TY - JOUR
T1 - In vivo confocal microscopy of the ocular surface
T2 - From bench to bedside
AU - Villani, Edoardo
AU - Baudouin, Christophe
AU - Efron, Nathan
AU - Hamrah, Pedram
AU - Kojima, Takashi
AU - Patel, Sanjay V.
AU - Pflugfelder, Stephen C.
AU - Zhivov, Andrey
AU - Dogru, Murat
N1 - Funding Information:
Mayo Foundation, Rochester, MN [National Institutes of Health Grant EY11915 (to S.C.P.), the Oshman Foundation, Houston, TX (to S.C.P.), the William Stamps Farish Fund, Houston, TX (to S.C.P.) and the Hamill Foundation, Houston, TX (to S.C.P.)
Funding Information:
This work was supported in part by: Research to Prevent Blindness Grant Program, New York, NY (Unrestricted Departmental Grant; to S.V.P. as Olga Keith Wiess Scholar and to S.C.P.), the
PY - 2014/3
Y1 - 2014/3
N2 - In vivo confocal microscopy (IVCM) is an emerging technology that provides minimally invasive, high resolution, steady-state assessment of the ocular surface at the cellular level. Several challenges still remain but, at present, IVCM may be considered a promising technique for clinical diagnosis and management. This mini-review summarizes some key findings in IVCM of the ocular surface, focusing on recent and promising attempts to move "from bench to bedside". IVCM allows prompt diagnosis, disease course follow-up, and management of potentially blinding atypical forms of infectious processes, such as acanthamoeba and fungal keratitis. This technology has improved our knowledge of corneal alterations and some of the processes that affect the visual outcome after lamellar keratoplasty and excimer keratorefractive surgery. In dry eye disease, IVCM has provided new information on the whole-ocular surface morphofunctional unit. It has also improved understanding of pathophysiologic mechanisms and helped in the assessment of prognosis and treatment. IVCM is particularly useful in the study of corneal nerves, enabling description of the morphology, density, and disease-or surgically induced alterations of nerves, particularly the subbasal nerve plexus. In glaucoma, IVCM constitutes an important aid to evaluate filtering blebs, to better understand the conjunctival wound healing process, and to assess corneal changes induced by topical antiglaucoma medications and their preservatives. IVCM has significantly enhanced our understanding of the ocular response to contact lens wear. It has provided new perspectives at a cellular level on a wide range of contact lens complications, revealing findings that were not previously possible to image in the living human eye. The final section of this mini-review provides a focus on advances in confocal microscopy imaging. These include 2D wide-field mapping, 3D reconstruction of the cornea and automated image analysis.
AB - In vivo confocal microscopy (IVCM) is an emerging technology that provides minimally invasive, high resolution, steady-state assessment of the ocular surface at the cellular level. Several challenges still remain but, at present, IVCM may be considered a promising technique for clinical diagnosis and management. This mini-review summarizes some key findings in IVCM of the ocular surface, focusing on recent and promising attempts to move "from bench to bedside". IVCM allows prompt diagnosis, disease course follow-up, and management of potentially blinding atypical forms of infectious processes, such as acanthamoeba and fungal keratitis. This technology has improved our knowledge of corneal alterations and some of the processes that affect the visual outcome after lamellar keratoplasty and excimer keratorefractive surgery. In dry eye disease, IVCM has provided new information on the whole-ocular surface morphofunctional unit. It has also improved understanding of pathophysiologic mechanisms and helped in the assessment of prognosis and treatment. IVCM is particularly useful in the study of corneal nerves, enabling description of the morphology, density, and disease-or surgically induced alterations of nerves, particularly the subbasal nerve plexus. In glaucoma, IVCM constitutes an important aid to evaluate filtering blebs, to better understand the conjunctival wound healing process, and to assess corneal changes induced by topical antiglaucoma medications and their preservatives. IVCM has significantly enhanced our understanding of the ocular response to contact lens wear. It has provided new perspectives at a cellular level on a wide range of contact lens complications, revealing findings that were not previously possible to image in the living human eye. The final section of this mini-review provides a focus on advances in confocal microscopy imaging. These include 2D wide-field mapping, 3D reconstruction of the cornea and automated image analysis.
KW - Confocal microscopy
KW - Dry eye
KW - Glaucoma
KW - Keratitis
KW - Keratoplasty
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U2 - 10.3109/02713683.2013.842592
DO - 10.3109/02713683.2013.842592
M3 - Review article
C2 - 24215436
AN - SCOPUS:84893934184
SN - 0271-3683
VL - 39
SP - 213
EP - 231
JO - Current Eye Research
JF - Current Eye Research
IS - 3
ER -