title: Laser confocal microscopy is a valuable, non-invasive tool for early diagnosis and characterisation of epithelial nests.
abstract: A 22-year-old woman presented with blurred vision and glare in the right eye, which had been present for three months. The patient had undergone laser-assisted in situ keratomileusis nine months previously and enhancement three months thereafter. On ophthalmological examination, visual acuity was 6/8.6 in the right eye and 6/6 in the left eye. An opaque epithelial nest below the flap with a visible demarcation line was detected along the pupil margin in the right eye. Subsequent laser confocal microscopy revealed the presence of epithelial cells in a whorled pattern with irregular astigmatism on corneal topography. Three months later, the clinical symptoms had worsened and a denser and larger wedge-shaped epithelial nest was observed. The nest was scraped. Six months later, the patient exhibited restored visual acuity (6/6) without glare. Laser confocal microscopy is a valuable, non-invasive tool and provides in vivo pathological images for early diagnosis and localisation of lesion depth in epithelial nests to guide appropriate surgical management.
authors.affiliation: Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Ke-Hung
authors.initials: KH
authors.lastname: Chien
authors.forename: Ching-Long
authors.initials: CL
authors.lastname: Chen
authors.forename: Da-Wen
authors.initials: DW
authors.lastname: Lu
authors.forename: Ming-Cheng
authors.initials: MC
authors.lastname: Tai
authors.forename: Jiann-Torng
authors.initials: JT
authors.lastname: Chen
mesh_terms: D000328:Adult; D003315:Cornea / Q000473:pathology*; D042241:Early Diagnosis; D004847:Epithelial Cells / Q000473:pathology; D005260:Female; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects*; D018613:Microscopy, Confocal / Q000379:methods*; D014792:Visual Acuity