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T.-I. Chikama, N. Takahashi, M. Wakuta, T. Nishida; Clinical Evaluation of Recurrent Corneal Erosion by Laser in vivo Confocal Microscopy. Invest. Ophthalmol. Vis. Sci. 2007;48(13):3486. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To characterize specific morphological features of the cornea in patients with recurrent corneal erosion by laser in vivo confocal microscopy.
Seven eyes of six patients were analyzed 2 days to 1 month after the onset of the most recent recurrence of corneal erosion. The patients were examined with a slitlamp biomicroscope and with a laser in vivo confocal microscope (HRT II-Rostock Cornea Module, HRT II-RCM, Heidelberg Engineering).
Brightly reflective granular structures were detected with the HRT II-RCM not only in the basal cell layer but also in the wing cell layer of the corneal epithelium in all eyes affected by recurrent erosion. Furthermore, fine particles with the reduced density characteristic of keratocytes were apparent in the shallow stroma of all affected eyes. An increase in the number of inflammatory cells such as neutrophils and changes in the phenotype of epithelial cells, likely indicative of the wound healing process, were observed during the early phase of lesion development but gradually subsided with time. Regeneration of the subepithelial nerve plexus was apparent in two eyes more than 1 month after onset of recurrence.
The HRT II-RCM allows detection of abnormal structures in the cornea. Indeed, laser in vivo confocal microscopy provides noninvasively images that are equivalent to high-quality histology, having been termed "in vivo biopsy". In the case of recurrent corneal erosion, the presence of granular structures in the wing cell and basal cell layers as well as persistent inflammation in the shallow stroma may contribute to deterioration of corneal epithelial cell alignment and to weakening of adhesion between basal cells and the basement membrane.
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