Impact of Age on the Characteristics of Corneal Nerves and Corneal Epithelial Cells in Healthy Adults

Author:

Chin Jia Ying1,Liu Chang1,Lee Isabelle Xin Yu1,Lin Molly Tzu Yu1,Cheng Ching-Yu234,Wong Jipson Hon Fai1,Teo Cong Ling3,Mehta Jodhbir S.125,Liu Yu-Chi1256ORCID

Affiliation:

1. Tissue Engineering and Stem Cell Group, Singapore Eye Research Institute, Singapore;

2. Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore;

3. Epidemiology Group, Singapore Eye Research Institute, Singapore;

4. Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore;

5. Department of Cornea and External Eye Disease, Singapore National Eye Centre, Singapore; and

6. Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.

Abstract

Purpose: The aim of this study was to investigate age-related changes in corneal nerves and corneal epithelial cell parameters and to establish age-adjusted reference values. Methods: A total of 7025 corneal nerve images and 4215 corneal epithelial images obtained using in vivo confocal microscopy from 281 eyes of 143 healthy participants were included. Seven corneal nerve parameters and 3 corneal epithelial cell parameters were quantified using 2 automatic analytic software and analyzed across 6 age groups ranging from 21 to 80 years. Results: There was a declining trend in all 7 nerve parameters with advancing age. In particular, corneal nerve fiber length and corneal nerve fiber density demonstrated a significant decrease in subjects aged 65 years or older compared with subjects younger than 65 years (10.8 ± 2.6 mm/mm2 vs. 9.9 ± 2.0 mm/mm2, P = 0.011 in corneal nerve fiber length; 15.8 ± 5.2 fibers/mm2 vs. 14.4 ± 4.3 fibers/mm2, P = 0.046 in corneal nerve fiber density), whereas corneal nerve fractal dimension demonstrated a borderline significant decrease (P = 0.057). Similarly, there was a general declining trend in all epithelial cell parameters with advancing age. Corneal epithelial cell circularity was significantly lower in subjects aged 65 years and older as compared to subjects younger than 65 years (0.722 ± 0.021 μm2 vs. 0.714 ± 0.021 μm2; P = 0.011). Conclusions: Advancing age results in reduced corneal nerve metrics and alteration of corneal cell morphology. Aging effects should be considered when evaluating patients with corneal neuropathy.

Funder

Singapore National Medical Research Council

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Ophthalmology

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