Corneal Confocal Microscopy Detects Alterations in Corneal Endothelial Cell Morphology in Patients Admitted with Acute Ischemic Stroke

Abstract Background: In patients with ischemic stroke, pial collaterals play a key role in limiting neurological disability by maintaining blood flow to ischemic penumbra. We hypothesized that patient with poor pial collateral status will have greater corneal nerve and endothelial cell abnormalities.Method: 35 patients with acute ischemic stroke secondary to middle cerebral artery occlusion with poor (n=12) and moderate/good (n=23) pial collaterals and 35 healthy controls underwent corneal confocal microscopy and quantification of corneal nerve and endothelial cell morphology.Results: In patients with MCA stroke, corneal nerve fibre length (CNFL) (P=0.000), density (CNFD) (P=0.025) and branch density (CNBD) (P=0.002) were lower compared to controls. Age, BMI, cholesterol, triglycerides, HDL, LDL, systolic blood pressure, NIHSS and endothelial cell parameters did not differ but mRS was higher (p=0.023) and CNFL (p=0.026) and CNBD (p=0.044) were lower in patients with poor compared to moderate-good collaterals. CNFL and CNBD distinguished subjects with poor from good pial collaterals with an AUC of 72% (95% CI: 53-92%) and 71% (95% CI: 53-90%), respectively. Conclusion: Corneal nerve loss is greater in patients with poor compared to good pial collaterals and may act as a surrogate marker for pial collateral status in patients with ischemic stroke.

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Corneal nerve loss as a surrogate marker for poor pial collaterals in patients with acute ischemic stroke

Scientific Reports ◽

10.1038/s41598-021-99131-0 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Adnan Khan ◽

Ajay Menon ◽

Naveed Akhtar ◽

Saadat Kamran ◽

Ahmad Muhammad ◽

...

Keyword(s):

Ischemic Stroke ◽

Endothelial Cell ◽

Acute Ischemic Stroke ◽

Nerve Fibre ◽

Fibre Length ◽

Surrogate Marker ◽

Nerve Branch ◽

Cell Parameters ◽

Corneal Confocal Microscopy ◽

Corneal Nerve

AbstractIn patients with acute ischemic stroke, pial collaterals play a key role in limiting neurological disability by maintaining blood flow to ischemic penumbra. We hypothesized that patient with poor pial collaterals will have greater corneal nerve and endothelial cell abnormalities. In a cross-sectional study, 35 patients with acute ischemic stroke secondary to middle cerebral artery (MCA) occlusion with poor (n = 12) and moderate-good (n = 23) pial collaterals and 35 healthy controls underwent corneal confocal microscopy and quantification of corneal nerve and endothelial cell morphology. In patients with MCA stroke, corneal nerve fibre length (CNFL) (P < 0.001), corneal nerve fibre density (CNFD) (P = 0.025) and corneal nerve branch density (CNBD) (P = 0.002) were lower compared to controls. Age, BMI, cholesterol, triglycerides, HDL, LDL, systolic blood pressure, NIHSS and endothelial cell parameters did not differ but mRS was higher (p = 0.023) and CNFL (p = 0.026) and CNBD (p = 0.044) were lower in patients with poor compared to moderate-good collaterals. CNFL and CNBD distinguished subjects with poor from moderate-good pial collaterals with an AUC of 72% (95% CI 53–92%) and 71% (95% CI 53–90%), respectively. Corneal nerve loss is greater in patients with poor compared to moderate-good pial collaterals and may act as a surrogate marker for pial collateral status in patients with ischemic stroke.

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Evaluation of corneal endothelial cell morphology by specular microscopy in patients with acute anterior uveitis

International Ophthalmology ◽

10.1007/s10792-021-02122-3 ◽

2021 ◽

Author(s):

Duygu Sevinc ◽

Tuba Celik ◽

Silay Canturk Ugurbas ◽

Suat Hayri Ugurbas

Keyword(s):

Endothelial Cell ◽

Cell Morphology ◽

Anterior Uveitis ◽

Corneal Endothelial Cell ◽

Specular Microscopy ◽

Acute Anterior Uveitis

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Abstract WP430: Endothelial Cell Collection from Ipsilateral Middle Cerebral Artery in Acute Ischemic Stroke

Stroke ◽

10.1161/str.48.suppl_1.wp430 ◽

2017 ◽

Vol 48 (suppl_1) ◽

Author(s):

Sunil A Sheth ◽

Abhishek Verma ◽

David S Liebeskind ◽

Jeffrey L Saver ◽

Gary Duckwiler ◽

...

Keyword(s):

Ischemic Stroke ◽

Endothelial Cell ◽

Middle Cerebral Artery ◽

Acute Ischemic Stroke ◽

Cerebral Artery ◽

Critical Role ◽

Early Time ◽

Stent Retriever ◽

Positive Controls

Introduction: The cerebrovascular endothelium plays a critical role in the pathogenesis of and response to acute ischemic stroke (AIS). To date, techniques to study its function have relied on animal and in vitro models. A robust method of endothelial cell (EC) capture in patients with AIS at early time points, from within the ischemic region, could greatly advance our understanding of cerebrovascular injury. Method: Patients undergoing thrombectomy for middle cerebral artery occlusion (MCA) within 8 hours of onset were offered enrollment if the pass of their stent-retriever device occurred directly into a distal access catheter in the proximal M1 segment, limiting exposure of the device to only the MCA. After retrieval, ECs adherent to the devices were retrieved and stained for EC (CD31) and leukocyte (CD45) markers. EC identity and yield were confirmed by flow cytometry with simultaneous immuno-fluorescence microscopy. Cultured human ECs were used as positive controls. The EC fraction was defined as CD31 + CD45 - with size and morphological features consistent with the positive controls. Results: ECs from stent-retriever devices (n=3) were collected and pooled. Approximately 8% of the collected cells represented ECs. EC collected from the stent-retrievers demonstrated highly similar shape, morphology and antibody staining patterns compared to the positive controls (Figure). Conclusions: Here we provide the first demonstration of a rapid post-thrombectomy method for reliable harvesting of cerebral ECs in humans. The ability to capture these cells in patients with AIS within hours of symptom onset opens many avenues of exploration for determining the role of ECs in AIS.

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