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Reza A Badian, Tor Utheim, Stephan Allgeier, Xu Liu, Bernd Köhler, Neil S Lagali; Quantification of Inflammatory Cells in the Corneal Sub-basal Layer in Type 2 Diabetes by In Vivo Confocal Microscopy (IVCM). Invest. Ophthalmol. Vis. Sci. 2017;58(8):3535. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To quantify and compare mature dendritic cells (mDCs), immature dendritic cells (imDCs) and globular cells (GCs) in the sub-basal layer of the central cornea in healthy and Type 2 diabetes mellitus (T2DM) patients, using IVCM obtained large-area mosaic images.
82 subjects, including healthy and T2DM patients were included in the study. The central cornea in both eyes of all study subjects (163 eyes) was imaged by IVCM, using a Heidelberg HRT 3 with Rostock corneal module. IVCM images were used to make the best possible mosaics that were subsequently analyzed by an experienced examiner using image J. Mosaics were subjected to multiple-parameter quantitative analyses with respect to different types of inflammatory cells (mDCs, imDCs, GCs).
Average size of mosaics was 6.0 mm2, which consisted of an average of 37 single confocal fields of view. Mature DCs were the least prevalent cells compared to immature DCs and globular cells. The ratio between both the number of imDCs and globular cells to the total number of inflammatory cells did not show any significant difference between healthy and T2DM patients. Interestingly, the ratio of mDCs/Type1cells to the total number of inflammatory cells showed a significant increase (P= 0.006, Mann-Whitney) in patients with T2DM compared to healthy subjects.
The corneal sub-basal layer can be imaged using IVCM to produce large-area mosaics. The analysis of the sub-basal layer can provide information on the presence and distribution of different types of inflammatory cells (mDCs, imDCs and GCs) and their characteristics. Inflammatory cells of mature dendritic phenotype and morphology could be a marker for increased inflammation or immune activation in type 2 diabetes. The possibility to non-invasively assess inflammation in diabetes may improve management of the condition.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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