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In Vivo Investigation of the Limbal Area with a Confocal Laser Scanning Microscope

1Sommer U., 1Knappe S., 2Eckard A., 1Stave J., 1Guthoff R.,
1Universität Rostock, Augenklinik (Rostock)
2Universität Rostock, Augenklinik, Station 1 (Rostock)

Introduction: With the modified Heidelberg Retina Tomograph (HRT II), a confocal digital laser scanning system, in vivo investigations of the front eye segments are possible with precise localisation of the individual structures. Our aim is a visualisation of the limbal area including conjunctival epithelium, conjunctival stroma, Tenon´s capsule, episclera and limbal corneoscleral stroma.
Method: Using a modified HRT II with a confocal laser scanning microscope the imaging level of the retina can be focused to the anterior segment in combination with an increasing resolution. Without intervening in the hard- and software of the equipment, images of the cornea with an enlargement to approximatelly 600-times could be achieved. The system works with a contact system without applanation of the cornea. It allows a semi-quantitative estimation of cell's densities of the corneal epithelium, its innervation on height of the Bowman layer of the keratocytes, as well as structural components and blood vessels of the conjunctiva and sclera.
Results: First investigations show that a presentation of the limbal area with epithelium, basal cells, collagen fibers and cells of the immune system (for example macrophages, mast cells, lymphocytes), blood vessels and nerves structures in vivo is possible with high resolution and high contrast.
Conclusions: The method allows to investigate the cell distribution and the morphology of the limbal area in vivo. For a morphological identification of the observed structures an additional histological and biological cooperation is necessary. In further investigations we expect to be able to get explanations about pathological findings by comparing to structures of normal individuals.