ARVO 2026: Corneal nerve metrics with CellChek C

This brief interview highlights innovative work from NYU Langone Health on imaging corneal nerves in patients with dry eye disease. Mina Massaro-Giordano, MD, professor of ophthalmology, frames the problem by noting that dry eye is highly prevalent and that neurosensory abnormalities are now recognized, per the DEWS classification, as a key component of disease pathophysiology. Traditionally, in vivo confocal microscopy has been used to visualize the corneal subbasal nerve plexus, but its limited availability and cost can be barriers in many clinical settings.

To address this gap, the NYU team has implemented the CellChek C (CCC) widefield specular microscopy system as an alternative modality. Julia, a clinical research fellow, describes how they acquired video images of the corneal subbasal nerve plexus and then applied CC Metrics software to quantify corneal nerve fiber length and density. In a cohort of 225 eyes, they demonstrated that corneal nerve fiber length was significantly reduced in dry eye patients across all four o’clock positions, as well as at the inferior whorl. Moreover, the inferior whorl pattern was more frequently observed in healthy controls than in the dry eye cohort.

These findings are clinically meaningful because many emerging dry eye therapies aim to regenerate or preserve corneal nerves. By providing a more accessible imaging platform, this approach offers clinicians an additional tool to diagnose dry eye, monitor disease progression, and evaluate treatment response when confocal microscopy is not available. This work underscores the growing importance of objective, nerve-based biomarkers in the management of dry eye disease.