We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Letters |

In Vivo Confocal Laser Scanning Microscopy of Corneal Nerves in Leprosy

Chen Zhao, MD, PhD; Shasha Lu, MD, PhD; Nadja Tajouri, MD; Andre Dosso, MD; Avinoam B. Safran, MD
Arch Ophthalmol. 2008;126(2):282-284. doi:10.1001/archophthalmol.2007.67.
Text Size: A A A
Published online


Leprosy has a high incidence of ocular complications, including corneal lesions, lagophthalmos, iridocyclitis, and cataract. Involvement of the trigeminal nerve is common and can result in corneal hypoesthesia. Changes in corneal nerves might be the initial ocular manifestation.1

We describe a patient in whom leprosy developed without any apparent ocular complications. In vivo confocal microscopy, however, revealed abnormal corneal nerves. Being a noninvasive imaging technique, confocal microscopy plays a valuable role in visualization of corneal nerves in that condition.

Figures in this Article


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview


Place holder to copy figure label and caption
Figure 1.

For comparison, these in vivo confocal microscopy images show the normal appearance of basal epithelial and stromal nerves. A, Basal epithelial nerve plexus showing a preferred direction from 6 to 12 o’clock. B, Stromal nerve bundle appearing straight without beading and communicating branches.

Graphic Jump Location
Place holder to copy figure label and caption
Figure 2.

Corneal epithelium in vivo confocal microscopy image of the right (A) and left (B) eyes showing thickened basal epithelial nerve bundles with local enlargements (arrows). C, The epithelial nerve plexus at the corneal apex demonstrating irregular orientations. D, Dendritic particles (arrows), sometimes interspersed between nerve bundles.

Graphic Jump Location
Place holder to copy figure label and caption
Figure 3.

In vivo confocal microscopy images. A, Stromal nerves in the central cornea. In vivo confocal microscopy shows numerous stromal nerve bundles appearing tortuous, thin, and beaded, with some abnormal communicating branches. B, Peripheral stromal nerves were thickened, tortuous, and less numerous than central stromal nerves.

Graphic Jump Location




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

5 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.