PURPOSE: To compare corneal structures in buphthalmic eyes and healthy eyes in patients with unilateral congenital glaucoma using a corneal confocal microscope. METHODS: Ten patients with unilateral buphthalmos (mean ± SD age, 14.85 ± 5.12 years) were examined using corneal confocal microscopy. The cell density and cell area of endothelial cells and superficial and basal epithelial cells and the number of keratocytes were evaluated. RESULTS: There was no significant difference between the cell density of superficial epithelial cells in buphthalmic eyes relative to healthy eyes (P = 0.1944). The cell density of basal epithelial cells was significantly higher (P = 0.0234) and the cell area was significantly smaller (P = 0.0181) in buphthalmic eyes relative to healthy eyes. There was no difference between the number of keratocytes in buphthalmic eyes and healthy eyes in the anterior stroma (P = 0.273) or in the posterior stroma (P = 0.0799). The cell density of endothelial cells was significantly lower and the cell area was significantly larger in buphthalmic eyes relative to healthy eyes (P = 0.0009). CONCLUSIONS: We demonstrated a lower cell density of endothelial cells in buphthalmic eyes. We found no differences in keratocyte density between the buphthalmic eyes and healthy eyes. The cell density of basal epithelial cells was higher in buphthalmic eyes. These differences could be due to buphthalmos or due to the previous surgical and medical therapies. Monitoring of these changes could help to contribute to accurate assessments regarding future ocular surgical procedures.

• Klíčová slova
• buphthalmos, congenital glaucoma, corneal confocal microscopy, corneal endothelial cells, corneal epithelial cells,
• MeSH
• Descemetova membrána patologie   MeSH
• dítě MeSH
• glaukom s otevřeným úhlem vrozené   patologie   chirurgie   MeSH
• hydroftalmus patologie   chirurgie   MeSH
• konfokální mikroskopie metody   MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• počet buněk MeSH
• rohovkové keratocyty patologie   MeSH
• rohovkový epitel patologie   MeSH
• stroma rohovky patologie   MeSH
• Sturgeův-Weberův syndrom patologie   MeSH
• trabekulektomie MeSH
• úbytek endoteliálních buněk rohovky vrozené   patologie   chirurgie   MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

PURPOSE: To demonstrate the use of in vivo corneal confocal microscopy to reveal the reason for persistent disturbance of vision after a corneal abrasion. CASE REPORT: A 49-year-old man presented with a decrease in visual acuity and monocular diplopia after a traumatic corneal abrasion. Anterior segment optical coherence tomography was not beneficial. In vivo corneal confocal microscopy showed abnormal folding in the basal epithelial layer of the cornea. Based on these findings, a therapeutic abrasion of the affected epithelium was performed. Visual acuity returned to 1.0 after therapeutic abrasion, and overall findings on the eye were within physiological limits. Control corneal confocal microscopic examination confirmed reparation of the structure of epithelial cell layers. CONCLUSIONS: The in vivo corneal confocal microscopy can reveal corneal pathologic abnormality even in cases where other methods are not beneficial. Alongside other modern methods, it may become an important tool to help locate pathologic abnormality accurately and choose the proper therapeutic strategy.

• MeSH
• debridement MeSH
• hojení ran fyziologie   MeSH
• konfokální mikroskopie * MeSH
• lidé středního věku MeSH
• lidé MeSH
• optická koherentní tomografie MeSH
• poranění oka diagnóza   etiologie   patofyziologie   chirurgie   MeSH
• poruchy zraku diagnóza   etiologie   patofyziologie   MeSH
• rohovkový epitel zranění   patologie   MeSH
• tupá poranění diagnóza   etiologie   patofyziologie   chirurgie   MeSH
• zraková ostrost fyziologie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• práce podpořená grantem MeSH

BACKGROUND: Immune-mediated neuropathies, such as chronic inflammatory demyelinating polyneuropathy (CIDP) are treatable neuropathies. Among individuals with diabetic neuropathy, it remains a challenge to identify those individuals who develop CIDP. Corneal confocal microscopy (CCM) has been shown to detect corneal nerve fiber loss and cellular infiltrates in the sub-basal layer of the cornea. The objective of the study was to determine whether CCM can distinguish diabetic neuropathy from CIDP and whether CCM can detect CIDP in persons with coexisting diabetes. METHODS: In this multicenter, case-control study, participants with CIDP (n = 55) with (n = 10) and without (n = 45) diabetes; participants with diabetes (n = 58) with (n = 28) and without (n = 30) diabetic neuropathy, and healthy controls (n = 58) underwent CCM. Corneal nerve fiber density (CNFD), corneal nerve fiber length (CNFL), corneal nerve branch density (CNBD), and dendritic and non-dendritic cell density, with or without nerve fiber contact were quantified. RESULTS: Dendritic cell density in proximity to corneal nerve fibers was significantly higher in participants with CIDP with and without diabetes compared to participants with diabetic neuropathy and controls. CNFD, CNFL, and CNBD were equally reduced in participants with CIDP, diabetic neuropathy, and CIDP with diabetes. CONCLUSIONS: An increase in dendritic cell density identifies persons with CIDP. CCM may, therefore, be useful to differentiate inflammatory from non-inflammatory diabetic neuropathy.

• Klíčová slova
• Chronic inflammatory demyelinating neuropathy, Diabetes mellitus, corneal confocal microscopy,
• MeSH
• chronická zánětlivá demyelinizační polyneuropatie diagnóza   epidemiologie   MeSH
• dendrity patologie   MeSH
• diabetes mellitus 2. typu diagnóza   epidemiologie   MeSH
• diabetické neuropatie diagnóza   epidemiologie   MeSH
• diferenciální diagnóza MeSH
• dospělí MeSH
• konfokální mikroskopie metody   normy   MeSH
• lidé středního věku MeSH
• lidé MeSH
• nervová vlákna patologie   MeSH
• rohovka patologie   MeSH
• senioři MeSH
• studie případů a kontrol MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH

BACKROUND: In vivo corneal confocal microscopy allows the examination of each layer of the cornea in detail and the identification of pathological changes at the cellular level. The purpose of this study was to identify the possible effects of a three-month treatment with autologous serum eye-drops in different corneal layers of patients with severe dry eye disease using corneal confocal microscopy. METHODS: Twenty-six patients with dry eye disease were included in the study. Corneal fluorescein staining was performed. The corneas of the right eyes were examined using in vivo corneal confocal microscopy before and after a three-month treatment with autologous serum drops. The densities of superficial and basal epithelial cells, Langerhans cells, the keratocytes and activated keratocytes, the density of endothelial cells and the status of the sub-basal nerve plexus fibres were evaluated. RESULTS: A significant decrease in corneal fluorescein staining was found after the three-month autologous serum treatment (p = 0.0006). The basal epithelial cell density decreased significantly (p = 0.001), while the density of superficial epithelial cells did not change significantly (p = 0.473) nor did the number of Langerhans cells or activated keratocytes (p = 0.223; p = 0.307, respectively). There were no differences in the other corneal cell layers or in the status of the nerve fibres. CONCLUSIONS: The results demonstrate the ability of corneal confocal microscopy to evaluate an improvement in the basal epithelial cell layer of the cornea after autologous serum treatment in patients with dry eye disease. More studies with longer follow-up periods are needed to elucidate the suitability of corneal confocal microscopy to follow the effect of autologous serum treatment on nerve fibres or other corneal layers in dry eye disease patients.

• Klíčová slova
• Sjögren syndrome, autologous serum, corneal confocal microscopy, dry eye disease, graft-versus-host disease,
• MeSH
• aplikace lokální MeSH
• fluorescein farmakologie   MeSH
• fluorescenční barviva farmakologie   MeSH
• konfokální mikroskopie metody   MeSH
• lidé středního věku MeSH
• lidé MeSH
• oční roztoky aplikace a dávkování   MeSH
• počet buněk MeSH
• prospektivní studie MeSH
• rohovka patologie   MeSH
• sérum * MeSH
• syndromy suchého oka diagnostické zobrazování   terapie   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• pozorovací studie MeSH
• Názvy látek
• fluorescein MeSH
• fluorescenční barviva MeSH
• oční roztoky MeSH

Evaluation of: Tavakoli M, Kallinikos P, Iqbal A et al. Corneal confocal microscopy detects improvement in corneal nerve morphology with an improvement in risk factors for diabetic neuropathy. Diabet. Med. 28(10), 1261-1267 (2011). A recent observational study has evaluated whether a novel examination method, corneal confocal microscopy, can be used to detect changes in corneal nerve morphology following improvements of conventional risk factors in diabetic patients with mild-to-moderate neuropathy. At 2-year follow-up, improvement of glycemic control (HbA1c) correlated significantly with increases in corneal nerve fiber density. The results add new supportive evidence to data from previous studies of corneal confocal microscopy for its potential use as a convenient noninvasive technique in trials of therapeutic interventions for diabetic neuropathy. Since so far only intensive glycemic control has been proven as an effective measure, this could represent an important advance in the search for new treatment options for this major diabetic complication.

• Klíčová slova
• corneal confocal microscopy, corneal nerves, diabetic neuropathy, risk factors,
• Publikační typ
• časopisecké články MeSH

Corneal confocal microscopy is a new, non-invasive imaging method. It provides serial images of a face optical sections through the full-thickness of the living cornea, avoiding artefacts associated with ex vivo study. It provides qualitative as well as quantitative analysis of the corneal layers, nerves, and cells. It also allows longitudinal examination of the corneal structure changes over time. The purpose of this article is to describe the principles and capabilities of the currently available corneal confocal microscopes, and possible applications of this tool.Key words: confocal microscopy, cornea.

• MeSH
• konfokální mikroskopie * MeSH
• lidé MeSH
• rohovka * diagnostické zobrazování   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

In vivo corneal confocal microscopy (CCM) represents a new, non-invasive, rapidly developing corneal examination technique that enables individual layers of the cornea to be displayed at the cellular level. The cornea is the translucent and at the same time the most innervated tissue of the human body. Diabetic neuropathy (DN) is a serious complication of diabetes mellitus (DM). A close correlation has been demonstrated between the development of diabetic neuropathy and the pathological changes of the corneal subbasal plexus. Currently, great attention is directed towards the possibility of using CCM to determine early DN. Interestingly, changes in nerve plexus in the cornea precede the clinical manifestations of DN. Our work aims to give a comprehensive overview of the current possibilities and trends in use of in vivo CCM in connection with DN evaluation. In vivo CCM becomes important in the search for patients at risk of developing DN, in early diagnosis of DN in pre-symptomatology, in quantifying severe DN, in monitoring and evaluating the therapeutic response to DM treatment. In addition to its diagnostic and preventive significance, it is a research tool important for understanding the pathophysiology of DM changes.Key words: confocal microscopy, cornea, small fibre neuropathy, diabetes mellitus, diabetic neuropathy.

• MeSH
• diabetické neuropatie * diagnostické zobrazování   MeSH
• konfokální mikroskopie * MeSH
• lidé MeSH
• rohovka MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

• MeSH
• konfokální mikroskopie * MeSH
• lidé MeSH
• nemoci rohovky diagnóza   MeSH
• rohovka patologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

UNLABELLED: Confocal microscopy represents modern, non-invasive, semi-contact examination method making possible to visualize separate corneal layers (from the endothel to the epithel) in high resolution. Phototherapeutic keratectomy (PTK) is a method using argon-fluoride laser with 193 nm wavelength to treat corneal surface diseases. AIM: To evaluate the use of confocal microscopy for epithelial basal membrane dystrophy diagnosis (Cogan microcystic dystrophy) and following corneal ultra-structural changes in vivo after PTK. MATERIAL AND METHODS: The group consisted of 14 eyes of 9 patients (6 men and 3 women) of average age 45.8 +/- 14.4 years who underwent in the department in last two years phototherapeutic keratectomy for recurrent erosion in Cogan microcystic corneal dystrophy. For the diagnosis of this disease, the confocal corneal microscope (Confoscan 4, Nidek, probe x 40) was used. Computer controlled laser photoablation was in all patients performed; the average depth was 14.8 +/- 3.3 microm (Technolas 217, Bausch & Lomb). The follow-up visits were scheduled always day 5 and 12, and month 1, 3, 6, and 12 after the PTK. The reactive processes in all corneal layers, the subepithelial inervation restoration velocity and recurrence of the primary disease detectable by means of the confocal corneal microscope were followed-up. RESULTS: Cogan microcystic dystrophy was diagnosed in all followed-up patients by means of confocal microscope according to the findings of the area thickening and corneal epithelium basal membrane irregularities. These patients were indicated to the PTK. After the treatment, the healing of the epithelial layer was finished as early as the fifth day. The subepithelial nervous plexus average regeneration period was 6.2 +/- 2.8 months. In all patients, the edema of the anterior stroma was found at the day 5. The beginning of the re-popularization of the anterior stroma by keratocytes from deeper layers we diagnosed, on average, at the day 11.5 +/- 1.9 after the treatment and the following reduction after 5.1 +/- 1.4 months. In the posterior stroma and in the endothel, no changes were found. During the follow-up period, in none of the followed-up patients, the recurrence of the primary disease was found. CONCLUSION: The confocal microscopy may be recommended for superficial corneal dystrophies quality and accurate diagnosis and to follow up changes after phototherapeutic keratectomy as suitable treatment method of these diseases.

• MeSH
• fotorefrakční keratektomie * MeSH
• konfokální mikroskopie * MeSH
• lasery excimerové * MeSH
• lidé středního věku MeSH
• lidé MeSH
• nemoci rohovky patologie   chirurgie   MeSH
• rohovkový endotel ultrastruktura   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH

BACKGROUND: The purpose of this study was to identify the genetic cause and describe the clinical phenotype of Schnyder corneal dystrophy (SCD) in six unrelated probands. METHODS: We identified two white Czech, two white British and two South Asian families with a clinical diagnosis of SCD. Ophthalmic assessment included spectral domain optical coherence tomography (SD-OCT) of one individual with advanced disease, and SD-OCT and confocal microscopy of a child with early stages of disease. UBIAD1 coding exons were amplified and Sanger sequenced in each proband. A fasting serum lipid profile was measured in three probands. Paternity testing was performed in one family. RESULTS: A novel heterozygous c.527G>A; p.(Gly176Glu) mutation in UBIAD1 was identified in one Czech proband. In the second Czech proband, aged 6 years when first examined, a previously described de novo heterozygous c.289G>A; p.(Ala97Thr) mutation was found. Two probands of South Asian descent carried a known c.305G>A; p.(Asn102Ser) mutation in the heterozygous state. Previously reported heterozygous c.361C>T; p.(Leu121Phe) and c.308C>T; p.(Thr103Ile) mutations were found in two white British families. Although crystalline deposits were present in all probands the affected area was small in some individuals. Corneal arcus and stromal haze were the most prominent phenotypical feature in two probands. In the Czech probands, SD-OCT confirmed accumulation of reflective material in the anterior stroma. Crystalline deposits were visualized by confocal microscopy. Mild dyslipidemia was found in all three individuals tested. CONCLUSION: Although de novo occurrence of mutations in UBIAD1 is extremely rare, SCD should be considered in the differential diagnosis of bilateral corneal haze and/or crystal deposition, especially in children.

• Klíčová slova
• Confocal microscopy, Crystalline deposits, De novo, Novel mutation, Schnyder corneal dystrophy, Spectral domain optical coherence tomography, UBIAD1,
• MeSH
• dědičné dystrofie rohovky diagnóza   genetika   metabolismus   MeSH
• dítě MeSH
• DNA genetika   MeSH
• dospělí MeSH
• fenotyp MeSH
• konfokální mikroskopie MeSH
• lidé středního věku MeSH
• lidé MeSH
• mutace * MeSH
• mutační analýza DNA MeSH
• optická koherentní tomografie metody   MeSH
• prenyltransferáza genetika   metabolismus   MeSH
• rodokmen MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• DNA MeSH
• prenyltransferáza MeSH
• UBIAD1 protein, human MeSH Prohlížeč