Corneal Sensitivity Changes and Nerve Plexus Abnormalities in Noninfectious Anterior Uveitis.

Abstract

This study evaluated the structural and functional alterations of corneal nerves in unilateral noninfectious anterior uveitis patients. Cross-sectional study. Eighty-two patients with unilateral noninfectious anterior uveitis were included. Affected eyes were assigned to the affected group, contralateral clinically unaffected eyes to the unaffected group, and eyes from 25 healthy subjects to the control group. Corneal sensitivity was assessed using noncontact corneal aesthesiometer (NCCA), followed by Cochet-Bonnet aesthesiometer. Corneal subbasal nerve plexus was imaged using in vivo confocal microscopy, and nerve morphology parameters were quantified using ACCMetrics software. A masked observer assessed central corneal inflammatory cell density and microneuroma counts. Based on anterior chamber cell grade and treatment status, patients were further stratified into subgroups for exploratory analyses. NCCA thresholds were significantly higher in affected eyes than in controls (β = 0.97; 95% CI, 0.63-1.31) and in unaffected eyes (β = 0.48; 95% CI, 0.23-0.72; all adjusted P < .001). Moreover, compared with controls, affected eyes exhibited significantly lower corneal nerve parameters, notably CNFL (β = -6.09; 95% CI, -7.44 to -4.74), alongside higher inflammatory cell density and microneuroma counts (all adjusted P < .001). Relative to controls, unaffected eyes also demonstrated measurable differences, including higher NCCA thresholds, reduced CNFL, CNFD, and CFracDim, as well as increased microneuroma counts (all adjusted P < .010). Unilateral noninfectious anterior uveitis was associated with reduced corneal nerve sensitivity and altered nerve parameters in the affected eye, and measurable differences in the contralateral eye.