Corneal confocal microscopy in patients with vernal keratoconjunctivitis

Andrea Leonardi, Daniela Lazzarini, Massimo Bortolotti, Federico Piliego, Edoardo Midena, Iva Fregona

Research output: Contribution to journalArticle

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Abstract

Purpose: To compare corneal morphologic features using in vivo confocal microscopy in vernal keratoconjunctivitis (VKC) patients compared with normal subjects. Design: Prospective, comparative study. Participants: Thirty-two VKC patients (26 males, 6 females; mean age, 17.1 years) and 40 normal subjects (20 males, 20 females; mean age, 19.3 years) were included. Methods: All subjects underwent a full ophthalmologic examination. Confoscan CS4 (Nidek, Gamagori, Japan) images of the central cornea were obtained with a ×40 noncontact lens and Z-ring device. Main Outcome Measures: The superficial and basal epithelium, subbasal nerve plexus, anterior stroma, stromal nerves, and endothelium of the central cornea were studied. Results: The VKC patients had increased diameter, reflectivity, and presence of nuclear activation of superficial epithelial cells; reduced density of the basal membrane; lower density of keratocytes, increased presence of activated keratocytes, and inflammatory cells in the anterior stroma; and lower density and number of fibers, lower number of beadings, and higher grade of tortuosity of fibers in the subbasal nerve plexus. Increased alterations in thickness, deflections, and tortuosity were observed in stromal corneal nerves. An increased number of inflammatory cells in close proximity to the subbasal and stromal nerve fibers also was observed in VKC subjects. Conclusions: Corneal involvement in VKC is associated with alterations of the epithelium and subbasal and stromal corneal nerves. These changes may relate to the tear dysfunction and nonspecific hyperreactivity typical of these patients. Corneal confocal microscopy is a useful tool for studying in vivo pathologic corneal changes in VKC. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Original languageEnglish
Pages (from-to)509-515
Number of pages7
JournalOphthalmology
Volume119
Issue number3
DOIs
Publication statusPublished - Mar 2012

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Allergic Conjunctivitis
Confocal Microscopy
Cornea
Epithelium
Disclosure
Tears
Nerve Fibers
Lenses
Endothelium
Japan
Cell Count
Epithelial Cells
Outcome Assessment (Health Care)
Prospective Studies
Equipment and Supplies
Membranes

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Leonardi, A., Lazzarini, D., Bortolotti, M., Piliego, F., Midena, E., & Fregona, I. (2012). Corneal confocal microscopy in patients with vernal keratoconjunctivitis. Ophthalmology, 119(3), 509-515. https://doi.org/10.1016/j.ophtha.2011.09.018

Corneal confocal microscopy in patients with vernal keratoconjunctivitis. / Leonardi, Andrea; Lazzarini, Daniela; Bortolotti, Massimo; Piliego, Federico; Midena, Edoardo; Fregona, Iva.

In: Ophthalmology, Vol. 119, No. 3, 03.2012, p. 509-515.

Research output: Contribution to journalArticle

Leonardi, A, Lazzarini, D, Bortolotti, M, Piliego, F, Midena, E & Fregona, I 2012, 'Corneal confocal microscopy in patients with vernal keratoconjunctivitis', Ophthalmology, vol. 119, no. 3, pp. 509-515. https://doi.org/10.1016/j.ophtha.2011.09.018
Leonardi, Andrea ; Lazzarini, Daniela ; Bortolotti, Massimo ; Piliego, Federico ; Midena, Edoardo ; Fregona, Iva. / Corneal confocal microscopy in patients with vernal keratoconjunctivitis. In: Ophthalmology. 2012 ; Vol. 119, No. 3. pp. 509-515.
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