In Vivo Confocal Microscopy (IVCM)

A practical guide to interpreting corneal nerve structure, immune activity, and pathological patterns. Focused on real-world findings such as nerve loss, microneuromas, and inflammation markers.

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5. Beading

Beyond density, nerve shape matters. Abnormal morphology can indicate ongoing pathology.

Beading
Algorithm for automatic beading size (BS) measure: We cropped 0.1 mm of nerve in the original image of sub-basal plexus (A). The algorithm used the coordinates of corneal beadings' centroids from the image with overlaying analysis (B) to segment the area and defined the beadings in the original image. The intensity of each centroid was used to mask all the pixels below this value (C). On the original image, the perimeter of the beadings was segmented and the BS quantified (D,E). Source

These changes are often associated with metabolic stress, inflammation, or nerve regeneration. They do not always correlate directly with pain severity but indicate altered nerve physiology.