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A.–C. Ott–Benoist; Pathological aspects in cornea and conjunctiva in ocular surface disease found with the Heidelberg Retina Tomograph (HRT II) cornea module in vivo . Invest. Ophthalmol. Vis. Sci. 2004;45(13):153.
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Purpose:Introduction: The Heidelberg Retina Tomograph (HRT II) can be transformed into a high–resolution digital laser scanning microscope for the exploration of the anterior segment of the eye using a lens adapter developed in Rostock, Germany. Corneal, conjunctival and scleral structures can be visualized in vivo with a magnification until 800x. Methods:We examined and explored eyes with chronic dry eye syndrome due to various pathologies such as Sjögren’s syndrome, blepharitis, allergies and the long–term use of preservative–containing eye drops. Pictures were taken from all corneal structures of the central and peripheral cornea as well as from the limbal and surrounding conjunctiva from patients with ocular surface disease and compared to those of healthy subjects. Results:We visualized inflammatory cells, notably dendritic cells, on corneal and conjunctival pictures in vivo. In some cases of ocular surface diseases we were able to identify goblet cells, especially in peripheral cornea and limbal areas. Conclusions:Whatever the initial causes of dry eye, it has been clearly demonstrated that keratoconjunctivitis sicca results in inflammatory reactions and induces alterations and cell damage of corneal and conjunctival epithelial cells. The cornea module of the HRT II allows very high quality imaging and visualization of corneal and conjunctival structures in vivo. The screening of inflammatory cells in vivo is now possible and could allow to replace more invasive examinations. The cornea module of the HRT II is a highly performing tool to explore in vivo not only all corneal structures as epithelium, endothelium and keratocytes but also the surrounding conjunctiva. All these parameters encourage the use of the cornea module to analyze and explore ocular surface diseases in a noninvasive way.
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