Effects of Fluorescein Staining on Laser In Vivo Confocal Microscopy Images of the Cornea

Abstract

This study was designed to identify whether topical fluorescein, a common ophthalmic tool, affects laser in vivo confocal microscopy of the cornea, a tool with growing applications. Twenty-five eye care specialists were asked to identify presence or absence of fluorescein in 99 confocal micrographs of healthy corneas. Responses were statistically similar to guessing for the epithelium (48% ± 14% of respondents correct per image) and the subbasal nerve plexus (49% ± 11% correct), but results were less clear for the stroma. Dendritic immune cells were quantified in bilateral images from subjects who had been unilaterally stained with fluorescein. Density of dendritic immune cells was statistically similar between the unstained and contralateral stained eyes of 24 contact lens wearers (P = .72) and of 10 nonwearers (P = .53). Overall, the results indicated that fluorescein staining did not interfere with laser confocal microscopy of corneal epithelium, subbasal nerves, or dendritic immune cells.

Non-invasive objective and contemporary methods for measuring ocular surface inflammation in soft contact lens wearers – A review

“…Corneal dendritic cell recruitment may also be higher in silicone hydrogel than hydrogel wearers, as well as higher in peroxide than multipurpose solution users [174]. A relationship between corneal dendritic cell density and corneal staining could not be demonstrated, in either contact or non-contact lens wearers [177]. Changes in corneal dendritic cell response over a period of contact lens wear beyond 1 month has not been investigated, nor has the time course of dendritic cell changes following discontinuation of contact lens wear in humans.…”

Rapid Image Evaluation System for Corneal In Vivo Confocal Microscopy

“…Software-assisted in vivo confocal microscopy could reveal subclinical responses to contact lenses or lens care solutions that have been laborious to analyze manually. 5,22,23 In summary, the newly developed software was capable of analyzing perpendicular volume scans from laser in vivo confocal microscopy of the central corneas of healthy volunteers, yielding results quickly, consistently, and accurately. This software should be a useful addition to clinical practice and research.…”

“…gov as NCT00804999. Subjects met a list of prespecified ocular health criteria as previously described 22,23 and were habitual wearers of soft contact lenses (n = 38) or were naive to contact lens wear (n = 10). The 15 best representative scans were selected from this data set.…”

In Vivo Confocal Microscopy of Corneal Nerves in Health and Disease

“…The subbasal nerve plexus can be viewed and imaged with excellent resolution by the LSCM, unaffected by corneal fluorescein staining. 87 A unique feature of the LSCM is its provision of sequence scans, which are dynamic scans at a user-determined depth of imaging. The utility of a 670 nm laser by LSCM also allows visualization of corneal immune and inflammatory cells in vivo.…”