Confocal microscopy usable to study inflammatory and trachomatous scarring changes

Ophthalmology. 2011:118(11);2138-2146.

Inflammatory and scarring changes in the conjunctiva in subjects with trachoma can be quantitatively assessed by in vivo confocal microscopy, study results showed.

Researchers conducted two separate, complimentary case-control studies to characterize inflammation and tissue and cellular changes in trachomatous scarring using in vivo confocal microscopy.

The first study included 363 controls and 363 cases with trachomatous scarring but without trichiasis. Of the controls, 319 were assessed by in vivo confocal microscopy compared with 328 cases with trachomatous scarring.

The second study included 33 controls and 34 cases with trachomatous trichiasis. Of the controls, 26 had in vivo confocal microscopy assessment compared with 28 cases with trachomatous trichiasis.

Results showed that those with clinical scarring had a characteristic appearance of well-defined bands and sheets of scar tissue. There were similar changes consistent with subclinical scarring in some clinically normal cases. Of scarred cases, more dendritic cells and an elevated inflammatory infiltrate were noted, according to the study.

"Dendritic cells seem to be closely associated with the scarring process in trachoma and are likely to be an important target in antifibrotic therapies or the development of a chlamydial vaccine," the study authors said.

Further, they suggested that the increased number of inflammatory cells was consistent with the nature of trachoma.