March 2012
Volume 53, Issue 14
Free
ARVO Annual Meeting Abstract  |   March 2012
In Vivo Confocal Microscopy as a Tool to Evaluate Cellular Changes in the Cornea and Conjunctiva in Ocular Allergy and Non-Allergic Ocular Inflammatory Diseases
Author Affiliations & Notes
  • Candice G. Williams
    Cornea,
    Ocular Surface Imaging Center,
    Massachusetts Eye and Ear Infirmary, Boston, Massachusetts
  • Bernardo M. Cavalcanti
    Cornea,
    Ocular Surface Imaging Center,
    Massachusetts Eye and Ear Infirmary, Boston, Massachusetts
  • Andrea Cruzat
    Cornea,
    Ocular Surface Imaging Center,
    Massachusetts Eye and Ear Infirmary, Boston, Massachusetts
  • Monique Trinidad
    Cornea,
    Ocular Surface Imaging Center,
    Massachusetts Eye and Ear Infirmary, Boston, Massachusetts
  • Yesim Haussler-Sinangin
    Schepens Eye Research Institute, Boston, Massachusetts
  • Reza Dana
    Cornea,
    Massachusetts Eye and Ear Infirmary, Boston, Massachusetts
  • Pedram Hamrah
    Cornea,
    Ocular Surface Imaging Center,
    Massachusetts Eye and Ear Infirmary, Boston, Massachusetts
  • Footnotes
    Commercial Relationships  Candice G. Williams, None; Bernardo M. Cavalcanti, None; Andrea Cruzat, None; Monique Trinidad, None; Yesim Haussler-Sinangin, None; Reza Dana, None; Pedram Hamrah, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science March 2012, Vol.53, 4016. doi:
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      Candice G. Williams, Bernardo M. Cavalcanti, Andrea Cruzat, Monique Trinidad, Yesim Haussler-Sinangin, Reza Dana, Pedram Hamrah; In Vivo Confocal Microscopy as a Tool to Evaluate Cellular Changes in the Cornea and Conjunctiva in Ocular Allergy and Non-Allergic Ocular Inflammatory Diseases. Invest. Ophthalmol. Vis. Sci. 2012;53(14):4016.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : To evaluate cellular changes on the conjunctiva and cornea in patients with ocular allergy and non-allergic ocular inflammatory diseases (OID) by in vivo confocal microscopy (IVCM).

Methods: : Laser IVCM (HRT3/RCM) of the conjunctiva, central and peripheral cornea was performed in 6 patients (8 eyes) with ocular allergy (OA), 9 patients (10 eyes) with OID, and 6 control subjects (8 eyes) between March 2010 and September 2011. Images for each area were quantified for dendritic (DC) and non-dendritic immune cells (IC) density. Cellular and cell border reflectivity of superficial epithelial cells (SE) were evaluated. Conjunctival vessels were assessed for presence and location of immune cells.

Results: : Patients with OA and OID demonstrated increased hyperreflectivity of corneal (71% and 78%) and conjunctival SE (63% and 42%) as compared to controls (0%). SE cell border reflectivity in the area of tight junctions was increased in the cornea for OA and OID (83%) and the conjunctiva (77% OA; 70% OID) compared to controls (0% cornea; 11% conjunctiva). While central corneal DC density was lower in acute OA (46.8±31 cells/mm2) vs. acute OID (83.7±37) cases, patients with chronic OA (256.3±243) had higher DC density compared to chronic OID (65.6±56; p<0.05). In the peripheral cornea, a 35% (acute OA) and 90% (chronic OA) increase in DC density was observed as compared to controls. Moreover, conjunctival DC density was significantly increased in both OA (131.2±100) and OID (234.4±206) as compared to controls (17.5±16.2; p<0.05). Finally, conjunctival vessels demonstrated increased immune cell adhesion in OA (5.5±0.7 cells/100µm vessel length) and OID (5.7±1.7) compared to controls (0.13±0.35; p<0.05).

Conclusions: : IVCM demonstrates profound immune and inflammatory changes in ocular allergic and non-allergic ocular inflammatory diseases. IVCM also shows superficial epithelial cell changes in the cornea and conjunctiva epithelium of patients with both OA and OID. IVCM provides a powerful platform for the evaluation of the ocular surface beyond slit-lamp examination and may provide a tool for patient stratification and objective assessment of treatment response in clinical trials through sensitive imaging biomarkers.

Keywords: cornea: epithelium • conjunctiva • microscopy: confocal/tunneling 
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