Evaluation of Contact Lens–Induced Changes in Keratoconic Corneas Using In Vivo Confocal Microscopy

Bitirgen, Gülfidan; Özkağnıcı, Ahmet; Malik, Rayaz A.; Oltulu, Refik

doi:10.1167/iovs.13-12437

Cited by 31 publications

(27 citation statements)

References 39 publications

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“…Consequently, it is a common subject for evaluation when investigating the impact of ocular and systemic diseases on corneal innervation, such as in dry eye, 5 infectious keratitis, 6 and keratoconus. 7 In addition, quantification of the SBNP morphology is seen as a potential ophthalmic marker for the detection of diabetic peripheral neuropathy. 8,9 Furthermore, studies have analyzed nerve regeneration in the SBNP as an indicator of corneal recovery following surgical refractive correction and other ocular surgery.…”

Section: Introductionmentioning

confidence: 99%

Changes in Corneal Subbasal Nerve Morphology and Sensitivity During Orthokeratology: Onset of Change

Lum¹,

Golebiowski²,

Swarbrick³

2017

The Ocular Surface

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Section: Introductionmentioning

confidence: 99%

Changes in Corneal Subbasal Nerve Morphology and Sensitivity During Orthokeratology: Onset of Change

Lum¹,

Golebiowski²,

Swarbrick³

2017

The Ocular Surface

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“…IVCM studies have consistently demonstrated lower keratocyte density in keratoconus compared to healthy corneas . This observation may be associated with the proposed contribution of keratocyte apoptosis to the pathogenesis of keratoconus .…”

Section: In Vivo Confocal Microscopymentioning

confidence: 83%

“…IVCM has revealed that both anterior and posterior keratocyte density is reduced in keratoconus compared to controls . Interestingly, CL‐wearing keratoconics have been demonstrated to have a significantly lower anterior keratocyte density than keratoconics who did not wear CLs . However, posterior keratocyte density does not appear to be affected by the use of CLs in patients with keratoconus …”

Section: In Vivo Confocal Microscopymentioning

confidence: 99%

Advanced anterior segment imaging in keratoconus: a review

Gokul

Vellara

Patel

2017

Clinical Exper Ophthalmology

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Advances in anterior segment imaging have enhanced our ability to detect keratoconus in its early stages and characterize the pathologic changes that occur. Computerized corneal tomography has elucidated the alterations in shape of the anterior and posterior corneal surfaces and alterations in thickness as the disease progresses. Automated screening indices such as the keratoconus screening index were developed to assist in detecting keratoconus in suspicious cases. In vivo assessment of keratoconic corneas has revealed that compromised corneal biomechanics can now be measured clinically. Optical coherence tomography has demonstrated alterations in corneal epithelial thickness and distribution in keratoconus, has a role in assessing Descemet's membrane detachment in acute corneal hydrops (ACH) and the depth of the demarcation line following corneal collagen cross-linking. In vivo confocal microscopy has exhibited cellular changes that occur in keratoconus and provided insight into cellular events that may be related to the development of neovascularization in ACH.

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“…22–24,31,32 In addition, the decline in keratocyte density has been shown to correlate with disease severity. 24,25 By carefully comparing IVCM images with images from SD-OCT, FFOCM, and histology, we were able to improve our 3D understanding of the tissue and better interpret the IVCM data, allowing us to identify features illustrated in Figures 1–3, such as flattened basal epithelial cells, hyperreflective ferritin deposits in basal epithelial cells, damage to basement membrane and BL, and stromal scarring in IVCM images.…”

Section: Discussionmentioning

confidence: 99%

Imaging Microscopic Features of Keratoconic Corneal Morphology

Grieve

Georgeon

Andreiuolo

et al. 2016

Cornea

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Purpose:To search for gold-standard histology indicators using alternative imaging modalities in keratoconic corneas.Methods:Prospective observational case–control study. Fourteen keratoconic corneas and 20 normal corneas (10 in vivo healthy subjects and 10 ex vivo donor corneas) were examined. Images of corneas were taken by spectral domain optical coherence tomography (SD-OCT) and in vivo confocal microscopy (IVCM) before keratoplasty. The same removed corneal buttons were imaged after keratoplasty with full-field optical coherence microscopy (FFOCM) and then fixed and sent for histology. Controls consisted of normal subjects imaged in vivo with IVCM and donor corneas imaged ex vivo with FFOCM. Corneal structural changes related to pathology were noted with each imaging modality. Cell density was quantified by manual cell counting.Results:Keratoconus indicators (ie, epithelial thinning/thickening, cell shape changes, ferritin deposits, basement membrane anomalies, Bowman layer thinning, ruptures, interruptions, scarring, stromal modifications, and appearance of Vogt striae) were generally visible with all modalities. Additional features could be seen with FFOCM in comparison with gold-standard histology, particularly in the Bowman layer region, whereas the combination of SD-OCT plus IVCM detected 76% of those features detected in histology. Three-dimensional FFOCM imaging aided interpretation of two-dimensional IVCM and SD-OCT data. Basal epithelial cell and keratocyte densities were significantly lower in patients with keratoconus than those in normals (P < 0.0001).Conclusions:Structural and cellular assessment of the keratoconic cornea by means of either in vivo SD-OCT combined with IVCM or ex vivo FFOCM in both cross-sectional and en face views can detect as many keratoconus indicators as gold-standard histology.

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Evaluation of Contact Lens–Induced Changes in Keratoconic Corneas Using In Vivo Confocal Microscopy

Cited by 31 publications

References 39 publications

Changes in Corneal Subbasal Nerve Morphology and Sensitivity During Orthokeratology: Onset of Change

Changes in Corneal Subbasal Nerve Morphology and Sensitivity During Orthokeratology: Onset of Change

Advanced anterior segment imaging in keratoconus: a review

Imaging Microscopic Features of Keratoconic Corneal Morphology

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