Abstract
AbstractPurpose To present different variants of epithelial changes observed in patients with herpetic keratitis in corneal confocal microscopy in vivo images.Methods In 19 patients with diagnosed herpetic keratitis of typical clinical course, we performed the following: basic slit lamp examination, corneal scans using Scheimpflug camera and corneal confocal microscopy in vivo. Full thickness corneal scans were made and compared with corresponding images from healthy objects. Additional imaging of epithelial layer with higher magnification was made to compare detailed changes within all components of epithelial layer.Results On a slit lamp examination we described different size and surface ulceration of typical dendritic shape. In the image from Scheimpflug camera – local turbidity of stroma and lack of superficial layers in place of ulceration. The corneal confocal microscopy images showed different severity of stromal changes in form of hazing, turbidity, keratocytes activation, inflammatory cells infiltration or fibrosis. In epithelial layer scans except mostly diffused inflammatory infiltration, we described changes involving: epithelial cells‐intracellular inclusions, abnormal cells shape and size, degeneration; intercellular matrix‐hazing, inclusions; superficial nerve plexus‐thinning or lack of nerves, mace expand of nerves, nerve fibers proliferation; Bowman membrane and anterior stroma‐epithelial hernias into deeper layers.Conclusion Herpetic corneal inflammations have no typical image in corneal confocal microscopy; however can show repeatable features in epithelial layer, which are helpful in diagnosis. Corneal confocal microscopy is useful tool for recognizing viral keratitis.
Published Version
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call