{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T12:47:37Z","timestamp":1792154857325,"version":"4.4.0"},"reference-count":0,"publisher":"Ovid Technologies (Wolters Kluwer Health)","license":[{"start":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:00:00Z","timestamp":1792108800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To compare and analyze corneal confocal changes in patients with vernal keratoconjunctivitis (VKC) based on the disease duration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method:<\/jats:title>\n                    <jats:p>A prospective cross-sectional hospital-based analysis of patients with VKC who underwent laser scanning confocal microscopy of the central cornea. Based on disease duration, patients were categorized as Group A (&lt;5 years) and Group B (&gt;5 years) irrespective of their disease activity. ACC Metrics was used for nerve fiber layer analysis, while Image J was used to evaluate the superficial epithelium and anterior stromal keratocytes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Confocal microscopy was performed on 38 eyes of 21 patients, with 22 eyes in Group A and 16 in Group B. Both groups had a comparable distribution of active versus inactive cases and mild versus severe grades. Group B demonstrated a significant increase in superficial epithelial cell length and inflammatory cell density. Additionally, Group B exhibited significantly thinner sub-basal nerves, along with increased stromal nerve thickness, branching, and deflection compared to Group A. No significant differences were observed in sub-basal nerve density or length, or in keratocyte density and area. Although an increase in activated keratocytes was noted in Group B, it did not reach statistical significance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Corneal confocal microscopy reveals distinct morphological changes in VKC based on disease duration, suggesting that chronicity may contribute to progressive neuroinflammatory alteration in the cornea.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijo.ijo_511_26","type":"journal-article","created":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T12:01:14Z","timestamp":1792152074000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Morphological changes in vernal keratoconjunctivitis over time: A confocal imaging perspective"],"prefix":"10.4103","author":[{"given":"Sharath","family":"Thirumanwar","sequence":"first","affiliation":[{"name":"CJ Shah Cornea Services, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shweta","family":"Agarwal","sequence":"additional","affiliation":[{"name":"CJ Shah Cornea Services, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karthick","family":"Jayavel","sequence":"additional","affiliation":[{"name":"CJ Shah Cornea Services, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Barros","sequence":"additional","affiliation":[{"name":"Instituto Universitario Fern\u00e1ndez-Vega, Fundaci\u00f3n de Investigaci\u00f3n Oftalmol\u00f3gica, University of Oviedo, Oviedo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Varsha","family":"Bhambhani","sequence":"additional","affiliation":[{"name":"CJ Shah Cornea Services, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mugundhan","family":"Rajarajan","sequence":"additional","affiliation":[{"name":"CJ Shah Cornea Services, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jes\u00fas","family":"Merayo","sequence":"additional","affiliation":[{"name":"Instituto Universitario Fern\u00e1ndez-Vega, Fundaci\u00f3n de Investigaci\u00f3n Oftalmol\u00f3gica, University of Oviedo, Oviedo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,10,16]]},"container-title":["Indian Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/IJO.IJO_511_26","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T12:01:14Z","timestamp":1792152074000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/IJO.IJO_511_26"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,16]]},"references-count":0,"URL":"https:\/\/doi.org\/10.4103\/ijo.ijo_511_26","relation":{},"ISSN":["0301-4738","1998-3689"],"issn-type":[{"value":"0301-4738","type":"print"},{"value":"1998-3689","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,16]]},"assertion":[{"value":"2026-02-21","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-07","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}