title: Corneal involvement in Crohn's disease: an in vivo confocal microscopy study.
abstract: OBJECTIVE
  To evaluate the corneal changes of patients with Crohn's disease (CD) using confocal microscopy and to investigate the association among confocal parameters and CD activity and CD treatment.
  
  
  METHODS
  Thirty consecutive patients (age: 42 ± 12 years; 19 women and 11 men) affected by CD and 30 control eyes (age matched and gender matched) underwent an ophthalmic examination and, in 1 eye chosen at random, confocal microscopy of the central cornea using the cornea module of Heidelberg Retina Tomograph. The following confocal parameters were evaluated: density of basal epithelial cells, epithelial dendritic cells, anterior and posterior stromal keratocytes, and endothelial cells; the subbasal plexus was assessed for number and tortuosity of the nerve fibers.
  
  
  RESULTS
  Routine ophthalmic evaluation was normal in the whole population. At confocal microscopy, 40% of patients with CD had hyperreflective dots in the basal epithelium, which were absent in the control group. Activation of keratocytes was found in 86.6% of patients with CD and was absent in the control group. Compared with controls, patients with CD had lower density of dendritic cells (12.2 ± 26.3 vs. 50.3 ± 37.6 cells per square millimeter; P = 0.001). The other confocal parameters were similar in the 2 groups. No correlation between CD activity index and confocal changes was found.
  
  
  CONCLUSIONS
  Confocal microscopy can detect subtle corneal changes in patients with CD, which may be signs of subclinical inflammation.
authors.affiliation: Cinica Oculistica, Dipartimento di Medicina, Chirurgia e Odontoiatria, Ospedale San Paolo, Milano, Italy. gaia.ceresara@gmail.com
authors.forename: Gaia
authors.initials: G
authors.lastname: Ceresara
authors.forename: Paolo
authors.initials: P
authors.lastname: Fogagnolo
authors.forename: Stefano
authors.initials: S
authors.lastname: De Cillà
authors.forename: Valerio
authors.initials: V
authors.lastname: Panizzo
authors.forename: Pier Giorgio
authors.initials: PG
authors.lastname: Danelli
authors.forename: Nicola
authors.initials: N
authors.lastname: Orzalesi
authors.forename: Luca
authors.initials: L
authors.lastname: Rossetti
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D003315:Cornea / Q000473:pathology*; D003319:Corneal Stroma / Q000473:pathology; D003424:Crohn Disease / Q000188:drug therapy / Q000473:pathology*; D003430:Cross-Sectional Studies; D003713:Dendritic Cells / Q000473:pathology; D019573:Epithelium, Corneal / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D019804:Mesalamine / Q000627:therapeutic use; D018613:Microscopy, Confocal; D008875:Middle Aged; D015203:Reproducibility of Results
chemical_list: D000305:Adrenal Cortex Hormones; D000894:Anti-Inflammatory Agents, Non-Steroidal; D019804:Mesalamine