研究目的
To observe and compare corneal cell morphology in a patient with moderate and severe keratoconus using in vivo slit scanning confocal microscopy.
研究成果
The right eye with stage 3 keratoconus exhibited more severe morphological alterations, including increased haze, elongation of keratocyte nuclei, and presence of dark bands in the anterior stroma, compared to the left eye with stage 2 keratoconus. Quantitative analysis confirmed lower cell densities in the more severely affected eye. These differences are attributed to the increased disease severity, highlighting the utility of confocal microscopy in monitoring keratoconus progression.
研究不足
The study was limited to a single case, which may not be generalizable. Poor image quality in some layers, particularly the epithelium, hindered analysis. Further studies with larger sample sizes are needed to confirm findings.
1：Experimental Design and Method Selection:
A case report design was used to evaluate corneal cell morphology in a patient with bilateral keratoconus of different severities (stage 3 in the right eye and stage 2 in the left eye) using in vivo slit scanning confocal microscopy. The methodology included qualitative and quantitative analysis of corneal layers based on confocal images.
2：Sample Selection and Data Sources:
A single 22-year-old Indian female patient diagnosed with bilateral keratoconus was selected. Data were obtained from clinical examinations at Sg Buloh hospital, including slit lamp biomicroscopy, corneal topography, and confocal microscopy.
3：List of Experimental Equipment and Materials:
Confocal microscope (ConfoScan4, Nidek Technologies Srl), nonaplanatic water immersion 40× objective lens with numerical aperture of 0.75, corneal topographer (Pentacam, Oculus, Optikgerate GmBH), slit lamp biomicroscopy equipment, and NAVIS software (Nidek Technologies Srl) for image analysis.
4：75, corneal topographer (Pentacam, Oculus, Optikgerate GmBH), slit lamp biomicroscopy equipment, and NAVIS software (Nidek Technologies Srl) for image analysis.
Experimental Procedures and Operational Workflow:
4. Experimental Procedures and Operational Workflow: The patient underwent standard clinical examinations. Confocal microscopy was performed using a full thickness scan, capturing 350 images per eye. The best three images of each corneal layer were selected for analysis. Qualitative analysis involved grading stromal haze using a scale by Hollingsworth et al (2005), and quantitative analysis used semiautomated and automated methods with NAVIS software to measure cell density and area.
5：Data Analysis Methods:
Qualitative analysis assessed visibility and morphological changes. Quantitative analysis included manual cell counting using the 'L' method for stromal keratocytes and automated analysis for endothelial cells, calculating densities, areas, polymegathism, and pleomorphism.
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