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N. Morishige, K. Seki, T. Chikama, T. Nishida; Comparison between Confocal Microscopy and Light Microscopy for Histopathologic Observation of the Corneal Lesions Associated with Luetic Interstitial Keratitis . Invest. Ophthalmol. Vis. Sci. 2003;44(13):3661.
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Purpose: To compare confocal microscopy and light microscopy for examination of the histopathologic changes associated with corneal opacity in luetic interstitial keratitis. Methods: Ten Japanese individuals (three men, seven women; aged 60 to 87 years, with a mean ± SD of 73.1 ± 8.9 years) were enrolled in the study. All of the subjects underwent penetrating keratoplasty. Before surgery, they were subjected to confocal biomicroscopy and slitlamp examination. Corneas were subjected to histopathologic examination by light microscopy after their removal during surgery. We compared the images obtained by confocal microscopy in situ with those obtained by light microscopy of the surgical specimens. Results: Confocal microscopy revealed numerous granules between the subepithelial layer and the anterior stroma, tubular components in the middle stroma, and a high level of light scattering at the deep stroma for all subjects. Light microscopy revealed hematoxylin-positive granules between Bowman’s layer and the anterior stroma in 7 of the 10 subjects, loose lamellar components in all subjects, irregular separated fiber components in the middle to deep stroma in all subjects, and round cavities indicative of ghost vessels surrounded by irregular stromal fibers in the deep stroma of 4 of the 10 subjects. Conclusions: Confocal images were consistent with those obtained by slitlamp microscopy and light microscopy. The anterior portion of the cornea was observable by confocal microscopy despite the presence of corneal opacity. Confocal microscopy thus allows examination of corneal structure at the cellular level and is potentially a noninvasive alternative to biopsy.
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