Microstructural analysis of the corneal changes in pigment dispersion syndrome - clinical study assisted by in vivo laser scanning confocal microscopy

Purpose: To evaluate and define microstructural changes in the cornea of patients with pigment dispersion syndrome (PDS) using in vivo laser scanning confocal microscopy (LSCM). To demonstrate the option of this technology for precise diagnosis and monitoring PDS disease, including dynamic observations.Material and methods: 40 eyes of 20 patients with clinically detectable PDS were examined by in vivo laser confocal microscopy (HR TII Rostock corneal module). Several examinations were performed in order to facilitate quantitative and qualitative analysis of the sub-basal nerve plexus, endothelial cells and bright granules, consistent with pigment granules at the level of endothelium.Results: The most demonstrative findings were hyper-reflective, polymorphic granules on endothelial surface, meаsured 10-25 μm. The size and density of the particles increased in patients with higher intraocular pressure. There were a correlation between the clinical characteristic and the degree of polymegathism and pleomorphism of affected endothelial zones.Conclusion: In vivo laser confocal microscopy demonstrates new perspectives for diagnostics and staging of the pigment dispersion syndrome. The method has wider applications for monitoring and long term prognosis