Non-contact in vivo confocal scanning laser microscopy in exfoliation syndrome, exfoliation syndrome suspect and normal eyes

Authors

  • Zaher Sbeity,

    1. Department of Ophthalmology, Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, New York, USA
    2. Department of Ophthalmology, New York Medical College, Valhalla, New York, USA
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  • Pat-Michael Palmiero,

    1. Department of Ophthalmology, Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, New York, USA
    2. Department of Ophthalmology, New York Medical College, Valhalla, New York, USA
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  • Celso Tello,

    1. Department of Ophthalmology, Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, New York, USA
    2. Department of Ophthalmology, New York Medical College, Valhalla, New York, USA
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  • Jeffrey M. Liebmann,

    1. Department of Ophthalmology, Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, New York, USA
    2. Department of Ophthalmology, Manhattan Eye, Ear and Throat Hospital, New York, New York, USA
    3. Department of Ophthalmology, New York University, New York, New York, USA
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  • Robert Ritch

    1. Department of Ophthalmology, Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, New York, USA
    2. Department of Ophthalmology, New York Medical College, Valhalla, New York, USA
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Zaher Sbeity MD
Department of Ophthalmology
Einhorn Clinical Research Center
New York Eye and Ear Infirmary
310 East 14th Street
New York
New York 10003
USA
Tel: + 1 212 477 7540
Fax: + 1 212 420 0067
Email: z.sbeity@web.de

Abstract.

Purpose:  This study aimed to evaluate the efficacy of non-contact confocal laser microscopy in detecting structural alterations of the cornea, iris and lens in fellow eyes of patients with clinically unilateral exfoliation syndrome (XFS) and XFS suspects.

Methods:  In a prospective observational case series, eyes of 12 patients with clinically unilateral XFS, six XFS suspects and six age-matched controls were divided into four groups. Group A included eyes with clinically visible exfoliation material (XFM) on the pupillary border or anterior lens capsule (n = 12); group B included fellow eyes of clinically unilateral XFS patients without visible XFM (n = 12); group C comprised eyes in XFS suspects with signs of pigment dispersion without visible XFM (n = 10), and group D consisted of control eyes with no evidence of XFM or pigment dispersion (n = 12). The cornea, iris and lens were imaged using a non-contact lens prototype for the Rostock Cornea Module (HRT II). Images were analysed by two observers masked to the clinical findings.

Results:  Visible XFM (group A) on the lens capsule was characterized by hyperreflectivity in the granular and central disc areas and hyporeflective spaces in the intermediate zones. Similar hyperreflectivity was noted in four of 12 and one of 10 eyes in groups B and C, respectively, but in none in group D. Corneal endothelial hyperreflective deposits were found in eight of 12, four of 12 and one of 10 eyes in groups A, B and C, respectively, and no eyes in group D.

Conclusions:  This technology permits visualization of XFM and/or XFM-related changes in the cornea and lens in the unaffected eyes of patients with clinically unilateral XFS. It may allow early detection of XFS and impact glaucoma screening and clinical surveillance decisions.

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