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Juan O. Croxatto; In Vivo Confocal Microscopy of Deep Stroma and Pre-Descemet Corneal Deposits. Invest. Ophthalmol. Vis. Sci. 2011;52(14):2530.
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© ARVO (1962-2015); The Authors (2016-present)
To analyze pre-Descemet's membrane corneal deposits using in vivo corneal confocal microscopy to facilitate the clinical diagnosis in patients with rare degenerations, dystrophies, and interpretation of findings after corneal surgery.
We studied both eyes of 10 patients (six females, four males; mean age 44,2 years; range 30-83 years) with the clinical diagnosis of deep stromal dystrophy, punctiform and polychromatic pre-Descemet dominant corneal dystrophy, fleck corneal dystrophy, pre-Descemet dystrophy, monoclonal gammopathy, and deposits after deep anterior lamellar keratoplasty and Descemet’s stripping endothelial keratoplasty. The central and peripheral cornea, specifically the deep corneal stroma next to the corneal endothelium was examined using the Rostock Cornea Module/HRT-II.
Distinctive shapes: punctiform, granular, oval, vesicular (sizes 2 to 30 µm); crystallin-like: rectangular (23 x 14 µm) and spicular lipids (average size 48 x 8 µm), protein (32 x 7 µm); and setting of hyperreflective deposits, whether intracellular, extracellular or both, were observed for each dystrophy, degeneration and monoclonal gammopathy, as well as lipid deposits after deep anterior lamellar keratoplasty and talc-like material after Descemet stripping endothelial keratoplasty.
In vivo confocal microscopy provides a method to examine the cornea at the light microscopic level and facilitates the differential diagnosis of several types of deposits in corneal diseases where a tissue biopsy is not indicated.
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