中国神经再生研究(英文版) ›› 2024, Vol. 19 ›› Issue (1): 140-147.doi: 10.4103/1673-5374.375308

• 综述:视神经损伤修复保护与再生 • 上一篇    下一篇

角膜神经瘤与眼表疾病的临床联系

  

  • 出版日期:2024-01-15 发布日期:2023-08-02

Clinical associations of corneal neuromas with ocular surface diseases

Charmaine Jan Li Toh1, Chang Liu2, Isabelle Xin Yu Lee2, Molly Tzu Yu Lin2, Louis Tong2, 3, 4, Yu-Chi Liu2, 3, 4, *   

  1. 1Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore; 2Singapore Eye Research Institute, Singapore; 3Department of Cornea and External Eye Disease, Singapore National Eye Centre, Singapore; 4Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore
  • Online:2024-01-15 Published:2023-08-02
  • Contact: Yu-Chi Liu, MD, MCI, PhD, liuchiy@gmail.com.

摘要: https://orcid.org/0000-0001-5408-0382 (Yu-Chi Liu)

Abstract: Corneal neuromas, also termed microneuromas, refer to microscopic, irregularly-shaped enlargements of terminal subbasal nerve endings at sites of nerve damage or injury. The formation of corneal neuromas results from damage to corneal nerves, such as following corneal pathology or corneal or intraocular surgeries. Initially, denervated areas of sensory nerve fibers become invaded by sprouts of intact sensory nerve fibers, and later injured axons regenerate and new sprouts called neuromas develop. In recent years, analysis of corneal nerve abnormalities including corneal neuromas which can be identified using in vivo confocal microscopy, a non-invasive imaging technique with microscopic resolution, has been used to evaluate corneal neuropathy and ocular surface dysfunction. Corneal neuromas have been shown to be associated with clinical symptoms of discomfort and dryness of eyes, and are a promising surrogate biomarker for ocular surface diseases, such as neuropathic corneal pain, dry eye disease, diabetic corneal neuropathy, neurotrophic keratopathy, Sjögren’s syndrome, bullous keratopathy, post-refractive surgery, and others. In this review, we have summarized the current literature on the association between these ocular surface diseases and the presentation of corneal microneuromas, as well as elaborated on their pathogenesis, visualization via in vivo confocal microscopy, and utility in monitoring treatment efficacy. As current quantitative analysis on neuromas mainly relies on manual annotation and quantification, which is user-dependent and labor-intensive, future direction includes the development of artificial intelligence software to identify and quantify these potential imaging biomarkers in a more automated and sensitive manner, allowing it to be applied in clinical settings more efficiently. Combining imaging and molecular biomarkers may also help elucidate the associations between corneal neuromas and ocular surface diseases. 

Key words: cornea, corneal diseases, corneal nerve, corneal neuropathy, in vivo confocal microscopy, microneuroma, neuroma, ocular surface diseases