Mosaicking the subbasal nerve plexus

Summary Corneal confocal microscopy (CCM) has been established as a noninvasive, in vivo imaging technology that provides high-resolution images of the corneal tissue layers at a cellular level. In particular, several research groups focus on the nerve fiber bundles constituting the subbasal nerve plexus (SNP). The ability to visualize - and quantify - morphological alterations of the SNP provides a new and potentially sensitive diagnostic approach for peripheral neuropathies, e.g. associated with diabetes. However, because of the small field of view of current CCM systems (approx. 0.16 mm²) and the locally inhomogeneous distribution of the subbasal nerve structures, a single image does not reliably reflect the condition of the SNP. To address this issue, we present a highly automated and integrated system that facilitates the imaging of an extended contiguous SNP area in a short recording time by guiding the gaze direction of the patient with a computer-controlled moving fixation target. The system achieves growth rates of the scanned area of approximately 0.16 mm² per second. Following the image acquisition process, a high-quality mosaic image of the scanned area is computed using specialized image processing software.