J Korean Ophthalmol Soc > Volume 54(12); 2013 > Article
Journal of the Korean Ophthalmological Society 2013;54(12):1923-1928.
DOI: https://doi.org/10.3341/jkos.2013.54.12.1923    Published online December 13, 2013.
In Vivo Confocal Microscopic Findings of Corneal Tissue in Bullous Keratopathy.
Young Min Park, Han Jo Kwon, Jong Soo Lee
Department of Ophthalmology, Pusan National University Hospital, Pusan National University & Medical Research Institute School of Medicine, Busan, Korea. jongsool@pusan.ac.kr
수포성 각막병증의 공초점주사현미경 소견
박영민⋅권한조⋅이종수
Department of Ophthalmology, Pusan National University Hospital, Pusan National University &
Medical Research Institute School of Medicine, Busan, Korea
Abstract
PURPOSE
To analyze the morphology and density of corneal tissue in patients with bullous keratopathy using in vivo confocal microscopy (IVCM). CASE SUMMARY: Four eyes of 4 patients with clinically diagnosed bullous keratopathy were examined using IVCM. Cross-sectioned corneal images of the corneal epithelium, Bowman's layer, stromal layer, Descemet's membrane, and endothelium were evaluated. In bullous keratopathy patients, the outline of corneal epithelial wing cells was blurred. Several hyper-reflective whitish dots were found at the corneal epithelial level and a reduction in the density and thickness of the corneal nerves was observed. There was also a reduction in the density of the stromal keratocytes. The outline of the stromal keratocytes was blurred. Some keratocytes resembled myofibroblast. The hypo-reflective vertical strands were observed in the stroma adjacent to the Descemet's membrane. Endothelium showed hyper-reflectivity with associated increased endothelial pleomorphism and polymegathism. CONCLUSIONS: In patients with bullous keratopathy, IVCM showed tissue edema in the corneal epithelium, stroma, and endothelium. Hyper-reflectivity appearances were noted due to the increase in the metabolic rate of the cells or extracellular matrix accumulation. Corneal endothelium showed morphological changes.
Key Words: Bullous keratopathy;Confocal microscopy Address


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