In Vivo Confocal Microscopic Findings of Corneal Tissue in Bullous Keratopathy.
10.3341/jkos.2013.54.12.1923
- Author:
Young Min PARK
1
;
Han Jo KWON
;
Jong Soo LEE
Author Information
1. Department of Ophthalmology, Pusan National University Hospital, Pusan National University & Medical Research Institute School of Medicine, Busan, Korea. jongsool@pusan.ac.kr
- Publication Type:Case Report
- Keywords:
Bullous keratopathy;
Confocal microscopy Address
- MeSH:
Descemet Membrane;
Edema;
Endothelium;
Endothelium, Corneal;
Epithelium, Corneal;
Extracellular Matrix;
Humans;
Microscopy, Confocal;
Myofibroblasts
- From:Journal of the Korean Ophthalmological Society
2013;54(12):1923-1928
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To analyze the morphology and density of corneal tissue in patients with bullous keratopathy using in vivo confocal microscopy (IVCM). CASE SUMMARY: Four eyes of 4 patients with clinically diagnosed bullous keratopathy were examined using IVCM. Cross-sectioned corneal images of the corneal epithelium, Bowman's layer, stromal layer, Descemet's membrane, and endothelium were evaluated. In bullous keratopathy patients, the outline of corneal epithelial wing cells was blurred. Several hyper-reflective whitish dots were found at the corneal epithelial level and a reduction in the density and thickness of the corneal nerves was observed. There was also a reduction in the density of the stromal keratocytes. The outline of the stromal keratocytes was blurred. Some keratocytes resembled myofibroblast. The hypo-reflective vertical strands were observed in the stroma adjacent to the Descemet's membrane. Endothelium showed hyper-reflectivity with associated increased endothelial pleomorphism and polymegathism. CONCLUSIONS: In patients with bullous keratopathy, IVCM showed tissue edema in the corneal epithelium, stroma, and endothelium. Hyper-reflectivity appearances were noted due to the increase in the metabolic rate of the cells or extracellular matrix accumulation. Corneal endothelium showed morphological changes.
