Microstructural imaging examinations of the cornea
Csorba Anita
Clinical Medicine
Dr. Reusz György
SE Szemészeti Klinika, Tanterem
2023-12-04 14:30:00
Ophthalmology
Dr. Nagy Zoltán Zsolt
Dr. Nagy Zoltán Zsolt
Dr. Sisa-Vajda Szilvia
Dr. Kerényi Ágnes
Dr. Szabó Dóra
Dr. Lesch Balázs
Dr. Tátrai Erika
The contemporary anterior segment-imaging techniques allow us the quantitative evaluation of certain parameters of corneal structure and may broaden our knowledge of the pathophysiology of various diseases. In our studies, we used various imaging methods to investigate the corneal microstructure from different aspects and to visualize characteristic alterations in different clinical conditions.
First, a retrospective analysis was performed patients with progressive keratoconus using the Pentacam HR Scheimpflug camera before and 1, 3, 6, and 12 months after cross-linking therapy. The study was focused on the changes in corneal densitometry values, which are indicative of the natural course of the most characteristic cross-linking-related structural alteration, i.e., the stromal haze formation. Besides, the changes in visual acuity, pachymetry keratometry, and the effects of densitometry values on visual outcomes were analysed. Our findings indicated that in more advanced keratoconus more significant corneal flattening parallel with haze formation can be observed. Moreover, despite the significant reduction of keratometry, postoperative haze may limit the final visual acuity.
In the second study, patients with quiescent vernal keratoconjunctivitis and healthy controls were compared in terms of cell density of different corneal layers and morphology of SBNP using in vivo confocal microscopy in a cross-sectional manner. The main aim of this study was to assess whether any signs of an ongoing inflammatory process or of long-term structural alteration can be observed. Our data showed that in quiescent vernal keratoconjunctivitis, both the density and the maturity of Langerhans-cells were increased, and they were associated with the severity of papillary hypertrophy. Alterations of Langerhans cells indicate a subclinical inflammatory process without ocular symptoms.
In our third study, we analysed the characteristics of crystal arrangement in different corneal layers and assessed morphological changes in relation to age in three children and three adults who had nephropathic cystinosis using in vivo confocal microscopy and anterior-segment optical coherence tomography in a cross sectional manner. Our results confirmed an age-related pattern of crystal deposition. In children, crystals tend to locate anteriorly, while in adults, deposits are found posteriorly in the corneal stroma.
