In-vivo-Bildgebung des Limbusepithels und der Vogt-Palisaden

 

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Zusammenfassung

Erkrankungen des Limbus führen zu einem Verlust der Stammzellpopulation und somit zu Störungen der kornealen Integrität. Ziel der vorgestellten Untersuchungen ist die morphologische Erfassung dieser Region mittels in vivo konfokaler Laser-Scanning-Mikroskopie (CLSM) und optischer Kohärenztomografie (SD-OCT) sowohl in gesunden Probanden als auch in Kontaktlinsenträgern und Patienten mit Oberflächenproblematiken. Typischerweise stellen sich konfokalmikroskopisch fingerartige hyper- und hyporeflektive Ausläufer mit umgebenden dicht gelagerten Epithelzellen dar. Systembedingt kommen in der OCT-Bildgebung Zellunterschiede nicht zur Darstellung, es finden sich aber ebenfalls hyperreflektive Ausläufer. In Fällen kornealer Oberflächenstörungen zeigt sich diese typische Kryptenform nicht mehr. Weitere morphologische Unterschiede im Bereich des Epithels werden diskutiert. Ein besseres Verständnis des Hornhautlimbus kann Aufschluss über die korneale Zellintegrität und das Wundheilungsvermögen geben. Perspektivisch sind eine Quantifizierung dieser Region sowie Untersuchungen an verschiedenen Hornhautpathologien anzustreben.

Abstract

Limbal disorders can lead to loss of stem cell population and deficiency in corneal integrity. The aim of this study is to describe the morphological features of this region by using confocal laser scanning microscopy (CLSM) and spectral domain optical coherence tomography (SD-OCT) in healthy subjects, contact lens wearers and in patients with surface disorders. On examination hyper- and hyporeflective finger-like structures were found with numerous basal epithelial cells within and in between crypts. In contrast, detailed imaging of limbal palisades of Vogt was not possible on SD-OCT, the corresponding hyperreflective line was identified. These typical crypts were less pronounced or absent in cases with corneal alterations as has been demonstrated. Additionally morphological changes at the level of intermediate and basal cell layers were discussed. A better understanding of the corneal limbus can provide valuable clues on understanding cell integrity and wound-healing processes. In future, quantitative analyses of limbal epithelium in different corneal disorders will be preferable.

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