Application of in vivo confocal microscopy to observe ocular surface morphology in dry eye patients
Yu Chenying,Li Ying
Department of Ophthalmology， Peking Union Medical College Hospital， Peking Union Medical College， Chinese Academy of Medical Sciences， Beijing 100730， China
Dry eye syndrome is one of the most common ocular disorders. Although significant advances in both basic and clinical research have been made over the past years， the pathophysiological mechanisms of dry eye syndrome still need further clarification. In vivo confocal microscopy is a noninvasive ocular imaging tool that allows the observation of ocular surface epithelial cells， immune and inflammatory cells， corneal nerves， keratocytes， and meibomian gland structures on a cellular level. Therefore， it could help improve understanding of the pathogenesis and pathophysiology of the dry eye syndrome. Ocular surface structures in dry eye-related conditions could be assessed and alterations could be quantified using in vivo confocal microscopy， and it may enable the disease to be detected at much earlier stages and allow stratification of patients for clinical therapies. Furthermore， dynamic observation of the changes in confocal images could also help monitor the efficacy of treatment strategies， thus tailoring treatment in a timely manner and evaluating the prognoses more accurately.
余晨颖,李莹. 活体共聚焦显微镜在干眼患者眼表形态观察中的应用[J]. 中华眼视光学与视觉科学杂志, 2014, 16(9): 573-576.
Yu Chenying,Li Ying. Application of in vivo confocal microscopy to observe ocular surface morphology in dry eye patients. Chinese Journal of Optometry Ophthalmology and Visual science, 2014, 16(9): 573-576. DOI: 10.3760/cma.j.issn.1674-845X.2014.09.015
The definition and classification of dry eye disease： report of the definition and classification subcommittee of the international dry eye workshop （2007）[J]. Ocul Surf，2007，5：75-92.
[2]
Gayton JL. Etiology， prevalence， and treatment of dry eye disease[J]. Clin Ophthalmol，2009，3：405-412.
[3]
Alhatem A， Cavalcanti B， Hamrah P. In vivo confocal microscopy in dry eye disease and related conditions[J]. Semin Ophthalmol，2012，27：138-148.
Liu Z， Pflugfelder SC. Corneal thickness is reduced in dry eye[J]. Cornea，1999，18：403-407.
[6]
Tuominen IS， Konttinen YT， Vesaluoma MH， et al. Corneal innervation and morphology in primary Sjögren′s syndrome[J]. Invest Ophthalmol Vis Sci，2003，44：2545-2549.
[7]
Benítez del Castillo JM， Wasfy MA， Fernandez C， et al. An in vivo confocal masked study on corneal epithelium and subbasal nerves in patients with dry eye[J]. Invest Ophthalmol Vis Sci，2004，45：3030-3035.
[8]
Villani E， Galimberti D， Viola F， et al. The cornea in Sjögren′s syndrome： an in vivo confocal study[J]. Invest Ophthalmol Vis Sci，2007，48：2017-2022.
[9]
Villani E， Magnani F， Viola F， et al. In vivo confocal evaluation of the ocular surface morpho-functional unit in dry eye[J]. Optom Vis Sci，2013，90：576-586.
[10]
Chen JJ， Rao K， Pflugfelder SC. Corneal epithelial opacity in dysfunctional tear syndrome[J]. Am J Ophthalmol，2009，148： 376-382.
[11]
Erdélyi B， Kraak R， Zhivov A， et al. In vivo confocal laser scanning microscopy of the cornea in dry eye[J]. Graefes Arch Clin Exp Ophthalmol，2007，245：39-44.
[12]
Zhang X， Chen Q， Chen W， et al. Tear dynamics and corneal confocal microscopy of subjects with mild self-reported office dry eye[J]. Ophthalmology，2011，118：902-907.
[13]
Mokhtarzadeh M， Casey R， Glasgow BJ. Fluorescein punctate staining traced to superficial corneal epithelial cells by impression cytology and confocal microscopy[J]. Invest Ophthalmol Vis Sci，2011，52：2127-2135.
[14]
Villani E， Viola F， Sala R， et al. Corneal involvement in Graves′ orbitopathy： an in vivo confocal study[J]. Invest Ophthalmol Vis Sci，2010，51：4574-4578.
[15]
Villani E， Galimberti D， Viola F， et al. Corneal involvement in rheumatoid arthritis： an in vivo confocal study[J]. Invest Ophthalmol Vis Sci，2008，49：560-564.
[16]
Efron N. Contact lens-induced changes in the anterior eye as observed in vivo with the confocal microscope[J]. Prog Retin Eye Res，2007，26：398-436.
[17]
Ho?/sxal BM， Ornek N， Zilelio?/sxlu G， et al. Morphology of corneal nerves and corneal sensation in dry eye： a preliminary study[J]. Eye （Lond），2005，19：1276-1279.
[18]
Benítez-Del-Castillo JM， Acosta MC， Wassfi MA， et al. Relation between corneal innervation with confocal microscopy and corneal sensitivity with noncontact esthesiometry in patients with dry eye[J]. Invest Ophthalmol Vis Sci，2007，48：173-181.
[19]
De Paiva CS， Pflugfelder SC. Corneal epitheliopathy of dry eye induces hyperesthesia to mechanical air jet stimulation[J]. Am J Ophthalmol，2004，137：109-115.
[20]
Tuisku IS， Konttinen YT， Konttinen LM， et al. Alterations in corneal sensitivity and nerve morphology in patients with primary Sjögren′s syndrome[J]. Exp Eye Res，2008，86：879-885.
[21]
Labbé A， Liang Q， Wang Z， et al. Corneal nerve structure and function in patients with non-sjogren dry eye： clinical correlations[J]. Invest Ophthalmol Vis Sci，2013，54：5144-5150.
[22]
Labbé A， Alalwani H， Van Went C， et al. The relationship between subbasal nerve morphology and corneal sensation in ocular surface disease[J]. Invest Ophthalmol Vis Sci，2012，53： 4926-4931.
[23]
Zhang M， Chen J， Luo L， et al. Altered corneal nerves in aqueous tear deficiency viewed by in vivo confocal microscopy[J]. Cornea，2005，24：818-824.
[24]
Cruzat A， Pavan-Langston D， Hamrah P. In vivo confocal microscopy of corneal nerves： analysis and clinical correlation[J]. Semin Ophthalmol，2010，25（5-6）：171-177.
[25]
Cruzat A， Witkin D， Baniasadi N， et al. Inflammation and the nervous system： the connection in the cornea in patients with infectious keratitis[J]. Invest Ophthalmol Vis Sci，2011，52： 5136-5143.
[26]
Lin H， Li W， Dong N， et al. Changes in corneal epithelial layer inflammatory cells in aqueous tear-deficient dry eye[J]. Invest Ophthalmol Vis Sci，2010，51：122-128.
[27]
Stern ME， Schaumburg CS， Pflugfelder SC. Dry eye as a mucosal autoimmune disease[J]. Int Rev Immunol，2013，32：19-41.
[28]
Hong J， Zhu W， Zhuang H， et al. In vivo confocal microscopy of conjunctival goblet cells in patients with Sjogren′s syndrome dry eye[J]. Br J Ophthalmol，2010，94：1454-1458.
[29]
Corrales RM， de Paiva CS， Li DQ， et al. Entrapment of conjunctival goblet cells by desiccation-induced cornification[J]. Invest Ophthalmol Vis Sci，2011，52：3492-3499.
[30]
Villani E， Beretta S， Galimberti D， et al. In vivo confocal microscopy of conjunctival roundish bright objects： young， older， and Sjögren subjects[J]. Invest Ophthalmol Vis Sci，2011，52：4829-4832.
[31]
Wakamatsu TH， Sato EA， Matsumoto Y， et al. Conjunctival in vivo confocal scanning laser microscopy in patients with Sjögren syndrome[J]. Invest Ophthalmol Vis Sci，2010，51：144-150.
[32]
Kojima T， Matsumoto Y， Dogru M， et al. The application of in vivo laser scanning confocal microscopy as a tool of conjunctival in vivo cytology in the diagnosis of dry eye ocular surface disease[J]. Mol Vis，2010，16：2457-2464.
[33]
Villani E， Beretta S， De Capitani M， et al. In vivo confocal microscopy of meibomian glands in Sjögren′s syndrome[J]. Invest Ophthalmol Vis Sci，2011，52：933-939.
[34]
Matsumoto Y， Sato EA， Ibrahim OM， et al. The application of in vivo laser confocal microscopy to the diagnosis and evaluation of meibomian gland dysfunction[J]. Mol Vis，2008，14：1263-1271.
[35]
Ibrahim OM， Matsumoto Y， Dogru M， et al. The efficacy， sensitivity， and specificity of in vivo laser confocal microscopy in the diagnosis of meibomian gland dysfunction[J]. Ophthalmology，2010，117：665-672.
[36]
Matsumoto Y， Shigeno Y， Sato EA， et al. The evaluation of the treatment response in obstructive meibomian gland disease by in vivo laser confocal microscopy[J]. Graefes Arch Clin Exp Ophthalmol，2009，247：821-829.
[37]
Villani E， Canton V， Magnani F， et al. The aging Meibomian gland： an in vivo confocal study[J]. Invest Ophthalmol Vis Sci，2013，54：4735-4740.
[38]
Villani E， Ceresara G， Beretta S， et al. In vivo confocal microscopy of meibomian glands in contact lens wearers[J]. Invest Ophthalmol Vis Sci，2011，52：5215-5219.
[39]
Pflugfelder SC， Solomon A， Stern ME. The diagnosis and management of dry eye： a twenty-five-year review[J]. Cornea，2000，19：644-649.
[40]
Patel DV， McGhee CN. In vivo confocal microscopy of human corneal nerves in health， in ocular and systemic disease， and following corneal surgery： a review[J]. Br J Ophthalmol，2009， 93：853-860.
浙公网安备 33030202001892号