Confocal microscopy in bowman and stromal corneal dystrophies11The authors have no financial or proprietary interest in the devices described in this article.

Werner, L; Werner, Liliana; Dighiero, P.; Jm, Legeais; Renard, G

doi:10.1016/s0161-6420(99)90358-5

Cited by 51 publications

(16 citation statements)

References 31 publications

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“…The histopathology examination (LM and TEM) of corneal specimens also demonstrated that the abnormal deposits were not only limited to the anterior part of the cornea as previously thought, but were also present in the posterior stroma [6,9,10,16]. These deposits appeared positive with Masson trichrome and HE staining, like the deposits observed at Bowman's layer.…”

Section: Discussionsupporting

confidence: 73%

“…3g). These deposits, observed in the posterior stroma with both in vivo and ex vivo techniques, are very similar to those found in lattice type-1 dystrophy [6]. Werner et al [6] also used IVCM to describe diffuse small dystrophic material in the middle and posterior stroma in cases of lattice type-1 dystrophy and granular dystrophy.…”

Section: Discussionmentioning

confidence: 76%

“…Therefore, IVCM was developed to overcome this limitation, and it now provides better resolution and image contrast for the in vivo analysis of corneal structures [14,15]. With IVCM, an amorphous hyperreflective material was observed in RBCD at the basal epithelium, Bowman's layer and anterior stroma without inflammatory cells or signs of stromal activation [6,7,9,10]. We originally also observed epithelial cell alterations above this abnormal hyperreflective material.…”

Section: Discussionmentioning

confidence: 99%

“…However, in clinical practice, corneal dystrophies are mostly diagnosed and differentiated using siltlamp biomicroscopy. Because the slitlamp cannot provide details of corneal structures at the cellular level, many corneal dystrophies and most particularly granular dystrophies are difficult to distinguish [5,6]. Recently developed in vivo imaging techniques such as in vivo confocal microscopy (IVCM) and anterior segment (AS) optical coherence tomography (OCT) are providing new insights into the clinical evaluation of corneal dystrophies [7,8].…”

Section: Introductionmentioning

confidence: 99%

“…Recently developed in vivo imaging techniques such as in vivo confocal microscopy (IVCM) and anterior segment (AS) optical coherence tomography (OCT) are providing new insights into the clinical evaluation of corneal dystrophies [7,8]. In RBCD, IVCM studies have shown an abnormal hyperreflective dystrophic material in both the epithelium and Bowman layers [6,7,9,10]. Similarly, AS-OCT is also providing high-resolution in vivo cross-sections of the cornea, and granular dystrophies have already been analyzed using this technique [11].…”

Section: Introductionmentioning

confidence: 99%

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Reis-Bücklers Corneal Dystrophy: A Reappraisal Using in vivo and ex vivo Imaging Techniques

Liang¹,

Pan²,

Sun³

et al. 2014

Ophthalmic Res

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Purpose: To characterize the phenotype of Reis-Bücklers corneal dystrophy (RBCD) using in vivo and ex vivo imaging techniques. Methods: Five RBCD patients with penetrating keratoplasty (PK) were enrolled. Before surgery, all patients underwent a complete ophthalmological examination including slitlamp biomicroscopy, in vivo confocal microscopy (IVCM) and anterior segment (AS) optical coherence tomography (OCT). After PK, corneal buttons were examined by light and transmission electron microscopy (TEM). Correlations between in vivo and ex vivo images were analyzed. Results: In all cases, irregular geographic-like subepithelial gray-white opacities were observed in the central and mid-peripheral cornea. AS-OCT images of the cornea of all patients revealed hyperreflective homogeneous and continuous deposits concentrated at the level of Bowman's layer and anterior stroma. Using IVCM, a highly reflective irregular amorphous material was observed from intermediate epithelial cells to the anterior stroma. Sparse deposits of highly reflective material were also detected in the posterior stroma. TEM showed in all specimens basal epithelial cells containing small vesicles with rod-shaped dense material. Conclusions: IVCM and AS-OCT may be a useful adjunct to biomicroscopy for the diagnosis and management of RBCD. The correlations between the different in vivo and ex vivo imaging techniques emphasize the hypothesis of an epithelial origin for RBCD.

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Section: Discussionsupporting

confidence: 73%

Section: Discussionmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Reis-Bücklers Corneal Dystrophy: A Reappraisal Using in vivo and ex vivo Imaging Techniques

Liang¹,

Pan²,

Sun³

et al. 2014

Ophthalmic Res

View full text Add to dashboard Cite

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In Vivo Laser Confocal Microscopic Findings of Corneal Stromal Dystrophies

Kobayashi

Fujiki²,

Fujimaki³

et al. 2007

Arch Ophthalmol

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Objective: To investigate in vivo laser confocal microscopic findings of genetically mapped corneal stromal dystrophies and their relationship to histopathologic findings.Methods: Seven patients with Avellino corneal dystrophy, 2 patients with lattice corneal dystrophy, and 2 patients with macular corneal dystrophy were examined genetically and using slitlamp biomicroscopy and in vivo laser confocal microscopy. Corneal specimens obtained after surgery in selected patients were histopathologically studied.Results: In Avellino corneal dystrophy (Arg124His mutation of human transforming growth factor ␤-induced gene [TGFBI]), highly reflective granular materials with irregular edges were observed in the superficial stroma. In lattice corneal dystrophy (Arg124Cys and Leu527Arg mutations of TGFBI), highly reflective branching filaments of variable width were observed in the stroma. In macular corneal dystrophy (Ala217Thr mutation of the carbohydrate sulfotransferase gene [CHST6]), homogeneous reflective materials with dark striaelike images were observed throughout the stroma. All confocal findings correlated well with histopathologic findings. Conclusions:In vivo laser confocal microscopy is capable of high-resolution visualization of characteristic corneal microstructural changes related to 3 types of genetically mapped corneal stromal dystrophies. The use of laser confocal microscopy may be valuable in the differential diagnosis of corneal stromal dystrophies, especially when diagnosis is otherwise uncertain.

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Corneal structural alterations in autism spectrum disorder: An in vivo confocal microscopy study

Chien,

Wu,

et al. 2023

Autism Research

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Individuals with autism spectrum disorder (ASD) often exhibit joint hypermobility and connective tissue disorders. However, it remains unclear if ASD individuals also have structural alterations in the connective tissue of the cornea. This study aims to determine whether the Kobayashi structure (K‐structure) characteristics differ between adults with ASD and typically developing controls (TDC) and explore the clinical correlates of the K‐structure abnormality. We recruited 30 ASD adults and 35 TDC. Corneal structures, particularly the K‐structure in the Bowman's layer, of the participants were examined using in vivo confocal microscopy (IVCM), and a K‐grading ranging from 1 to 4 was given to each eye based on the level of morphological mosaicism. The ASD participants' eyes received a significantly higher single‐eye K‐grading than that of the TDC eyes (p < 0.001), and the medians [25th, 75th percentile] of bilateral‐eye summed K‐grading were 8 [7, 8] and 5 [4, 6] in ASD and TDC, respectively (p < 0.001). A significantly higher K‐grading in the ASD participants' eyes was still observed after adjusting for the within‐subject inter‐eye correlation (p < 0.001). Youden Index showed the optimal cutoffs to differentiate ASD from TDC by bilateral‐eye summed K‐grading and single‐eye K‐grading was >6 and >3, respectively. Additionally, a higher K‐grading was associated with fewer visual sensation seeking in ASD (Spearman's correlation coefficient ρ = −0.518, p = 0.008) and low visual registration (i.e., higher sensory threshold) in TDC (ρ = 0.446, p = 0.023). This study provided novel evidence of corneal structural alterations in ASD by IVCM. Our findings may not only support the prior hypothesis of the association between ASD and connective tissue abnormalities but also shed light on the relationship between connective tissue disorder and neurodevelopmental disorders.

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Confocal microscopy in bowman and stromal corneal dystrophies11The authors have no financial or proprietary interest in the devices described in this article.

Cited by 51 publications

References 31 publications

Reis-Bücklers Corneal Dystrophy: A Reappraisal Using in vivo and ex vivo Imaging Techniques

Reis-Bücklers Corneal Dystrophy: A Reappraisal Using in vivo and ex vivo Imaging Techniques

In Vivo Laser Confocal Microscopic Findings of Corneal Stromal Dystrophies

Corneal structural alterations in autism spectrum disorder: An in vivo confocal microscopy study

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