ABSTRACT

Purpose:

To report the in vivo confocal microscopy findings in cases with corneal dystrophies.

Material and Method:

Following detailed ophthalmological examination, 21 cases prediagnosed as corneal dystrophy were evaluated using 40X lens of in vivo confocal microscopy (ConfoScan 4, Nidek, Albinasego, Italy).

Results:

Twelve female and 9 male patients with a mean age of 37.8±12.6 years were included in this study. The patients were prediagosed as epithelial basal membrane dystrophy (EBMD; n=2), as stromal dystrophy (n=11), as Fuchs’ dystrophy (n=2), as posterior polymorphous dystrophy (PPMD; n=4), and as congenital hereditary endothelial dystrophy (CHED; n=2). Three cases with PPMD had no visual symptoms and the lesions were observed during routine ophthalmological examination. Out of sixteen patients who presented with blurred vision, 7 also had photophobia, foreign body sensation and irritation. In vivo confocal microscopy examination revealed curly thickening of the basal membrane and epithelial microcysts in EBMD, deposits with various forms and reflectances in stromal dystrophies, and abnormal changes in the Descemet’s membrane in endothelium dystrophies. In two siblings suspected to have CHED, the stroma and endothelium could not be imaged due to excessive edema.

Discussion:

Confocal microscopy is an imaging technique that shows the pathologic morphological changes of the cornea in vivo in cases prediagnosed as corneal dystrophy and may indicate which corneal layer has been involved. Especially in cases where the exact diagnosis cannot be established and the dystrophy cannot be classified, it may help to confirm the diagnosis and guide the treatment plans by showing the microstructural changes and deposits. (Turk J Ophthalmol 2011; 41: 66-72)