Epithelial Basement Membrane Dystrophy: An Evaluation With a New in vivo Confocal Microscope

Abstract

Abstract: : Purpose: To describe with a new in vivo confocal microscope (corneal module of HRT II) the corneal characteristics of patients with epithelial basement membrane dystrophy (map–dot–fingerprint dystrophy). Methods: We have evaluated 16 eyes of 10 patients after being diagnosed with epithelial basement membrane dystrophy. All patients were examined by slit–lamp biomicroscopy and in vivo confocal microscopy using the new HRT II confocal microscorpope. Selected digitized images of the corneal layers were analyzed visually and compared to clinical findings. Morphological appearances of corneal epithelial and basal cells, Bowman’s layer and stroma were evaluated. Results: Surface epithelial cells of all eyes were normal. In 10 eyes we have observed between normal basal epithelial cells, highly reflective deposits. These deposits had map and ring–like configuration. In 2 patients microcysts were seen in the basal epithelial cell area. All eyes showed highly reflective streaks in the basal epithelial cell layer corresponding to bowman’s layer microfolds. No pathological finding was observed in the stroma. Conclusions: In vivo confocal microscopy of corneas of patients with epithelium basement membrane dystrophy showed alterations at the level of basal corneal epithelial cells and bowman’s layer. The new in vivo HRT II confocal microscope by providing high resolution images of corneal structures helps to diagnose and to understand physiopathology of corneal diseases.

Keywords: microscopy: confocal/tunneling • cornea: epithelium • imaging/image analysis: clinical