In vivo confocal microscopic findings in patients with limbal stem cell deficiency

Miri, Ammar; Alomar, Thaer; Nubile, Mario; Al-aqaba, Muhamed; Lanzini, Manuela; Fares, Usama; Said, Dalia G.; Lowe, James; Dua, Harminder S.

doi:10.1136/bjophthalmol-2011-300551

Cited by 64 publications

(68 citation statements)

References 38 publications

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“…32 The corneal or conjunctival epithelial transition zone and cellular phenotype as revealed by IVCM have also been shown in correlation with the presence or absence of the POV in LSCD. 33,34 In another series of LSCD patients, IVCM was used to examine the POV and limbal epithelium in early, intermediate, and late clinical stages of LSCD, where one could see that the POV were completely degraded at the early stage. 35 The above studies examined LSCD as a heterogeneous group, often with only one or two aniridia patients included.…”

Section: The Limbal Stem Cells and The Stem Cell Nichementioning

confidence: 99%

“…41 In humans, IVCM has been used to quantify subbasal epithelial nerves in LSCD, where a markedly reduced nerve density has likewise been found in a case series without aniridia patients 35 and in a series including two aniridia patients. 34 In a Swedish cohort of 16 aniridia subjects where IVCM was used, a wide range of subbasal nerve density was reported, including 3 patients with abnormally high innervation of the central cornea. 29 Nerve patterns were disrupted, and esthesiometry indicated that corneal touch sensitivity was reduced below normal levels in 5 of 14 patients.…”

Section: Corneal Nervesmentioning

confidence: 99%

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Congenital Aniridia and the Ocular Surface

et al. 2016

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Aniridia is a congenital pan-ocular disorder caused by haplo-insufficiency of Pax6, a crucial gene for proper development of the eye. Aniridia affects a range of eye structures, including the cornea, iris, anterior chamber angle, lens, and fovea. The ocular surface in particular can be severely affected by a progressive pathology termed aniridiaassociated keratopathy (AAK), markedly contributing to impaired vision. The purpose of this review is to provide an update of the current knowledge of the genetic, clinical, micromorphological, and molecular aspects of AAK. We draw upon material presented in the literature and from our own observations in large aniridia cohorts. We summarize signs and symptoms of AAK, describe current options for management, and discuss the latest research 2 findings that may lead to better diagnosis and new treatment or prevention strategies for this debilitating ocular surface condition.

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Section: The Limbal Stem Cells and The Stem Cell Nichementioning

confidence: 99%

Section: Corneal Nervesmentioning

confidence: 99%

Congenital Aniridia and the Ocular Surface

et al. 2016

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“…In the past, LSCD diagnosis rested primarily on history and clinical signs 1 , with confirmation by histology 2 and impression cytology. 3 With the advent of in vivo laser scanning confocal microscopy (IVCM), live imaging of the corneo-limbal epithelial architecture in healthy individuals [4][5][6][7] and LSCD patients 2,3,8 became possible. Confirmation of loss of palisades of Vogt (POV) and conjunctivalization by IVCM is now an adjuvant to diagnose LSCD.…”

Section: Introductionmentioning

confidence: 99%

“…IVCM scanning in the above studies focused on the POV [2][3][4][5][6][7][8] in the limbus, but not the microarchitecture of the limbal stroma. Recent studies using human cadaver tissue examined the cellular components of the anterior limbal stroma and their role in the maintenance of stemness in the basal epithelium.…”

Section: Introductionmentioning

confidence: 99%

In Vivo Confocal Microscopic Analysis of Normal Human Anterior Limbal Stroma

Mathews¹,

Chidambaram

Lanjewar

et al. 2015

Cornea

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Purpose-To characterize the microarchitecture of the anterior limbal stroma in healthy individuals using in vivo confocal microscopy (IVCM) and to correlate it with mesenchymal stem cells (MSCs), a component of the limbal-niche.Methods-The corneal side of the superior limbus was scanned in 30 eyes of 17 normal subjects beyond the basal epithelium, deep into the stroma using a HRT III laser scanning microscope. The IVCM findings were correlated with the immunohistochemical features of MSCs in the anterior limbal stroma.Results-Clusters of hyperreflective structures were observed in the anterior limbal stroma, subjacent to the basal epithelium (depth: 50.2±8.7 -98±12.8 μm), but not in the corneal stroma. The structures showed unique morphology compared to epithelial cells, keratocytes, neurons and dendritic cells. In parallel, confocal analysis of immunostained sections showed clusters of cells, double positive for MSC specific markers (CD90 and CD105) in the anterior limbal stroma at a depth of 55.3±12.7 μm to 72±37.6 μm. The organization and distribution of the MSC clusters locates them within the hyperreflective region in the anterior limbal stroma. Conclusions-The hyperreflective structures, demonstrated for the first time in the human anterior limbal stroma, probably represent an important component of the limbal-niche. Our approach of in vivo imaging may pave the way for assessing the limbal stromal health.

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“…Zmniejsza się gęstość komórek podstawnych nabłonka, a jednocześnie zwiększają ich wymiary. W obrazie mikroskopowym możliwe jest również zidentyfikowanie komórek kubkowych spojówki, jednak ich obecność nie jest jednoznaczna z występo-waniem LSCD [68].…”

Section: Choroby Rąbka Rogówki Związane Z Niedoborem Lescunclassified

Limbal epithelial stem cells in regeneration of corneal epithelium – clinical and molecular aspects

Sikora

Skubis

Sedlak

et al. 2018

Ann. Acad. Med. Siles.

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ST R ES ZCZ E NI EKomórki macierzyste rąbka rogówki (limbal epithelial stem cells -LESC) zlokalizowane są na granicy rogówki i spojówki. Ich funkcja polega na odbudowie rogówki poprzez zastępowanie uszkodzonych lub niefunkcjonalnych komórek. W niniejszej pracy zawarto informacje dotyczące charakterystyki LESC, opisano sposoby ich identyfikacji z wykorzystaniem markerów powierzchniowych oraz cech morfologicznych. W pracy zawarto również informacje dotyczące hodowli komórek w warunkach in vitro jako potencjalnego źródła komórek wykorzystywanych w terapii oraz poruszono zagadnienia dysfunkcji LESC spowodowanych niedoborem komórek macierzystych wywołanych różnymi czynnikami, a także przedstawiono stosowane obecnie metody leczenia LSCD (limbal stem cell deficiency). Standardowe leczenie niedoboru komórek macierzystych rąbka rogówki polega na farmakoterapii oraz transplantacji autologicznego rąbka rogówki bogatego w komórki macierzyste. W przypadku całkowitego niedoboru LESC konieczne jest wykonanie przeszczepów allogenicznych.

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In vivo confocal microscopic findings in patients with limbal stem cell deficiency

Abstract: A number of features were demonstrated by laser IVCM in patients presenting clinically with LSCD. Some of these features were corroborated with features observed on histological examination of tissue samples.

Cited by 64 publications

References 38 publications

Congenital Aniridia and the Ocular Surface

Congenital Aniridia and the Ocular Surface

In Vivo Confocal Microscopic Analysis of Normal Human Anterior Limbal Stroma

Limbal epithelial stem cells in regeneration of corneal epithelium – clinical and molecular aspects

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