In Vivo Confocal Microscopy Demonstrates Increased Immune Cell Densities in Corneal Graft Rejection Correlating With Signs and Symptoms

American Journal of Ophthalmology
Chareenun ChirapapaisanPedram Hamrah

Abstract

Diagnosis of graft rejection is based on patient symptoms and on clinical signs detected by slit-lamp biomicroscopy. This study investigated whether laser in vivo confocal microscopy (IVCM) can aid in the diagnosis of corneal graft rejection by detecting cellular corneal changes that take place after transplantation. Prospective case-control study. Thirty-eight eyes of 38 patients with penetrating keratoplasty (15 eyes with corneal graft rejection, 23 eyes without rejection) and 9 age-matched normal controls. Laser IVCM was performed in the corneal grafts centrally. The density of immune cells (IC) was assessed for epithelial, sub-epithelial, stromal, and endothelial layers by 2 masked observers. IC density was compared among different groups and correlated to clinical signs and symptoms of corneal graft rejection. Outcome measurement was the IC density in the corneal layers and its associations with the presence of clinical signs and symptoms of corneal graft rejection. The IC density was significantly different between rejected and non-rejected grafts (P = 0.004) and different from that of normal controls (P = 0.001). Among corneal layers, IC density was significantly higher in rejected grafts than in non-rejected grafts in o...Continue Reading

Citations

Feb 27, 2020·Journal of Clinical Medicine·Antonio Di ZazzoTakenori Inomata
Aug 14, 2020·Journal of Refractive Surgery·Leonardo MastropasquaMario Nubile
Jan 29, 2021·Ocular Immunology and Inflammation·Roberto VignapianoRita Mencucci
May 15, 2021·Current Opinion in Ophthalmology·Jia Yin
Sep 2, 2021·Clinical Ophthalmology·Chareenun ChirapapaisanAnupong Veeraburinon
Dec 30, 2021·International Ophthalmology Clinics·Taher K EleiwaShazia F Ali

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