title: Confocal microscopic diagnosis of epithelial downgrowth.
abstract: OBJECTIVE
  The purpose of this study was to report the confocal microscopic, characteristics of epithelial downgrowth and the clinical utility of serial confocal examinations in the management of epithelial downgrowth.
  
  
  METHODS
  Retrospective case review of 3 eyes from 3 patients that developed epithelial downgrowth after ocular surgery with penetrating ocular trauma and literature review.
  
  
  RESULTS
  Two cases developed epithelial downgrowth and a retrocorneal membrane after both penetrating ocular trauma and multiple intraocular surgeries. A third case developed epithelial downgrowth presenting as a membranous growth noted on the endothelial surface after multiple intraocular surgeries. In all cases, confocal microscopy revealed round, hyperreflective nuclei characteristic of epithelial cells at the level of the endothelium, and in 2 cases, the diagnosis was confirmed by histopathologic evaluation. In cases 2 and 3, confocal microscopic analysis proved useful in following epithelial regression after 5-fluorouracil injection, and in case 3, confocal microscopy proved to be potentially more sensitive in identifying residual epithelial downgrowth than routine light microscopy.
  
  
  CONCLUSIONS
  Confocal microscopy can definitively diagnose epithelial downgrowth occurring after previous ocular surgery or ocular trauma and may prove useful for following downgrowth after intervention.
authors.affiliation: Department of Ophthalmology, Emory University, Atlanta, GA, USA.
authors.forename: Phoebe D
authors.initials: PD
authors.lastname: Lenhart
authors.forename: J Bradley
authors.initials: JB
authors.lastname: Randleman
authors.forename: Hans E
authors.initials: HE
authors.lastname: Grossniklaus
authors.forename: R Doyle
authors.initials: RD
authors.lastname: Stulting
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002467:Cell Nucleus / Q000648:ultrastructure; D003316:Corneal Diseases / Q000188:drug therapy / Q000209:etiology / Q000473:pathology*; D019573:Epithelium, Corneal / Q000473:pathology*; D015807:Eye Injuries, Penetrating / Q000150:complications; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D007267:Injections; D008297:Male; D018613:Microscopy, Confocal; D013508:Ophthalmologic Surgical Procedures / Q000009:adverse effects; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D005472:Fluorouracil