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Angelica Dipinto, Paolo Fogagnolo, Massimo Zuin, Mariangela Delliponti, Maurizio Digiuni, Laura Ottobelli, Luca Rossetti; Corneal Involvement In Primary Biliary Cirrhosis: An In Vivo Confocal Microscopy Study. Invest. Ophthalmol. Vis. Sci. 2012;53(14):1079.
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To investigate the corneal involvement in Primary Biliary Cirrhosis (PBC), a slowly progressive cholestatic liver disease of autoimmune etiology.
Seven female patients affected by PBC underwent a slit-lamp biomicroscopy of the anterior segment with and without Goldmann's three-mirror contact lens, and laser scanning confocal microscopy (LSCM, Heidelberg Engineering Germany). LSCM images were acquired and analyzed for all layers of central and peripheral cornea (four quadrants).
All patients had normal findings both at slit-lamp biomicroscopy and at gonioscopy. Peculiar findings were shown at LSCM: all patients showed keratocytes activation (Figure 1); sub-basal nerve fibers with beadlike structure (Figure 2) were found in six patients (86%); four subjects (57%) had hyper-reflective stromal macro-deposits (Figure 2). No deposits suggestive for copper deposition were detected at the level of Descemet’s membrane.
To the best of our knowledge this is the first confocal microscopy study on PBC patients. LSCM could show that subclinical corneal inflammation is a very common finding also in ophthalmoscopically normal patients affected by this autoimmune disease.
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