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Tulika Chauhan, Qihua Le, ERICK OMAR ENCAMPIRA, Fei Yu, Sophie X. Deng; New diagnostic parameters in staging Limbal Stem Cell deficiency using in vivo laser scanning confocal microscopy.. Invest. Ophthalmol. Vis. Sci. 2018;59(9):2992. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the epithelial thickness and its correlation with the morphology of basal epithelial cells in limbal stem cell deficiency (LSCD) by using in vivo laser scanning confocal microscopy.
A total of 101 eyes of 74 patients(mean age 61.7±20.5years) diagnosed as LSCD and 40 eyes of 34 healthy control subjects(mean age 62.9±18.6years) were enrolled.The number of eyes classified as mild, moderate and severe stage were 42, 34 and 25 respectively. In vivo laser scanning confocal microscopy was performed with Z-scan mode. Central epithelial thickness (CET) and limbal epithelial thickness (LET) were measured by two independent examiners. The morphology of basal epithelial cells at central cornea was evaluated and classified as grade 0 to 3 with grade 0 as the normal morphology and grade 3 as the most abnormal.
The mean CET in LSCD eyes was 42.2±14.4 μm, which is 23.1% lower than normal eyes. The mean LET in LSCD eyes were 43.8±18.9 μm at the superior quadrant, 49.2±20.0 μm at the inferior quadrant, 46.0±16.6 μm at nasal quadrant, and 48.5±18.2 μm at the temporal quadrant. Compared with normal controls, LET was reduced in LSCD eyes by an average of 37.5%, 31.6%, 27.7%, 27.6% at each quadrant (all p<.0001). Further comparisons among different severities showed that the reduction of both CET and LET had a significant correlation with the severity of LSCD (all p<.0001). In the eyes with sectoral LSCD, a significant thinning of limbal epithelium was found even in clinically unaffected limbal area, with an average decrease of 19.5%, 29%, 20.09% and 23.28% in superior, inferior, nasal and temporal quadrant, respectively. The classification of cell morphology in the controls eyes showed that 50% were grade 0 and the other 50% were grade 1. However, 3.96%, 55.45%, 18.81% and 21.78% of LSCD patients classified as grade 0, 1, 2 and 3 respectively. The deterioration of basal epithelial morphology had a close relationship with the severity of LSCD and reduction of CET(r=-0.57167and p<.0001). No significant differences were found between two examiners
Epithelial thinning were found in the central cornea and limbus in eyes with LSCD and the degree of thinning correlated with the deterioration of basal epithelial morphology.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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