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In Vivo Laser Scanning Confocal Microscopy of the Ocular Surface in Glaucoma

Published online by Cambridge University Press:  27 February 2014

Leonardo Mastropasqua ,
Luca Agnifili ,
Rodolfo Mastropasqua ,
Vincenzo Fasanella ,
Mario Nubile ,
Lisa Toto ,
Paolo Carpineto  and
Marco Ciancaglini
Leonardo Mastropasqua*
Affiliation:
Ophthalmic Clinic, Department of Medicine and Aging Science, University G. d’Annunzio of Chieti-Pescara, Chieti, 66100, Italy
Luca Agnifili
Affiliation:
Ophthalmic Clinic, Department of Medicine and Aging Science, University G. d’Annunzio of Chieti-Pescara, Chieti, 66100, Italy
Rodolfo Mastropasqua
Affiliation:
Ophthalmology Unit, Department of Neurological, Neuropsychological, Morphological and Movement Sciences, University of Verona, Verona, 53593, Italy
Vincenzo Fasanella
Affiliation:
Ophthalmic Clinic, Department of Medicine and Aging Science, University G. d’Annunzio of Chieti-Pescara, Chieti, 66100, Italy
Mario Nubile
Affiliation:
Ophthalmic Clinic, Department of Medicine and Aging Science, University G. d’Annunzio of Chieti-Pescara, Chieti, 66100, Italy
Lisa Toto
Affiliation:
Ophthalmic Clinic, Department of Medicine and Aging Science, University G. d’Annunzio of Chieti-Pescara, Chieti, 66100, Italy
Paolo Carpineto
Affiliation:
Ophthalmic Clinic, Department of Medicine and Aging Science, University G. d’Annunzio of Chieti-Pescara, Chieti, 66100, Italy
Marco Ciancaglini
Affiliation:
Ophthalmic Clinic, Department of Surgical Science, University of L’Aquila, L’Aquila, 67100, Italy
*
*Corresponding author.r.mastropasqua@hotmail.com
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Abstract

Over the past decade, knowledge about the ocular surface in glaucoma has significantly increased through the use of in vivo laser scanning confocal microscopy (LSCM). This in vivo imaging method can show modifications at the cellular level induced by anti-glaucoma drugs on ocular surface structures and adnexa in the eye. High-quality images of the conjunctiva, cornea, limbus, meibomian glands, and lymphoid structures during therapy can be obtained. In addition, LSCM opened new fields of research on the patho-physiology of aqueous humor (AH) hydrodynamics in untreated, and in medically or surgically treated glaucomatous patients. In these conditions, an enhancement of the trans-scleral AH outflow contributed to clarification of the mechanism of action of different anti-glaucoma medications and surgical approaches. Finally, the use of LSCM represented a huge advance in evaluation of bleb functionality after filtration surgery, defining the hallmarks of AH filtration through the bleb-wall and distinguishing functional from nonfunctional blebs. Thus, signs seen with LSCM may anticipate clinical failure, guiding the clinician in planning the appropriate timing of the various steps in bleb management. In this review we summarize the current knowledge about in vivo LSCM of the ocular surface in glaucoma.

Keywords

in vivo confocal microscopyglaucomaocular surfaceconjunctivacorneasclero-corneal limbusmeibomian glandsCALTfiltering bleb
Type
Biological Applications
Information
Microscopy and Microanalysis , Volume 20 , Issue 3 , June 2014 , pp. 879 - 894
Copyright
© Microscopy Society of America 2014 

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Footnotes

a

L.M. and L.A. equally contributed to this work

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