Endothelial involvement in XXXX : an in vivo confocal microscopy study.

@entity1 @entity778 @entity1034 @entity1036 @entity2687
PURPOSE: To describe the appearance, frequency, and clinical consequences of corneal endothelial involvement in @entity1 @entity778 ( @entity778 ) @entity1036 as seen by in vivo confocal microscopy (IVCM). DESIGN: Prospective observational case series. @entity1 : A total of 285 @entity1 with @entity1034 who visited the cornea department of the Rotterdam Eye Hospital between May 2005 and May 2008. The control groups comprised the unaffected fellow eyes of @entity1 with @entity1034 , the eyes of 58 healthy volunteers, and the affected eyes of 62 @entity1 with inflammatory @entity2687 other than @entity778 . METHODS: We examined the eyes of all @entity1 by IVCM and slit-lamp examination. For IVCM, corneas were scanned with Confoscan 3 or 4 (Nidek Technologies, Albignasego, Padova, Italy). MAIN OUTCOME MEASURES: All IVCM examinations were qualitatively reviewed for signs of endothelial deviations characteristic of endotheliitis. Endothelial cell density (ECD) was evaluated on the first and last visits of @entity1 who were followed for more than 100 days. The differences in ECDs were calculated and converted to percent ECD change per year. RESULTS: Endothelial alterations characteristic of endotheliitis were detected by IVCM in 107 of 250 @entity1 with @entity1034 (43%). These deviations consisted of pseudoguttata, enlarged intercellular gaps, infiltration of inflammatory cells into the endothelial layer, loss of defined cell boundaries, spot-like holes, and endothelial denudation. All of these signs disappeared with appropriate antiviral and anti-inflammatory treatment. However, the endothelium in eyes with endotheliitis-characteristic alterations showed a significant decrease in ECD (10.3% per year) compared with healthy fellow eyes. CONCLUSIONS: IVCM allows earlier detection of endothelial alterations in @entity1 with @entity1034 compared with slit-lamp examination. Although endotheliitis-specific alterations appear to resolve, the corneal endothelium can become irreversibly damaged.
