Corneal In Vivo Confocal Scanning Laser Microscopy in Patients with Atopic Keratoconjunctivitis

Yiqian Hu, Yukihiro Matsumoto, Enrique Sato Adan, Murat Dogru, Kazumi Fukagawa, Kazuo Tsubota, Hiroshi Fujishima

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Objective: To elucidate the morphologic alterations of the cornea in atopic keratoconjunctivitis (AKC) using confocal microscopy (Heidelberg Retina Tomograph II-Rostock Cornea Module: HRT-II RCM). Design: Prospective comparative study. Participants: We studied 21 right eyes of 21 AKC patients (11 males, 10 females; mean age, 26.3 years) as well as 19 right eyes of 19 normal subjects (12 males, 7 females; mean age, 28.4 years). Methods: All subjects underwent corneal sensitivity measurements, Schirmer test, tear film break-up time, fluorescein and Rose Bengal stainings, and HRT-II confocal laser scanning microscopy of the central cornea. Main Outcome Measures: The epithelial and endothelial cell densities of the central cornea, the density of subbasal long nerve fibers (LNFs) and total nerve branches (NBs) of the subbasal nerve plexus were calculated. The morphologic characteristics of the corneal nerves were studied. Correlation between nerve density, tear functions, and ocular surface examination parameters were investigated. Results: The corneal sensitivity, tear stability and vital staining scores were significantly worse in eyes with AKC (P<0.01). Eyes with AKC showed a significantly lower density of basal epithelial cells, LNFs, and NBs compared with normal eyes. Nerve fiber abnormalities such as increased tortuosity, bifurcation abnormality, sharp deflections, and thickening of stromal nerves, as well as several inflammatory cells in close proximity of the subbasal and stromal nerve fibers were observed. Conclusions: The corneal disease in AKC was associated with significant alterations of the basal epithelium, and subbasal and stromal corneal nerves, which related to the changes in tear functions and corneal sensitivity. Confocal scanning laser microscopy was useful to study the pathological in vivo corneal changes in AKC. Financial Disclosure(s): The authors have no proprietary or commercial interest in any materials discussed in this article.

Original languageEnglish
Pages (from-to)2004-2012
Number of pages9
JournalOphthalmology
Volume115
Issue number11
DOIs
Publication statusPublished - 2008 Nov

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Keratoconjunctivitis
Confocal Microscopy
Tears
Nerve Fibers
Cornea
Epithelial Cells
Corneal Diseases
Staining and Labeling
Rose Bengal
Disclosure
Fluorescein
Retina
Epithelium
Endothelial Cells
Cell Count
Outcome Assessment (Health Care)
Prospective Studies

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Corneal In Vivo Confocal Scanning Laser Microscopy in Patients with Atopic Keratoconjunctivitis. / Hu, Yiqian; Matsumoto, Yukihiro; Adan, Enrique Sato; Dogru, Murat; Fukagawa, Kazumi; Tsubota, Kazuo; Fujishima, Hiroshi.

In: Ophthalmology, Vol. 115, No. 11, 11.2008, p. 2004-2012.

Research output: Contribution to journalArticle

Hu, Y, Matsumoto, Y, Adan, ES, Dogru, M, Fukagawa, K, Tsubota, K & Fujishima, H 2008, 'Corneal In Vivo Confocal Scanning Laser Microscopy in Patients with Atopic Keratoconjunctivitis', Ophthalmology, vol. 115, no. 11, pp. 2004-2012. https://doi.org/10.1016/j.ophtha.2008.05.010
Hu, Yiqian ; Matsumoto, Yukihiro ; Adan, Enrique Sato ; Dogru, Murat ; Fukagawa, Kazumi ; Tsubota, Kazuo ; Fujishima, Hiroshi. / Corneal In Vivo Confocal Scanning Laser Microscopy in Patients with Atopic Keratoconjunctivitis. In: Ophthalmology. 2008 ; Vol. 115, No. 11. pp. 2004-2012.
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AU - Dogru, Murat

AU - Fukagawa, Kazumi

AU - Tsubota, Kazuo

AU - Fujishima, Hiroshi

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AB - Objective: To elucidate the morphologic alterations of the cornea in atopic keratoconjunctivitis (AKC) using confocal microscopy (Heidelberg Retina Tomograph II-Rostock Cornea Module: HRT-II RCM). Design: Prospective comparative study. Participants: We studied 21 right eyes of 21 AKC patients (11 males, 10 females; mean age, 26.3 years) as well as 19 right eyes of 19 normal subjects (12 males, 7 females; mean age, 28.4 years). Methods: All subjects underwent corneal sensitivity measurements, Schirmer test, tear film break-up time, fluorescein and Rose Bengal stainings, and HRT-II confocal laser scanning microscopy of the central cornea. Main Outcome Measures: The epithelial and endothelial cell densities of the central cornea, the density of subbasal long nerve fibers (LNFs) and total nerve branches (NBs) of the subbasal nerve plexus were calculated. The morphologic characteristics of the corneal nerves were studied. Correlation between nerve density, tear functions, and ocular surface examination parameters were investigated. Results: The corneal sensitivity, tear stability and vital staining scores were significantly worse in eyes with AKC (P<0.01). Eyes with AKC showed a significantly lower density of basal epithelial cells, LNFs, and NBs compared with normal eyes. Nerve fiber abnormalities such as increased tortuosity, bifurcation abnormality, sharp deflections, and thickening of stromal nerves, as well as several inflammatory cells in close proximity of the subbasal and stromal nerve fibers were observed. Conclusions: The corneal disease in AKC was associated with significant alterations of the basal epithelium, and subbasal and stromal corneal nerves, which related to the changes in tear functions and corneal sensitivity. Confocal scanning laser microscopy was useful to study the pathological in vivo corneal changes in AKC. Financial Disclosure(s): The authors have no proprietary or commercial interest in any materials discussed in this article.

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