Quantitative analysis of corneal microstructure in keratoconus utilising in vivo confocal microscopy

Weed, Kathryn H.; MacEwen, C J; Cox, Andrew T.; McGhee, Charles N J

doi:10.1038/sj.eye.6702286

Cited by 72 publications

(64 citation statements)

References 62 publications

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“…4) shows a gradual increase in mean cell area (80-160 mm²) from BCs through ICs toward SCs in all subjects. This graph also highlights results from previously reported studies 5,8,[13][14][15][16][17][18][19][20][21][22][23] in comparison with our results. By looking at sequential confocal images from each subject, we were able to differentiate BC layers from IC layers, based on their morphologic features, to define the extent of different cell layers on the x axis.…”

Section: Resultssupporting

confidence: 92%

Characteristic Quantities of Corneal Epithelial Structures in Confocal Laser Scanning Microscopic Volume Data Sets

Prakasam

Winter²,

Schwiede³

et al. 2013

Cornea

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Section: Resultssupporting

confidence: 92%

Characteristic Quantities of Corneal Epithelial Structures in Confocal Laser Scanning Microscopic Volume Data Sets

Prakasam

Winter²,

Schwiede³

et al. 2013

Cornea

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“…This finding was supported by Ucakhan et al, who reported the presence of Vogt's striae in the anterior stroma of keratoconic eyes with moderate and severe (3)(4)(5)(6)22). In the present study, polymegathism and pleomorphism were higher in patients with keratoconus than in those with healthy eyes.…”

Section: Discussionsupporting

confidence: 90%

“…Therefore, the dark bands (Vogt's striae) are commonly seen in relatively severe keratoconic eyes. The abnormal separation of collagen fibrils in stromal lamellae could be the contributing factor in Vogt's striae (5,20). However, Ucakhan et al stated that the pulling of the endothelium and Descemet's membrane towards the cone apex could be the reason (4).…”

Section: Discussionmentioning

confidence: 99%

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Corneal Cell Morphology in Keratoconus: A Confocal Microscopic Observation

Ghosh¹,

Mutalib²,

Kaur³

et al. 2017

MJMS

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Purpose: To evaluate corneal cell morphology in patients with keratoconus using an in vivo slit scanning confocal microscope.Methods: A cross-sectional study was conducted to evaluate the corneal cell morphology of 47 keratoconus patients and 32 healthy eyes without any ocular disease. New keratoconus patients with different disease severities and without any other ocular co-morbidity were recruited from the ophthalmology department of a public hospital in Malaysia from June 2013 to May 2014. Corneal cell morphology was evaluated using an in vivo slit-scanning confocal microscope. Qualitative and quantitative data were analysed using a grading scale and the Nidek Advanced Visual Information System software, respectively.Results: The corneal cell morphology of patients with keratoconus was significantly different from that of healthy eyes except in endothelial cell density (P = 0.072). In the keratoconus group, increased level of stromal haze, alterations such as the elongation of keratocyte nuclei and clustering of cells at the anterior stroma, and dark bands in the posterior stroma were observed with increased severity of the disease. The mean anterior and posterior stromal keratocyte densities and cell areas among the different stages of keratoconus were significantly different (P < 0.001 and P = 0.044, respectively). However, the changes observed in the endothelium were not significantly different (P > 0.05) among the three stages of keratoconus.Conclusion: Confocal microscopy observation showed significant changes in corneal cell morphology in keratoconic cornea from normal healthy cornea. Analysis also showed significant changes in different severities of keratoconus. Understanding the corneal cell morphology changes in keratoconus may help in the long-term monitoring and management of keratoconus.

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“…[13][14][15] Various semi-automated and automated methods are available on specular and confocal microscopes that are routinely used to assess ECD. 11,16,17 In vivo confocal microscopy (IVCM) provides highly magnified images of corneal layers, including the corneal endothelium, 11,[18][19][20][21] even from corneas with advanced Fuchs' dystrophy before grafting 19 or from previously failed grafts with partial opacities. 10 One of the endothelial morphometry programmes available with one confocal microscope (Confoscan CS4, Nidek Technologies, Albignasego, Italy) is the Nidek Advanced Vision Information System software (NAVIS).…”

Section: Introductionmentioning

confidence: 99%

In vivo confocal microscopy of the corneal endothelium: comparison of three morphometry methods after corneal transplantation

Jonuscheit

Doughty

Ramaesh

2011

Eye

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Purpose The purpose of this study was to assess the endothelium of corneal grafts by in vivo confocal microscopy (IVCM), and to evaluate an automated endothelial software system in comparison with a manual cell count and planimetry. Patients and methods Overall, 40 corneal grafts (20 deep anterior lamellar keratoplasties (DALKs) and 20 penetrating keratoplasties (PKs)) were assessed by scanning-slit IVCM. The endothelial cell density (ECD) was estimated with the automated and the manual cell count method of the instrument's Nidek Advanced Vision Information System (NAVIS) software. The results were compared with planimetry as the reference method, and the agreement was assessed. Results The mean ( ± SD) automated ECD was 2278 ± 524 cells/mm 2 (range 1167-3192 cells/mm 2 ), whereas the manual cell count method gave significantly lower ECDs with a mean of 1213±677 cells/mm 2 (range 218-2440 cells/mm 2 ; Po0.001). The manual cell counts were also significantly lower than those by planimetry, with a mean ECD of 1617 ± 813 cells/mm 2 (range 336-2941, Po0.001). Bland-Altman analyses indicated that the limits of agreement (LoA) between the automated and the planimetry method were À671 and þ 1992 cells/mm 2 , whereas they were À1000 and þ 202 cells/mm 2 when comparing the manual cell counts with planimetry. Conclusion Following keratoplasty, the NAVIS automated method is likely to overestimate endothelial cell counts due to oversegmenting of the cell domains. Automated ECDs are substantially higher than those by the manual counting method or planimetry. The differences are considerably larger post-keratoplasty than for normal corneas, and the methods should not be used interchangeably.

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Quantitative analysis of corneal microstructure in keratoconus utilising in vivo confocal microscopy

Cited by 72 publications

References 62 publications

Characteristic Quantities of Corneal Epithelial Structures in Confocal Laser Scanning Microscopic Volume Data Sets

Characteristic Quantities of Corneal Epithelial Structures in Confocal Laser Scanning Microscopic Volume Data Sets

Corneal Cell Morphology in Keratoconus: A Confocal Microscopic Observation

In vivo confocal microscopy of the corneal endothelium: comparison of three morphometry methods after corneal transplantation

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