Aging and corneal layers: an in vivo corneal confocal microscopy study

Catia Gambato, Evelyn Longhin, Anton Giulio Catania, Daniela Lazzarini, Raffaele Parrozzani, Edoardo Midena

Research output: Contribution to journalArticlepeer-review


Purpose: To describe age-related changes of different corneal layers using a quantitative analysis of in vivo corneal confocal microscopy.

Design: Descriptive observational cross-sectional study.

Methods: A total of 108 healthy corneas of 108 subjects, distributed in four age categories, underwent in vivo corneal confocal microscopy. The effect of aging on the main features of corneal epithelium, sub-basal nerve plexus, stroma, and endothelium was investigated.

Results: Mean diameter of superficial epithelial cells increases with age (0.05 μm per year; p <0.0001). Mean cell density of basal epithelium does not change with age (p = 0.37). The sub-basal nerve plexus fiber number, density, and the number of beadings do not statistically change with age (p = 0.14, p = 0.10 and p = 0.17, respectively). Keratocyte density significantly reduces with age in each stromal layer (p <0.0001). Endothelial cell count decreases by 10.92 cells/mm2 per year (p <0.0001). Endothelial polymegathism index and pleomorphism index do not change with age (p = 0.79 and p = 0.39, respectively).

Conclusions: Corneal confocal microscopy allows a non-invasive examination of the living cornea, analyzing the microstructure of each corneal layer. Aging significantly influences the corneal confocal microscopy parameters of individual corneal layers, except sub-basal nerve plexus and basal epithelium.

Original languageEnglish
Pages (from-to)267-275
Number of pages9
JournalGraefe's Archive for Clinical and Experimental Ophthalmology
Issue number2
Publication statusPublished - 2014


  • Confocal microscopy
  • Corneal aging
  • Healthy cornea

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience
  • Medicine(all)


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