Abstract
Purpose:
Total bilateral corneal limbal epithelial stem cell deficiency (LSCD) cannot be treated with the surgical transplantation of autologous limbus or cultured autologous limbal epithelium. Transplantation of allogenic limbal epithelium is possible but requires immunosuppressive treatments. Cultured autologous oral mucosal epithelial cell sheet (CAOMECS) was recently demonstrated as an alternative treatment for LSCD. Here we digitally analyzed the epithelial defects as well as the neovascularization pre- and post CAOMECS transplantation.
Methods:
The objectives were to quantify precisely the efficacy of CAOMECS, used in a prospective clinical study. We quantified epithelial defects based on fluorescein staining pattern as well as the area covered by vessels on digital images. Therefore we modified the images and performed grey scale analysis using an image analysis program (Cell^F, Olympus Germany).
Results:
From the 26 eyes of 25 patients which have received a graft, 16 eyes for epithelial defect quantification and 18 eyes for neovascularization could be followed up. We compared the data between pre-transplantation and 12 month post transplantation. The area of epithelial defects showed a significant reduction of 51.6% compared to preOP (p<0.001). In addition, the area of neovascularization was reduced by 18.7%, but could not reach significance (p>0.05). These results support the clinical ratings.
Conclusions:
This study shows that digital, semiautomatic analysis of epithelial defects reflects the clinical assessment and provides moreover quantifiable data. The obtained results confirm objectively that CAOMECS is effective for reconstructing the ocular surface in patients with total bilateral corneal LSCD and seems to have angioregressive effects.
Keywords: 482 cornea: epithelium •
550 imaging/image analysis: clinical •
468 clinical research methodology