Estimation of the retinal nerve fibre layer thickness in the papillomacular area of long standing stage IV macular holes.
AIM: To compare the thickness of the retinal nerve fibre layer (RNFL) in the papillomacular area of patients with long standing stage IV macular holes with age matched controls, using a scanning laser polarimeter. METHODS: The nerve fibre analyser (NFA) was used to measure the mean thickness of the RNFL around the optic nerve head, the thickness values of temporal and nasal 45 degrees sectors and the integral values in 10 patients with macular holes and in 10 age matched controls. RESULTS: The mean RNFL thickness around the optic nerve head was 79.71 (SD 15.06) microm in the macular hole group and 75.1 (10.8) microm in the control group (p = 0.44). The mean thickness in the temporal sector was 63.69 (12.08) microm in the macular hole group and 58.65 (8.9) microm in the control group (p = 0.3). The mean ratio between the temporal and nasal sector thickness values was 0.8441 in the macular hole group and 0.7819 in the controls (p = 0.42). CONCLUSIONS: There was no significant difference in the thickness of the RNFL in the papillomacular area in the two groups. This suggests that there may be no changes in the thickness of the RNFL in patients with long standing macular holes. (+info)
Behavioral modulation of tactile responses in the rat somatosensory system.
We investigated the influence of four different behavioral states on tactile responses recorded simultaneously via arrays of microwires chronically implanted in the vibrissal representations of the rat ventral posterior medial nucleus (VPM) of the thalamus and the primary somatosensory cortex (SI). Brief (100 microsecond) electrical stimuli delivered via a cuff electrode to the infraorbital nerve yielded robust sensory responses in VPM and SI during states of quiet immobility. However, significant reductions in tactile response magnitude and latency were observed in VPM and SI during large-amplitude, exploratory movements of the whiskers (at approximately 4-6 Hz). During small-amplitude, 7-12 Hz whisker-twitching movements, a significant reduction in SI response magnitude and an increase in VPM and SI response latencies were observed as well. When pairs of stimuli with interstimulus intervals <100 msec were delivered during quiet immobility, the response to the second stimulus in the pair was reduced and occurred at a longer latency compared with the response to the first stimulus. In contrast, during large-amplitude whisker movements and general motor activity, paired stimuli yielded similar sensory responses at interstimulus intervals >25 msec. These response patterns were correlated with the amount and duration of postexcitatory firing suppression observed in VPM and SI during each of these behaviors. On the basis of these results, we propose that sensory responses are dynamically modulated during active tactile exploration to optimize detection of different types of stimuli. During quiet immobility, the somatosensory system seems to be optimally tuned to detect the presence of single stimuli. In contrast, during whisker movements and other exploratory behaviors, the system is primed to detect the occurrence of rapid sequences of tactile stimuli, which are likely to be generated by multiple whisker contacts with objects during exploratory activity. (+info)
Corneal stromal changes induced by myopic LASIK.
PURPOSE. Despite the rapidly growing popularity of laser in situ keratomileusis (LASIK) in correction of myopia, the tissue responses have not been thoroughly investigated. The aim was to characterize morphologic changes induced by myopic LASIK in human corneal stroma. METHODS: Sixty-two myopic eyes were examined once at 3 days to 2 years after LASIK using in vivo confocal microscopy for measurement of flap thickness, keratocyte response zones, and objective grading of haze. RESULTS: Confocal microscopy revealed corneal flap interface particles in 100% of eyes and microfolds at the Bowman's layer in 96.8%. The flaps were thinner (112 +/- 25 microm) than intended (160 microm). The keratocyte activation in the stromal bed was greatest on the third postoperative day. Patients with increased interface reflectivity due to abnormal extracellular matrix or activated keratocytes at > or = 1 month (n = 9) had significantly thinner flaps than patients with normal interface reflectivity (n = 18; 114 +/- 12 versus 132 +/- 22 microm, P = 0.027). After 6 months the mean density of the most anterior layer of flap keratocytes was decreased. CONCLUSIONS: Keratocyte activation induced by LASIK was of short duration compared with that reported after photorefractive keratectomy. The flaps were thinner than expected, and microfolds and interface particles were common complications. The new findings such as increased interface reflectivity associated with thin flaps and the apparent loss of keratocytes in the most anterior flap 6 months to 2 years after surgery may have important clinical relevance. (+info)
Effect of myopic LASIK on corneal sensitivity and morphology of subbasal nerves.
PURPOSE: To investigate whether the morphology of the subbasal nerves corresponds to corneal sensitivity after laser in situ keratomileusis (LASIK). METHODS: In a case series study, 59 patients were examined at 2 to 4 hours, 3 days, 1 to 2 weeks, 1 to 2 months, 3 months, or 6 or more months after undergoing LASIK for myopia, by using a Cochet-Bonnet esthesiometer and an in vivo confocal microscope, and were compared with control subjects. Corneal sensitivity and confocal images of subbasal nerves were obtained centrally and 2 mm nasally and temporally. Subbasal nerve fiber bundles (NFBs) were grouped as follows: corneas with no nerve images; corneas with short (<200 microm), unconnected NFBs; corneas with long (> or =200 microm) NFBs without interconnections; and corneas with long NFBs with interconnections. RESULTS: Corneal sensitivity was at its lowest at 1 to 2 weeks after LASIK. Sensitivity of the hinge area was higher than temporal or central areas at every time point. At 6 or more months the sensitivity values were comparable with the values observed in control subjects. The central area showed mainly short, unconnected subbasal NFBs, even at 6 months. In general, the temporal area presented with long NFBs from 3 months onward, whereas the nasal area showed long NFBs at every time point. CONCLUSIONS: The results suggest that the corneal areas with no nerve images or short, unconnected NFBs are associated with lower sensitivities than corneal areas with long NFBs with or without interconnections. In vivo confocal microscopy reveals LASIK-induced alterations of subbasal nerve morphology and thus enables a direct comparison of corneal sensory innervation and sensitivity. (+info)
Autosomal recessive cornea plana: in vivo corneal morphology and corneal sensitivity.
PURPOSE: Autosomal recessive corneal plana (RCP) is a rare corneal anomaly with unknown pathogenesis and a high incidence in Finland. The aim was to examine corneal sensitivity and the morphology of different corneal layers and subbasal nerves in RCP patients. METHODS: Three patients with a diagnosed autosomal recessive cornea plana were examined. Corneal sensitivity to different modalities of stimulation was tested in four corneas using noncontact esthesiometry. Tissue morphology of three corneas was evaluated, and in two corneas thickness of corneal layers was measured using in vivo confocal microscopy. RESULTS: Corneas of RCP patients appear to have mechanosensory, polymodal, and cold-sensitive nerve terminals. RCP patients had normal sensation thresholds for chemical, heat, and cold stimulation but a high threshold for mechanical stimulation. Their capacity to discriminate increasing intensities of stimulus was reduced, except for cold stimuli. Thickness of the epithelial layer was reduced, whereas total corneal and stromal thicknesses were slightly reduced or close to normal values. In all cases Bowman's layer was absent. Subbasal nerves had abnormal branching patterns. The arrangement of anterior keratocytes was altered, showing clustered and irregularly shaped nuclei. Increased backscattering of light in confocal microscopy through focusing (CMTF) profiles was observed throughout the stroma. Epithelial and endothelial cells appeared to be regular in shape. CONCLUSIONS: The present study revealed qualitative and quantitative alterations in corneal sensitivity, cellular morphology, and the thickness of corneal layers in RCP patients. (+info)
Development of conjunctival goblet cells and their neuroreceptor subtype expression.
PURPOSE: To investigate expression of muscarinic, cholinergic, and adrenergic receptors on developing conjunctival goblet cells. METHODS: Eyes were removed from rats 9 to 60 days old, fixed, and used for microscopy. For glycoconjugate expression, sections were stained with Alcian blue/periodic acid-Schiffs reagent (AB/PAS) and with the lectins Ulex europeus agglutinin I (UEA-I) and Helix pomatia agglutinin (HPA). Goblet cell bodies were identified using anti-cytokeratin 7 (CK7). Nerve fibers were localized using anti-protein gene product 9.5. Location of muscarinic and adrenergic receptors was investigated using anti-muscarinic and beta-adrenergic receptors. RESULTS: At days 9 and 13, single apical cells in conjunctival epithelium stained with AB/PAS, UEA-I, and CK7. At days 17 and 60, increasing numbers of goblet cells were identified by AB/PAS, UEA-I, HPA, and CK7. Nerve fibers were localized around stratified squamous cells and at the epithelial base at days 9 and 13, and around goblet cells and at the epithelial base at days 17 and 60. At days 9 and 13, M2- and M3-muscarinic and beta2-adrenergic receptors were found in stratified squamous cells, but M1-muscarinic and beta1-adrenergic receptors were not detected. At days 17 and 60, M2- and M3-muscarinic receptors were found in goblet cells, whereas M1-muscarinic receptors were in stratified squamous cells. Beta1- and beta2-adrenergic receptors were found on both cell types. Beta3-adrenergic receptors were not detected. CONCLUSIONS: In conjunctiva, nerves, M2- and M3-muscarinic, and beta1- and beta2-adrenergic receptors are present on developing goblet cells and could regulate secretion as eyelids open. (+info)
Effects of oleoresin capsicum pepper spray on human corneal morphology and sensitivity.
PURPOSE: To examine the potential harmful effects on corneal structure, innervation, and sensitivity of a spray containing the neurotoxin capsaicin (oleoresin capsicum, OC). METHODS: Ten police officers who volunteered for the study were exposed to OC. Clinical signs were assessed. Corneal sensitivity was measured using a Cochet-Bonnet or a noncontact esthesiometer that provides separate measurements of mechanical, chemical, and thermal sensitivity. Tear fluid nerve growth factor (NGF) was measured. Corneal cell layers and subbasal nerves were examined by in vivo confocal microscopy. The subjects were examined before application and 30 minutes, 1 day, 1 week, and 1 month after OC exposure. RESULTS: OC spray produced occasional areas of focal epithelial cell damage that healed within 1 day. Each eye showed conjunctival hyperemia and in two subjects, mild chemosis. All except one eye had unchanged best corrected visual acuity (BCVA). A transient decrease (day 1) of mechanical sensitivity was observed with the Cochet-Bonnet esthesiometer. With the gas esthesiometer, mechanical sensitivity remained below normal values for 7 days. Chemical sensitivity to CO2 was high for as much as 1 day and decreased below normal 1 week later, whereas sensitivity to cold was unaffected. Two subjects had measurable tear NGF that increased after exposure. Basal epithelial cell morphology suggested temporary corneal epithelial swelling, whereas keratocytes, endothelial cells, and subbasal nerves remained unchanged. CONCLUSIONS: Although OC causes immediate changes in mechanical and chemical sensitivity that may persist for a week, a single exposure to OC appears harmless to corneal tissues. The changes are possibly associated with damage of corneal nerve terminals of mainly unmyelinated polymodal nociceptor fibers. (+info)
Corneal structure and sensitivity in type 1 diabetes mellitus.
PURPOSE: Corneal wound healing is impaired in diabetic cornea. The purpose of this study was to examine patients with type 1 diabetes mellitus for changes in corneal morphology and to correlate corneal sensitivity, subbasal nerve morphology, and degree of polyneuropathy with each other. METHODS: Forty-four eyes of 23 patients with diabetes and nine control eyes were included. Corneal sensitivity was tested with a Cochet-Bonnet esthesiometer (Luneau, Paris, France), and corneal morphology and epithelial and corneal thickness were determined by in vivo confocal microscopy. The density of subbasal nerves was evaluated by calculating the number of long subbasal nerve fiber bundles per confocal microscopic field. The degree of polyneuropathy was evaluated using the clinical part of the Michigan Neuropathy Screening Instrument (MNSI) classification, and retinopathy was evaluated using fundus photographs. RESULTS: A reduction of long nerve fiber bundles per image was noted to have occurred already in patients with mild to moderate neuropathy, but corneal mechanical sensitivity was reduced only in patients with severe neuropathy. Compared with control subjects the corneal thickness was increased in patients with diabetes without neuropathy. The epithelium of patients with diabetes with severe neuropathy was significantly thinner than that of patients with diabetes without neuropathy. CONCLUSIONS: Confocal microscopy appears to allow early detection of beginning neuropathy, because decreases in nerve fiber bundle counts precede impairment of corneal sensitivity. Apparently, the cornea becomes thicker in a relatively early stage of diabetes but does not further change with the degree of neuropathy. A reduction in neurotrophic stimuli in severe neuropathy may induce a thin epithelium that may lead to recurrent erosions. (+info)