Subclinical corneal inflammation and subbasal nerve alterations in keratoconus detected by in vivo confocal microscopy: a cross-sectional study

• Published in: Graefe's archive for clinical and experimental ophthalmology 2024-11
• Main Authors: Chirapapaisan, Chareenun, Sawarot, Methawee, Kengpunpanich, Sathiya
• Format: Article
• Language: English
• ISSN: 0721-832X; 1435-702X; 1435-702X
• DOI: 10.1007/s00417-024-06664-x

To investigate the intracorneal inflammation and subbasal nerve alterations in keratoconus. This prospective cross-sectional study recruited patients with keratoconus, who were diagnosed and graded the severity based on clinical examination and Schiempflug tomography. Laser in vivo confocal microscopy (IVCM) was performed on the corneal subbasal layer centrally to explore the inflammatory cells (ICs), subbasal nerve density (SND), and nerve tortuosity. Keratoconus severity and related factors including ocular allergy, systemic atopy, eye rubbing, floppy eyelids, and contact lens use were recorded. Association between the factors, IC density, SND and keratoconus severity were analyzed. Thirty-four keratoconus eyes were enrolled, and their IVCM findings were compared with those of 20 age-matched normal eyes. Keratoconus showed a significant increase in ICs (44.25 ± 7.01 vs. 13.06 ± 7.51 cells/mm , p