title: In vivo laser confocal microscopy findings of Thygeson superficial punctate keratitis.
abstract: OBJECTIVE
  We looked for microstructural corneal characteristics of Thygeson superficial punctate keratitis (TSPK) in an in vivo investigation using laser scanning confocal microscopy.
  
  
  METHODS
  Five patients (3 men and 2 women; mean age, 51.8 years) with clinically diagnosed TSPK were enrolled in this study. All patients were examined by slit-lamp biomicroscopy and in vivo laser confocal microscopy. Deposits in selected confocal images of all corneal layers were evaluated qualitatively for shape and degree of light reflection.
  
  
  RESULTS
  The most characteristic finding was aggregates of highly reflective deposits with a starburst-like appearance that corresponded with epithelial punctate lesions identified by slit-lamp biomicroscopy; the aggregates were sporadically observed in all cases at the superficial and basal epithelial cell layers. Subepithelial haze was observed in all cases. Langerhans cells were also sporadically observed in all cases at the basal epithelial layer. Bowman layer abnormalities were observed in 3 of 5 cases; all these patients had a long history of TSPK (eg, more than 1 year). In addition, the 3 patients had highly reflective, tiny, needle-shaped materials in the corneal stroma.
  
  
  CONCLUSIONS
  In vivo laser confocal microscopy is capable of identifying characteristic corneal microstructural changes related to TSPK with a higher resolution than is available with slit-lamp biomicroscopy. It may also be a valuable tool for further research to elucidate both pathogenesis and the natural course of TSPK.
authors.affiliation: Department of Ophthalmology, Kanazawa University Graduate School of Medical Science, Kanazawa, Ishikawa-ken, Japan. kobaya@kenroku.kanazawa-u.ac.jp
authors.forename: Akira
authors.initials: A
authors.lastname: Kobayashi
authors.forename: Hideaki
authors.initials: H
authors.lastname: Yokogawa
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Sugiyama
mesh_terms: D000328:Adult; D050541:Bowman Membrane / Q000473:pathology; D003318:Corneal Opacity / Q000175:diagnosis*; D019573:Epithelium, Corneal / Q000473:pathology*; D005260:Female; D006801:Humans; D007634:Keratitis / Q000175:diagnosis*; D007801:Langerhans Cells / Q000473:pathology; D008297:Male; D018613:Microscopy, Confocal; D008875:Middle Aged