In Vivo Confocal Microscopic Evidence of Keratopathy in Patients with Pseudoexfoliation Syndrome

Zheng, Xiaodong; Shiraishi, Atsushi; Okuma, Shinichi; Mizoue, Shiro; Gotō, Tomoko; Kawasaki, Shiro; Uno, Toshihiko; Miyoshi, Tomoko; Ruggeri, Alfredo; Ohashi, Yuichi

doi:10.1167/iovs.10-6098

Cited by 64 publications

(77 citation statements)

References 18 publications

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“…We found no significant difference in the mean basal epithelial cell density between groups 1 and 2 and between patients with PEX and healthy control subjects. This finding contradicts those of previous studies, which showed significant differences in the mean basal epithelial cell density between patients with PEX and healthy control subjects (3,4) .…”

Section: Discussioncontrasting

confidence: 99%

“…In a prospective observational case series, Sbeity et al used noncontact in vivo corneal confocal microscopy to detect PEM on the lens surfaces and corneal endothelium of PEX eyes and their fellow eyes (8) . Moreover, Zheng et al demonstrated a decrease in corneal sensitivity as well as all of the corneal cell density and corneal sub-basal nerve plexus variables in patients with PEX (3) .…”

Section: Discussionmentioning

confidence: 99%

“…However, these variables did not significantly differ between groups 1 and 2. Zheng et al observed PEM deposits in the anterior stroma of PEX eyes and suggested that the PEM may somehow cause PEX, perhaps by inducing apoptosis of the keratocytes as well as other pathogenic factors, such as altered levels of cytokines or chemokines in the cornea (3) .…”

Section: Discussionmentioning

confidence: 99%

“…In vivo corneal confocal microscopy enables real-time, high re solution microscopic imaging of the cornea and has been increa singly used to evaluate the corneal changes in PEX (3,4) . Previously, the only method of delineating the structural features of this disease was pathological examination after corneal biopsy.…”

Section: Introductionmentioning

confidence: 99%

“…In vivo corneal confocal microscopy allows the examination of PEX-related corneal alterations. Using in vivo confocal microscopy, Zheng et al showed that eyes with PEX, as well as their contralateral eyes, have significantly lower cell densities in the basal epithelium, anterior and posterior stroma, and endothelium (3) . They also demonstrated the deposition of hyperreflective material on the endothelium, which they presumed to be PEM, on eyes with PEX and the contralateral eyes (3) .…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Characteristics of the cornea in patients with pseudoexfoliation syndrome

Oltulu¹,

Şatırtav²,

Kayitmazbatir³

et al. 2015

Arquivos Brasileiros De Oftalmologia

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Characteristics of the cornea in patients with pseudoexfoliation syndrome

Oltulu¹,

Şatırtav²,

Kayitmazbatir³

et al. 2015

Arquivos Brasileiros De Oftalmologia

View full text Add to dashboard Cite

Corneal Changes in Neurosurgically Induced Neurotrophic Keratitis

et al. 2013

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IMPORTANCE Neurotrophic keratitis (NK) represents a sight-threatening complication after trigeminal impairment. To our knowledge, the duration for which trigeminal injury may affect corneal structures and function has not been investigated previously. OBJECTIVE To describe the long-term clinical, morphological, and functional outcomes of NK after neurosurgical trigeminal damage. DESIGN, SETTING, AND PARTICIPANTS Observational case series performed at a corneal and ocular surface diseases referral center in 2010. Eight consecutive patients with monolateral NK from 1 to 19 years after neurosurgery and 20 age-and sex-matched healthy participants were included. MAIN OUTCOMES AND MEASURES Complete eye examination, tear film function tests, corneal staining, and Cochet-Bonnet esthesiometry were performed. The number and density of corneal nerves, number of hyperreflective keratocytes, and corneal epithelial, endothelial, and keratocyte cell densities were evaluated by in vivo slit scanning confocal microscopy. Clinical and morphological data were compared with the contralateral unaffected eyes and with the eyes of healthy control participants. RESULTS All patients showed superficial punctate keratitis and dry eye in the NK eye and a healthy contralateral eye. Decreased corneal sensitivity was observed in all affected eyes (mean [SD], 2.0 [1.9] mm in the affected eyes vs 5.8 [0.3] mm in the contralateral unaffected eyes; P = .01) and was related to decreased subbasal nerve length (P = .04; R = 0.895). Corneal epithelial and endothelial cell densities were significantly decreased and the number of hyperreflective keratocytes was significantly increased in NK eyes compared with contralateral unaffected eyes and with the eyes of healthy participants. A longer duration of NK was associated with lower endothelial cell density (P = .046; R = −0.715). CONCLUSIONS AND RELEVANCE Corneal morphology and function were impaired even years after neurosurgical trigeminal damage, suggesting that assessment of tear film and corneal sensitivity as well as in vivo confocal microscopy examination should be performed in all patients with trigeminal impairment.

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