Corneal epithelial dendritic cells in patients with multiple sclerosis: An in vivo confocal microscopy study

Valeria Testa, Nicole De Santis, Riccardo Scotto, Piero Della Giustina, Lorenzo Ferro Desideri, Maria Cellerino, Christian Cordano, Maria Inglese, Antonio Uccelli, Aldo Vagge, Carlo Enrico Traverso, Michele Iester

Research output: Contribution to journalArticlepeer-review


Purpose: To evaluate density and morphology of corneal epithelial dendritic cells (DCs) in patients with multiple sclerosis (MS) using in vivo confocal microscopy (IVCM). Methods: This was a single-center cross-sectional comparative study. All MS patients were clinically scored using the Expanded Disability Status Scale (EDSS) score. Patients underwent ophthalmological examination and then cornea was analyzed by IVCM Heidelberg Retina Tomograph (HRT 3) in combination with Rostock Cornea Module and CCD camera. Five sectors (central, nasal, temporal, inferior, superior and central area) were analyzed in both patient eyes, then for each sector one image was selected and analyzed by using the manual cell counting system offered with the software and ImageJ program. DCs density (cell/mm2) and DCs size (µm2) were considered for the analyses. Difference between the two groups and correlation between DCs, MS type, EDSS score, optic neuritis and ongoing therapy were analyzed. Results: We enrolled 46 consecutive patients: 23 with MS (age 47.87 ± 7.22 years (mean ± standard deviation) and 21 healthy subjects (age 46.0 ± 12.6 years) from July 2017 to July 2018. MS patients showed a lower DCs density when compared with healthy subjects (p < 0.05). Moreover, we found a direct correlation (r:0.48, p < 0.05) between DCs density and ongoing disease-modifying therapy. Conclusion: IVCM was able to show a difference in corneal DCs density between MS patients and healthy subjects, providing an insight to the underlying changes of the clinical manifestations of MS. Further studies are needed to provide evidence of possible clinical implications.

Original languageEnglish
Pages (from-to)139-143
Number of pages5
JournalJournal of Clinical Neuroscience
Publication statusPublished - Nov 2020


  • Dendritic cells
  • In-vivo confocal microscopy
  • Multiple sclerosis

ASJC Scopus subject areas

  • Surgery
  • Neurology
  • Clinical Neurology
  • Physiology (medical)


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