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Introduction/Aims: In patients with amyotrophic lateral sclerosis (ALS), axonal spheroids in motor axons have been identified in post‐mortem studies. In this study, axonal spheroids and swellings on C‐fibers of ALS patients were investigated using corneal confocal microscopy (CCM) and skin biopsy, respectively. Methods: Thirty‐one ALS patients and 20 healthy subjects were evaluated with CCM to assess corneal nerve‐fiber length (CNFL), ‐fiber density (CNFD), ‐branch density (CNBD), dendritic cell (DC) density, and axonal spheroids originating from C‐fibers (>100 μm2). In addition, intraepidermal nerve fiber density (IENFD) and axonal swellings (>1.5 μm) were assessed in skin biopsies obtained from the arms and legs of 22 patients and 17 controls. Results: In ALS patients, IENFD, CNFD, CNFL, and CNBD were not different from controls. The density of DCs and the number of patients with increased DC density were higher in ALS patients than controls (p =.0005 and p =.008). The number of patients with axonal spheroids was higher than controls (p =.03). Discussion: Evaluation of DCs and axonal bulbs in C‐fibers of ALS patients could provide insights into pathophysiology or potentially serve as biomarkers in ALS. [ABSTRACT FROM AUTHOR]

Objectives: To assess the visual performance of a mini-scleral lens in patients with keratoconus and to evaluate its fit by optical coherence tomography (OCT). Materials and methods: Twenty-nine eyes of 24 patients with keratoconus were fitted with a mini-scleral lens (Esclera; Mediphacos Inc., Belo Horizonte, Brazil). Diagnostic lenses were used in the initial fitting process. The lens fit was evaluated by the fluorescein pattern and also by anterior segment OCT (RTVue, Optovue Inc., Fremont, CA). Within 30-45 minutes after insertion, the lens fit parameters including central corneal and limbal clearance, and peripheral landing zone alignment were evaluated by OCT. High- and low-contrast visual acuity (VA), subjective performance for comfort and vision (5-point Likert scale), and overall satisfaction with the lens (100 mm visual analog scale [VAS]) were measured before and after lens wear. Results: The mean decimal high-contrast VA (best spectacle-corrected VA: 0.40±0.14 vs VA with the scleral lens: 0.93±0.12, p<0.0001) and low-contrast VA (best spectacle-corrected VA: 0.60±0.24 vs VA with the scleral lens: 1.15±0.18, p<0.0001) significantly improved with lens wear. The mean central corneal clearance was 120.7±24.5 μm. There were no correlations between the keratometric values and the sagittal depth of the scleral lens. The mean number of trial lenses required for ideal fit was 2.2 lenses (range: 1-8). Patients reported high scores for comfort (mean score: 4.69; range: 4-5), vision (mean score: 4.62; range: 3-5) and overall satisfaction with the lens (mean VAS score: 88.1; range: 70-100). Conclusion: The mini-scleral lens provided good high- and low-contrast visual acuity and high patient satisfaction in patients with keratoconus. Anterior segment OCT imaging facilitated the evaluation of the fit. [ABSTRACT FROM AUTHOR]

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