Association of fluorescein anterior corneal mosaic and corneal K-structures by in vivo laser confocal microscopy in patients with keratoconus

Akira Kobayashi, Hideaki Yokogawa, Natsuko Mori, Toshinori Masaki, Kazuhisa Sugiyama Department of Ophthalmology, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan Objective: To report the in vivo laser confocal microscopy findings of corneas with keratoconus, with special a...

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Autores principales:	Kobayashi A, Yokogawa H, Mori N, Masaki T, Sugiyama K
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2017
Materias:	keratoconus anterior corneal mosaic K-structure confocal microscopy Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/543394a15cef41308aa83ed1b0cb13d0
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spelling	oai:doaj.org-article:543394a15cef41308aa83ed1b0cb13d02021-12-02T00:37:41ZAssociation of fluorescein anterior corneal mosaic and corneal K-structures by in vivo laser confocal microscopy in patients with keratoconus1177-5483https://doaj.org/article/543394a15cef41308aa83ed1b0cb13d02017-07-01T00:00:00Zhttps://www.dovepress.com/association-of-fluorescein-anterior-corneal-mosaic-and-corneal-k-struc-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Akira Kobayashi, Hideaki Yokogawa, Natsuko Mori, Toshinori Masaki, Kazuhisa Sugiyama Department of Ophthalmology, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan Objective: To report the in vivo laser confocal microscopy findings of corneas with keratoconus, with special attention to abnormality of Bowman’s layer and sub-Bowman’s fibrous structures (Kobayashi-structures [K-structures]).Methods: Sixteen keratoconic eyes in 8 consecutive patients with keratoconus (4 males, 4 females, mean age, 41.1 years) were included in this study. Slit-lamp biomicroscopic photos were taken with or without fluorescein staining. The existence of anterior corneal mosaic (ACM) after eyelid rubbing under fluorescein staining was documented. In vivo laser confocal microscopic examinations were performed for all patients in both the central cone and the peripheral cornea to examine the existence of K-structures.Results: According to the Amsler–Krumeich scale, the eyes were graded as follows: stage 1 (n=3), stage 2 (n=1), stage 3 (n=1), and stage 4 (n=11). ACM was observed in 7 eyes (61.1%) in the cone area and 16 eyes (100%) in the peripheral cornea among all keratoconic eyes enrolled in this study. In addition, K-structures were observed in the 7 eyes (61.1%) and 16 eyes (100%) in the peripheral cornea among all keratoconic eyes. The presence of the K-structures was completely matched (100%) with the presence of ACM in both the central cone and the peripheral cornea. In 11 eyes with stage 4 keratoconus, ACM and K-structure was absent in 9 eyes (81.8%) in the cone area. On the contrary, in 5 eyes with mild-to-moderate keratoconus (grade 1 to 3), ACM and K-structure was present in all eyes (100%) in the cone area. The absent ratio of ACM and K-structures in the cone area was significantly higher in stage 4 severe keratoconus compared to mild-to-moderate keratoconus (grade 1 to 3) (Fisher, P=0.005).Conclusion: The existence of ACM and K-structures in both the central cone and the peripheral cornea showed perfect accord in patients with keratoconus, indicating a strong association of ACM and K-structures in patients with keratoconus. With the progress of the keratoconus, it seemed that ACM and K-structure progressively disappeared, suggesting Bowman’s layer abnormalities due to keratoconus. Further study in larger groups of patients with keratoconus is required to fully understand the significance of ACM/K-structures in keratoconic eyes and their association with Bowman’s layer. Keywords: keratoconus, anterior corneal mosaic, K-structure, confocal microscopy Kobayashi AYokogawa HMori NMasaki TSugiyama KDove Medical Pressarticlekeratoconusanterior corneal mosaicK-structureconfocal microscopyOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 11, Pp 1359-1363 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	keratoconus anterior corneal mosaic K-structure confocal microscopy Ophthalmology RE1-994
spellingShingle	keratoconus anterior corneal mosaic K-structure confocal microscopy Ophthalmology RE1-994 Kobayashi A Yokogawa H Mori N Masaki T Sugiyama K Association of fluorescein anterior corneal mosaic and corneal K-structures by in vivo laser confocal microscopy in patients with keratoconus
description	Akira Kobayashi, Hideaki Yokogawa, Natsuko Mori, Toshinori Masaki, Kazuhisa Sugiyama Department of Ophthalmology, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan Objective: To report the in vivo laser confocal microscopy findings of corneas with keratoconus, with special attention to abnormality of Bowman’s layer and sub-Bowman’s fibrous structures (Kobayashi-structures [K-structures]).Methods: Sixteen keratoconic eyes in 8 consecutive patients with keratoconus (4 males, 4 females, mean age, 41.1 years) were included in this study. Slit-lamp biomicroscopic photos were taken with or without fluorescein staining. The existence of anterior corneal mosaic (ACM) after eyelid rubbing under fluorescein staining was documented. In vivo laser confocal microscopic examinations were performed for all patients in both the central cone and the peripheral cornea to examine the existence of K-structures.Results: According to the Amsler–Krumeich scale, the eyes were graded as follows: stage 1 (n=3), stage 2 (n=1), stage 3 (n=1), and stage 4 (n=11). ACM was observed in 7 eyes (61.1%) in the cone area and 16 eyes (100%) in the peripheral cornea among all keratoconic eyes enrolled in this study. In addition, K-structures were observed in the 7 eyes (61.1%) and 16 eyes (100%) in the peripheral cornea among all keratoconic eyes. The presence of the K-structures was completely matched (100%) with the presence of ACM in both the central cone and the peripheral cornea. In 11 eyes with stage 4 keratoconus, ACM and K-structure was absent in 9 eyes (81.8%) in the cone area. On the contrary, in 5 eyes with mild-to-moderate keratoconus (grade 1 to 3), ACM and K-structure was present in all eyes (100%) in the cone area. The absent ratio of ACM and K-structures in the cone area was significantly higher in stage 4 severe keratoconus compared to mild-to-moderate keratoconus (grade 1 to 3) (Fisher, P=0.005).Conclusion: The existence of ACM and K-structures in both the central cone and the peripheral cornea showed perfect accord in patients with keratoconus, indicating a strong association of ACM and K-structures in patients with keratoconus. With the progress of the keratoconus, it seemed that ACM and K-structure progressively disappeared, suggesting Bowman’s layer abnormalities due to keratoconus. Further study in larger groups of patients with keratoconus is required to fully understand the significance of ACM/K-structures in keratoconic eyes and their association with Bowman’s layer. Keywords: keratoconus, anterior corneal mosaic, K-structure, confocal microscopy
format	article
author	Kobayashi A Yokogawa H Mori N Masaki T Sugiyama K
author_facet	Kobayashi A Yokogawa H Mori N Masaki T Sugiyama K
author_sort	Kobayashi A
title	Association of fluorescein anterior corneal mosaic and corneal K-structures by in vivo laser confocal microscopy in patients with keratoconus
title_short	Association of fluorescein anterior corneal mosaic and corneal K-structures by in vivo laser confocal microscopy in patients with keratoconus
title_full	Association of fluorescein anterior corneal mosaic and corneal K-structures by in vivo laser confocal microscopy in patients with keratoconus
title_fullStr	Association of fluorescein anterior corneal mosaic and corneal K-structures by in vivo laser confocal microscopy in patients with keratoconus
title_full_unstemmed	Association of fluorescein anterior corneal mosaic and corneal K-structures by in vivo laser confocal microscopy in patients with keratoconus
title_sort	association of fluorescein anterior corneal mosaic and corneal k-structures by in vivo laser confocal microscopy in patients with keratoconus
publisher	Dove Medical Press
publishDate	2017
url	https://doaj.org/article/543394a15cef41308aa83ed1b0cb13d0
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Association of fluorescein anterior corneal mosaic and corneal K-structures by in vivo laser confocal microscopy in patients with keratoconus

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