Intravital microscopy of leukocyte-endothelial dynamics using the Heidelberg confocal laser microscope in scleritis and allergic conjunctivitis.
OBJECTIVE
To examine leukocyte-endothelial cell rolling and arrest in human ocular vessels overlying sites of inflammation in various ocular inflammatory diseases in comparison to normal controls using the Heidelberg confocal laser microscope, which provides images with greater clarity and resolution than the tandem scanning microscope that uses white light.


METHODS
Healthy controls (n=8) and patients with active anterior scleritis (n=7) or allergic eye disease (n=4) were scanned using the Heidelberg confocal laser microscope (HRT II) with the Rostock cornea module attachment for a minimum of 5 min at a depth of 45-120 microm from the conjunctival epithelial surface.


RESULTS
There was a marked increase in the number of rolling leukocytes in scleritis patients (534+/-119 cells per mm2/min) versus controls (6+/-6 cells per mm2/min; p=0.0002) or allergic patients (59+/-44 cells per mm2/min; p=0.009). No statistically significant increase was seen in allergic patients compared to controls (p=0.059). A similar pattern was seen in the number of arrested leukocytes in patients with scleritis (56+/-23 cells per mm2) in comparison to either those with allergic eye disease or controls (each=0 cells per mm2; p=0.02).


CONCLUSIONS
Patients with scleritis have a significantly increased number of rolling and arrested leukocytes in superficial ocular vessels in comparison to patients with mild allergic conjunctivitis and controls. The image quality with this microscope is superior to prior studies with a scanning microscope.
Lim
Lyndell L
LL
Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, OR, USA. limllp@unimelb.edu.au
Hoang
Lani
L
Wong
Tiffany
T
Planck
Stephen R
SR
Ronick
Mischa B
MB
Gould
Robert R
RR
Mathers
William D
WD
Rosenbaum
James T
JT
D000328:Adult; D000368:Aged; D003233:Conjunctivitis, Allergic / Q000473:pathology / Q000503:physiopathology*; D042783:Endothelial Cells; D005123:Eye / Q000098:blood supply*; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D036904:Leukocyte Rolling; D008297:Male; D018613:Microscopy, Confocal; D008875:Middle Aged; D015423:Scleritis / Q000473:pathology / Q000503:physiopathology*