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In vivo confocal microscopy in the diagnosis of corneal conjunctivalization
Author(s) -
LANZINI M,
NUBILE M,
CALIENNO R,
COLESANTI E,
CIAFRE M,
CURCIO C,
MASTROPASQUA L
Publication year - 2008
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2008.6232.x
Subject(s) - pathology , cornea , corneal epithelium , confocal microscopy , epithelium , in vivo , ex vivo , confocal , medicine , biology , ophthalmology , microbiology and biotechnology , geometry , mathematics
Purpose The diagnosis of corneal conjunctivalization (CC) due to limbal stem cells deficiency(LSCD)is usually based on clinical features and on impression cytology (IC) which provides ex vivo morphology and immunoistochemical features of the corneal epithelium. The aim of this study was to validate laser scanning in vivo confocal microscopy (IVCM) as a new method to assess CC, based on the morphology of epithelium in central cornea and microstructural analysis of the limbal architecture Methods 15eyes of 15patients with suspected CC were enrolled. All patients underwent IVCM (HRT2‐Heidelberg Eng.)on the central cornea and limbus. CC was defined as presence of monolayered epithelium with goblet cells and subepithelial fibrovascular tissue. These findings were related with limbal alterations. Patients underwent IC of the central cornea to evaluate epithelial features in a masked fashion by mean of PAS and immunofluorescence CK12 staining. The epithelia were then classified into corneal,conjunctival and mixed pattern and the diagnostic hypotheses of in vivo and ex‐vivo findings were compared . Results The diagnostic hypotheses were concordant in 87% of the cases. In 3 we found corneal epithelium with corneal morphology by IVCM, no goblet cells and k12 positive cells by IC. In 2 we found an epithelium with conjunctival morphology by IVCM, presene of goblet cells and ck12 negative cells by IC.In 5 we found mixed epithelia with both methods.The last two cases were discordant.IVCM showed limbal alterations in the cases of mixed and conjunctival epithelium. Conclusion IVCM is a useful non invasive method to help the diagnosis of LSCD and CC which well correlates with IC allowing also the analysis of the limbal structure.