New 3D imaging technique enhances corneal nerve assessment in limbal stem cell deficiency

Three-dimensional (3D) reconstruction significantly improves the quantification and characterization of corneal subbasal nerve parameters in eyes with limbal stem cell deficiency (LSCD), offering more accurate assessments compared to traditional 2-dimensional scans, according to a study.

This advancement could enhance diagnostic precision and treatment planning, particularly when integrated with machine learning for automated measurements, the study authors speculated.

The study involved in vivo laser scanning confocal microscopy (IVCM) volume scans from 73 eyes with varying degrees of LSCD (mild, moderate, severe) confirmed through multimodal anterior segment imaging, including IVCM, and 20 control subjects.

There was a significant decrease in 3D subbasal nerve density (SND) in eyes with LSCD compared to controls, particularly in moderate and severe cases (P < 0.01). SND reductions were 3.7% for mild LSCD, 32.4% for moderate LSCD, and 96.5% for severe LSCD. The number of long nerves and branch points also correlated strongly with LSCD severity (P < 0.0001) and declining SND (R² = 0.66 and 0.67, respectively). Compared to 2-dimensional scans, 3D reconstructions showed increased SND and branch points in all conditions except severe LSCD. There was also a 46% increase in long nerves in mild LSCD cases (P < 0.01).

Reference
Stoddard-Bennett T, Bonnet C, Deng SX. Three-Dimensional Reconstruction of Subbasal Nerve Density in Eyes With Limbal Stem Cell Deficiency: A Pilot Study. Cornea. 2024;doi: 10.1097/ICO.0000000000003571. Epub ahead of print. PMID: 38923539.