By Prof.Dr. med. Rudolf F. Guthoff, Christophe Baudouin MD, Phd, Prof.Dr. rer. nat. Joachim Stave (auth.)
Confocal microscopy with laser scanning know-how yields in-vivo photos of ocular and ocular adnexal surfaces which are so incredible that they rival histology when it comes to quality.This certain atlas and textbook demonstrates general in-vivo anatomy of the cornea, limbus and conjunctiva, quantifies a number of mobile constructions utilizing cell-density calculations and establishes correlations among novel optical sections of varied ailments of the ocular floor and medical findings. moreover, it helps the translation of novel high-magnification optical sections via evaluating corneal and conjunctival imprint cytology with in-vivo photographs and describes early inflammatory alterations in corneal grafts, in addition to corneal conjunctivalisation in limbal stem cellphone deficiency, corneal dystrophies or infections, flap interface and margin features after laser in-situ keratomileusis (LASIK). moreover, it instructs the reader approximately diagnostic and healing follow-up suggestions and gives a short creation to purposes in different fields reminiscent of dentistry and ear, nostril and throat surgery.
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Additional info for Atlas of Confocal Laser Scanning In-vivo Microscopy in Ophthalmology: Principles and Applications in Diagnostic and Therapeutic Ophthalmology
2 Intermediate Cells/Wing Cells (Up to Approximately 20 mm in Diameter) The cells of the intermediate layers are characterized by bright cell borders and a dark cytoplasm. The cell nucleus can be distinguished only with difficulty. In terms of size and appearance, wing cells in healthy subjects exhibit only minimal variation (Fig. 6). The average density is approximately 5,000 cells/mm2 in the central cornea and approximately 5,500 cells/mm2 in the periphery. a b Fig. 5 Superficial cells: the cytoplasm and cell nuclei are visualized; cells in the process of desquamation possess a highly reflective cytoplasm, in the center of which the bright (pyknic) cell nucleus with its dark perinuclear space is clearly visible.
B Confocal in vivo microscopy image of the plaque with hyperreflective area within the corneal epithelium. c Confocal in vivo microscopy image of the scar after surgical scraping of the plaque 45 46 Chapter 5 Confocal Laser Scanning In Vivo Microscopy a b c d Fig. 26 Vernal keratoconjunctivitis. a Slit-lamp photograph of a 13-year-old boy with vernal keratoconjunctivitis: Trantas dots. b Confocal in vivo microscopy image of the limbus. Epithelial infiltration by dendritic cells. c Confocal in vivo microscopy im- age of Trantas dots: microcysts and inflammatory cells (hyperreflective cells).
Enlarged corneal cells displaying reflective nuclei and polymorphism. b Impression cytology immunostaining: goblet cells (green) in the corneal epithelium c Fig. 20 Keratoconjunctivitis sicca in a case of Sjögren’s syndrome. a Slit-lamp photograph of a 50-year-old woman with severe keratoconjunctivitis sicca. b Confocal in-vivo microscopy image of abnormal corneal-conjunctival junction at the limbus. c Impression cytology of the limbus showing the same abnormal corneal–conjunctival junction 43 44 Chapter 5 Confocal Laser Scanning In Vivo Microscopy a b c d Fig.