Corneal innervation changes ın Alzheimer's: implications for sensory dysfunction

Int Ophthalmol. 2024 Jun 24;44(1):270. doi: 10.1007/s10792-024-03162-1.

Abstract

Purpose: To compare, between Alzheimer's disease (AD) patients and healthy individuals, corneal subbasal nerve plexus (CSNP) parameters and corneal sensitivities.

Methods: Twenty-two patients who were followed up with Alzheimer's disease (Alzheimer's group) and 18 age- and gender-matched healthy individuals (control group) were included in this cross-sectional study. CSNP parameters, including nerve fiber length (NFL), nerve fiber density (NFD), and nerve branch density (NBD), were evaluated using in vivo confocal microscopy. Corneal sensitivity was evaluated using a Cochet-Bonnet esthesiometer. The results were compared between the two groups.

Results: In the Alzheimer's group, NFL was 12.2 (2.4) mm/mm2, NFD was 12.5 [3.1] fibers/mm2, and NBD was 29.7 [9.37] branches/mm2. In the control group, NFL was 16.5 (2.0) mm/mm2, NFD was 25.0 [3.13] fibers/mm2, and NBD was 37.5 [10.9] branches/mm2. All three parameters were significantly lower in the Alzheimer's group compared to the control group (p < 0.001, p < 0.001, and p = 0.001, respectively). Similarly, corneal sensitivity was significantly lower in the Alzheimer's group (55.0 [5.0] mm) compared to the control group (60.0 [5.0] mm) (p < 0.001).

Conclusion: We determined that, in AD, corneal sensitivity decreases significantly, in parallel with the decrease in corneal nerves. Changes in the corneal nerve plexus and a decrease in corneal sensitivity may be used in the early diagnosis and follow-up of AD. In addition, ocular surface problems secondary to these changes should also be kept in mind.

Keywords: Alzheimer's disease; Corneal sensitivity; Corneal subbasal nerve plexus; Esthesiometer; In vivo corneal confocal microscopy.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Alzheimer Disease* / physiopathology
  • Cornea* / innervation
  • Cornea* / pathology
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Microscopy, Confocal*
  • Middle Aged
  • Nerve Fibers* / pathology
  • Ophthalmic Nerve / pathology
  • Sensation Disorders / diagnosis
  • Sensation Disorders / etiology
  • Sensation Disorders / physiopathology