In vivo confocal microscopy of the ocular surface : from bench to bedside

Villani, Edoardo, Baudouin, Christophe, Efron, Nathan, Hamrah, Pedram, Kojima, Takashi, Patel, Sanjay V., Pflugfelder, Stephen C., Zhivov, Andrey, & Dogru, Murat (2014) In vivo confocal microscopy of the ocular surface : from bench to bedside. Current Eye Research, 39(3), pp. 213-231.

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In vivo confocal microscopy (IVCM) is an emerging technology that provides minimally invasive, high resolution, steady-state assessment of the ocular surface at the cellular level. Several challenges still remain but, at present, IVCM may be considered a promising technique for clinical diagnosis and management. This mini-review summarizes some key findings in IVCM of the ocular surface, focusing on recent and promising attempts to move “from bench to bedside”. IVCM allows prompt diagnosis, disease course follow-up, and management of potentially blinding atypical forms of infectious processes, such as acanthamoeba and fungal keratitis. This technology has improved our knowledge of corneal alterations and some of the processes that affect the visual outcome after lamellar keratoplasty and excimer keratorefractive surgery. In dry eye disease, IVCM has provided new information on the whole-ocular surface morphofunctional unit. It has also improved understanding of pathophysiologic mechanisms and helped in the assessment of prognosis and treatment. IVCM is particularly useful in the study of corneal nerves, enabling description of the morphology, density, and disease- or surgically induced alterations of nerves, particularly the subbasal nerve plexus. In glaucoma, IVCM constitutes an important aid to evaluate filtering blebs, to better understand the conjunctival wound healing process, and to assess corneal changes induced by topical antiglaucoma medications and their preservatives. IVCM has significantly enhanced our understanding of the ocular response to contact lens wear. It has provided new perspectives at a cellular level on a wide range of contact lens complications, revealing findings that were not previously possible to image in the living human eye. The final section of this mini-review provides a focus on advances in confocal microscopy imaging. These include 2D wide-field mapping, 3D reconstruction of the cornea and automated image analysis.

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56 citations in Scopus
48 citations in Web of Science®
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ID Code: 67473
Item Type: Journal Article
Refereed: Yes
Keywords: Confocal microscopy, dry eye, glaucoma, keratitis, keratoplasty
DOI: 10.3109/02713683.2013.842592
ISSN: 1460-2202
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > OPTOMETRY AND OPHTHALMOLOGY (111300)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Optometry & Vision Science
Deposited On: 17 Feb 2014 23:40
Last Modified: 10 Mar 2014 01:27

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