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Quantitative Assessment of Corneal Nerve Fiber Density in Patients with Rheumatoid Arthritis Performing Con-focal Microscopy

Sherif Z., Hopp P., Pleyer U.,
Humboldt-Universität zu Berlin, Charité Campus Virchow-Klinikum, Augenklinik (Berlin)

Purpose: Corneal ulceration in patients with rheumatoid arthritis is supposed to be supported by neurotrophic alterations. This study was performed to assess the density of corneal nerve fibres in patients with rheumatoid arthritis in comparison to healthy persons who served as controls.
Patients and methods: 22 eyes of 22 patients with rheumatoid arthritis and 21 eyes of 21 persons who served as controls were investigated. Therefore, the central subepithelial nerve plexus of the cornea was detected using slit-scanning confocal microscopy (Confoscanâ Tomey). The images were documented in real time, digitalized and statistically analyzed. We evaluated the number of nerve fibres per image, the length of each single nerve fibre as well as the cumulative length of all nerve fibres per image.
Results: The number of nerve fibres per image in patients with rheumatoid arthritis / controls was 2,72 (SD1,16) / 2,71 (SD1.23), the median length of the nerve fibres within the image was 190.65mm (SD70.34mm) / 225.25mm (SD96.91mm). The median of the cumulative length per image was 496.70mm (SD227.39mm) / 546.86mm (SD267.70mm).
Conclusions: In comparison, both groups did not show a statistically significant difference concerning the number of nerve fibres per image. The other parameters measured, supported by the morphological impression, suggest an alteration of the ultrastructure of the subepithelial nerve plexus in patients with rheumatoid arthritis allthough further investigations are needed to confirm this hypothesis.