Objective To describe the corneal and limbal epithelial changes in patients with imbal stem cells deficiency (LSCD) using in vivo laser scanning confocal microscopy (LSCM), and to classify the stages of LSCD at the cellular level.
Method This is a prospective, noncomparative clinical study. Patients were selected according to their clinical presentations. Twenty four eyes of 18 subjects with LSCD were classified into 4 stages groups initially according to their cornea status. In vivo imagings of the corneal and limbal epithelium in all the 24 eyes were obtained with HRT 3 Rostock cornea module LSCM. The LSCM images were reviewed.
Results Five useful parameters were found to evaluate all the LSCM images: the epithelium layers; epithelial cells size and activity; invading cells; epithelial and subepithelial nerve, intraepithelial vessels. Both the central cornea and limbus showed 4 different stages changes which correlated with the initial clinical 4 stages group. The staging system for LSCD at the cellular level was established.
Conclusion The morphological and structural changes of corneal and limbal epithelium at the cellular level correlated with clinical presentations at different stages in LSCD. Confocal microscopy might be a useful tool to detect very early stage of LSCD and could aid in the staging of LSCD. |
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