Abstract

SA.08.09

Confocal Laser-Scanning-Microscopy of cornea for screening of pseudoexfoliation syndrome

Meinhardt B., Guthoff R., Geerling G.
University Eye Hospital, University Wuerzburg, Wuerzburg

Objective: Pseudoexfoliations (PEX) syndrome is associated with open-angle-glaucoma and the risk for intra-operative complications in cataract surgery. Eyes without clinical signs of PES, electron microscopy was able to reveal the typical extracellular proteins deposits ex vivo. We examined, whether PEX-material can be detected in vivo by confocal laser-scanning- microscopy.
Methods: The corneal endothelium of 16 patients, with characteristic PEX-material on the anterior lens-capsule or papillary margin on slit-lamp-microscopy was investigated with the confocal laser scanning microscope (Rostock Cornea Modul, HRT II (Heidelberg Engineering)).
Results: Mean patient age was 78±6.4 years and 90.9% were treated for glaucoma. In eyes with visible PEX material on slit-lamp microscopy high reflective extracellular material could mostly be detected on the corneal endothelium by in vivo confocal laser-scanning-microscopy. That applies often to corresponding eyes too. The high reflective extracellular material appears granular, mostly spherically and irregular bordered. Furthermore there were perspicuous differences in size dimension. At 65.5 percent of the examined eyes were rather less high reflective material, with averaged 5.7µm (±2.7µm) longitudinal diameter, at 27.6 percent midsize deposits with averaged 23.5 (±5.9µm) and in two eyes a big finding with averaged 76.5µm (±37.4µm).
Conclusions: With high probability the high reflective extracellular material at corneal endothelium is about pseudoexfoliation. Thus confocal laser-scanning-microscopy could be used to screen for PEX-syndrome.

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