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T Nakagawa, K Nishida, N Maeda, H Watanabe, Y Inoue, H Hamano, Y Tano; In Vivo Observation of Corneal Cells With a Newly Developed Specular Microscope . Invest. Ophthalmol. Vis. Sci. 2002;43(13):1661.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To assess a new specular microscope designated a "scanning specular microscope" that we recently developed to image the corneal epithelium, stroma and endothelium without the need for a special contact lens. This device uses simultaneously moving slits on both sides of the slit lamp and CCD camera. Methods: We observed corneal epithelium, stroma and endothelium in healthy volunteers and patients with various corneal diseases by our scanning specular microscope. Topical anesthesia was used before contacting the cone lens to the cornea. The cornea was scanned, and images from the epithelium to endothelium collected on a video recorder. Results: In healthy volunteers we obtained clear pictures of epithelial cells, stromal keratocytes, stromal nerves and endothelial cells. We also successfully obtained clear images of superficial epithelial cells and endothelium at both the center and periphery of the cornea. Because we didn't require a contact lens for examination we were able to detect subtle epithelial alternation in a number of conditions including gelatinous drop-like corneal dystrophy (GDLD) and Thygeson's superficial punctate keratitis. Notable findings included the detection of unusually large endothelial cells in congenital hereditary endothelial dystrophy, seen through a highly thickened corneal stroma. Also, in GDLD we were able to calculate the exposed area of the superficial epithelial cells above the regions without amyloid deposition, and found that the area covered by GDLD epithelial cells (n=4, 1517±167.4 µm2) was significantly larger than the area covered by normal cells (n=4, 694.4±104.5 µm2) (unpaired t-test, P=0.001). Conclusion: The newly developed scanning specular microscope is useful for in-vivo examination of corneal epithelial, stromal and endothelial cells in various corneal diseases. It is especially helpful in detecting subtle cellular alternations in superficial epithelial cells and in peripheral endothelial cells.
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