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Clara Colon, Bernardo Cavalcanti, Shruti Aggarwal, Andrea Cruzat, Candice Williams, Douglas Critser, Amy Watts, Christine Sindt, Pedram Hamrah; Morphologic Dendritic Immune Cells Parameters Reveal Differential Characteristics between the Central and Peripheral Cornea: an In Vivo Confocal Microscopy Normative Data. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2063.
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© ARVO (1962-2015); The Authors (2016-present)
To determine the morphology of dendritic immune cells (DC) in the central and four peripheral quadrants in corneas of normal subjects.
Eighty-five normal non-contact lens wearers (85 eyes) were prospectively enrolled and underwent laser in vivo confocal microscopy (IVCM; HRT3/RCM) of the central cornea, as well as inferior, nasal, superior and temporal quadrants. Slit-lamp examination was performed to confirm lack of ocular disease. Baseline images were assessed for DC morphology and density by two masked observers. Morphology was assessed by number of dendrites per cell, area of DC and DC field. Statistical analysis was performed with ANOVA/Bonferroni to compare the differences between corneal areas and intraclass coefficient was used to assess interobserver reproducibility.
The mean age of subjects was 31.4 years (range 20 to 69). IVCM revealed the presence of central (35.6±4.3 cells/mm2) and peripheral (74.1±4.5) corneal DC in all areas of all subjects. The number of dendrites, area of DC, and DC field centrally were 2.4±0.04 n/cell, 71.6±4.3 µm2, and 304.2±19.2 µm2 respectively. Number of dendrites (3.2±0.07 inferior, 2.9±0.03 nasal, 3.0±0.03 superior, 2.9±0.03 temporal), area of DC (134.6±3.5, 115.3±3.4, 117.0±3.5, 121.2±3.9), and DC field area (684.4±19.1, 586.2±19.7, 587.7±17.4, 601±18.6), were found to be significantly larger in all 4 peripheral quadrants (p<0.001). While the peripheral areas had larger DC in general, the inferior quadrant demonstrated the largest area of DC and DC field, as well as the highest dendrite numbers. Good interobserver reproducibility coefficients were found for DC area (0.83; 0.77-0.91 95%CI), number of dendrites (0.97; 0.95-0.99), and DC coverage area (0.94; 0.85-0.98).
IVCM revealed significant difference in morphology of peripheral versus central corneal DC. These changes suggest increased DC activation in peripheral cornea. The morphological parameters may be used to detect early changes in the corneal inflammatory status. Further, they may provide additional data to investigate cell activation state for corneal disease and monitor response to anti-inflammatory therapy. With the increased use of IVCM to detect subclinical inflammatory changes, the normative data may serve as the basis for future clinical studies and trials.
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