Angiographic and In Vivo Confocal Microscopic Characterization of Human Corneal Blood and Presumed Lymphatic Neovascularization

Vito Romano, Bernhard Steger, Yalin Zheng, Sajjad Ahmad, Colin Willoughby, Stephen B. Kaye

    Research output: Contribution to journalArticle

    11 Citations (Scopus)

    Abstract

    PURPOSE:To characterize corneal nevocoarization (CoNV) in vivo.METHODS:Patients with CoNV were categorized into those with active disease defined by the presence of corneal infiltrates and/or edema and those with inactive disease, the latter divided into those with or without corneal red blood cell traffic (RBCT). CoNV were imaged using in vivo confocal microscopy (IVCM) and angiography. Leakage and uptake of dye from the extravascular to intravascular space were investigated using repeat angiography and digital subtraction analysis. Vessel parameters and the presence of RBCT were analyzed using custom-designed software.RESULTS:Thirteen patients with CoNV were included: 4 had active and 9 had inactive disease with CoNV present for 3.5 ± 1.7 months and 30.2 ± 30.7 months, respectively. Using a combination of digital subtraction analysis and IVCM, presumed lymphatic vessels were detected only in patients with active CoNV. These vessels were characterized by an indistinct vessel wall, carrying nucleated cells, and on IVCM, it had a mean diameter of 19.7 ± 6.1 μm (11-30 μm). The ratio of the diameter of presumed lymphatic vessels to that of neighboring vessels was 0.6 ± 0.1 (0.5-0.6). Of the patients with inactive disease, 4 had CoNV with RBCT (mean age CoNV, 17.3 ± 7.6 months) and 5 (mean age CoNV, 40.6 ± 35 months) had CoNV without evidence of RBCT on biomicroscopy, but evident on angiography and IVCM. These represent perfused vessels with no or intermittent RBCT.CONCLUSIONS:CoNV can be characterized in vivo using a combination of IVCM and angiography. The vascular features vary according to the age of the CoNV and disease activity. Further improvements in angiographic image alignment, however, are needed.
    LanguageEnglish
    Pages1459-1465
    JournalCORNEA
    Volume34
    Issue number11
    DOIs
    Publication statusAccepted/In press - 17 Jul 2015

    Fingerprint

    Confocal Microscopy
    Erythrocytes
    Corneal Diseases
    Angiography
    Lymphatic Vessels
    Digital Subtraction Angiography
    Blood Vessels
    Edema
    Coloring Agents
    Software
    Intravital Microscopy

    Keywords

    • cornea
    • angiography
    • lymphatics

    Cite this

    Romano, Vito ; Steger, Bernhard ; Zheng, Yalin ; Ahmad, Sajjad ; Willoughby, Colin ; Kaye, Stephen B. / Angiographic and In Vivo Confocal Microscopic Characterization of Human Corneal Blood and Presumed Lymphatic Neovascularization. In: CORNEA. 2015 ; Vol. 34, No. 11. pp. 1459-1465.
    @article{714813dedfe5413d840d9d33db5370db,
    title = "Angiographic and In Vivo Confocal Microscopic Characterization of Human Corneal Blood and Presumed Lymphatic Neovascularization",
    abstract = "PURPOSE:To characterize corneal nevocoarization (CoNV) in vivo.METHODS:Patients with CoNV were categorized into those with active disease defined by the presence of corneal infiltrates and/or edema and those with inactive disease, the latter divided into those with or without corneal red blood cell traffic (RBCT). CoNV were imaged using in vivo confocal microscopy (IVCM) and angiography. Leakage and uptake of dye from the extravascular to intravascular space were investigated using repeat angiography and digital subtraction analysis. Vessel parameters and the presence of RBCT were analyzed using custom-designed software.RESULTS:Thirteen patients with CoNV were included: 4 had active and 9 had inactive disease with CoNV present for 3.5 ± 1.7 months and 30.2 ± 30.7 months, respectively. Using a combination of digital subtraction analysis and IVCM, presumed lymphatic vessels were detected only in patients with active CoNV. These vessels were characterized by an indistinct vessel wall, carrying nucleated cells, and on IVCM, it had a mean diameter of 19.7 ± 6.1 μm (11-30 μm). The ratio of the diameter of presumed lymphatic vessels to that of neighboring vessels was 0.6 ± 0.1 (0.5-0.6). Of the patients with inactive disease, 4 had CoNV with RBCT (mean age CoNV, 17.3 ± 7.6 months) and 5 (mean age CoNV, 40.6 ± 35 months) had CoNV without evidence of RBCT on biomicroscopy, but evident on angiography and IVCM. These represent perfused vessels with no or intermittent RBCT.CONCLUSIONS:CoNV can be characterized in vivo using a combination of IVCM and angiography. The vascular features vary according to the age of the CoNV and disease activity. Further improvements in angiographic image alignment, however, are needed.",
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    author = "Vito Romano and Bernhard Steger and Yalin Zheng and Sajjad Ahmad and Colin Willoughby and Kaye, {Stephen B.}",
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    Angiographic and In Vivo Confocal Microscopic Characterization of Human Corneal Blood and Presumed Lymphatic Neovascularization. / Romano, Vito; Steger, Bernhard; Zheng, Yalin; Ahmad, Sajjad; Willoughby, Colin; Kaye, Stephen B.

    In: CORNEA, Vol. 34, No. 11, 17.07.2015, p. 1459-1465.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - Angiographic and In Vivo Confocal Microscopic Characterization of Human Corneal Blood and Presumed Lymphatic Neovascularization

    AU - Romano, Vito

    AU - Steger, Bernhard

    AU - Zheng, Yalin

    AU - Ahmad, Sajjad

    AU - Willoughby, Colin

    AU - Kaye, Stephen B.

    PY - 2015/7/17

    Y1 - 2015/7/17

    N2 - PURPOSE:To characterize corneal nevocoarization (CoNV) in vivo.METHODS:Patients with CoNV were categorized into those with active disease defined by the presence of corneal infiltrates and/or edema and those with inactive disease, the latter divided into those with or without corneal red blood cell traffic (RBCT). CoNV were imaged using in vivo confocal microscopy (IVCM) and angiography. Leakage and uptake of dye from the extravascular to intravascular space were investigated using repeat angiography and digital subtraction analysis. Vessel parameters and the presence of RBCT were analyzed using custom-designed software.RESULTS:Thirteen patients with CoNV were included: 4 had active and 9 had inactive disease with CoNV present for 3.5 ± 1.7 months and 30.2 ± 30.7 months, respectively. Using a combination of digital subtraction analysis and IVCM, presumed lymphatic vessels were detected only in patients with active CoNV. These vessels were characterized by an indistinct vessel wall, carrying nucleated cells, and on IVCM, it had a mean diameter of 19.7 ± 6.1 μm (11-30 μm). The ratio of the diameter of presumed lymphatic vessels to that of neighboring vessels was 0.6 ± 0.1 (0.5-0.6). Of the patients with inactive disease, 4 had CoNV with RBCT (mean age CoNV, 17.3 ± 7.6 months) and 5 (mean age CoNV, 40.6 ± 35 months) had CoNV without evidence of RBCT on biomicroscopy, but evident on angiography and IVCM. These represent perfused vessels with no or intermittent RBCT.CONCLUSIONS:CoNV can be characterized in vivo using a combination of IVCM and angiography. The vascular features vary according to the age of the CoNV and disease activity. Further improvements in angiographic image alignment, however, are needed.

    AB - PURPOSE:To characterize corneal nevocoarization (CoNV) in vivo.METHODS:Patients with CoNV were categorized into those with active disease defined by the presence of corneal infiltrates and/or edema and those with inactive disease, the latter divided into those with or without corneal red blood cell traffic (RBCT). CoNV were imaged using in vivo confocal microscopy (IVCM) and angiography. Leakage and uptake of dye from the extravascular to intravascular space were investigated using repeat angiography and digital subtraction analysis. Vessel parameters and the presence of RBCT were analyzed using custom-designed software.RESULTS:Thirteen patients with CoNV were included: 4 had active and 9 had inactive disease with CoNV present for 3.5 ± 1.7 months and 30.2 ± 30.7 months, respectively. Using a combination of digital subtraction analysis and IVCM, presumed lymphatic vessels were detected only in patients with active CoNV. These vessels were characterized by an indistinct vessel wall, carrying nucleated cells, and on IVCM, it had a mean diameter of 19.7 ± 6.1 μm (11-30 μm). The ratio of the diameter of presumed lymphatic vessels to that of neighboring vessels was 0.6 ± 0.1 (0.5-0.6). Of the patients with inactive disease, 4 had CoNV with RBCT (mean age CoNV, 17.3 ± 7.6 months) and 5 (mean age CoNV, 40.6 ± 35 months) had CoNV without evidence of RBCT on biomicroscopy, but evident on angiography and IVCM. These represent perfused vessels with no or intermittent RBCT.CONCLUSIONS:CoNV can be characterized in vivo using a combination of IVCM and angiography. The vascular features vary according to the age of the CoNV and disease activity. Further improvements in angiographic image alignment, however, are needed.

    KW - cornea

    KW - angiography

    KW - lymphatics

    U2 - 10.1097/ICO.0000000000000609

    DO - 10.1097/ICO.0000000000000609

    M3 - Article

    VL - 34

    SP - 1459

    EP - 1465

    JO - CORNEA

    T2 - CORNEA

    JF - CORNEA

    SN - 0277-3740

    IS - 11

    ER -