scholarly journals In VivoLaser Scanning Confocal Microscopy of Human Meibomian Glands in Aging and Ocular Surface Diseases

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Vincenzo Fasanella ◽  
Luca Agnifili ◽  
Rodolfo Mastropasqua ◽  
Lorenza Brescia ◽  
Federico Di Staso ◽  
...  
Keyword(s):  
Confocal Microscopy ◽  
Dry Eye ◽  
Ocular Surface ◽  
Tear Film ◽  
Response To Therapy ◽  
Tissue Response ◽  
Scanning Confocal Microscopy ◽  
Ocular Surface Diseases ◽  
Meibomian Glands

Meibomian glands (MGs) play a crucial role in the ocular surface homeostasis by providing lipids to the superficial tear film. Their dysfunction destabilizes the tear film leading to a progressive loss of the ocular surface equilibrium and increasing the risk for dry eye. In fact, nowadays, the meibomian gland dysfunction is one of the leading causes of dry eye. Over the past decades, MGs have been mainly studied by using meibography, which, however, cannot image the glandular structure at a cellular level. The diffusion of thein vivolaser scanning confocal microscopy (LSCM) provided a new approach for the structural assessment of MGs permitting a major step in the noninvasive evaluation of these structures. LSCM is capable of showing MGs modifications during aging and in the most diffuse ocular surface diseases such as dry eye, allergy, and autoimmune conditions and in the drug-induced ocular surface disease. On the other hand, LSCM may help clinicians in monitoring the tissue response to therapy. In this review, we summarized the current knowledge about the role ofin vivoLSCM in the assessment of MGs during aging and in the most diffuse ocular surface diseases.

scholarly journals Role of ion channels in the functional response of conjunctival goblet cells to dry eye

2018 ◽  
Vol 315 (2) ◽  
pp. C236-C246 ◽  
Author(s):  
Donald G. Puro
Keyword(s):  
Ion Channels ◽  
Dry Eye ◽  
Ocular Surface ◽  
Adaptive Response ◽  
Tear Film ◽  
Goblet Cells ◽  
Cation Conductance ◽  
Conjunctival Goblet Cells

Optimal vision requires an ocular surface with a stable tear film whose many critical tasks include providing >70% of the eye’s refractive power. However, for millions, tear film instability produces uncomfortable sight-impairing dry eye. Despite the multitude of etiologies for dry eye, a universal hallmark is hyperosmolarity of the tear film. Presently, knowledge of how the ocular surface responds to hyperosmolarity remains incomplete with little understood about the role of ion channels. This bioelectric analysis focused on conjunctival goblet cells whose release of tear-stabilizing mucin is a key adaptive response to dry eye. In freshly excised rat conjunctiva, perforated-patch recordings demonstrated that a ≥10% rise in osmolarity triggers goblet cells to rapidly generate a ~15-mV hyperpolarization due to the oxidant-dependent activation of ATP-sensitive K+ (KATP) channels. High-resolution membrane capacitance measurements used to monitor exocytosis revealed that this hyperpolarization results in an approximately fourfold boost in exocytotic activity evoked by cholinergic input, which in vivo occurs via a neural reflex and depends chiefly on calcium influxing down its electro-gradient. We discovered that this adaptive response is transient. During 30–80 min of hyperosmolarity, development of a depolarizing nonspecific cation conductance fully counterbalances the KATP-driven hyperpolarization and thereby eliminates the exocytotic boost. We conclude that hyperosmotic-induced hyperpolarization is a previously unappreciated mechanism by which goblet cells respond to transient ocular dryness. Loss of this voltage increase during long-term dryness/hyperosmolarity may account for the clinical conundrum that goblet cells in chronically dry eyes can remain filled with mucin even though the tear film is hyperosmotic and mucin-deficient.

scholarly journals In Vivo Confocal Microscopic Evaluation of Corneal Langerhans Cells in Dry Eye Patients§

2014 ◽  
Vol 8 (1) ◽  
pp. 51-59 ◽  
Author(s):  
Federica Machetta ◽  
Antonio M Fea ◽  
Alessandro G Actis ◽  
Ugo de Sanctis ◽  
Paola Dalmasso ◽  
...  
Keyword(s):  
Confocal Microscopy ◽  
Dry Eye ◽  
Ocular Surface ◽  
Tear Film ◽  
Surface Damage ◽  
Nerve Plexus ◽  
Sjogren Syndrome ◽  
Central Cornea ◽  
Eye Symptoms ◽  
Dry Eye Symptoms

Purpose. To assess inflammatory involvement of cornea in dry eye by means of confocal microscopy, evaluating the presence and distribution of Langherans cells (LCs). Methods: 98 eyes of 49 subjects were enrolled: 18 subjects affected by Sjögren Syndrome Dry Eye (SSDE), 17 with Non-Sjögren Syndrome Dry Eye (NSSDE), 14 healthy volunteeers. Dry eye symptoms, tear film, ocular surface damage and corneal confocal microscopy were analized. Results: A significant increase of LCs density was observed at sub-basal nerve plexus (SSDE = 79 cells/mm2 and NDE = 22 cells/mm2; p = 0,0031) and sub-epithelial nerve plexus (SSDE = 38 cells/mm2 and NDE = 3 cells/mm2; p = 0,0169) in central cornea of SSDE group. An increased number of LCs from the center to the periphery of the cornea was observed, significant only in healthy volunteers group. In dry eye patients there was an increase in LCs density in both peripheral and central cornea with a significant difference between NDE (14,66 cells/mm2) and SSDE (56,66 cells/mm2) only in central cornea (p = 0,0028). In SSDE group, mean density of LCs in central cornea results also superior to NSSDE group (29,33 cells/mm2). There was no correlation between LCs density and dry eye symptoms, tear film deficiency and ocular surface damage. Conclusion: This study demonstrates the activation of an inflammatory and immunological reaction in cornea of NSSDE and SSDE patients. Confocal microscopy can be an important diagnostic tool in evaluation and follow-up of dry eye disease.

scholarly journals Effect of Autologous Serum Eye Drops in Patients with Sjögren Syndrome-related Dry Eye: Clinical and In Vivo Confocal Microscopy Evaluation of the Ocular Surface

In Vivo ◽  
2016 ◽  
Vol 30 (6) ◽  
pp. 931-938 ◽  
Author(s):  
FRANCESCO SEMERARO ◽  
ELIANA FORBICE ◽  
GIUSEPPE NASCIMBENI ◽  
MARCO TAGLIETTI ◽  
VITO ROMANO ◽  
...  
Keyword(s):  
Confocal Microscopy ◽  
Dry Eye ◽  
Ocular Surface ◽  
Sjögren Syndrome ◽  
Autologous Serum ◽  
Sjogren Syndrome ◽  
Eye Drops ◽  
In Vivo Confocal Microscopy ◽  
Serum Eye Drops

In Vivo Laser Scanning Confocal Microscopy of the Ocular Surface in Glaucoma

2014 ◽  
Vol 20 (3) ◽  
pp. 879-894 ◽  
Author(s):  
Leonardo Mastropasqua ◽  
Luca Agnifili ◽  
Rodolfo Mastropasqua ◽  
Vincenzo Fasanella ◽  
Mario Nubile ◽  
...  
Keyword(s):  
Confocal Microscopy ◽  
Ocular Surface ◽  
Laser Scanning ◽  
Current Knowledge ◽  
Laser Scanning Confocal Microscopy ◽  
Cellular Level ◽  
Surgical Approaches ◽  
Imaging Method ◽  
Scanning Confocal Microscopy

AbstractOver the past decade, knowledge about the ocular surface in glaucoma has significantly increased through the use of in vivo laser scanning confocal microscopy (LSCM). This in vivo imaging method can show modifications at the cellular level induced by anti-glaucoma drugs on ocular surface structures and adnexa in the eye. High-quality images of the conjunctiva, cornea, limbus, meibomian glands, and lymphoid structures during therapy can be obtained. In addition, LSCM opened new fields of research on the patho-physiology of aqueous humor (AH) hydrodynamics in untreated, and in medically or surgically treated glaucomatous patients. In these conditions, an enhancement of the trans-scleral AH outflow contributed to clarification of the mechanism of action of different anti-glaucoma medications and surgical approaches. Finally, the use of LSCM represented a huge advance in evaluation of bleb functionality after filtration surgery, defining the hallmarks of AH filtration through the bleb-wall and distinguishing functional from nonfunctional blebs. Thus, signs seen with LSCM may anticipate clinical failure, guiding the clinician in planning the appropriate timing of the various steps in bleb management. In this review we summarize the current knowledge about in vivo LSCM of the ocular surface in glaucoma.

In vivo observation of the human tear film by tandem scanning confocal microscopy

Scanning ◽  
1994 ◽  
Vol 16 (3) ◽  
pp. 316-319 ◽  
Author(s):  
William D. Mathers ◽  
Thomas E. Daley
Keyword(s):  
Confocal Microscopy ◽  
Tear Film ◽  
Scanning Confocal Microscopy

scholarly journals Confocal microscopy in ocular surface disease

2017 ◽  
Vol 10 (1) ◽  
pp. 23-30
Author(s):  
Vitaly V Potemkin ◽  
Tatyana S Varganova ◽  
Elena V Ageeva
Keyword(s):  
Confocal Microscopy ◽  
Dry Eye ◽  
Ocular Surface ◽  
Eye Disease ◽  
Disease Monitoring ◽  
Efficacy Evaluation ◽  
Clinical Method ◽  
Non Invasive ◽  
Mode A

Confocal microscopy is a modern clinical method, which provides in real-time mode a non-invasive possibility for in vivo imaging of the cornea, limbus, and conjunctiva. In several ocular surface disorders, this method could be applied for diagnostic purposes, as well as for disease monitoring and treatment efficacy evaluation. In present article, we discuss main changes observed by confocal microscopy in patients with dry eye, and propose our examination algorithm of ocular surface investigation in dry eye disease.

scholarly journals In vivo confocal microscopy assessment of meibomian glands microstructure in patients with Graves’ orbitopathy

2020 ◽  
Author(s):  
Sheng-Nan Cheng ◽  
Yue-Qi Yu ◽  
Jin Chen ◽  
Lin Ye ◽  
Xing-Hua Wang ◽  
...  
Keyword(s):  
Confocal Microscopy ◽  
Ocular Surface ◽  
Disease Process ◽  
Ocular Surface Disease ◽  
In Vivo Confocal Microscopy ◽  
Microstructural Changes ◽  
Graves Orbitopathy ◽  
Meibomian Glands ◽  
Breakup Time

Abstract Background: To evaluate microstructural changes in the meibomian glands (MGs) in patients with active and inactive Graves’ orbitopathy (GO), using in vivo confocal microscopy (IVCM), and to investigate the correlations between clinical and confocal findings.Methods: Forty patients (80 eyes) with GO (34 eyes with active GO, 46 eyes with inactive GO), and 31 age- and sex-matched control participants (62 eyes) were enrolled consecutively. Each participant completed an Ocular Surface Disease Index (OSDI) questionnaire and underwent a full eye examination, including assessments of clinical activity score (CAS), proptosis, palpebral fissure height (PFH), lagophthalmos, lipid layer thickness (LLT), partial blinking rate, noninvasive first breakup time (NIF-BUT), average breakup time (NIAvg-BUT), tear film breakup area (TBUA), corneal fluorescein staining (CFS), Schirmer I Test (SIT), meibum quality and MG expressibility. IVCM of the MGs was performed to determine the MG acinar density (MAD), MG longest and shortest diameters (MALD and MASD), MG orifice area (MOA), MG acinar irregularity (MAI), meibum secretion reflectivity (MSR), acinar wall inhomogeneity (AWI), acinar periglandular interstices inhomogeneity (API), and severity of MG fibrosis (MF).Results: All parameters demonstrated statistically significant differences among groups (all P＜0.05), except OSDI, LLT and NIAvg-BUT (P＞0.05). Compared to controls, GO groups showed lower MOA and MAD; greater MALD and MASD; and higher degrees of MAI, MSR, AWI, API, and MF (all P＜0.05). Eyes with active GO had higher degrees of MAI, AWI, and API, while eyes with inactive GO had higher degrees of MSR and MF (all P＜0.05). In GO groups, the two measured confocal signs of inflammation (AWI and API) were significantly correlated with CAS, proptosis, PFH, lagophthalmos, OSDI, NIF-BUT, CFS, SIT, meibum quality, and MG expressibility (all P＜0.05). MF was significantly correlated with CAS, OSDI, meibum quality, and MG expressibility (all P＜0.05). Conclusions: IVCM effectively revealed microstructural changes of MGs in eyes with GO and provided strong in vivo evidence for the roles of obstruction and inflammation in the ocular surface disease process. Furthermore, it revealed discernible patterns of MG abnormalities in eyes with active GO and inactive GO, which are not easily distinguishable by typical clinical examinations.

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