Klin Monbl Augenheilkd 2020; 237(12): 1442-1454
DOI: 10.1055/a-1297-4717
Experimentelle Studie

In vivo Histology of the Cornea – from the “Rostock Cornea Module” to the “Rostock Electronic Slit Lamp” – a Clinical “Proof of Concept” Study

Artikel in mehreren Sprachen: English | deutsch
Sebastian Bohn
1   Universitätsaugenklinik, Universitätsmedizin Rostock, Deutschland
2   Department Leben, Licht & Materie, Universität Rostock, Deutschland
,
1   Universitätsaugenklinik, Universitätsmedizin Rostock, Deutschland
2   Department Leben, Licht & Materie, Universität Rostock, Deutschland
,
Karsten Sperlich
1   Universitätsaugenklinik, Universitätsmedizin Rostock, Deutschland
2   Department Leben, Licht & Materie, Universität Rostock, Deutschland
,
Stephan J. Linke
3   Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Hamburg-Eppendorf (UKE), Deutschland
4   Augenarztpraxis am UKE, Zentrumsehstärke, Hamburg, Deutschland
,
Sanaz Farrokhi
3   Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Hamburg-Eppendorf (UKE), Deutschland
,
Maren Klemm
3   Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Hamburg-Eppendorf (UKE), Deutschland
,
5   Institut für Automation und angewandte Informatik, Karlsruher Institut für Technologie (KIT), Eggenstein-Leopoldshafen, Deutschland
,
5   Institut für Automation und angewandte Informatik, Karlsruher Institut für Technologie (KIT), Eggenstein-Leopoldshafen, Deutschland
,
Klaus-Martin Reichert
5   Institut für Automation und angewandte Informatik, Karlsruher Institut für Technologie (KIT), Eggenstein-Leopoldshafen, Deutschland
,
Martin Witt
6   Institut für Anatomie, Universitätsmedizin Rostock, Deutschland
,
Oliver Stachs
1   Universitätsaugenklinik, Universitätsmedizin Rostock, Deutschland
2   Department Leben, Licht & Materie, Universität Rostock, Deutschland
,
Rudolf F. Guthoff
1   Universitätsaugenklinik, Universitätsmedizin Rostock, Deutschland
2   Department Leben, Licht & Materie, Universität Rostock, Deutschland
› Institutsangaben

Dedication

dedicated to Joachim Stave on his 80th birthday.

Abstract

Introduction Confocal in vivo microscopy is an established method in ophthalmology research. As it requires contact coupling and calibration of the instruments is suboptimal, this method has been only rarely used in clinical routine work. As a result of close collaboration between physicists, information scientists and ophthalmologists, confocal laser scanning microscopy (CLSM) of the eye has been developed in recent years and a prototype can now be used in patients. The present study evaluates possible clinical uses of this method.

Material and Methods The essential innovations in CLSM are (1) a newly designed coupling element with superficial adaptation to corneal curvature and (2) the use of a dual computerised piezo drive for rapid and precise focusing. In post-processing and after elastic imaging registration of the individual images parallel to the surface, it is also possible to produce sagittal sections resembling a split lamp and with resolution in the micrometer range. The concept was tested on enucleated pig bulbi and tested on normal volunteers and selected patients with diseases of the cornea.

Results Simultaneous imaging in planes parallel to the surface and in sagittal planes provided additional information that can help us to understand the processes of wound healing in all substructures of the cornea and the role of immune competent cells. Possible clinical uses were demonstrated in a volunteer with healthy eyes and several groups of patients (keratoconus after CXL, recurrent keratitis, status after PRK). These show that this new approach can be used in morphological studies at cellular level in any desired and appropriate test plane.

Conclusions It could be shown that this new concept of CLSM can be used clinically. It can provide valuable and novel information to both preclinical researchers and to ophthalmologists interested in corneal disease, e.g. density of Langerhans cells and epithelial stratification in ocular surface diseases.



Publikationsverlauf

Eingereicht: 02. Oktober 2020

Angenommen: 21. Oktober 2020

Artikel online veröffentlicht:
23. November 2020

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