<i>In vivo</i>Confocal Microscopy for the Evaluation of Corneal Microstructure in Keratoconus

Mocan, Mehmet Cem; Topçu-Yılmaz, Pınar; İrkeç, Murat; Orhan, Mehmet

doi:10.1080/02713680802439219

Cited by 71 publications

(62 citation statements)

References 26 publications

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“…Ucakhan et al reported a significant decrease in endothelial cell density in severe keratoconus compared with mild and moderate keratoconus (4). However, Bitirgen et al and Mocan et al found a significant difference in endothelial cell density among mild, moderate and severe keratoconus (22,29). The reason for the endothelial cell loss in keratoconus is not yet completely understood.…”

Section: Discussionmentioning

confidence: 96%

Corneal Cell Morphology in Keratoconus: A Confocal Microscopic Observation

Ghosh¹,

Mutalib²,

Kaur³

et al. 2017

MJMS

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Purpose: To evaluate corneal cell morphology in patients with keratoconus using an in vivo slit scanning confocal microscope.Methods: A cross-sectional study was conducted to evaluate the corneal cell morphology of 47 keratoconus patients and 32 healthy eyes without any ocular disease. New keratoconus patients with different disease severities and without any other ocular co-morbidity were recruited from the ophthalmology department of a public hospital in Malaysia from June 2013 to May 2014. Corneal cell morphology was evaluated using an in vivo slit-scanning confocal microscope. Qualitative and quantitative data were analysed using a grading scale and the Nidek Advanced Visual Information System software, respectively.Results: The corneal cell morphology of patients with keratoconus was significantly different from that of healthy eyes except in endothelial cell density (P = 0.072). In the keratoconus group, increased level of stromal haze, alterations such as the elongation of keratocyte nuclei and clustering of cells at the anterior stroma, and dark bands in the posterior stroma were observed with increased severity of the disease. The mean anterior and posterior stromal keratocyte densities and cell areas among the different stages of keratoconus were significantly different (P < 0.001 and P = 0.044, respectively). However, the changes observed in the endothelium were not significantly different (P > 0.05) among the three stages of keratoconus.Conclusion: Confocal microscopy observation showed significant changes in corneal cell morphology in keratoconic cornea from normal healthy cornea. Analysis also showed significant changes in different severities of keratoconus. Understanding the corneal cell morphology changes in keratoconus may help in the long-term monitoring and management of keratoconus.

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Section: Discussionmentioning

confidence: 96%

Corneal Cell Morphology in Keratoconus: A Confocal Microscopic Observation

Ghosh¹,

Mutalib²,

Kaur³

et al. 2017

MJMS

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“…Central epithelial thinning [4][5][6][7][8] and irregular thinning and breaks in Bowman's layer along with incursion of fine cellular processes in the Bowman's layer [9][10][11] and increased haze in epithelium and Bowman's layer 13,16 have been observed in previous studies on KC corneas. Therefore, the outcome measures for this study include the differences in the average thickness, thickness variability and the amount of light scatter of the normal and KC eyes along the superior-inferior sections for these two layers.…”

Section: Outcome Measuresmentioning

confidence: 96%

“…In vivo confocal microscope (IVCM) which provides cellular level resolution en face images of the cornea has also been commonly used in studying KC corneas. 12,13 Previous studies using IVCM have shown changes in the density of epithelial cells 13,14 and stromal keratocytes 14,15 in KC corneas. Increased haze/scatter in all the corneal layers 13,16 has also been observed in the KC eyes.…”

Section: Introductionmentioning

confidence: 99%

“…12,13 Previous studies using IVCM have shown changes in the density of epithelial cells 13,14 and stromal keratocytes 14,15 in KC corneas. Increased haze/scatter in all the corneal layers 13,16 has also been observed in the KC eyes. These findings suggest that any change in corneal microstructure will disrupt its transparency, increasing light scatter.…”

Section: Introductionmentioning

confidence: 99%

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Epithelium and Bowman’s layer thickness and light scatter in keratoconic cornea evaluated using ultrahigh resolution optical coherence tomography

et al. 2012

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Abstract. A custom-developed ultrahigh resolution optical coherence tomography with an axial resolution of 1.1 μm in corneal tissue was used to characterize thickness and light scatter of the epithelium and Bowman's layer in keratoconic (KC) cornea noninvasively. A 4-mm wide vertical corneal section around the apex in nine KC and eight normal eyes was imaged in vivo. The epithelium and Bowman's layer were visualized and their thickness profiles were quantified. Scatter was quantified based on the sensitivity normalized mean signal intensity distribution. Average mean thickness of the epithelium and Bowman's layer in KC eyes was significantly smaller ðp < 0.05Þ than the normal eyes. The epithelium thickness variation across a central 3-mm cornea was significantly larger in KC eyes than in normal eyes. The scatter in KC eyes was significantly increased only for Bowman's layer. The changes observed in this study could improve our understanding of the underlying disease mechanism of KC and can provide new indications for early disease diagnosis.

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“…1 Korneal konfokal mikroskopi, korneayı etkileyen hastalıklarla ilgili araştırmalarda geniş bir kullanım alanı bulmaktadır. [2][3][4][5][6][7] Anormal kornealarda elde edilen ölçümlerin kıyaslanabilmesi için, normal kornealara ait veriler büyük önem taşımaktadır.…”

Section: Sağlıklı İnsan Korneasında Hücre Veunclassified

In Vivo Confocal Microscopic Evaluation of Cells and Nerve Fibers of the Healthy Human Cornea

Bitirgen¹,

Özkağnıcı²

2014

Turkiye Klinikleri J Med Sci

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In vivoConfocal Microscopy for the Evaluation of Corneal Microstructure in Keratoconus

Abstract: Corneal microstructure is abnormal in patients with keratoconus. Keratocyte and endothelial cell loss appears to be present in keratoconic corneas.

Cited by 71 publications

References 26 publications

Corneal Cell Morphology in Keratoconus: A Confocal Microscopic Observation

Corneal Cell Morphology in Keratoconus: A Confocal Microscopic Observation

Epithelium and Bowman’s layer thickness and light scatter in keratoconic cornea evaluated using ultrahigh resolution optical coherence tomography

In Vivo Confocal Microscopic Evaluation of Cells and Nerve Fibers of the Healthy Human Cornea

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