Laser scanning in vivo confocal microscopy reveals reduced innervation and reduction in cell density in all layers of the keratoconic cornea

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dc.contributor.author Niederer, RL en
dc.contributor.author Perumal, D en
dc.contributor.author Sherwin, Trevor en
dc.contributor.author McGhee, Charles en
dc.date.accessioned 2012-05-13T20:12:01Z en
dc.date.issued 2008 en
dc.identifier.citation Invest Ophthalmol Vis Sci 49(7):2964-2970 Jul 2008 en
dc.identifier.issn 0146-0404 en
dc.identifier.uri http://hdl.handle.net/2292/17919 en
dc.description.abstract purpose. The exact pathophysiological processes underlying keratoconus remain an enigma. In this study, laser scanning in vivo confocal microscopy (IVCM) was used to define further the microstructural abnormalities in the keratoconic cornea and to establish the relationship with disease severity. methods. This was a prospective, cross-sectional study comparing 52 subjects with keratoconus and 52 age-matched control subjects. Assessment included demographics, history, slit lamp biomicroscopy, computerized corneal tomography, and laser scanning IVCM. results. Significantly lower cell densities (in cells per square millimeter, mean ± SD) were observed in keratoconus corneas than in normal ones: basal epithelial cells, 4340.6 ± 595.2 vs. 5777.6 ± 958.2 (P < 0.001), anterior keratocytes, 523.6 ± 206.4 vs. 859.7 ± 219.1 (P < 0.001), posterior keratocytes, 240.4 ± 64.5 vs. 330.6 ± 52.3 (P < 0.001), and endothelial cells 2412.2 ± 339.5 vs. 2845.6 ± 313.0 (P < 0.001). Subbasal nerve fiber density was 52.7% lower in keratoconus corneas than in the control (P < 0.001). Basal epithelial cell density (P = 0.001), subbasal nerve fiber density (P = 0.015), and anterior keratocyte density (P < 0.001) correlated with severity of disease. Lower subbasal nerve density also correlated with younger age at diagnosis (r = 0.397, P = 0.004). Severe disease was associated with diagnosis at a younger age (P = 0.023), a history of eye rubbing (P = 0.025), and Maori or Pacific Island ethnicity (P = 0.001). conclusions. Significant microstructural abnormalities were identified at every level of the keratoconic cornea and were related to disease severity. IVCM offers a potential insight into the pathophysiology of the microstructural changes in keratoconus. en
dc.publisher Association for Research in Vision and Ophthalmology (ARVO) en
dc.relation.ispartofseries Investigative Ophthalmology & Visual Science en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. Details obtained from http://www.sherpa.ac.uk/romeo/issn/0146-0404/ en
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm en
dc.title Laser scanning in vivo confocal microscopy reveals reduced innervation and reduction in cell density in all layers of the keratoconic cornea en
dc.type Journal Article en
dc.identifier.doi 10.1167/iovs.07-0968 en
pubs.issue 7 en
pubs.begin-page 2964 en
pubs.volume 49 en
dc.rights.holder Copyright: Association for Research in Vision and Ophthalmology (ARVO) en
dc.identifier.pmid 18579760 en
pubs.end-page 2970 en
dc.rights.accessrights http://purl.org/eprint/accessRights/RestrictedAccess en
pubs.subtype Article en
pubs.elements-id 99750 en
pubs.org-id Medical and Health Sciences en
pubs.org-id School of Medicine en
pubs.org-id Ophthalmology Department en
pubs.record-created-at-source-date 2010-09-01 en
pubs.dimensions-id 18579760 en


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