alexa <em>In Vivo</em> Three-Dimensional Analysis of Conjunctival Epithelial Microcysts in Glaucoma | OMICS International | Abstract
ISSN: 2155-9570

Journal of Clinical & Experimental Ophthalmology
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Research Article

In Vivo Three-Dimensional Analysis of Conjunctival Epithelial Microcysts in Glaucoma

Silvio Di Staso1, Marco Ciancaglini1, Luca Agnifili2*, Vincenzo Fasanella2, Mario Nubile2, Rodolfo Mastropasqua3 Emilio Galassi1 and Leonardo Mastropasqua2
1Ophthalmology Unit, Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100, Italy
2Ophthalmic Clinic, Department of Medicine and Aging Science, University G. d’Annunzio of Chieti-Pescara, Chieti, 66100, Italy
3Ophthalmology Unit, Department of Neurological, Neuropsychological, Morphological and Movement Sciences, University of Verona, 37100, Verona, Italy
*Corresponding Author : Luca Agnifili
Ophthalmology Clinic
114, 66100 Chieti, Italy
Tel: +39-0871-358410
Fax: +39-0871-358794
E-mail: [email protected]
Received date: December 26, 2015; Accepted date: February 15, 2016; Published date: February 18, 2016
Citation: Di Staso S, Ciancaglini M, Agnifili L, Fasanella V, Nubile M, et al. (2016) In Vivo Three-Dimensional Analysis of Conjunctival Epithelial Microcysts in Glaucoma. J Clin Exp Ophthalmol 7:524. doi:10.4172/2155-9570.1000524
Copyright: © 2016 Di Staso S, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Objective: To analyze the three-dimensional (3D) features of conjunctival epithelial microcysts (CEM) in eyes affected with primary open angle glaucoma (POAG).
Methods: This was a case series study. Nine patients that underwent successful trabeculectomy and four eyes with medically controlled POAG were enrolled. Patients were examined with confocal laser-scanning microscope (Heidelberg Retina Tomograph/Rostock Cornea Module). Sequential images 300 × 300 μm (384 × 384 pixels) derived from automatic scans were acquired throughout the upper bulbar conjunctiva, 2 mm from the limbus. Image acquisition was performed in z-scan automatic volume mode and a series of 40 images to a maximum depth of 40 μm were captured. The 3-D volume tissue reconstruction with a maximal size of 300 × 300 × 40 μm and voxel size of 0.78 × 0.78 × 0.95 μm was performed with the AMIRA volume-rendering software package, to provide a 3-D characterization of conjunctival epithelial microcysts (CEM).
Results: In the enface view, CEM appeared as empty, optically clear, round or oval shaped sub-epithelial structures. In eyes that underwent trabeculectomy CEM showed greater density and larger area compared to medically controlled glaucomatous eyes. The 3-D spatial reconstruction showed microcysts as oval-shaped, optically clear, differently sized structures, often surrounded by a well-defined and mildly thick wall. All microcysts were embedded in the extra cellular spaces and located 10 μm below the epithelial surface.
Conclusions: Conjunctival epithelial microcysts were proposed as hallmark of trans-scleral aqueous humor outflow in eyes with glaucoma. They can be effectively imaged with a 3-D reconstruction system, which permits to better clarify their microscopic anatomy and patho-physiological significance.

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