title: In vivo laser scanning confocal microscopy of the ocular surface in glaucoma.
abstract: Over the past decade, knowledge about the ocular surface in glaucoma has significantly increased through the use of in vivo laser scanning confocal microscopy (LSCM). This in vivo imaging method can show modifications at the cellular level induced by anti-glaucoma drugs on ocular surface structures and adnexa in the eye. High-quality images of the conjunctiva, cornea, limbus, meibomian glands, and lymphoid structures during therapy can be obtained. In addition, LSCM opened new fields of research on the patho-physiology of aqueous humor (AH) hydrodynamics in untreated, and in medically or surgically treated glaucomatous patients. In these conditions, an enhancement of the trans-scleral AH outflow contributed to clarification of the mechanism of action of different anti-glaucoma medications and surgical approaches. Finally, the use of LSCM represented a huge advance in evaluation of bleb functionality after filtration surgery, defining the hallmarks of AH filtration through the bleb-wall and distinguishing functional from nonfunctional blebs. Thus, signs seen with LSCM may anticipate clinical failure, guiding the clinician in planning the appropriate timing of the various steps in bleb management. In this review we summarize the current knowledge about in vivo LSCM of the ocular surface in glaucoma.
authors.affiliation: 1Ophthalmic Clinic,Department of Medicine and Aging Science,University G. d'Annunzio of Chieti-Pescara,Chieti,66100,Italy.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Mastropasqua
authors.affiliation: 1Ophthalmic Clinic,Department of Medicine and Aging Science,University G. d'Annunzio of Chieti-Pescara,Chieti,66100,Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Agnifili
authors.affiliation: 2Ophthalmology Unit,Department of Neurological,Neuropsychological,Morphological and Movement Sciences,University of Verona,Verona,53593,Italy.
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Mastropasqua
authors.affiliation: 1Ophthalmic Clinic,Department of Medicine and Aging Science,University G. d'Annunzio of Chieti-Pescara,Chieti,66100,Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Fasanella
authors.affiliation: 1Ophthalmic Clinic,Department of Medicine and Aging Science,University G. d'Annunzio of Chieti-Pescara,Chieti,66100,Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Nubile
authors.affiliation: 1Ophthalmic Clinic,Department of Medicine and Aging Science,University G. d'Annunzio of Chieti-Pescara,Chieti,66100,Italy.
authors.forename: Lisa
authors.initials: L
authors.lastname: Toto
authors.affiliation: 1Ophthalmic Clinic,Department of Medicine and Aging Science,University G. d'Annunzio of Chieti-Pescara,Chieti,66100,Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Carpineto
authors.affiliation: 3Ophthalmic Clinic,Department of Surgical Science,University of L'Aquila,L'Aquila,67100,Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Ciancaglini
mesh_terms: D005123:Eye / Q000473:pathology*; D005901:Glaucoma / Q000473:pathology* / Q000628:therapy*; D006801:Humans; D018613:Microscopy, Confocal; D013499:Surface Properties; D013514:Surgical Procedures, Operative