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Mapping of dendritic lesions in patients with herpes simplex keratitis using in vivo confocal microscopy.

Yokogawa H, Kobayashi A, Mori N, Sugiyama K - Clin Ophthalmol (2015)

Bottom Line: Mapping of dendritic lesion was successful in all cases, and the subconfluent montages clearly showed the larger image of dendritic lesion.In two cases, inflammatory cells were observed at the level of endothelial cell layer.Cellular level observation of dendritic lesion at a relatively larger magnification may help understand the in vivo morphological change of HSK.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.

ABSTRACT

Purpose: To produce a two-dimensional reconstruction map of dendritic lesions in patients with herpes simplex keratitis (HSK) using in vivo confocal microscopy.

Methods: Four eyes of four patients (mean 65.8 years) with HSK presenting with a dendritic lesion were enrolled. Slit-lamp biomicroscopy and in vivo laser confocal microscopy were performed. Acquired confocal images at the level of the epithelium were arranged and mapped into subconfluent montages. Changes in the shape and degree of light reflection of abnormal cells and deposits around dendritic lesions as well as other corneal layers were qualitatively evaluated.

Results: Mapping of dendritic lesion was successful in all cases, and the subconfluent montages clearly showed the larger image of dendritic lesion. In all cases, the dendritic lesion consisted of hyperreflective irregular epithelial cells, and was surrounded by distorted and elongated epithelial cells. In three cases, hyperreflective deposits were noted at the midline of the lesion. The corneal stroma showed a hyperreflective honeycomb pattern. In two cases, inflammatory cells were observed at the level of endothelial cell layer.

Conclusion: Mapping of dendritic lesions in patients with HSK was successful in all patients using in vivo confocal microscopy. Cellular level observation of dendritic lesion at a relatively larger magnification may help understand the in vivo morphological change of HSK. Further study in more patients with HSK and nonherpetic dendritic lesion is needed to utilize confocal microscopy images in differential diagnosis and follow-up of the epithelial lesions with dendrite.

No MeSH data available.


Related in: MedlinePlus

In vivo confocal microscopic images at the level of stroma and endothelium.Notes: (A and B) Representative stromal image in Case 2 (A) and Case 4 (B). Honeycomb-shaped hyperreflective keratocytes were seen, suggesting stromal edema. (C and D) At the level of endothelium, inflammatory cells (arrows) were seen in Case 1 (C) and 4 (D). (Bar =100 μm).
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f4-opth-9-1771: In vivo confocal microscopic images at the level of stroma and endothelium.Notes: (A and B) Representative stromal image in Case 2 (A) and Case 4 (B). Honeycomb-shaped hyperreflective keratocytes were seen, suggesting stromal edema. (C and D) At the level of endothelium, inflammatory cells (arrows) were seen in Case 1 (C) and 4 (D). (Bar =100 μm).

Mentions: At the level of deep epithelium to subbasal nerve plexus, numerous inflammatory cells including possible Langerhans cells were noted, and were not exclusively located at the dendritic lesion (Figure 3). At the level of corneal stroma, honeycomb-shaped hyperreflective keratocytes were seen in all cases, suggesting stromal edema (Figure 4A and B). At the level of endothelium, inflammatory cells were only seen in two cases (Cases 1 and 4) (Figure 4C and D).


Mapping of dendritic lesions in patients with herpes simplex keratitis using in vivo confocal microscopy.

Yokogawa H, Kobayashi A, Mori N, Sugiyama K - Clin Ophthalmol (2015)

In vivo confocal microscopic images at the level of stroma and endothelium.Notes: (A and B) Representative stromal image in Case 2 (A) and Case 4 (B). Honeycomb-shaped hyperreflective keratocytes were seen, suggesting stromal edema. (C and D) At the level of endothelium, inflammatory cells (arrows) were seen in Case 1 (C) and 4 (D). (Bar =100 μm).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4590674&req=5

f4-opth-9-1771: In vivo confocal microscopic images at the level of stroma and endothelium.Notes: (A and B) Representative stromal image in Case 2 (A) and Case 4 (B). Honeycomb-shaped hyperreflective keratocytes were seen, suggesting stromal edema. (C and D) At the level of endothelium, inflammatory cells (arrows) were seen in Case 1 (C) and 4 (D). (Bar =100 μm).
Mentions: At the level of deep epithelium to subbasal nerve plexus, numerous inflammatory cells including possible Langerhans cells were noted, and were not exclusively located at the dendritic lesion (Figure 3). At the level of corneal stroma, honeycomb-shaped hyperreflective keratocytes were seen in all cases, suggesting stromal edema (Figure 4A and B). At the level of endothelium, inflammatory cells were only seen in two cases (Cases 1 and 4) (Figure 4C and D).

Bottom Line: Mapping of dendritic lesion was successful in all cases, and the subconfluent montages clearly showed the larger image of dendritic lesion.In two cases, inflammatory cells were observed at the level of endothelial cell layer.Cellular level observation of dendritic lesion at a relatively larger magnification may help understand the in vivo morphological change of HSK.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.

ABSTRACT

Purpose: To produce a two-dimensional reconstruction map of dendritic lesions in patients with herpes simplex keratitis (HSK) using in vivo confocal microscopy.

Methods: Four eyes of four patients (mean 65.8 years) with HSK presenting with a dendritic lesion were enrolled. Slit-lamp biomicroscopy and in vivo laser confocal microscopy were performed. Acquired confocal images at the level of the epithelium were arranged and mapped into subconfluent montages. Changes in the shape and degree of light reflection of abnormal cells and deposits around dendritic lesions as well as other corneal layers were qualitatively evaluated.

Results: Mapping of dendritic lesion was successful in all cases, and the subconfluent montages clearly showed the larger image of dendritic lesion. In all cases, the dendritic lesion consisted of hyperreflective irregular epithelial cells, and was surrounded by distorted and elongated epithelial cells. In three cases, hyperreflective deposits were noted at the midline of the lesion. The corneal stroma showed a hyperreflective honeycomb pattern. In two cases, inflammatory cells were observed at the level of endothelial cell layer.

Conclusion: Mapping of dendritic lesions in patients with HSK was successful in all patients using in vivo confocal microscopy. Cellular level observation of dendritic lesion at a relatively larger magnification may help understand the in vivo morphological change of HSK. Further study in more patients with HSK and nonherpetic dendritic lesion is needed to utilize confocal microscopy images in differential diagnosis and follow-up of the epithelial lesions with dendrite.

No MeSH data available.


Related in: MedlinePlus