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 language | English |
|---|---|
| Pages (from-to) | 509-515 |
| Number of pages | 7 |
| Journal | Ophthalmology |
| Volume | 119 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Mar 2012 |
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- Ophthalmology
Cite this
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 journal › Article
}
TY - JOUR
T1 - Corneal confocal microscopy in patients with vernal keratoconjunctivitis
AU - Leonardi, Andrea
AU - Lazzarini, Daniela
AU - Bortolotti, Massimo
AU - Piliego, Federico
AU - Midena, Edoardo
AU - Fregona, Iva
PY - 2012/3
Y1 - 2012/3
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=84857923421&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84857923421&partnerID=8YFLogxK
U2 - 10.1016/j.ophtha.2011.09.018
DO - 10.1016/j.ophtha.2011.09.018
M3 - Article
C2 - 22176802
AN - SCOPUS:84857923421
VL - 119
SP - 509
EP - 515
JO - Ophthalmology
JF - Ophthalmology
SN - 0161-6420
IS - 3
ER -