Abstract:
The measurement of corneal sensation allows clinicians to assess the status of corneal innervation and serves as a crucial indicator of corneal disease and eye health. Many devices are available to assess corneal sensation, including the Cochet-Bonnet aesthesiometer, the Belmonte Aesthesiometer, the Swiss Liquid Jet Aesthesiometer, and the newly introduced Corneal Esthesiometer Brill. Increasing the clinical use of in vivo confocal microscopy and optical coherence tomography will allow for greater insight into the diagnosis, classification, and monitoring of ocular surface diseases such as neurotrophic keratopathy; however, formal esthesiometric measurement remains necessary to assess the functional status of corneal nerves. These aesthesiometers vary widely in their mode of corneal stimulus generation and their relative accessibility, precision, and ease of clinical use. The development of future devices to optimize these characteristics, as well as further comparative studies between device types should enable more accurate and precise diagnosis and treatment of corneal innervation deficits. The purpose of this narrative review is to describe the advancements in the use of aesthesiometers since their introduction to clinical practice, compare currently available devices for assessing corneal innervation and their relative limitations, and discuss how the assessment of corneal innervation is crucial to understanding and treating pathologies of the ocular surface.
摘要:
角膜感觉的测量使临床医生能够评估角膜神经支配的状态,并作为角膜疾病和眼睛健康的关键指标。许多设备可用于评估角膜感觉,包括Cochet-Bonnet美度计,Belmonte的麻醉机,瑞士液体喷射麻醉仪,和新推出的角膜美学Brill。增加体内共聚焦显微镜和光学相干断层扫描的临床使用将有助于更深入地了解诊断,分类,和监测眼表疾病,如神经营养性角膜病变;然而,正式的美学测量对于评估角膜神经的功能状态仍然是必要的。这些美学仪在角膜刺激产生模式和相对可达性方面差异很大,精度,易于临床使用。未来设备的发展,以优化这些特性,以及设备类型之间的进一步比较研究应该能够更准确和精确地诊断和治疗角膜神经支配缺陷。这篇叙述性综述的目的是描述自将麻醉计引入临床实践以来,其使用的进步,比较目前可用的评估角膜神经支配的设备及其相对局限性,并讨论如何评估角膜神经支配对理解和治疗眼表病理至关重要。