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Hamid-Reza Moein, Rodrigo Müller, Deborah Pavan-Langston, Bernardo M. Cavalcanti, Clara Colon, Debora Witkin, Arsia Jamali, Andrea Cruzat, Pedram Hamrah; Differential Alterations in Dendritic Cell Density and Morphology in Patients with Central and Peripheral Scars from Herpes Simplex Keratitis: A Longitudinal In Vivo Confocal Microscopy Study. Invest. Ophthalmol. Vis. Sci. 2016;57(12):No Pagination Specified.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the effect of corneal scar location in patients with herpes simplex keratitis (HSK) on longitudinal changes in dendritic cell (DC) density and morphology by in vivo confocal microscopy (IVCM).
This prospective, longitudinal, controlled study included 39 HSK patients with either central cornea scars (CCS, n=21) or peripheral cornea scars (PCS, n=18), as well as 16 age-matched normal reference controls. IVCM (HRT3/RCM) was applied to image the corneas centrally. Image J software was used to quantify DC density and to assess the DC area (cell size) and the DC field (span of a cell) in a masked fashion by two independent observers.
Patients with HSV corneal scars demonstrated a significantly higher mean DC density (140 ± 141.8 cells/mm2) compared to controls (40.2 ± 28.6 cells/mm2; p=0.0003). In addition, mean DC area (70.3 ± 20.2 µm2) and DC field (106.9 ± 36.0 µm2) increased as compared to controls (48.2 ± 11.4 µm2,and 69.8 ± 19.9 µm2; p<001). Patients with CCS had significantly higher DC density (190.6 ± 163.7 cells/mm2) compared to patients with PCS (72.3 ± 61.5 cells/mm2; p=0.008) and controls. Mean DC area and field did not differ between CCS and PCS subgroups (71.7 ± 21.9 vs. 68.3 ± 18.2 and 108.2 ± 35.9 vs. 105.1 ± 37.4 µm2; p>0.05). There was a positive correlation between DC density and both DC area and field (r=0.31, p=0.01 for both). At follow-up visits (mean of 13.8 ± 3.5 months), mean DC density (119.5 ± 109.2 cells/mm2), DC area (68.9 ± 29.7 µm2), and DC field (107.3 ± 50.8 µm2) remained higher compared to controls (p=0.003, p=0.005, and p=0.003, respectively). DC density in CCS remained about two times higher than PCS at follow-up (147.5 ± 130.4 vs. 78.9 ± 51.6 cells/mm2; p=0.1). Mean DC area and field were not different in the CCS and PCS groups (66.3 ± 33.6 vs. 72.7 ± 24.4 and 100.73 ± 52.2 vs.116.9 ± 50.2 µm2; p>0.05).
Patients with HSK demonstrate increased DC density, area, and field in affected eyes compared to controls at baseline and follow-up. Eyes with CCS had higher DC density compared with PCS even at 1-year follow-up. This study demonstrates differential alterations in corneal DC density, but not morphology, in patients with CCS vs. PCS due to HSV. We further demonstrate a novel methodology for quantification of DC parameters.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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