Epithelial dendritic cell distribution in normal and inflamed human cornea: in vivo confocal microscopy study.
OBJECTIVE
To evaluate dendritic cell (DCs) density, distribution, and morphology in central corneal and limbal epithelium in normal subjects and patients with immune-mediated corneal inflammation using in vivo confocal microscopy (IVCM).


METHODS
Comparative case-controlled, observational confocal microscopy study.


METHODS
A total of 135 eyes of 135 patients were investigated. Group 1 (normal eyes) included 45 eyes of 45 healthy volunteers, group 2 photorefractive keratectomy (PRK-treated eyes) included 45 myopic eyes of 45 patients treated with PRK, and group 3 (inflamed eyes) comprised 45 eyes of 45 patients affected by immune-mediated corneal inflammation. The central cornea and limbus were examined for epithelial dendritic-shaped cells using laser scanning IVCM. DCs density was calculated using image analysis software.


RESULTS
Cells with a branching dendritic morphology were visualized in the basal epithelial layer, basal lamina, and subbasal nerve plexus, in the central cornea, and in the basal layer and basal membrane of the limbal epithelium. The limbal epithelium demonstrated DCs in 93.3%, 89%, and 97.7% of eyes in group 1, 2, and 3, respectively (P = ns). Central epithelial DCs were observed in 20.0% and 13.3% of eyes in group 1 and 2 (P = ns), while in 93.3% of eyes in group 3 (P < .001). DCs were found to be significantly higher at the limbus compared with central cornea in each group (P < .001). Cell densities observed in group 3 were significantly greater than groups 1 and 2, at both locations (P < .05).


CONCLUSIONS
Laser scanning IVCM is a useful method for evaluating epithelial DCs distribution at the limbus and central cornea in both healthy and diseased eyes.
Mastropasqua
Leonardo
L
Department of Medicine and Aging Science, Ophthalmic Clinic, University of Chieti-Pescara, Chieti, Italy.
Nubile
Mario
M
Lanzini
Manuela
M
Carpineto
Paolo
P
Ciancaglini
Marco
M
Pannellini
Tania
T
Di Nicola
Marta
M
Dua
Harminder S
HS
D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D002452:Cell Count; D003315:Cornea / Q000166:cytology*; D003713:Dendritic Cells / Q000166:cytology* / Q000473:pathology*; D005260:Female; D006801:Humans; D007634:Keratitis / Q000473:pathology*; D008297:Male; D018613:Microscopy, Confocal; D008875:Middle Aged