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Cornea. 2011 Feb;30(2):136-42. doi: 10.1097/ICO.0b013e3181e9ac98.

Corneal involvement in Crohn's disease: an in vivo confocal microscopy study.

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  • 1Cinica Oculistica, Dipartimento di Medicina, Chirurgia e Odontoiatria, Ospedale San Paolo, Milano, Italy. gaia.ceresara@gmail.com

Abstract

PURPOSE:

To evaluate the corneal changes of patients with Crohn's disease (CD) using confocal microscopy and to investigate the association among confocal parameters and CD activity and CD treatment.

METHODS:

Thirty consecutive patients (age: 42 ± 12 years; 19 women and 11 men) affected by CD and 30 control eyes (age matched and gender matched) underwent an ophthalmic examination and, in 1 eye chosen at random, confocal microscopy of the central cornea using the cornea module of Heidelberg Retina Tomograph. The following confocal parameters were evaluated: density of basal epithelial cells, epithelial dendritic cells, anterior and posterior stromal keratocytes, and endothelial cells; the subbasal plexus was assessed for number and tortuosity of the nerve fibers.

RESULTS:

Routine ophthalmic evaluation was normal in the whole population. At confocal microscopy, 40% of patients with CD had hyperreflective dots in the basal epithelium, which were absent in the control group. Activation of keratocytes was found in 86.6% of patients with CD and was absent in the control group. Compared with controls, patients with CD had lower density of dendritic cells (12.2 ± 26.3 vs. 50.3 ± 37.6 cells per square millimeter; P = 0.001). The other confocal parameters were similar in the 2 groups. No correlation between CD activity index and confocal changes was found.

CONCLUSION:

Confocal microscopy can detect subtle corneal changes in patients with CD, which may be signs of subclinical inflammation.

[PubMed - indexed for MEDLINE]
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