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Naoyuki Morishige, Kazuhito Shinkai, Yumi Soejima, Taka^aki Matsui; Clinical features and confocal microscopic findings of contact lens-related noninfectious keratitis. Invest. Ophthalmol. Vis. Sci. 2018;59(9):5729.
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Uncontrolled usage of contact lenses (CL) often causes corneal diseases such as noninfectious keratitis as well as infectious keratitis. To investigate CL-related non-infectious keratitis, we reviewed the clinical features of CL-related keratitis and confocal microscopic observation findings.
Out of 23 patients who visited Ohshima Eye Hospital from January 2017 through November 2017 with the complaint due to CL-related keratitis, 10 patients (2 males and 8 females, mean age 32.6+/-12.0 y-o, range 18 to 49) who showed no obvious infectious sign such as discharge, microbial detection or focus formations were enrolled in this clinical study. Based on the clinical charts, (1) clinical features, (2) Type of contact lens and (3) usage condition were reviewed. Further, confocal microscopy (Heiderberg Retina Tomography II-Rostock Corneal Module) were performed to identify the findings of epithelial basal cell layer, Bowman’s layer, anterior stroma and posterior stroma adjacent to Descemet membrane were evaluated.
Out of 10 patients, 8 patients showed marginal infiltration of the cornea, and 2 showed slight corneal infiltration at the central cornea. Out of nine patients who used frequent replacement soft CL, 5 patients purchased CL at the general store or CL mass retailer, which did not educate CL users the usage of CL. Confocal microscopic observation revealed that no remarkable change such as infiltration of the inflammatory cells at the level of epithelial basal cell layer. Increased infiltration of dendritic cells at the level of Bowman’s layer were observed in 6 soft CL users out of 10 patients. I filtrated polymorph neutrophil-like cells were detected in 2 out of 10 patients.
CL-related non-infectious keratitis manly showed the clinical feature as corneal marginal infiltration. Confocal observation suggested that dendritic cells may play the important role in this inflammatory condition, and finding dendritic cell-like structure without polymorph neutrophil infiltration at the anterior stroma would be the help to diagnose as CL-related non-infectious keratitis.
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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