In vivo corneal confocal microscopic analysis in patients with keratoconus

Gulfidan Bitirgen, Ahmet Ozkagnici, Banu Bozkurt, Rayaz Malik

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

AIM: To quantify corneal ultrastructure using laser scanning in vivo confocal microscopy (IVCM) in patients with keratoconus and control subjects. • METHODS: Unscarred corneas of 78 keratoconic subjects without a history of contact lens use and 36 age-matched control subjects were evaluated with slit-lamp examination (SLE), corneal topography and laser scanning IVCM. One eye was randomly chosen for analysis. Anterior and posterior stromal keratocyte, endothelial cell and basal epithelial cell densities and sub-basal nerve structure were evaluated. • RESULTS: IVCM qualitatively demonstrated enlarged basal epithelial cells, structural changes in sub-basal and stromal nerve fibers, abnormal stromal keratocytes and keratocyte nuclei, and pleomorphism and enlargement of endothelial cells. Compared with control subjects, significant reductions in basal epithelial cell density (5817±306 cells/mm2 vs 4802±508 cells/mm2, P<0.001), anterior stromal keratocyte density (800±111 cells/mm2 vs 555±115 cells/mm2, P<0.001), posterior stromal keratocyte density (333±34 cells/mm2 vs 270±47 cells/mm2, P<0.001), endothelial cell density (2875±223 cells/mm2 vs 2686±265 cells/mm2, P< 0.001), sub-basal nerve fiber density (31.2±8.4 nerves/mm2 vs 18.1±9.2 nerves/mm2, P<0.001), sub-basal nerve fiber length (21.4±3.4 mm/mm2 vs 16.1±5.1 mm/mm2,P<0.001), and sub-basal nerve branch density (median 50.0 (first quartile 31.2 - third quartile 68.7) nerve branches/mm2 vs median 25.0 (first quartile 6.2 - third quartile 45.3) nerve branches/mm2, P<0.001) were observed in patients with keratoconus. • CONCLUSION: Significant microstructural abnormalities were identified in all corneal layers in the eyes of subjects with keratoconus using IVCM. This non-invasive in vivo technique provides an important means to define and follow progress of microstructural changes in patients with keratoconus.

Original languageEnglish
Pages (from-to)534-539
Number of pages6
JournalInternational Journal of Ophthalmology
Volume8
Issue number3
DOIs
Publication statusPublished - 18 Jun 2015
Externally publishedYes

Fingerprint

Keratoconus
Confocal Microscopy
Cell Count
Nerve Fibers
Endothelial Cells
Epithelial Cells
Lasers
Corneal Topography
Contact Lenses
Cornea
Intravital Microscopy

Keywords

  • Corneal nerves
  • In vivo confocal microscopy
  • Keratoconus

ASJC Scopus subject areas

  • Ophthalmology

Cite this

In vivo corneal confocal microscopic analysis in patients with keratoconus. / Bitirgen, Gulfidan; Ozkagnici, Ahmet; Bozkurt, Banu; Malik, Rayaz.

In: International Journal of Ophthalmology, Vol. 8, No. 3, 18.06.2015, p. 534-539.

Research output: Contribution to journalArticle

Bitirgen, Gulfidan ; Ozkagnici, Ahmet ; Bozkurt, Banu ; Malik, Rayaz. / In vivo corneal confocal microscopic analysis in patients with keratoconus. In: International Journal of Ophthalmology. 2015 ; Vol. 8, No. 3. pp. 534-539.
@article{f0221ec3dc274d01a3288b7b1e4460cb,
title = "In vivo corneal confocal microscopic analysis in patients with keratoconus",
abstract = "AIM: To quantify corneal ultrastructure using laser scanning in vivo confocal microscopy (IVCM) in patients with keratoconus and control subjects. • METHODS: Unscarred corneas of 78 keratoconic subjects without a history of contact lens use and 36 age-matched control subjects were evaluated with slit-lamp examination (SLE), corneal topography and laser scanning IVCM. One eye was randomly chosen for analysis. Anterior and posterior stromal keratocyte, endothelial cell and basal epithelial cell densities and sub-basal nerve structure were evaluated. • RESULTS: IVCM qualitatively demonstrated enlarged basal epithelial cells, structural changes in sub-basal and stromal nerve fibers, abnormal stromal keratocytes and keratocyte nuclei, and pleomorphism and enlargement of endothelial cells. Compared with control subjects, significant reductions in basal epithelial cell density (5817±306 cells/mm2 vs 4802±508 cells/mm2, P<0.001), anterior stromal keratocyte density (800±111 cells/mm2 vs 555±115 cells/mm2, P<0.001), posterior stromal keratocyte density (333±34 cells/mm2 vs 270±47 cells/mm2, P<0.001), endothelial cell density (2875±223 cells/mm2 vs 2686±265 cells/mm2, P< 0.001), sub-basal nerve fiber density (31.2±8.4 nerves/mm2 vs 18.1±9.2 nerves/mm2, P<0.001), sub-basal nerve fiber length (21.4±3.4 mm/mm2 vs 16.1±5.1 mm/mm2,P<0.001), and sub-basal nerve branch density (median 50.0 (first quartile 31.2 - third quartile 68.7) nerve branches/mm2 vs median 25.0 (first quartile 6.2 - third quartile 45.3) nerve branches/mm2, P<0.001) were observed in patients with keratoconus. • CONCLUSION: Significant microstructural abnormalities were identified in all corneal layers in the eyes of subjects with keratoconus using IVCM. This non-invasive in vivo technique provides an important means to define and follow progress of microstructural changes in patients with keratoconus.",
keywords = "Corneal nerves, In vivo confocal microscopy, Keratoconus",
author = "Gulfidan Bitirgen and Ahmet Ozkagnici and Banu Bozkurt and Rayaz Malik",
year = "2015",
month = "6",
day = "18",
doi = "10.3980/j.issn.2222-3959.2015.03.17",
language = "English",
volume = "8",
pages = "534--539",
journal = "International Journal of Ophthalmology",
issn = "2222-3959",
publisher = "Press of International Journal of Ophthalmology",
number = "3",

}

TY - JOUR

T1 - In vivo corneal confocal microscopic analysis in patients with keratoconus

AU - Bitirgen, Gulfidan

AU - Ozkagnici, Ahmet

AU - Bozkurt, Banu

AU - Malik, Rayaz

PY - 2015/6/18

Y1 - 2015/6/18

N2 - AIM: To quantify corneal ultrastructure using laser scanning in vivo confocal microscopy (IVCM) in patients with keratoconus and control subjects. • METHODS: Unscarred corneas of 78 keratoconic subjects without a history of contact lens use and 36 age-matched control subjects were evaluated with slit-lamp examination (SLE), corneal topography and laser scanning IVCM. One eye was randomly chosen for analysis. Anterior and posterior stromal keratocyte, endothelial cell and basal epithelial cell densities and sub-basal nerve structure were evaluated. • RESULTS: IVCM qualitatively demonstrated enlarged basal epithelial cells, structural changes in sub-basal and stromal nerve fibers, abnormal stromal keratocytes and keratocyte nuclei, and pleomorphism and enlargement of endothelial cells. Compared with control subjects, significant reductions in basal epithelial cell density (5817±306 cells/mm2 vs 4802±508 cells/mm2, P<0.001), anterior stromal keratocyte density (800±111 cells/mm2 vs 555±115 cells/mm2, P<0.001), posterior stromal keratocyte density (333±34 cells/mm2 vs 270±47 cells/mm2, P<0.001), endothelial cell density (2875±223 cells/mm2 vs 2686±265 cells/mm2, P< 0.001), sub-basal nerve fiber density (31.2±8.4 nerves/mm2 vs 18.1±9.2 nerves/mm2, P<0.001), sub-basal nerve fiber length (21.4±3.4 mm/mm2 vs 16.1±5.1 mm/mm2,P<0.001), and sub-basal nerve branch density (median 50.0 (first quartile 31.2 - third quartile 68.7) nerve branches/mm2 vs median 25.0 (first quartile 6.2 - third quartile 45.3) nerve branches/mm2, P<0.001) were observed in patients with keratoconus. • CONCLUSION: Significant microstructural abnormalities were identified in all corneal layers in the eyes of subjects with keratoconus using IVCM. This non-invasive in vivo technique provides an important means to define and follow progress of microstructural changes in patients with keratoconus.

AB - AIM: To quantify corneal ultrastructure using laser scanning in vivo confocal microscopy (IVCM) in patients with keratoconus and control subjects. • METHODS: Unscarred corneas of 78 keratoconic subjects without a history of contact lens use and 36 age-matched control subjects were evaluated with slit-lamp examination (SLE), corneal topography and laser scanning IVCM. One eye was randomly chosen for analysis. Anterior and posterior stromal keratocyte, endothelial cell and basal epithelial cell densities and sub-basal nerve structure were evaluated. • RESULTS: IVCM qualitatively demonstrated enlarged basal epithelial cells, structural changes in sub-basal and stromal nerve fibers, abnormal stromal keratocytes and keratocyte nuclei, and pleomorphism and enlargement of endothelial cells. Compared with control subjects, significant reductions in basal epithelial cell density (5817±306 cells/mm2 vs 4802±508 cells/mm2, P<0.001), anterior stromal keratocyte density (800±111 cells/mm2 vs 555±115 cells/mm2, P<0.001), posterior stromal keratocyte density (333±34 cells/mm2 vs 270±47 cells/mm2, P<0.001), endothelial cell density (2875±223 cells/mm2 vs 2686±265 cells/mm2, P< 0.001), sub-basal nerve fiber density (31.2±8.4 nerves/mm2 vs 18.1±9.2 nerves/mm2, P<0.001), sub-basal nerve fiber length (21.4±3.4 mm/mm2 vs 16.1±5.1 mm/mm2,P<0.001), and sub-basal nerve branch density (median 50.0 (first quartile 31.2 - third quartile 68.7) nerve branches/mm2 vs median 25.0 (first quartile 6.2 - third quartile 45.3) nerve branches/mm2, P<0.001) were observed in patients with keratoconus. • CONCLUSION: Significant microstructural abnormalities were identified in all corneal layers in the eyes of subjects with keratoconus using IVCM. This non-invasive in vivo technique provides an important means to define and follow progress of microstructural changes in patients with keratoconus.

KW - Corneal nerves

KW - In vivo confocal microscopy

KW - Keratoconus

UR - http://www.scopus.com/inward/record.url?scp=84938892956&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84938892956&partnerID=8YFLogxK

U2 - 10.3980/j.issn.2222-3959.2015.03.17

DO - 10.3980/j.issn.2222-3959.2015.03.17

M3 - Article

VL - 8

SP - 534

EP - 539

JO - International Journal of Ophthalmology

JF - International Journal of Ophthalmology

SN - 2222-3959

IS - 3

ER -