Abstract
Purpose:
To analyze the contribution of in vivo confocal microscopy for the diagnosis and follow-up of conjunctival intraepithelial neoplasia
Methods:
Retrospective case series of 5 patients with unilateral conjunctival intraepithelial neoplasia (CIN) submitted to surgery plus adjuvant therapy in a follow-up period of 12 months. All patients were evaluated before and after surgery with slit-lamp photography and confocal microscopy (Heidelberg Retina Tomograph II, Rostock Cornea Module). The authors did a comparative analysis of slit-lamp photographs, confocal microscopy images and histological examination photographs of the same lesions.
Results:
Five patients (4 males, 1 female) with a mean age of 79,6 years, were enrolled in this study. Three were identified as high-grade intraepithelial neoplasia and two as carcinoma in situ. The histological findings correlated well with those seen by confocal microscopy: epithelial disorganization with acanthosis, parakeratosis, cellular pleomorphism, high cellular and nuclear reflectivity, high nuclear to cytoplasmic ratio and sometimes binucleation. The lesion is well demarcated and the subbasal corneal nerves were not visualized in areas affected by CIN. Confocal microscopy has identified 1 relapse and was useful to monitor the treatment response.
Conclusions:
In vivo confocal microscopy may be important not only in the diagnosis of CIN, but also detecting relapses and monitoring the treatment response, in a relative non-invasive manner.
Keywords: 484 cornea: stroma and keratocytes •
549 image processing •
596 microscopy: confocal/tunneling