Cornea - ARVO

ARVO 2013 Annual Meeting Abstracts by Scientific Section/Group - Corneaedge of the optical zone (8-9mm diameter) with future wide-fieldOCT.Commercial Relationships: Maolong Tang, Optovue Inc. (F); YanLi, Optovue, Inc. (F), Optovue, Inc. (P), Carl Zeiss Meditec, Inc. (P);David Huang, Optovue (F), Optovue (I), Optovue (P), Optovue (R),Carl Zeiss Meditec (P)Support: NIH grant EY018184Program Number: 537 Poster Board Number: B0174Presentation Time: 10:30 AM - 12:15 PMNormal Variants of Human Limbus Detected by In Vivo LaserScanning Confocal MicroscopyElfren R. Baclagon 1 , Siamak Zarei-Ghanavati 2 , Sophie X. Deng 1 .1 Ophthalmology, Jules Stein Eye Institute, Los Angeles, CA; 2 CorneaDepartment and Eye Research Center, Mashhas University ofMedical Sciences, Mashhad, Islamic Republic of Iran.Purpose: To report normal variations of the human limbal structuresusing in vivo laser scanning confocal microscopy (LSCM).Methods: Fourteen eyes from 13 healthy individuals between theages of 22 to 94 years were included in this study. Confocal imagingof the cornea and limbus was performed using Heidelberg RetinaTomograph III Rostock Corneal Module.Results: The typical structure of the palisade of Vogt (POV) wasdetected in 57% of eyes. Four additional structures and patterns werefound in the normal limbus that had not been reported previously ineyes that did not have the POV. Whorl-like distribution of limbalepithelial cells was present in two eyes. Mixed corneal andconjunctival epithelial cells in a mosaic pattern were found at theposterior limbus in two eyes. Bright dots pattern within the normallimbal epithelial cells was observed in the wing and the basal layer infive eyes. The forth structure, “limbal lacuna” was detected in two ofthe subjects. It consisted of deep stromal lacuna filled with limbalepithelial cells.Conclusions: There are several structures variants in the normallimbus. POV may not be the only structure that harbors limbalstem/progenitor cells.Commercial Relationships: Elfren R. Baclagon, None; SiamakZarei-Ghanavati, None; Sophie X. Deng, NoneSupport: CIRM TR2-01768 and NEI 5T32EY007026-35by fungal keratitis was diagnosed with epithelial downgrowth afterundergoing 3 penetrating keratoplasties and placement of a glaucomadrainage device over a 3-year period. In case two, a 48 year-old malewith a history of acanthamoeba keratitis developed epithelialdowngrowth after undergoing two therapeutic keratoplasties over aone-year period. In case three, a 40 year-old female with a history ofperforating fungal keratitis developed epithelial downgrowth after 2therapeutic keratoplasties over a three-month period. In all threecases, IVCM revealed hyper-reflective nuclei characteristic ofepithelium and AS-OCT identified an epithelial layer at the level ofthe endothelium.Conclusions: This report provides useful images of epithelialdowngrowth from both IVCM and AS-OCT. These noninvasiveimaging modalities may potentially be more sensitive in identifyingand monitoring epithelial downgrowth than routine lightbiomicroscopy.Figure 1: A) Slit lamp photo showing diffuse epithelial downgrowth.B) IVCM showing hyper-reflective nuclei of epithelial cells at thelevel of the endothelium. C and D) AS-OCT with a hyper-reflectiveepithelial layer posteriorly and growing over the iris. The angle iscompletely sealed.Program Number: 538 Poster Board Number: B0175Presentation Time: 10:30 AM - 12:15 PMImaging of epithelial downgrowth following penetratingkeratoplasty by confocal microscopy and high-resolution opticalcoherence tomographyVivian Lien 1 , Michael Chen 1 , Dennis E. Cortes 1, 2 , Jennifer Li 1 , MarkJ. Mannis 1 . 1 Ophthalmology & Vision Science, University ofCalifornia Davis Eye Center, Sacramento, CA; 2 Ophthalmology,Pontificia Universidad Católica de Chile, Santiago, Chile.Purpose: To report the characteristics of epithelial downgrowthfollowing penetrating keratoplasty using in vivo confocal microscopy(IVCM) and high-resolution anterior segment optical coherencetomography (AS-OCT).Methods: A retrospective case review was performed of 3 eyes of 3patients that developed epithelial downgrowth after multiplepenetrating keratoplasties. IVCM images were obtained at varioustime points using the Heidelberg Retina Tomograph III RostockCornea Module (Heidelberg Engineering, Germany) and AS-OCTimages were obtained using a high-resolution spectral-domain OCT(Heidelberg Engineering, Germany). In two cases, the diagnosis wasconfirmed by histopathologic evaluation.Results: Three cases developed epithelial downgrowth. In case one, a40 year-old male with a history of a corneal laceration complicatedFigure 2: A) Slit lamp photo of diffuse epithelial downgrowth withunaffected area centrally. B) IVCM showing hyper-reflective nucleiof epithelial cells at the level of the endothelium. C) AS-OCT withhyper-reflective layer of epithelial downgrowth posteriorly withcorresponding uncompromised area centrally.Commercial Relationships: Vivian Lien, None; Michael Chen,None; Dennis E. Cortes, None; Jennifer Li, None; Mark J.Mannis, NoneProgram Number: 539 Poster Board Number: B0176Presentation Time: 10:30 AM - 12:15 PMRole of glutathione peroxidase 4 in maintaining homeostasis ofcorneal epithelial cells©2013, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permissionto reproduce any abstract, contact the ARVO Office at arvo@arvo.org.