Laser Scanning In Vivo Confocal Microscopy Reveals Reduced Innervation and Reduction in Cell Density in All Layers of the Keratoconic Cornea

Niederer, Rachael L; Perumal, Divya; Sherwin, Trevor; McGhee, Charles N J

doi:10.1167/iovs.07-0968

Cited by 135 publications

(111 citation statements)

References 34 publications

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“…The impairment of corneal innervation has been suggested to play a role in the pathogenesis of KC, and a significant reduction in NGF expression has been detected in KC corneas as part of an imbalance in the NGF signaling pathway [8,26]. Reduced numbers of stromal nerve fiber bundles together with an increase in tortuosity and nerve fiber diameter can explain the presence of prominent corneal nerves in KC [27]. To the best of our knowledge, tear NGF levels in patients with KC were measured for the first time in our study.…”

Section: Discussionmentioning

confidence: 99%

Association between Mediators in the Tear Fluid and the Severity of Keratoconus

Kolozsvári¹,

Petrovski²,

Gogolák

et al. 2013

Ophthalmic Res

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Purpose: To study the association between different types of mediators in the tear fluid and topographic indices characterizing the severity of keratoconus (KC). Methods: In this study, nonstimulated tear fluid samples were collected from 14 eyes of 11 patients with KC. The following indices were measured by corneal topography: maximum K value, average K value, Klyce/Maeda keratoconus index (KCI), Smolek/Klyce keratoconus severity index, opposite sector index, center/surround index, keratoconus prediction index and standard deviation of corneal power. The concentrations of interleukin (IL)-6, IL-13, CXCL8 (IL-8), chemokine (C-C motif) ligand 5 (CCL5, regulated and normal T cell expressed and secreted), matrix metalloproteinase-9 (MMP-9), MMP-13, tissue inhibitor of metalloproteinase-1, nerve growth factor (NGF) and epidermal growth factor were measured by cytometric bead array technology. Release of mediators was calculated from their concentrations and the volume of tears collected over 2 min. Results: Significant positive associations were found between CCL5, MMP-13 and NGF and several topographic indices. Significant negative correlations were found between IL-6 and KCI. Age-dependent associations were observed between IL-13, CXCL8, CCL5 and MMP-13 and the topographic data. Conclusion: Several correlations were observed between the mediators and the topographic indices, suggesting possible roles in the pathophysiology of KC. Our data indicate that some mediators have different effects on the severity of disease in an age-dependent manner.

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Section: Discussionmentioning

confidence: 99%

Association between Mediators in the Tear Fluid and the Severity of Keratoconus

Kolozsvári¹,

Petrovski²,

Gogolák

et al. 2013

Ophthalmic Res

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“…In vivo confocal microscope (IVCM) which provides cellular level resolution en face images of the cornea has also been commonly used in studying KC corneas. 12,13 Previous studies using IVCM have shown changes in the density of epithelial cells 13,14 and stromal keratocytes 14,15 in KC corneas. Increased haze/scatter in all the corneal layers 13,16 has also been observed in the KC eyes.…”

Section: Introductionmentioning

confidence: 96%

Epithelium and Bowman’s layer thickness and light scatter in keratoconic cornea evaluated using ultrahigh resolution optical coherence tomography

et al. 2012

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Abstract. A custom-developed ultrahigh resolution optical coherence tomography with an axial resolution of 1.1 μm in corneal tissue was used to characterize thickness and light scatter of the epithelium and Bowman's layer in keratoconic (KC) cornea noninvasively. A 4-mm wide vertical corneal section around the apex in nine KC and eight normal eyes was imaged in vivo. The epithelium and Bowman's layer were visualized and their thickness profiles were quantified. Scatter was quantified based on the sensitivity normalized mean signal intensity distribution. Average mean thickness of the epithelium and Bowman's layer in KC eyes was significantly smaller ðp < 0.05Þ than the normal eyes. The epithelium thickness variation across a central 3-mm cornea was significantly larger in KC eyes than in normal eyes. The scatter in KC eyes was significantly increased only for Bowman's layer. The changes observed in this study could improve our understanding of the underlying disease mechanism of KC and can provide new indications for early disease diagnosis.

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“…The physiology of nerve fibres tortuosity and its role in pathologies are not yet clear. Recent studies (e.g., [2,3]) are based on a manual qualitative assessment of corneal nerve tortuosity. Intra-observer and inter-observer variability can be high and unsuitable for an objective and reproducible evaluation [4,5].…”

Section: Introductionmentioning

confidence: 99%

Tortuosity classification of corneal nerves images using a multiple-scale-multiple-window approach

Annunziata

Kheirkhah

Aggarwal

et al. 2014

Proceedings of the Ophthalmic Medical Image Analysis First International Workshop

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Abstract. Classify in vivo confocal microscopy corneal images by tortuosity is complicated by the presence of variable numbers of fibres of different tortuosity level. Instead of designing a function combining manually selected features into a single coefficient, as done in the literature, we propose a supervised approach which selects automatically the most relevant combination of shape features from a pre-defined dictionary. To our best knowledge, we are the first to consider features at different spatial scales and show experimentally their relevance in tortuosity modelling. Our results, obtained with a set of 100 images and 20 fold cross-validation, suggest that multinomial logistic ordinal regression, trained on consensus ground truth from 3 experts, yields an accuracy indistinguishable, overall, from that of experts when compared against each other.

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Laser Scanning In Vivo Confocal Microscopy Reveals Reduced Innervation and Reduction in Cell Density in All Layers of the Keratoconic Cornea

Abstract: Significant microstructural abnormalities were identified at every level of the keratoconic cornea and were related to disease severity. IVCM offers a potential insight into the pathophysiology of the microstructural changes in keratoconus.

Cited by 135 publications

References 34 publications

Association between Mediators in the Tear Fluid and the Severity of Keratoconus

Association between Mediators in the Tear Fluid and the Severity of Keratoconus

Epithelium and Bowman’s layer thickness and light scatter in keratoconic cornea evaluated using ultrahigh resolution optical coherence tomography

Tortuosity classification of corneal nerves images using a multiple-scale-multiple-window approach

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