Confocal Microscopic Findings of Keratoconus

ABSTRACT

PURPOSE: To report the confocal morphological changes of keratoconus in comparison with that of normal cornea. METHODS: Confocal microscopy (ConfoScan 2.0, Fortune Technology, Italy) was used to obtain data from healthy volunteers and keratoconus. We evaluated corneal morphological images of the corneal epithelium, Bowman's layer, stromal layer (anterior, middle, and posterior keratocyte), Descemet's membrane, and endothelium. RESULTS: In keratoconus cornea, the wing cells of epithelium had somewhat irregular margin, and the subepithelial nerve bundle was slightly enlarged. Near Bowman's membrane, highly reflective changes and tear like structure were visible. While the anterior stromal keratocyte had nuclei with a highly reflective density and indefinite cell border, posterior keratocyte had a more distinct shape with less cellularity. Near descemet's membrane, vertical fold (Vogt's striae) was observed and keratocytes with long processes arranged nearly in parallel. Morphological change was not observed in the endothelium. CONCLUSIONS: Our confocal microscopic findings of keratoconus may help early diagnosis and assessment of prognosis in the management of keratoconus.