A Case of Corneal Neovascularization Misdiagnosed as Total Limbal Stem Cell Deficiency

Le, Qihua; Samson, C. Michael; Deng, Sophie X.

doi:10.1097/ico.0000000000001631

Cited by 23 publications

(16 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…84,85 2 Diagnostic tests-There are limitations of slit lamp clinical examination and fluorescein staining test in the diagnosis of LSCD. 86,87 The signs of abnormal epithelium can be subtle and often not specific to LSCD. Adjunct diagnostic tests are of great value in confirming LSCD whether or not associated with other ocular surface abnormalities such as tear deficiency, corneal neovascularization, keratinization, or if goblet cells are absent as determined by impression cytology and in vivo laser scanning confocal microscope (IVCM).…”

Section: Signs Of Limbal Stem Cell Deficiencymentioning

confidence: 99%

Global Consensus on Definition, Classification, Diagnosis, and Staging of Limbal Stem Cell Deficiency

Deng

Borderie

Chan

et al. 2018

Cornea

Self Cite

226

212

View full text Add to dashboard Cite

Purpose: Despite extensive knowledge gained over the last three decades regarding limbal stem cell deficiency (LSCD), the disease is not clearly defined, and there is lack of agreement on the diagnostic criteria, staging and classification system among treating physicians and research scientists working on this field. There is therefore an unmet need to obtain global consensus on the definition, classification, diagnosis and staging of LSCD. Methods: A Limbal Stem Cell Working Group was first established by the Cornea Society in 2012. The Working Group was divided into subcommittees. Four face-to-face meetings, frequent email discussions and teleconferences were conducted since then to obtain agreement on a strategic plan and methodology from all the participants after a comprehensive literature search,

show abstract

Section: Signs Of Limbal Stem Cell Deficiencymentioning

confidence: 99%

Global Consensus on Definition, Classification, Diagnosis, and Staging of Limbal Stem Cell Deficiency

Deng

Borderie

Chan

et al. 2018

Cornea

Self Cite

226

212

View full text Add to dashboard Cite

show abstract

“…Other conditions might be misdiagnosed as LSCD. 66,93 IC is considered a standard method to confirm the diagnosis of LSCD, either by detecting goblet cells on the corneal surface or by identifying specific cytokeratin of the conjunctiva. 92,101,110 Although the detection of goblet cells on the cornea has high specificity in the diagnosis of LSCD, its sensitivity is quite low, ranging from 13.8% to 59%.…”

Section: Discussionmentioning

confidence: 99%

“…23 In addition, we recently reported a case of corneal neovascularization misdiagnosed as total LSCD. 66 This highlights the subjective nature of the interpretation of clinical findings. Therefore, the diagnosis based only on clinical presentation may be inaccurate or even incorrect in some cases.…”

Section: Discussionmentioning

confidence: 99%

“…In complex eyes with other comorbidities, signs of other diseases such as corneal neovascularization, dry eye, and subepithelial scarring might be mistaken as severe LSCD. 66 Tests have been developed to confirm the diagnosis of LSCD. The presence of goblet cells or conjunctiva-derived cells in the corneal epithelium, which is a sign of LSCD, can be detected by impression cytology (IC) for confirming an LSCD diagnosis.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Diagnostic criteria for limbal stem cell deficiency before surgical intervention—A systematic literature review and analysis

Chauhan

Deng

2020

Survey of Ophthalmology

Self Cite

View full text Add to dashboard Cite

Keywords: limbal stem cell deficiency limbal stem cells diagnosis impression cytology in vivo laser scanning confocal microscopy imaging a b s t r a c t An accurate diagnosis of limbal stem cell deficiency (LSCD) is the premise of an appropriate treatment; however, there is no consensus about the diagnostic criteria for LSCD. We performed a systematic literature search of the peer-reviewed articles on PubMed, Medline, and Ovid to investigate how LSCD was diagnosed before surgical intervention. The methods used to diagnose LSCD included clinical presentation, impression cytology, and in vivo confocal microscopy. Among 131 eligible studies (4054 eyes), 26 studies (459 eyes, 11.3%) did not mention the diagnostic criteria. In the remaining 105 studies, the diagnosis of LSCD was made on the basis of clinical examination alone in 2398 eyes (62.9%), and additional diagnostic tests were used in 1047 (25.8%) eyes. Impression cytology was used in 981 eyes (24.2%), in vivo confocal microscopy was used in 29 eyes (0.7%), and both impression cytology and in vivo confocal microscopy were used in 37 eyes (0.9%). Our findings suggest that only a small portion of patients underwent a diagnostic test to confirm the diagnosis of LSCD. Treating physicians should be aware of the limitations of clinical examination in diagnosing LSCD and perform a diagnostic test whenever possible before surgical intervention. ª ScienceDirect journal h om epa ge: www.elsev ie r.com/locate/surv ophthal 0039-6257/$ e see front matter ª 2019 Elsevier Inc. All rights reserved. https://doi.org/10.1016/j.survophthal.2019.06.008 s u r v e y o f o p h t h a l m o l o g y 6 5 ( 2 0 2 0 ) 3 2 e4 0 r e f e r e n c e s

show abstract

“…По результатам этого исследования был также сделан вывод, что тотальные сосудистые послеожоговые бельма наряду с конъюнктивальным эпителием частично могут быть покрыты и эпителием роговичного фенотипа (что согласуется с данными современной литературы [11,12]). В свете вышеизложенного очевидно, что, хотя при ожогах с повреждением 1 / 2 и более протяженности лимба далеко не всегда имеется тотальная гибель ЛЭСК, отнесение автором классификации таких ожогов к III степени тяжести имело все основания.…”

Section: Discussionunclassified

On the new classification of eye burns

2020

View full text Add to dashboard Cite

В настоящее время в системе Минздрава России принята классификация ожогов глаз, предложенная в 1973 г. Н.А. Пучковской и В.М. Непомящей. Появление в последние годы концепции лимбальных стволовых клеток роговичного эпителия и ее применение в клинической практике существенно расширили возможности диагностики, лечения и зрительной реабилитации пациентов с ожогами глаз. В 1997 г. M. Wagoner предложил классификацию ожогов глаз, в которой градация тяжести ожога определяется по степени повреждения лимбальных стволовых клеток. С учетом такого подхода авторами проведен сравнительный анализ классификаций ожогов глаз (разных лет) России и появившихся в последние годы на Западе. В этой связи вниманию офтальмологов предлагается новая классификация ожогов глаз.

show abstract

A Case of Corneal Neovascularization Misdiagnosed as Total Limbal Stem Cell Deficiency

Abstract: Clinical presentation alone is insufficient to correctly diagnose LSCD in complex cases. Additional diagnostic tests, such as IVCM, are necessary to confirm the diagnosis before any surgical intervention.

Cited by 23 publications

References 9 publications

Global Consensus on Definition, Classification, Diagnosis, and Staging of Limbal Stem Cell Deficiency

Global Consensus on Definition, Classification, Diagnosis, and Staging of Limbal Stem Cell Deficiency

Diagnostic criteria for limbal stem cell deficiency before surgical intervention—A systematic literature review and analysis

On the new classification of eye burns

Contact Info

Product

Resources

About