal nerve progression, how to distinguish patients at risk for disability progression and the effect of disease-modifying drugs on corneal nerve regeneration, they added.
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Orešković EG, et al. In-vivo corneal confocal microscopy (IVCM): A promising tool for predicting disease course in persons with multiple sclerosis (MS). Presented at: Women in Ophthalmology Summer Symposium; Aug. 22-25, 2024; Carlsbad, California.
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