In Vivo Confocal Microscopy of Normal Conjunctiva and Conjunctivitis

Messmer, Elisabeth M.; Mackert, Marc J.; Zapp, Daniel; Kampik, Anselm

doi:10.1097/01.ico.0000224648.74095.90

Cited by 95 publications

(111 citation statements)

References 27 publications

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“…We used IVCM because this technique is minimally invasive, and it is effective in evaluating the histopathology of surface disease (Mastropasqua et al 2006;Messmer et al 2006;Hong et al 2010;Le et al 2010;Wakamatsu et al 2010;Zhu et al 2010) and the toxic effects of glaucoma therapy (Arici et al 2000;Messmer et al 2006;Ciancaglini et al 2008;Martone et al 2009;Bergonzi et al 2010). Our study showed that no changes occurred throughout followup in both controls and patients treated with preservative-free timolol; on the opposite, BAK-preserved eye drops were associated with signs of ocular surface inflammation (lower goblet cell density and epithelial irregularity) after 12 months of treatment.…”

Section: Discussionmentioning

confidence: 99%

In vivo confocal microscopy of conjunctiva in preservative‐free timolol 0.1% gel formulation therapy for glaucoma

Frezzotti

Fogagnolo

Haka

et al. 2013

Acta Ophthalmologica

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ABSTRACT.Purpose: To evaluate the effects at 1 year of preservative-free timolol gel and preserved timolol eye drops on conjunctiva and tear parameters. Methods: Forty patients with primary open-angle glaucoma or ocular hypertension were randomized to the two treatment groups and compared with 20 healthy age-matched controls. Clinical tests (IOP, Schirmer I test, and lacrimal film break-up time BUT) and in vivo conjunctival confocal microscopy (IVCM) were performed in all patients at baseline and after 12 months. IVCM (HRT II Rostock Cornea Module; Heidelberg Engineering GmbH, Heidelberg, Germany) was performed after topical anaesthesia in the four cardinal locations and at the corresponding limbus to analyse conjunctiva cells. The main IVCM outcomes were goblet cell density and epithelial regularity. Results: IVCM and clinical parameters were similar in the three groups at baseline. After 12 months, intra-epithelial goblet cell density was significantly lower in the preserved (48.25 AE 7.70) than in the preservative-free beta-blocker group (86.83 AE 22.17, p < 0.001) and controls (88.9 AE 18.33, p < 0.001). The epithelial layer was significantly more regular in the preserved beta-blocker medication group than in the preservative-free beta-blocker group (p < 0.001) and the control group (p < 0.001). A significant reduction in both Schirmer I and BUT was found in the group of preserved timolol (respectively, 11.3 AE 2.97 and 8.12 AE 0.99) compared with preservative-free timolol (16.8 AE 1.83 and 11.27 AE 1.27, p < 0.001) and controls (17.8 AE 1.87 and 12.10 AE 1.28, p < 0.001). Conclusions: Based on our IVCM data, preservative-free beta-blocker gel induces less changes at ocular surface than preserved beta-blockers, a fact that should be considered to obtain less adverse effects and maximal adherence to treatment in a chronic condition such as glaucoma.

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Section: Discussionmentioning

confidence: 99%

In vivo confocal microscopy of conjunctiva in preservative‐free timolol 0.1% gel formulation therapy for glaucoma

Frezzotti

Fogagnolo

Haka

et al. 2013

Acta Ophthalmologica

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“…Several reports of IVCM examination of the limbal palisades in normal and stem cell deficient patients has revealed the detailed in vivo morphology of this region thought to harbor epithelial stem cells. [15][16][17][18] The most notable characteristics are prominent ridge structures, circular focal stromal projections and limbal crypts residing between adjacent ridges at their base. Some or all of these structures were observed in healthy controls, but notably, the structures were present in an altered form in one case of aniridia.…”

Section: Discussionmentioning

confidence: 99%

“…The inferior limbal region was also examined by IVCM to assess morphology in the region of the limbal Palisades of Vogt. 15,16 Statistical analysis Mean BSCVA was calculated using the logmar scale, and logmar values were used for comparison of aniridia to controls. Visual acuity values were converted to the Snellen equivalent for reporting.…”

Section: Examinationsmentioning

confidence: 99%

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Pathologic Epithelial and Anterior Corneal Nerve Morphology in Early-Stage Congenital Aniridic Keratopathy

et al. 2012

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Objective: To document the clinical and morphologic corneal findings in the early stages of congenital aniridic keratopathy in Swedish families. less thanbrgreater than less thanbrgreater thanDesign: Prospective, observational, comparative case series. less thanbrgreater than less thanbrgreater thanParticipants: A total of 16 eyes of 16 subjects with congenital aniridic keratopathy and a clear central cornea, and 6 eyes from 6 healthy controls (unaffected relatives). Nine of the 16 eyes with aniridia came from 5 families with a documented familial history of aniridia. less thanbrgreater than less thanbrgreater thanMethods: Detailed ophthalmic examinations included best spectacle-corrected visual acuity (BSCVA), tear film production, tear break-up time (BUT), corneal touch sensitivity, intraocular pressure measurement, ultrasound pachymetry, slit-lamp biomicroscopy, and laser scanning in vivo confocal microscopy (IVCM). less thanbrgreater than less thanbrgreater thanMain Outcome Measures: Confirmed stage of aniridic keratopathy, clinical parameters of cornea and tear film (visual acuity, sensitivity, corneal thickness, tear production, and BUT), and the morphologic status of corneal epithelium, sub-basal nerves, and limbal palisades of Vogt. less thanbrgreater than less thanbrgreater thanResults: In early-stage aniridic keratopathy, BSCVA and tear BUT were reduced relative to controls (P andlt; 0.001 for both), and corneal thickness was increased (P = 0.01). Inflammatory dendritic cells were present in the central epithelium in aniridia, with significantly increased density relative to controls (P = 0.001). Discrete focal opacities in the basal epithelial region were present in 5 of 11 aniridia cases with an otherwise clear cornea. Opacities were associated with dendritic cells and harbored structures presumed to be goblet cells. Sub-basal nerves were extremely dense in 3 aniridia cases, and a prominent whorl pattern of nerves and epithelial cells was observed in 1 case. Normal limbal palisade morphology was absent in aniridia but present in controls. less thanbrgreater than less thanbrgreater thanConclusions: Early-stage aniridic keratopathy is characterized by the development of focal opacities in the basal epithelium, altered sub-basal nerves, infiltration of the central epithelium by dendritic cells, tear film instability, and increased corneal thickness and degradation of limbal palisade architecture. These findings may help to elucidate the pathogenesis of aniridic keratopathy. less thanbrgreater than less thanbrgreater thanFinancial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Funding Agencies|European Union||Crown Princess Margaretas Foundation for the Visually Impaired||Swedish Eye Fund||Carmen and Bertil Regners Foundation||David and Beth Dahlins Foundation||King Gustav V and Queen Victorias Freemasons Foundation||County Council of Ostergotland||Association of the Blind in Ostergotland||

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“…Nowadays, the most reliable method for analyzing GCs in vivo is laser scanning confocal microscopy (LSCM), a noninvasive in vivo technology that evaluates the ocular surface tissues at the cellular level, providing a valuable method to identify and characterize GC morphology in different OSDs including glaucoma-related OSD (14)(15)(16). Nevertheless, to date, no study was specifically dedicated to determining the effects of the commercially available classes of glaucoma medications, and their regimens, on the density of conjunctival GCs in patients with glaucoma.…”

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confidence: 99%

In Vivo Scanning Laser Confocal Microscopy of Conjunctival Goblet Cells in Medically-controlled Glaucoma

Staso

Agnifili

Ciancaglini

et al. 2018

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In Vivo Confocal Microscopy of Normal Conjunctiva and Conjunctivitis

Abstract: Confocal microscopy using near-infrared laser light is a useful new tool in the analysis of conjunctival tissue in vivo. It is a valuable aid in the differential diagnosis of conjunctival inflammation and thus may guide therapeutical decisions.

Cited by 95 publications

References 27 publications

In vivo confocal microscopy of conjunctiva in preservative‐free timolol 0.1% gel formulation therapy for glaucoma

In vivo confocal microscopy of conjunctiva in preservative‐free timolol 0.1% gel formulation therapy for glaucoma

Pathologic Epithelial and Anterior Corneal Nerve Morphology in Early-Stage Congenital Aniridic Keratopathy

In Vivo Scanning Laser Confocal Microscopy of Conjunctival Goblet Cells in Medically-controlled Glaucoma

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