Corneal confocal microscopy is helpful in VKC

Corneal confocal microscopy is useful for studying in vivo pathologic corneal changes in vernal keratoconjunctivitis (VKC), claims a study in the journal Ophthalmology.

Dr Andrea Leonardi et al., Department of Neuroscience, Ophthalmology Unit, University of Padova, Padova, Italy, completed a prospective, comparative case study on 32 patients with VKC and 40 normal participants.

All patients underwent a full ophthalmic examination and central cornea images were gathered using a x40 non-contact lens and a Z-ring device. The main outcome measures were the superficial and basal epithelium, subbasal nerve plexus, anterior stroma, stromal nerves and endothelium of the central cornea.

It was discovered that the VKC patients had increased diameter, reflectivity and presence of nuclear activation of superficial epithelial cells. They also had a reduced basal membrane density, an increased presence of activated keratocytes and inflammatory cells in the anterior stroma.

The VKC patients also presented with lower density and number of fibres, lower number of beadings and a higher grade of tortuosity of fibres in the subbasal nerve plexus. In the stromal corneal nerves there was an increased thickness, deflections and tortuosity changes.

The study authors concluded that the changes in the epithelium and subbasal and stromal corneal nerves could be linked to tear dysfunction and non-specific hyperactivity.