In Vivo Morphology of the Limbal Palisades of Vogt Correlates With Progressive Stem Cell Deficiency in Aniridia-Related Keratopathy
2013 (English)In: Investigative Ophthalmology and Visual Science, ISSN 0146-0404, Vol. 54, no 8, 5333-5342 p.Article in journal (Refereed) Published
Purpose. To investigate morphologic alterations in the limbal palisades of Vogt in a progressive form of limbal stem cell deficiency.
Methods. Twenty Norwegian subjects (40 eyes) with congenital aniridia and 9 healthy family members (18 eyes) without aniridia were examined. Clinical grade of aniridia-related keratopathy (ARK) was assessed by slit-lamp biomicroscopy, and tear production and quality, corneal thickness, and sensitivity were additionally measured. The superior and inferior limbal palisades of Vogt and central cornea were examined by laser scanning in vivo confocal microscopy (IVCM).
Results. In an aniridia patient with grade 0 ARK, a transparent cornea and normal limbal palisade morphology were found. In grade 1 ARK, 5 of 12 eyes had degraded palisade structures. In the remaining grade 1 eyes and in all 20 eyes with stage 2, 3, and 4 ARK, palisade structures were absent by IVCM. Increasing ARK grade significantly correlated with reduced visual acuity and corneal sensitivity, increased corneal thickness, degree of degradation of superior and inferior palisade structures, reduced peripheral nerves, increased inflammatory cell invasion, and reduced density of basal epithelial cells and central subbasal nerves. Moreover, limbal basal epithelial cell density and central corneal subbasal nerve density were both significantly reduced in aniridia compared to healthy corneas (P = 0.002 and 0.003, respectively).
Conclusions. Progression of limbal stem cell deficiency in aniridia correlates with degradation of palisade structures, gradual transformation of epithelial phenotype, onset of inflammation, and a corneal nerve deficit. IVCM can be useful in monitoring early- to late-stage degenerative changes in stem cell–deficient patients.
Place, publisher, year, edition, pages
Association for Research in Vision and Ophthalmology (ARVO) , 2013. Vol. 54, no 8, 5333-5342 p.
limbal palisades of Vogt, corneal stem cells, corneal epithelium, subbasal nerves, aniridia, in vivo confocal microscopy, stem cell deficiency
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:liu:diva-100040DOI: 10.1167/iovs.13-11780ISI: 000325167200024OAI: oai:DiVA.org:liu-100040DiVA: diva2:659426
Funding Agencies|Crown Princess Margaretas Foundation for the Visually Impaired||Carmen and Bertil Regners Foundation for Research in Eye Disease||County Council of Ostergotland||Konung Gustav V and Drottning Viktorias Frimurarestiftelse||The Swedish Research Council||Aniridia Norway||2013-10-252013-10-252013-10-28Bibliographically approved