In vivo Confocal Microscopic Analysis of Limbal Stroma in Patients With Limbal Stem Cell Deficiency

Chidambaranathan, Gowri Priya; Mathews, Saumi; Panigrahi, Arun Kumar; Mascarenhas, Jeena; Prajna, Namperumalsamy Venkatesh; Muthukkaruppan, Veerappan

doi:10.1097/ico.0000000000000593

Cited by 23 publications

(15 citation statements)

References 21 publications

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“…Severe damage to the limbal epithelial cells from various etiologies in the limbal region may lead to loss of the limbal epithelial cells [ 2 ], so called limbal stem cell deficiency (LSCD). LSCD, manifested by chronic inflammation, neovascularization, and goblet cell invasion into the cornea, may be complicated by persistent corneal epithelial defects, ulceration, and even perforation of the cornea [ 3 , 4 ]. The cornea may ultimately be healed by fibrosis, however, the vision will be greatly impaired.…”

Section: Introductionmentioning

confidence: 99%

Y-27632, a ROCK Inhibitor, Promoted Limbal Epithelial Cell Proliferation and Corneal Wound Healing

et al. 2015

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Transplantation of ex vivo cultured limbal epithelial cells is proven effective in restoring limbal stem cell deficiency. The present study aimed to investigate the promoting effect of Y-27632 on limbal epithelial cell proliferation. Limbal explants isolated from human donor eyes were expanded three weeks on culture dishes and outgrowth of epithelial cells was subsequently subcultured for in vitro experiments. In the presence of Y-27632, the ex vivo limbal outgrowth was accelerated, particularly the cells with epithelial cell-like morphology. Y-27632 dose-dependently promoted the proliferation of in vitro cultured human limbal epithelial cells as examined by phase contrast microscopy and luminescent cell-viability assay 30 hours after the treatment. The colony forming efficacy determined 7 days after the treatment was enhanced by Y-27632 also in a dose-dependent manner. The number of p63- or Ki67-positive cells was dose-dependently increased in Y-27632-treated cultures as detected by immunofluorescent staining and western blotanalysis. Cell cycle analysis by flow cytometric method revealed an increase in S-phase proliferating cells. The epithelial woundclosure rate was shown to be faster in experimental group received topical treatment withY-27632 than the sham control using a rat corneal wounding model. These resultsdemonstrate that Y-27632 can promote both the ex vivo and in vitro proliferation oflimbal epithelial cell proliferation. The in vivo enhanced epithelial wound healingfurther implies that the Y-27632 may act as a new strategy for treating limbal stem cell deficiency.

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Section: Introductionmentioning

confidence: 99%

Y-27632, a ROCK Inhibitor, Promoted Limbal Epithelial Cell Proliferation and Corneal Wound Healing

et al. 2015

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“…In fact, in our series, only a few patients showed goblet cells supporting the diagnosis for LSCD. Moreover, preoperatively, we found various degrees of stromal alterations including a highly reflective acellular stromal matrix related to the modification or degeneration of collagen structure due to the original cause of LSCD [22], and hyper-reflective needles, likely secondary to apoptosis of keratocytes and altered innervation that may lead to stromal collagen breakdown and degeneration.…”

Section: Discussionmentioning

confidence: 85%

In Vivo Confocal Microscopy of the Corneal-Conjunctival Transition in the Evaluation of Epithelial Renewal after SLET

Pedrotti

Chierego

Cozzini

et al. 2020

JCM

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Examination of the corneal surface by in vivo confocal microscopy (IVCM) allows for objective identification of corneal and conjunctival cell phenotypes to evaluate different epithelialization patterns. Detection of a corneal-conjunctival epithelial transition could be considered as a sign of restored epithelial function following simple limbal epithelial transplantation (SLET). This is a prospective, interventional case series. We assessed patients with limbal stem cell deficiency (LSCD) by IVCM, preoperatively and at monthly intervals following SLET. Sectors in the central and peripheral cornea were scanned. Immediately upon detection of multi-layered cells with the epithelial phenotype in the central cornea and confirmation of epithelial transition in all corneal sectors, the decision for keratoplasty was taken. Ten patients were enrolled. After SLET, epithelial phenotype in the central cornea and an epithelial transition were identified within six and nine months in seven and one patients, respectively. One patient was a partial success and one failed. Five patients underwent keratoplasty, with stable results up to 12 months. Identification of the epithelial transition zone by IVCM permits assessment of the efficacy of SLET, enabling subsequent planning of keratoplasty for visual rehabilitation. The stability of the corneal surface following keratoplasty confirms that the renewal of the corneal epithelium was effectively retained.

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“…Inflammatory cells can be present even in non-affected areas in partial. 40 This is an important prognostic factor in transplantation outcome. 41 The subbasal nerves are thinned and sparsely distributed in focal or partial, while absent in total LSCD.…”

Section: Diagnosismentioning

confidence: 99%

A Review of Limbal Stem Cell Deficiency

Conto

2019

JDED

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Limbal stem cell deficiency (LSCD) can be secondary to multiple etiologies including contact lens wear, chemical or thermal trauma, and systemic disease, any of which can result in the reduction of the number of stem cells or their decreased functionality. Primary LSCD is seen with a variety of congenital anterior segment disorders. Often LSCD can be stabilized and timely diagnosis is the key. The use of topical corticosteroids and artificial tear lubricants, along with treatment of any underlying conditions, and discontinuation of contact lenses are important initial treatment strategies. Advance treatments include amniotic membranes, limbal stem cell transplantation and keratoprostheses.

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In vivo Confocal Microscopic Analysis of Limbal Stroma in Patients With Limbal Stem Cell Deficiency

Cited by 23 publications

References 21 publications

Y-27632, a ROCK Inhibitor, Promoted Limbal Epithelial Cell Proliferation and Corneal Wound Healing

Y-27632, a ROCK Inhibitor, Promoted Limbal Epithelial Cell Proliferation and Corneal Wound Healing

In Vivo Confocal Microscopy of the Corneal-Conjunctival Transition in the Evaluation of Epithelial Renewal after SLET

A Review of Limbal Stem Cell Deficiency

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