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Mult Scler. 2017 Dec;23(14):1847-1853. doi: 10.1177/1352458516677590. Epub 2016 Nov 3.

Patients with multiple sclerosis demonstrate reduced subbasal corneal nerve fibre density.

Author information

1
NeuroCure Clinical Research Center and Clinical and Experimental Multiple Sclerosis Research Center, Charité - Universitätsmedizin Berlin, Berlin, Germany.
2
Ocular Surface Imaging Center, Cornea Service, Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA.
3
Department of Optometry, Beuth University of Applied Sciences, Berlin, Germany.
4
Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany/German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany.
5
NeuroCure Clinical Research Center and Clinical and Experimental Multiple Sclerosis Research Center, Charité - Universitätsmedizin Berlin, Berlin, Germany/Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany/Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Berlin, Germany.
6
Ocular Surface Imaging Center, Cornea Service, Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA/Boston Image Reading Center and Cornea Service, New England Eye Center, Boston, MA, USA/Tufts Medical Center, Department of Ophthalmology, School of Medicine, Tufts University, Boston, MA, USA.

Abstract

BACKGROUND:

Many studies in multiple sclerosis (MS) have investigated the retina. Little, however, is known about the effect of MS on the cornea, which is innervated by the trigeminal nerve. It is the site of neural-immune interaction with local dendritic cells reacting in response to environmental stimuli.

OBJECTIVE:

This study aims to investigate the effect of MS on corneal nerve fibres and dendritic cells in the subbasal nerve plexus using in vivo confocal microscopy (IVCM).

METHODS:

We measured the corneal nerve fibre and dendritic cell density in 26 MS patients and matched healthy controls using a Heidelberg Retina Tomograph with cornea module. Disease severity was assessed with the Multiple Sclerosis Functional Composite, Expanded Disability Status Scale, visual acuity and retinal optical coherence tomography.

RESULTS:

We observed significant reduction in total corneal nerve fibre density in MS patients compared to controls. Dendritic cell density was similar in both groups. Reduced total nerve fibre density was associated with worse clinical severity but not with previous clinical trigeminal symptoms, retinal neuro-axonal damage, visual acuity or disease duration.

CONCLUSION:

Corneal nerve fibre density is a promising new imaging marker for the assessment of disease severity in MS and should be investigated further.

KEYWORDS:

Multiple sclerosis; cornea; peripheral nerves; retina; subbasal nerve plexus; trigeminal neuralgia

PMID:
27811337
PMCID:
PMC5513781
DOI:
10.1177/1352458516677590
[Indexed for MEDLINE]
Free PMC Article

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