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Malaysian Journal of Medical Sciences
School of Medical Sciences, Universiti Sains Malaysia
ISSN: 1394-195X
Vol. 24, No. 2, 2017, pp. 44-54
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Bioline Code: mj17020
Full paper language: English
Document type: Research Article
Document available free of charge
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Malaysian Journal of Medical Sciences, Vol. 24, No. 2, 2017, pp. 44-54
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Corneal Cell Morphology in Keratoconus: A Confocal Microscopic Observation
Ghosh, Somnath; Mutalib, Haliza Abdul; Kaur, Sharanjeet; Ghoshal, Rituparna & Retnasabapathy, Shamala
Abstract
Purpose: To evaluate corneal cell morphology in patients with keratoconus using an in
vivo slit scanning confocal microscope.
Methods: A cross-sectional study was conducted to evaluate the corneal cell morphology
of 47 keratoconus patients and 32 healthy eyes without any ocular disease. New keratoconus
patients with different disease severities and without any other ocular co-morbidity were
recruited from the ophthalmology department of a public hospital in Malaysia from June 2013
to May 2014. Corneal cell morphology was evaluated using an in vivo slit-scanning confocal
microscope. Qualitative and quantitative data were analysed using a grading scale and the Nidek
Advanced Visual Information System software, respectively.
Results: The corneal cell morphology of patients with keratoconus was significantly
different from that of healthy eyes except in endothelial cell density (P = 0.072). In the
keratoconus group, increased level of stromal haze, alterations such as the elongation of
keratocyte nuclei and clustering of cells at the anterior stroma, and dark bands in the posterior
stroma were observed with increased severity of the disease. The mean anterior and posterior
stromal keratocyte densities and cell areas among the different stages of keratoconus were
significantly different (P < 0.001 and P = 0.044, respectively). However, the changes observed in
the endothelium were not significantly different (P > 0.05) among the three stages of keratoconus.
Conclusion: Confocal microscopy observation showed significant changes in corneal cell
morphology in keratoconic cornea from normal healthy cornea. Analysis also showed significant
changes in different severities of keratoconus. Understanding the corneal cell morphology
changes in keratoconus may help in the long-term monitoring and management of keratoconus.
Keywords
keratoconus; corneal cell morphology; in vivo confocal microscopy
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