Corneal Changes Assessed Using Confocal Microscopy in Patients With Unilateral Buphthalmos

Abstract

Citation: Mahelková G, Filouš A, Odehnal M, Cendelín J. Corneal changes assessed using confocal microscopy in patients with unilateral buphthalmos. Invest Ophthalmol Vis Sci. 2013;54:4048-4053. DOI:10. 1167/iovs.12-11165 PURPOSE. To compare corneal structures in buphthalmic eyes and healthy eyes in patients with unilateral congenital glaucoma using a corneal confocal microscope.METHODS. Ten patients with unilateral buphthalmos (mean 6 SD age, 14.85 6 5.12 years) were examined using corneal confocal microscopy. The cell density and cell area of endothelial cells and superficial and basal epithelial cells and the number of keratocytes were evaluated.RESULTS. There was no significant difference between the cell density of superficial epithelial cells in buphthalmic eyes relative to healthy eyes (P ¼ 0.1944). The cell density of basal epithelial cells was significantly higher (P ¼ 0.0234) and the cell area was significantly smaller (P ¼ 0.0181) in buphthalmic eyes relative to healthy eyes. There was no difference between the number of keratocytes in buphthalmic eyes and healthy eyes in the anterior stroma (P ¼ 0.273) or in the posterior stroma (P ¼ 0.0799). The cell density of endothelial cells was significantly lower and the cell area was significantly larger in buphthalmic eyes relative to healthy eyes (P ¼ 0.0009). CONCLUSIONS.We demonstrated a lower cell density of endothelial cells in buphthalmic eyes. We found no differences in keratocyte density between the buphthalmic eyes and healthy eyes. The cell density of basal epithelial cells was higher in buphthalmic eyes. These differences could be due to buphthalmos or due to the previous surgical and medical therapies. Monitoring of these changes could help to contribute to accurate assessments regarding future ocular surgical procedures.

Corneal profile in primary congenital glaucoma

“…Mahelkova et al. () could show these abnormalities in vivo . In our study, despite clinically clear buphthalmic corneas, that is without Haab's striae, scars or corneal oedema, mean endothelial cell density was significantly reduced in the affected eyes as compared to fellow eyes and normal controls.…”

“…Mahelkova et al. () compared corneal structure in buphthalmic versus healthy eyes in 10 patients with unilateral primary or secondary congenital glaucoma using corneal confocal microscopy, and most included patients (seven of 10 patients) in Mahelkova's study had Haab's striae. Using this technology, we evaluated corneal changes in a more uniform group of patients with unilateral PCG and no corneal oedema, Haab's striae or scars.…”

“…A similar intra‐individual study has been performed on corneal profile but included secondary congenital buphthalmos in addition to PCG (Mahelkova et al. ). In the current study, we only included patients with PCG to avoid more complex anterior segment conditions with an inherent corneal pathology.…”

“…Mahelkova et al. () used confocal microscopy to evaluate the cornea in 10 patients with unilateral buphthalmos and reported lower endothelial cell density in buphthalmic eyes .…”

Schnyder corneal dystrophy and associated phenotypes caused by novel and recurrent mutations in the UBIAD1 gene

“…We performed corneal imaging of probands 1 and 2 using spectral domain optical coherence tomography (SD-OCT) (Spectralis; Heidelberg Engineering GmbH). Proband 2 also underwent scanning slit confocal microscopy equipped with a non-applanating 40× immersion objective lens (Confoscan 3.0; Nidek Technologies, Viconza, Italy) [ 7 ].…”