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Donatella Musetti, Marina Papadia, Carlo Mosci, Francesco Lanza, Alessandro Bagnis, Riccardo Scotto, Carlo Enrico Traverso; Comparison Between In Vivo Confocal Microscopy And Biopsies Of Pigmented Corneal And Conjunctival Tumor-like Lesion. Invest. Ophthalmol. Vis. Sci. 2012;53(14):87.
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© ARVO (1962-2015); The Authors (2016-present)
To compare the images obtained with in vivo confocal microscopy (IVCF) with the histopathological evaluation of corneal and conjunctival pigmented lesions.
Eight patients with pigmented lesions (5 conjunctival and 3 corneal) were included in this study. All patients underwent in vivo confocal microscopy using the Heildeberg Retina Tomograph (HRTIII) with the Rostock cornea modul (RCM) followed by tissue biopsy.250 images were taken during each examination. Confocal images were analyzed using predefined criteria.
In all patients the confocal microscopy was able to acquire adequate images. In 7 out of 8 patients it was possible to distinguish between melanocitic lesions and pigmented accumulation. In one patient the IVCF images were not clear in pointing out whether the lesions was melanocitic or just pigment accumulation due to the abnormal morphology. All patients presented with hyperreflective matrix and a reduction of the density of keratocities in the area surrounding the lesion. In 3 out of 8 patients dendritic cells were visible in the basal epithelial layer.
Our data show that in IVCF has a promising role in diagnosing pigmented conjunctival and corneal tumor-like lesions. For the first time a positive predictive accuracy compared with histopathological tissue biopsy evaluation was shown. Further studies are needed to determine the role of IVCF in defining the microstructure of melanocitic lesions.
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