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T.-I. Chikama, N. Takahashi, Y. Kobayashi, N. Morishige, T. Nishida; In vivo Confocal Microscopy of the Immune Response in Human Corneal Allograft Rejection. Invest. Ophthalmol. Vis. Sci. 2009;50(13):1959.
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The purpose of the study was to investigate the immune response in cases of human corneal allograft rejection by in vivo laser confocal microscopy.
Eleven patients diagnosed with graft rejection by slitlamp examination participated in the study. The 11 corneas were evaluated with a laser-scanning confocal microscope, consisting of a Heidelberg Retina Tomograph II attached to a Rostock Cornea Module (HRTII-RCM).
Slitlamp examination revealed typical rejection signs including keratoprecipitates and stromal edema in all eyes. HRTII-RCM examination showed that keratoprecipitates contained single spherical cells, single cells with a dendritic morphology, or clusters of spherical cells. Activated keratocytes with evident cytoplasmic processes were also observed in the stroma of corneas with fewer numbers of infiltrating spherical cells. Furthermore, many dendritic cells, likely Langerhans cells, were apparent at the level of basal epithelial cells and Bowman’s membrane in eight of the 11 eyes.
In vivo laser confocal microscopy revealed pathological features of the immune response in human corneal allograft rejection. This technique may contribute to the diagnosis of early stages of rejection as well as to the differentiation of rejection from other corneal inflammatory diseases.
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