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A. Zhivov, R. Beck, O. Stachs, R. F. Guthoff; In vivo Confocal Microscopic Study of Langerhans Cells in the Corneal Epithelium After Preservatives Holding Local Therapy in Glaucoma Patients. Invest. Ophthalmol. Vis. Sci. 2007;48(13):4303.
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To examine and compare the density and distribution of Langerhans cells (LCs) in the corneal epithelium after preservatives holding local therapy in glaucoma patients and to compare it with healthy volunteers.
25 eyes of 15 glaucoma patients (age: 41-77 years) with more then 1 year of antihypertensive therapy (medicaments with preservatives) were examined in vivo with the combination of the Heidelberg Retina Tomograph II and the Rostock Cornea Module. The exclusion criteria were history of ocular inflammation, trauma or surgery. Results were compared with density and distribution of LCs in 225 eyes of 129 healthy volunteers (age: 16-81 years).
In glaucoma patients in vivo confocal microscopy revealed 25 eyes with LCs including 24 eyes presenting with both central and peripheral LC location. LC densities averaged 196+/-22 cells/mm2 in the central part and 304+/-27 cells/mm2 in the periphery of the cornea. The group of healthy volunteers comprised 70 eyes with LCs including 55 eyes with both central and peripheral LC location. In healthy volunteers, density of LCs varied from 34±3cells/mm2 in the central to 98±8 cells/mm2 in the peripheral part of the cornea. LC densities significantly differed between healthy volunteers and glaucoma patients both in the central (p<0,001) and the peripheral cornea (p<0,001), while the gradient of LC density from peripheral to central was found almost identical in both groups. LCs were located at the depth of 35-55µm, i.e. the level of intermediate cells, basal cells and subepithelial nervous plexus. Moreover, LCs presented as either large cells bearing long processes or smaller cells lacking cell dendrites, most supposedly indicating mature and immature phenotype, respectively.
In vivo confocal microscopy enables in vivo assessment of density and distribution of LCs in the corneal epithelium. The results show the significant increase of LCs density both in central and peripheral cornea in the group of preservative holding eye drops. This method could be useful in evaluation of preservative induced drug-related allergic reactions, providing insight into human eye immunology.
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