Pubblicazioni scientifiche

In vivo confocal evaluation of the ocular surface morpho-functional unit in dry eye.

Optom Vis Sci 2013/6

Villani E, Magnani F, Viola F, Santaniello A, Scorza R, Nucci P, Ratiglia R.

Università degli Studi di Milano, UO Oculistica Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy. eddy.villani@tiscali.it

PURPOSE: 
To study, by a new, integrated, laser scanning confocal microscopy approach, the ocular surface morpho-functional unit in patients with primary Sjogren syndrome (SSI), non-Sjogren syndrome dry eye (non-SSDE), and meibomian gland disease (MGD).
METHODS: 
Patients and age- and sex-matched control subjects (N = 60; 15 each) were consecutively enrolled in a prospective case-control study. Laser scanning confocal microscopy was used to obtain simultaneous optical sampling of the ocular surface components: cornea, bulbar and tarsal conjunctiva, MGs, and eyelid margin.
RESULTS: 
For all superficial epithelia, except eyelid margins, there were reduced cell densities in each group compared with that in controls (p < 0.001). The lowest cell densities were in the SSI group (p < 0.001). Eyelid margin superficial cell density was decreased only in MGD (p < 0.001). Basal epithelial cell density at the corneal apex was increased in both SSI and non-SSDE compared with that in controls (p < 0.01). In the conjunctiva, it was decreased in each group compared with that in controls (p < 0.01). Subbasal dendritic cell density was significantly increased in both SSI and MGD compared with that in controls (p < 0.01). Conjunctival inflammatory cell density and MG inflammation were increased in each group compared with those in controls (p < 0.001), with the highest values in SSI. Subbasal nerve plexi had fewer fibers and higher bead density in each group compared with those in controls (p < 0.001). There was increased tortuosity in both SSI and MGD (p < 0.001). Patients with MGD had the lowest MG acinar density, the largest diameter of acini and acinar orifices, and the highest secretion reflectivity (p < 0.001).
CONCLUSIONS: 
Laser scanning confocal microscopy can provide an in vivo, noninvasive, high-resolution overview of the ocular surface morpho-functional unit. This confocal integrated approach may be useful in both research and clinical settings.

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Soffro di congiuntivite cronica. Ogni mese mi si infiammano gli occhi, prendo un collirio in farmacia, i sintomi migliorano in qualche giorno e poi… si ripresentano! Posso risolvere questo problema?