title: Using corneal confocal microscopy to track changes in the corneal layers of dry eye patients after autologous serum treatment.
abstract: BACKGROUND
  In vivo corneal confocal microscopy allows the examination of each layer of the cornea in detail and the identification of pathological changes at the cellular level. The purpose of this study was to identify the possible effects of a three-month treatment with autologous serum eye-drops in different corneal layers of patients with severe dry eye disease using corneal confocal microscopy.
  
  
  METHODS
  Twenty-six patients with dry eye disease were included in the study. Corneal fluorescein staining was performed. The corneas of the right eyes were examined using in vivo corneal confocal microscopy before and after a three-month treatment with autologous serum drops. The densities of superficial and basal epithelial cells, Langerhans cells, the keratocytes and activated keratocytes, the density of endothelial cells and the status of the sub-basal nerve plexus fibres were evaluated.
  
  
  RESULTS
  A significant decrease in corneal fluorescein staining was found after the three-month autologous serum treatment (p = 0.0006). The basal epithelial cell density decreased significantly (p = 0.001), while the density of superficial epithelial cells did not change significantly (p = 0.473) nor did the number of Langerhans cells or activated keratocytes (p = 0.223; p = 0.307, respectively). There were no differences in the other corneal cell layers or in the status of the nerve fibres.
  
  
  CONCLUSIONS
  The results demonstrate the ability of corneal confocal microscopy to evaluate an improvement in the basal epithelial cell layer of the cornea after autologous serum treatment in patients with dry eye disease. More studies with longer follow-up periods are needed to elucidate the suitability of corneal confocal microscopy to follow the effect of autologous serum treatment on nerve fibres or other corneal layers in dry eye disease patients.
authors.affiliation: Department of Ophthalmology for Children and Adults, Charles University, 2nd Faculty of Medicine and University Hospital in Motol, Prague, Czech Republic.|Department of Physiology, Charles University, 2nd Faculty of Medicine, Prague, Czech Republic.
authors.forename: Gabriela
authors.initials: G
authors.lastname: Mahelkova
authors.affiliation: Laboratory of the Biology and Pathology of the Eye, Institute of Inherited Metabolic Disorders, Charles University, 1st Faculty of Medicine, Prague, Czech Republic.
authors.forename: Katerina
authors.initials: K
authors.lastname: Jirsova
authors.affiliation: Department of Ophthalmology, Charles University, 1st Faculty of Medicine and General University Hospital in Prague, Prague, Czech Republic.
authors.forename: Petra
authors.initials: P
authors.lastname: Seidler Stangova
authors.affiliation: Department of Ophthalmology, Charles University, 1st Faculty of Medicine and General University Hospital in Prague, Prague, Czech Republic.
authors.forename: Michalis
authors.initials: M
authors.lastname: Palos
authors.affiliation: Cell Therapy Department, Institute of Hematology and Blood Transfusion, Prague, Czech Republic.
authors.forename: Viera
authors.initials: V
authors.lastname: Vesela
authors.affiliation: Department of Ophthalmology, Charles University in Prague, Faculty of Medicine in Hradec Kralove and University Hospital in Hradec Kralove, Czech Republic.
authors.forename: Ivan
authors.initials: I
authors.lastname: Fales
authors.affiliation: Department of Ophthalmology, Charles University in Prague, Faculty of Medicine in Hradec Kralove and University Hospital in Hradec Kralove, Czech Republic.
authors.forename: Nada
authors.initials: N
authors.lastname: Jiraskova
authors.affiliation: Department of Ophthalmology for Children and Adults, Charles University, 2nd Faculty of Medicine and University Hospital in Motol, Prague, Czech Republic.
authors.forename: Dagmar
authors.initials: D
authors.lastname: Dotrelova
mesh_terms: D000287:Administration, Topical; D002452:Cell Count; D003315:Cornea / Q000473:pathology*; D015352:Dry Eye Syndromes / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D019793:Fluorescein / Q000494:pharmacology; D005456:Fluorescent Dyes / Q000494:pharmacology; D006801:Humans; D008297:Male; D018613:Microscopy, Confocal / Q000379:methods*; D008875:Middle Aged; D009883:Ophthalmic Solutions / Q000008:administration & dosage*; D011446:Prospective Studies; D044967:Serum; D016896:Treatment Outcome
chemical_list: D005456:Fluorescent Dyes; D009883:Ophthalmic Solutions; D019793:Fluorescein
keywords: Sjögren syndrome; autologous serum; corneal confocal microscopy; dry eye disease; graft-versus-host disease