gms | German Medical Science

102. Jahrestagung der DOG

Deutsche Ophthalmologische Gesellschaft e. V.

23. bis 26.09.2004, Berlin

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Presentation of corneal dystrophies using confocal microscopy

Meeting Abstract

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  • corresponding author S. Uhlmann - Department of Ophthalmology, University of Leipzig, Leipzig
  • I. Sterker - Department of Ophthalmology, University of Leipzig, Leipzig
  • P. Wiedemann - Department of Ophthalmology, University of Leipzig, Leipzig

Evidenzbasierte Medizin - Anspruch und Wirklichkeit. 102. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft. Berlin, 23.-26.09.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04dogP 022

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dog2004/04dog513.shtml

Published: September 22, 2004

© 2004 Uhlmann et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective

In patients suffering from corneal dystrophies transplantation of the cornea often is indicated. The cornea modul combined with the Heidelberg Retina Tomograph II (HRT II) allows 3-D tomography of corneal architecture. It offers a new diagnostic approach before and after corneal transplantation.

Methods

Patients with stromal and endothelial dystrophies have been examined with the "Rostock Cornea Modul". With a specially designed lens attachment, the imaging level of the HRT II system can be focussed from the retina to the anterior segment. It generates homogeneous, undistorted images of the cornea with up to 600 x magnification.

Results

Images showing granular stromal dystrophy, Fuchs` endothelial dystrophy and in vivo images after transplantation of the cornea will be presented. An assessment of the epithelium (superficial, intermediate, basal cells), stroma and endothelium, and especially of dendritic Langerhans cells close to the limbus basal cell layer after keratoplasty is possible. In case of granular dystrophy irregularly shaped deposits (300 - 400 μm size) were seen. Deposits were found in the middle of the stroma, between 100 and 400 μm depth. Endothelial cell count was within the normal range, but the cells showed increased polymorphism. In corneas with Fuchs`s dystrophy guttae were seen as hyporeflective areas at the level of the endothelium. Endothelial cell count was diminished compared to normal controls.

Conclusions

This new technique of investigation allows quantitative and careful in vivo histology of the cornea including exact depth analysis. After keratoplasty it helps to differentiate between recurrence of the primary disease and immunological rejection of the transplanted cornea. More varied experience in classification and validation of the images is necessary.