Evaluation of morphological changes and level of light scattering of the cornea in glaucoma patients by confocal corneal microscopy

• Main Authors: Egorova G.B, Averich V.V.
• Format: Article
• Language: Russian
• Published: Prime-Media 2018-07-01
• Series: РМЖ "Клиническая офтальмология"
• Online Access: http://clinopht.com/upload/iblock/976/976dae3c9e7353bd4027d0f76f29c0b7.pdf

<br> <br> Egorova G.B., Averich V.V.<br> <br> Scientific Research Institute of Eye Diseases, Moscow<br> <br> <b>Aim</b>: to assess morphological changes and the level of light scattering of the cornea in glaucoma patients with noncompensated IOP without using antihypertensive drugs, with medically compensated IOP and with tear-replacement therapy in combination with antiglaucoma drugs.<br> <b>Patients and methods:</b> the first group (20 patients) was examined to determine the normal level of light scattering, the second group (22 patients) had uncompensated IOP, the third group (24 patients) had medically compensated IOP. For 24 patients, in addition to the drug regimen, the artificial tear “Stillavit” was prescribed for 3-6 months. Confocal microscopy was performed on “Confoscan-4”. The light scattering intensity was evaluated in the Z-scan mode.<br> <b>Results</b>: the examination of a group of patients with newly diagnosed glaucoma and uncompensated IOP revealed an increase in the intensity of light scattering in the epithelium and in all layers of the corneal stroma as compared with the norm (P &lt;0.05). The largest deviations in the maximum intensity of light scattering (69.5%) were observed in the posterior layers of the corneal stroma, in the epithelium (33.5%) and in the anterior stroma (38.7%).<br> The results of the examination of patients with compensated IOP indicated a slight decrease in the intensity of light scattering, compared with normal values. The largest changes were recorded in the layer of the posterior epithelium of the cornea.<br> Estimation of the light scattering intensity during the instillations of the artificial tear “Stillavit” combined with antiglaucoma drugs, showed a decrease in the maximum and minimum intensity of light scattering in the epithelium and stroma of the cornea. The greatest decrease in the maximum intensity of light scattering was found in the layer of epithelium (by 21%) and in the anterior stroma (by 23.2%).<br> <b>Conclusion</b>: the intensity of light scattering can be used as an additional criterion for evaluating the morphological changes in the cornea, as well as evaluating the effectiveness of the use of medications. The results of confocal microscopy indicate a favorable effect of the use of artificial tear “Stillavit” in combination with antihypertensive drugs in glaucoma.<br> <br> <b>Key words:</b> cornea, glaucoma, confocal microscopy, intensity of light scattering of the cornea, benzalkonium chloride, Stillavit.<br> <b>For citation:</b> Egorova G.B., Averich V.V. Evaluation of morphological changes and level of light scattering of the cornea in glaucoma patients by confocal corneal microscopy // RMJ “Clinical ophthalmology”. 2018;1:1–6.<br>