Confocal Microscopic Evidence of Increased Langerhans Cell Activity after Corneal Metal Foreign Body Removal

Resch, Miklós; Imre, László; Tapasztó, Beáta; Németh, János

doi:10.1177/112067210801800507

Cited by 17 publications

(13 citation statements)

References 18 publications

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“…The presumed maturity of human Langerhans and corneal stromal dendritic cells can be differentiated during confocal microscopy by evaluating the dendritic processes and size of cell bodies, with larger mature cells possessing numerous long dendrites and smaller immature cells possessing relatively fewer and shorter dendrites 20 . Alterations in the in vivo confocal microscopic density and distribution of these cells have been described in humans during various keratopathies 35,38–42 …”

Section: Discussionmentioning

confidence: 99%

“…20 Alterations in the in vivo confocal microscopic density and distribution of these cells have been described in humans during various keratopathies. 35,[38][39][40][41][42] The clinical and research applications of in vivo confocal microscopy have increased dramatically over the past few years in human ophthalmology. 43 Many of the indications for, and advantages of, this diagnostic modality are shared by veterinary ophthalmology.…”

Section: Discussionmentioning

confidence: 99%

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In vivoconfocal microscopy of the normal equine cornea and limbus

Ledbetter

Scarlett

2009

Veterinary Ophthalmology

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Objective To describe morphologic features, pachymetry and endothelial cell density of the normal equine cornea and limbus by in vivo confocal microscopy. Animals studied Ten horses without ocular disease. Procedure The central and peripheral corneas were examined with a modified Heidelberg Retina Tomograph II and Rostock Cornea Module using a combination of automated and manual image acquisition modes. Thickness measurements of various corneal layers were performed and endothelial cell density determined. Results Images of the constituent cellular and noncellular elements of the corneal epithelium, stroma, endothelium, and limbus were acquired in all horses. Corneal stromal nerves, the subepithelial nerve plexus, and the sub-basal nerve plexus were visualized. Cells with an appearance characteristic of Langerhans cells and corneal stromal dendritic cells were consistently detected in the corneal basal epithelium and anterior stroma, respectively. Median central total corneal thickness was 835 lm (range 725-920 lm) and median central corneal epithelial thickness was 131 lm Conclusions In vivo corneal confocal microscopy provides a noninvasive method of assessing normal equine corneal structure at the cellular level and is a precise technique for corneal sublayer pachymetry and cell density measurements. A resident population of presumed Langerhans cells and corneal stromal dendritic cells was detected in the normal equine cornea. The described techniques can be applied to diagnostic evaluation of corneal alternations associated with disease and have broad clinical and research applications in the horse.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

In vivoconfocal microscopy of the normal equine cornea and limbus

Ledbetter

Scarlett

2009

Veterinary Ophthalmology

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“…Thus contact lens wear increases LCs and this has been demonstrated both ex vivo [14] and using corneal confocal microscopy in vivo [15]. Another recent study using corneal confocal microscopy in subjects after removal of metal foreign bodies has also shown an increase in the number of langerhans cells in relation to acute corneal injury [16]. …”

Section: Introductionmentioning

confidence: 99%

Increased Langerhan cell density and corneal nerve damage in diabetic patients: Role of immune mechanisms in human diabetic neuropathy

Tavakoli

Boulton

Efron

et al. 2011

Contact Lens and Anterior Eye

115

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Aim/hypothesis Immune mechanisms have been proposed to play a role in the development of diabetic neuropathy. We employed in vivo corneal confocal microscopy (CCM) to quantify the presence and density of Langerhans cells (LCs) in relation to the extent of corneal nerve damage in Bowman s layer of the cornea in diabetic patients. Methods 128 diabetic patients aged 58 ± 1 yrs with a differing severity of neuropathy based on Neuropathy Deficit Score (NDS- 4.7± 0.28) and 26 control subjects aged 53 ± 3 yrs were examined. Subjects underwent a full neurological evaluation, evaluation of corneal sensation with non contact corneal aesthesiometry (NCCA) and corneal nerve morphology using corneal confocal microscopy (CCM). Results The proportion of individuals with LCs was significantly increased in diabetic patients (73.8%) compared to control subjects (46.1%), P=0.001. Furthermore, LC density (no/mm2) was significantly increased in diabetic patients (17.73 ± 1.45) compared to control subjects (6.94 ± 1.58), P=0.001 and there was a significant correlation with age (r=0.162, P=0.047) and severity of neuropathy (r=−0.202, P=0.02). There was a progressive decrease in corneal sensation with increasing severity of neuropathy assessed using NDS in the diabetic patients (r=0.414, P=0.000). Corneal nerve fibre density (P<0.001), branch density (P<0.001) and length (P<0.001) were significantly decreased whilst tortuosity (P<0.01) was increased in diabetic patients with increasing severity of diabetic neuropathy. Conclusion Utilising in vivo corneal confocal microscopy we have demonstrated increased LCs in diabetic patients particularly in the earlier phases of corneal nerve damage suggestive of an immune mediated contribution to corneal nerve damage in diabetes.

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“…The reflection from metal corneal foreign bodies was lower than that from glass foreign bodies; the metal foreign bodies had sharp edges and were shaped as chunks or chippings. 19,20 The most common type of hidden corneal foreign body was plant matter, which was seen as spiny, exhibited a lower reflectivity than the other foreign bodies described and had a Figure 2. In vivo confocal microscopy images of hidden corneal foreign bodies in representative patients: (a) highly reflective spiny foreign body (arrow), the triangle shows a corneal nerve, scanned at a depth of 64 mm; (b) flaky metal foreign bodies (arrows) detected at a depth of 135 mm; (c) several highly reflective stone granules (arrows), located at a depth of 234 mm; (d) highly reflective and knife-edged glass foreign body (arrow), observed at a depth of 66 mm; (e) tiny particles (arrow) from a bee sting, observed at a depth of 97 mm; (f) a tiny eyelash fragment (arrow) at a depth of 449 mm in the cornea.…”

Section: Discussionmentioning

confidence: 99%

The role of in vivo confocal microscopy in the diagnosis of hidden corneal foreign bodies

et al. 2013

J Int Med Res

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Objective: To investigate in vivo confocal microscopy (IVCM) to diagnose hidden corneal foreign bodies. Methods: Male Kunming mice (n ¼ 25; 12 weeks old) were anaesthetized prior to the insertion of five different materials (spiny wood, rusty iron, sharp stone, sharp glass fragment and human hair fragment) into the cornea by different traumatic processes. A separate mouse was used for each corneal foreign body. The corneas of the mice were scanned 24 h later by a laser scanning IVCM to establish the characteristics (shape, reflectivity and depth in the cornea) of each foreign body. These findings were used to help screen and identify corneal foreign bodies in patients. Corneal smears and scraping cultures were performed in cases of probable corneal infection. Results: Animal models for the five different foreign particles were established successfully, with each showing distinctive characteristics. These animal results were used to diagnose 41 patients with suspected corneal foreign bodies who were negative by slit lamp examination, but positive by IVCM (observational case series). The most prevalent type of hidden foreign body was plant material (51.2%), followed by metal (29.3%). Ten patients with corneal foreign bodies developed fungal keratitis, found using IVCM. Conclusions: Laser IVCM is an effective and reliable tool for the diagnosis of hidden corneal foreign bodies.

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Confocal Microscopic Evidence of Increased Langerhans Cell Activity after Corneal Metal Foreign Body Removal

Cited by 17 publications

References 18 publications

In vivoconfocal microscopy of the normal equine cornea and limbus

In vivoconfocal microscopy of the normal equine cornea and limbus

Increased Langerhan cell density and corneal nerve damage in diabetic patients: Role of immune mechanisms in human diabetic neuropathy

The role of in vivo confocal microscopy in the diagnosis of hidden corneal foreign bodies

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