Posters

The results of in vivo studying of the structure of postadenoviral corneal infiltrates by confocal microscopy

Poster Details

First Author: O.Vasilyeva RUSSIAN FEDERATION

Co Author(s):    D. Maychuk   S. Aksenova                 

Abstract Details

Purpose:

To evaluate the structure of the corneal lesion forming in a period of 3 months or more after suffering adenoviral keratoconjunctivitis (AVKC) in the absence of the conjunctival reaction.

Setting:

S. Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russia

Methods:

The study of the structure of corneal infiltrative elements after suffering AVKK performed by confocal microscopy (Confoscan-4, NIDEK, Japan). The study was conducted in 10 patients (10 eyes) with re-developed postadenoviral corneal opacities in the period of 3 months or more after acute period of AVKK. In all patients there was no evidence of conjunctival inflammatio. Selection criteria: the negative results of PCR-DNA diagnostic of adenovirus in conjunctival smears. The study was conducted precisely in the area of postadenoviral corneal opacity location. The depth of the opacity, its optical density, structure, cellular composition, the state of intercellular space were evaluated.

Results:

Corneal postadenoviral opacity was defined as the rounded portion of fibroplastic reaction in the surface layers of the stroma, extending to a depth of 40-65 mkm. In this area hypocellularity and reducing the transparency of the extracellular matrix were determined, as well as signs of activation of keratocytes in paracentral parts of the cloud. Importantly, in the area of the reduction of stromal hyper-reflexivity there were visualized Langerhans cells clusters that may be a sign of an autoimmune enhanced activity in the border zone of opacities and corneal healthy tissue. In these patients the corneal epithelium was able to observe in the form of pseudo keratinization. The stromal layers near the localization of opacities and endothelial area remained unchanged.

Conclusions:

The structural features of individual postadenoviral corneal opacity were determined by using confocal microscopy. The main of these features were signs of fibrosis in the central part of the opacity (fibroplastic reaction with symptoms of hypocellularity and reducing of the transparency of the extracellular matrix) and signs of autoimmune reactions to its periphery (Langerhans cells, activation of keratocytes).

Financial Disclosure:

NONE