IN VIVO CONFOCAL LASER SCANNING MICROSCOPY STUDY OF CLIMATIC DROPLET KERATOPATHY

A. URRETS-ZAVALÍA, JULIO; JUAN O. CROXATTO; M. HOLOPAINEN, J.; A. CAFARO, THAMARA; FERNANDO A. ESPÓSITO; NEIRA WALDIR; HORACIO M. SERRA

EYE

NATURE PUBLISHING GROUP

Lugar: Londres; Año: 2012 vol. 26 p. 1021 - 1023

0950-222X

Aim and Purpose: To study corneal abnormalities in climatic droplet keratopathy (CDK) patients using in vivo confocal microscopy (ivCM).  Methods: Three CDK patients with different grades of disease were studied in detail with ivCM and Cochet-Bonnet aesthesiometry (CBA). Results: Grade I CDK was characterized by incipient changes under or within the Bowman’s layer (BL) and anterior stroma (AS) with a normal sub-basal nerve plexus. Grade II CDK showed hyper-reflectivity in the BL and AS making difficult the visualization of the nerve plexus. Light scattering was evident throughout the stroma and inclusion bodies were also found at the basal layer of the corneal epithelium. In grade III the AS showed fibrosis with the presence of vacuoles under the BL, increment of diffuse infiltrates throughout the full thickness of the stroma and lack of stromal nerve fibres. Concomitant to these changes there was an increased number of dendritic cells (DC) at the limbus. No abnormalities were found in the rest of cornea. CBA results demonstrated a decrease of the mechanical stimulation of the cornea in eyes with grade II and III CDK. Conclusions:  Using ivCM we show microscopic changes during the progression of CDK. The changes reported at the superficial corneal layers and the consequent changes in the sub basal nerve plexus seems to correlate with the loss of corneal sensitivity and the degree of CDK.