Purpose

To describe the pattern of the nerves in the inferocentral whorl region of the human corneal subbasal nerve plexus (SBNP) in health and diseases known to affect the subbasal nerves.

Methods

Laser-scanning in vivo confocal microscopy (IVCM) was used to image the SBNP bilaterally in 91 healthy subjects, 39 subjects with type 2 diabetes mellitus (T2DM), and 43 subjects with Parkinson's disease (PD). Whorl regions were classified according to nerve orientation relative to age and health/disease status.

Results

Of 346 examined eyes, 300 (86.7%) had an identifiable whorl pattern. In healthy subjects, a clockwise nerve orientation of the whorl was most common (67.9%), followed by non-rotatory or ‘seam’ morphology (21.4%), and counterclockwise (10.7%). The clockwise orientation was more prevalent in healthy subjects than in T2DM or PD (P < 0.001). Healthy individuals below 50 years of age had a predominantly clockwise orientation (93.8%) which was reduced to 51.9% in those over 50 years (P < 0.001). Age but not disease status explained whorl orientation in T2DM and PD groups. Moreover, whorl orientation is bilaterally clockwise in the young, but adopts other orientations and becomes asymmetric across eyes with age. Finally, we report reflective ‘dot-like’ features confined to the whorl region of the subbasal plexus, sometimes appearing in close association with subbasal nerves and present in 84–93% of examined eyes regardless of disease status, eye or sex.

Conclusion

Subbasal nerves in the inferocentral whorl region are predominantly clockwise in young, healthy corneas. With aging and conditions of T2DM and PD, counterclockwise and non-rotatory configurations increase in prevalence, and bilateral symmetry is lost. Mechanisms regulating these changes warrant further investigation.

中文翻译：

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角膜基底下神经丛的下中央螺旋区的模式随着年龄的增长而改变

目的

描述人类角膜基底下神经丛 (SBNP) 下中枢区域的神经模式，在健康和已知会影响基底下神经的疾病中。

方法

使用激光扫描体内共聚焦显微镜 (IVCM) 对 91 名健康受试者、39 名患有 2 型糖尿病 (T2DM) 的受试者和 43 名患有帕金森病 (PD) 的受试者的 SBNP 进行双侧成像。根据与年龄和健康/疾病状态相关的神经方向对螺纹区域进行分类。

结果

在 346 只检查的眼睛中，300 只 (86.7%) 具有可识别的螺纹图案。在健康受试者中，螺纹的顺时针神经方向最常见（67.9%），其次是非旋转或“接缝”形态（21.4%）和逆时针（10.7%）。顺时针方向在健康受试者中比在 T2DM 或 PD 中更为普遍（P < 0.001）。50 岁以下的健康人以顺时针方向为主 (93.8%)，而在 50 岁以上的人中，这一比例降至 51.9% (P < 0.001)。年龄而不是疾病状态解释了 T2DM 和 PD 组的螺纹方向。此外，年轻人的螺纹方向是双侧顺时针，但采用其他方向，随着年龄的增长，眼睛变得不对称。最后，我们报告了反射性“点状”特征，仅限于基底神经丛的螺纹区域，

结论

在年轻、健康的角膜中，下中央轮区域的基底神经主要是顺时针方向的。随着 T2DM 和 PD 的老化和病情，逆时针和非旋转配置的患病率增加，双侧对称性丧失。调节这些变化的机制值得进一步调查。