Corneal confocal microscopic characteristics of acute angle-closure crisis

Abstract Background To investigate characteristics of the acute angle-closure crisis (AACC) and fellow eyes using confocal microscopy. Methods Unilateral AACC patients hospitalized at the Xi’an People’s Hospital from October 2017 to October 2020 were recruited in this cross-sectional study. Age-matched participants scheduled for cataract surgery were enrolled as a healthy control group. Corneal epithelial cells, subepithelial nerve fiber plexus, stromal cells, and endothelial cells were examined by confocal and specular microscopy. Results This study enrolled 41 unilateral AACC patients (82 eyes) and 20 healthy controls (40 eyes). Confocal microscopy revealed that the corneal nerve fiber density, corneal nerve branch density and corneal nerve fiber length were reduced significantly in AACC eyes. The stromal cells were swollen and the size of the endothelial cells was uneven with the deposition of punctate high-reflective keratic precipitate on the surface. In severe cases, the cell volume was enlarged, deformed, and fused. The corneal subepithelial nerve fiber, stromal layer, and endothelial layer were unremarkable in the fellow eyes, and the density of the endothelial cells was 2601 ± 529 cells/mm2, which was higher than 1654 ± 999 cells/mm2 in AACC eyes (P < 0.001). Corneal edema prevented the examination of 17 eyes using specular microscopy and in only four eyes using confocal microscopy. There were no significant differences in endothelial cell density between confocal and specular microscopy in the AACC eyes (P = 0.674) and fellow eyes (P = 0.247). The hexagonal cell ratio reduced significantly (P < 0.001), and average cell size and coefficient of variation of the endothelial cells increased significantly compared with fellow eyes (P < 0.001, P = 0.008). Conclusions AACC eye showed decreased density and length of corneal subepithelial nerve fiber plexus, activation of stromal cells, increased endothelial cell polymorphism, and decreased density.

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Measurement of Retinal Nerve Fiber Layer in Primary Acute Angle Closure Glaucoma by Optical Coherence Tomography

Journal of Glaucoma ◽

10.1097/ijg.0b013e31802d6dd8 ◽

2007 ◽

Vol 16 (2) ◽

pp. 178-184 ◽

Cited By ~ 12

Author(s):

Ai-wu Fang ◽

Jia Qu ◽

Le-ping Li ◽

Bao-Ling Ji

Keyword(s):

Optical Coherence Tomography ◽

Nerve Fiber ◽

Retinal Nerve Fiber Layer ◽

Acute Angle ◽

Angle Closure Glaucoma ◽

Angle Closure ◽

Fiber Layer ◽

Nerve Fiber Layer ◽

Acute Angle Closure ◽

Acute Angle Closure Glaucoma

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In Vivo Confocal Microscopy Observation of Cell and Nerve Density in Different Corneal Regions with Monocular Pterygium

Journal of Ophthalmology ◽

10.1155/2020/6506134 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Yun-Zhi Shen ◽

Mi Xu ◽

Song Sun

Keyword(s):

Endothelial Cells ◽

Dendritic Cells ◽

Epithelial Cells ◽

Confocal Microscopy ◽

Stromal Cells ◽

Nerve Fibers ◽

Lower Region ◽

Central Cornea ◽

Fellow Eyes

Purpose. To investigate the effects of pterygium on corneal cell and nerve density in patients with unilateral pterygium using in vivo laser scanning confocal microscopy (LSCM). Methods. In this cross-sectional study, 24 patients with unilateral pterygium who were treated in the Department of Ophthalmology of the Second People’s Hospital of Wuxi City from April 2018 to July 2018 were analyzed. Each eye with pterygium and its fellow eye were imaged by LSCM. The density of basal corneal epithelial cells, anterior stromal cells, posterior stromal cells, dendritic cells, and endothelial cells in pterygium and adjacent clear cornea was measured. In the fellow eyes, the central cornea, nasal cornea, nasal mid-peripheral cornea, and temporal cornea were imaged. The difference in the density of cells and subepithelial nerve fibers in different corneal regions of eyes with pterygium was analyzed. The cell and nerve density of the fellow cornea were also measured to exclude the influencing factors. Results. The density of corneal basal epithelial cells in the central corneas of eyes with pterygium was 6497 ± 1776 cells/mm2, which was higher than that in the area near the head of pterygium (5580 ± 1294 cells/mm2, P<0.001), the region above pterygium (6097 ± 1281 cells/mm2, P=0.049), and the region below pterygium (5463 ± 1007 cells/mm2, P=0.001). The density of anterior stromal cells in the central cornea was 742 ± 243 cells/mm2, which was higher than that in the area near the head of pterygium (587 ± 189 cells/mm2, P=0.005), the region below pterygium (492 ± 159 cells/mm2, P=0.005), and the temporal cornea (574 ± 164 cells/mm2, P=0.003). The density of endothelial cells in the central cornea was 2398 ± 260 cells/mm2, which was higher than that in the area near the head of pterygium (2296 ± 231 cells/mm2, P=0.011) and the region below pterygium (2272 ± 400 cells/mm2, P=0.020). The density of dendritic cells in the central cornea was 53 ± 48 cells/mm2, which was lower than that in the area near the head of pterygium (250 ± 224 cells/mm2, P=0.001), the upper region (103 ± 47 cells/mm2, P=0.006), and the lower region (90 ± 48 cells/mm2, P=0.023). The corneal nerve fiber length (CNFL) in the center was higher than that in the area near the head of pterygium, the upper region, and the lower region. Compared with fellow eyes, eyes with pterygium had a significantly higher mean corneal power (KM) (P<0.001). There was a significant positive linear relationship between the corneal area invaded by pterygium of pterygia and KM (r = 0.609, P=0.009). Conclusion. Basal epithelial cells, stromal cells, endothelial cells, dendritic cells, and subepithelial nerve fibers in the central cornea of eyes with pterygium were different from those of pterygium and adjacent clear cornea. LSCM is effective for observing the morphology and quantity of corneal cells in pterygium.

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