Corneal confocal microscopy is efficient, well-tolerated, and reproducible

• Published in: Journal of the peripheral nervous system Vol. 18; no. 1; pp. 54 - 58
• Main Authors: Smith, Albert Gordon, Kim, Gene, Porzio, Michael, Allen, Blaine, Koach, Margaret, Mifflin, Mark, Digre, Kathleen, Keung, Bonnie M., Singleton, John Robinson
• Format: Journal Article
• Language: English
• Published: Malden, USA Wiley Periodicals, Inc 01.03.2013; Wiley Subscription Services, Inc
• Subjects: Adult; cornea; Cornea - innervation; Female; Humans; Male; Microscopy, Confocal; Middle Aged; Nerve Fibers - pathology; neuropathy; peripheral nerve; Peripheral Nervous System Diseases - diagnosis; Peripheral Nervous System Diseases - pathology; Reproducibility of Results; Studies
• ISSN: 1085-9489; 1529-8027; 1529-8027
• DOI: 10.1111/jns5.12008

In order to develop an efficient, reproducible, and well‐tolerated protocol for assessing corneal innervation, 11 normal subjects underwent corneal confocal microscopy (CCM) using a Heidelberg Retinal Tomography III microscope. Five standardized locations were sampled in the left eye and one centrally in the right. The protocol was repeated 1–4 weeks later. A blinded technician measured nerve fiber length (NFL) and tortuosity coefficient (TC). The relationship between image location and NFL and TC was assessed using one‐way analysis of variance, and reproducibility determined using relative intertrial variability and intraclass correlation coefficients. NFL reproducibility was maximized by averaging four or more images from the left eye, or one central image from both eyes. TC was less reproducible. CCM is a rapid, well‐tolerated, and reproducible method for assessing corneal innervation.