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Olivia L Lee, Ping Huang, Tudor Tepelus, Jianyan Huang, Vikas Chopra, Srinivas R Sadda; Vascular and morphologic analysis of pterygia evaluated by in vivo confocal microscopy. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1639.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the vascular and morphological characteristics of the cornea and conjunctiva in patients with unilateral primary pterygia by comparison with the fellow eye.
Six patients with unilateral primary pterygia were recruited for this prospective study. In the study eye, the body of the pterygium and clear central cornea were imaged using In Vivo Laser Scanning Confocal Microscopy (Heidelberg HRT III RCM). In the fellow eye, the corresponding nasal bulbar conjunctiva and central cornea were imaged to provide controls for comparison. The presence of inflammatory cells and blood vessels in the pterygium were evaluated by examination of three 400 x 400 micron fields per eye. The density of basal corneal epithelial cells, keratocytes, and dendritic cells were also analyzed and compared between eyes using the semi-automated cell analysis software provided by Heidelberg.
The stroma of pterygia demonstrated evidence of densely packed hyperreflective tissue in parallel arrangement with linearly-oriented blood vessels. The mean number of vessels within pterygia was 35.6±4.4/mm2 compared to 13.8±4.2/mm2 in normal nasal conjunctival of the fellow eyes (p<0.01). The mean dendritic cell density in the pterygia was significantly higher than in the nasal bulbar conjunctiva of the fellow eyes (106.9±36.5/mm2 vs 23.1±15.6/mm2, P < 0.001). The mean density of basal epithelial cells in the central cornea in the pterygia eyes and control eyes was 5172.0± 466.1 cells/mm2 and 6333.3±446.7 cells/mm2 respectively (p<0.05). The density of dendritic cells in the clear central cornea was 44.4±11.9/mm2 in pterygia eyes, which was significantly higher than in the fellow eyes (6.9±5.8/mm2, P < 0.05). There was no significant difference in the density of keratocytes in the anterior and posterior stroma between the two groups (p>0.05).
In vivo confocal microscopy may be helpful in evaluating morphologic and vascular alterations of pterygia. Our study demonstrates increased corneal and conjunctival dendritic cell density and decreased corneal epithelial cell density in eyes with pterygia. These findings suggest the potential for use of In vivo confocal microscopy in the evaluation and monitoring of patients with pterygia.
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