PDF(Pubmed)
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.
摘要：
角膜神经瘤,也被称为微神经，指微观，神经损伤或损伤部位基底下末端神经末梢不规则扩大。角膜神经瘤的形成是角膜神经损伤的结果，例如角膜病理学或角膜或眼内手术。最初，感觉神经纤维的去神经区域被完整的感觉神经纤维的芽侵入，后来受伤的轴突再生，新的豆芽被称为神经瘤。近年来,分析角膜神经异常，包括可以使用体内共聚焦显微镜识别的角膜神经瘤，一种具有显微分辨率的非侵入性成像技术，已用于评估角膜神经病变和眼表功能障碍。角膜神经瘤已被证明与眼睛不适和干燥的临床症状有关，并且是眼表疾病的有希望的替代生物标志物，如神经性角膜疼痛，干眼症,糖尿病性角膜神经病变，神经营养性角膜病变，干燥综合征,大疱性角膜病变,屈光手术后，和其他人。在这次审查中,我们总结了目前关于这些眼表疾病与角膜微神经瘤的关系的文献，并阐述了它们的发病机理，通过体内共聚焦显微镜可视化，并用于监测治疗效果。由于目前对神经瘤的定量分析主要依靠人工注释和量化，这是用户依赖和劳动密集型的，未来的方向包括开发人工智能软件，以更加自动化和灵敏的方式识别和量化这些潜在的成像生物标志物，允许它更有效地应用于临床环境。结合成像和分子生物标志物还可以帮助阐明角膜神经瘤和眼表疾病之间的关联。
