Abstract
Purpose: :
To assess the effect of topic therapy with Cyclosporine 0.05% drops using in vivo microstructural findings in a case of recurrent epithelial erosion syndrome.
Methods: :
A 64 year–old patient, affected by recurrent epithelial erosions in both eyes during last two years, was submitted to slit lamp examination and in vivo confocal microscopy (Confoscan 4, Nidek Co. Ltd). The examination showed multiple hypo–reflective lengthened areas within the basal epithelium layer and oval and tears drop like ones in the suprabasal epithelium layers. Hyper–reflective areas near and within the lesions described were seen too. Some Langherans cells, and small lymphocites cells were seen near the hypo–reflective lesions and inside the epithelium layers. Tortuous stromal nerves were evidenced, and an increase of the background reflectivity of subepithelial stroma was found. Topical Cyclosporine 0.05% drops four times a day therapy associated to artificial tear drops (Sodium Hyaluronate 0.15%) six times a day was started.
Results: :
One months after topical therapy the slit lamp examination showed a restoring of corneal epithelium integrity and in vivo microscopic confocal examination showed the total regression of the subepithelial lesions.
Conclusions: :
The microstructural abnormalities imaged by in vivo confocal microscopy resulted comparable to those observed in electromicroscopy studies. Confocal microscopy could be useful for the diagnosis and management of corneal distrophies.
Keywords: cornea: epithelium • imaging/image analysis: clinical • lesion study