In vivo confocal microscopy of cystic lesions in corneal disorders

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The purpose of this study was to assess the correlation between slit-lamp biomicroscopy and in vivo confocal microscopy and to describe the morphology of corneal intraepithelial cystic lesions by in vivo confocal microscopy in several corneal disorders.


15 patients with clinically diagnosed Cogan Dystrophy (9), Meesmann’s Dystrophy (2), Acanthamoeba Keratitis (2), Microsporidial Keratitis (1) and Incontinentia Pigmenti (1) were examined by slit-lamp biomicroscopy and in vivo confocal microscopy. Confocal microscopy images were used to assess size, shape and reflectivity of the corneal cystic structures.


Confocal microscopy was able to identify cystic lesions in all cases in which cysts were observed by slit – lamp biomicroscopy. In vivo confocal scans showed multiple brightly reflective round, oval or circular structures with diameter from 10 microns (Incontinentia Pigmenti) to 140 microns (Meesmann‘s Dystophy). Large intraepithelial clefts were observed in Microsporidial Keratitis and Meesmann‘s Dysrophy.


In vivo confocal microscopy provides a detailed microstructural image of cystic intraepithelial lesions in various corneal disorders and may play a role in appropriate diagnosis.

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