In Vivo Confocal Microscopic Observations of Vortex Keratopathy in Patients with Amiodarone-Induced Keratopathy and Fabry Disease
Purpose. To compare the morphology of two types of vortex keratopathy: amiodarone-induced keratopathy and the Fabry disease-associated keratopathy. Patients and Methods. Eight patients who were receiving oral amiodarone therapy and 3 patients with Fabry disease, a mother and her 2 daughters, were ex...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2018-01-01
|
| Series: | Journal of Ophthalmology |
| Online Access: | http://dx.doi.org/10.1155/2018/5315137 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832556643882106880 |
|---|---|
| author | Yasuhito Ikegawa Atsushi Shiraishi Yasuhito Hayashi Akiyoshi Ogimoto Yuichi Ohashi |
| author_facet | Yasuhito Ikegawa Atsushi Shiraishi Yasuhito Hayashi Akiyoshi Ogimoto Yuichi Ohashi |
| author_sort | Yasuhito Ikegawa |
| collection | DOAJ |
| description | Purpose. To compare the morphology of two types of vortex keratopathy: amiodarone-induced keratopathy and the Fabry disease-associated keratopathy. Patients and Methods. Eight patients who were receiving oral amiodarone therapy and 3 patients with Fabry disease, a mother and her 2 daughters, were examined by slit-lamp biomicroscopy and in vivo confocal microscopy (IVCM) regularly. Results. Amiodarone-induced keratopathy developed in 7 of the 8 patients, and it was detected as early as 7 days by IVCM and 14 days by slit-lamp biomicroscopy. The in vivo confocal microscopic images showed a clustering of corneal epithelial cells with a highly reflective cytoplasm in both types of keratopathy. In the amiodarone-induced keratopathy, the highly reflective epithelial cells were first found at the center of the cornea and then spread to the periphery with increasing time on amiodarone. In Fabry disease, the highly reflective epithelial cells were consistently observed extending from the limbus to the central cornea. Conclusion. These findings suggest that the corneal epithelial cells most likely endocytose amiodarone from the tear film in the amiodarone-induced keratopathy. In Fabry disease, globotriaosylceramide deposits are taken up by the lysosomes of the limbal epithelial stem cells, and they differentiate and migrate to the center of the cornea to form the whorl pattern. |
| format | Article |
| id | doaj-art-e40836e6ef1943c7ac14ce6a492a87f7 |
| institution | Kabale University |
| issn | 2090-004X 2090-0058 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Ophthalmology |
| spelling | doaj-art-e40836e6ef1943c7ac14ce6a492a87f72025-02-03T05:44:48ZengWileyJournal of Ophthalmology2090-004X2090-00582018-01-01201810.1155/2018/53151375315137In Vivo Confocal Microscopic Observations of Vortex Keratopathy in Patients with Amiodarone-Induced Keratopathy and Fabry DiseaseYasuhito Ikegawa0Atsushi Shiraishi1Yasuhito Hayashi2Akiyoshi Ogimoto3Yuichi Ohashi4Department of Ophthalmology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295, JapanDepartment of Ophthalmology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295, JapanDepartment of Ophthalmology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295, JapanDepartment of Cardiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295, JapanDepartment of Ophthalmology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295, JapanPurpose. To compare the morphology of two types of vortex keratopathy: amiodarone-induced keratopathy and the Fabry disease-associated keratopathy. Patients and Methods. Eight patients who were receiving oral amiodarone therapy and 3 patients with Fabry disease, a mother and her 2 daughters, were examined by slit-lamp biomicroscopy and in vivo confocal microscopy (IVCM) regularly. Results. Amiodarone-induced keratopathy developed in 7 of the 8 patients, and it was detected as early as 7 days by IVCM and 14 days by slit-lamp biomicroscopy. The in vivo confocal microscopic images showed a clustering of corneal epithelial cells with a highly reflective cytoplasm in both types of keratopathy. In the amiodarone-induced keratopathy, the highly reflective epithelial cells were first found at the center of the cornea and then spread to the periphery with increasing time on amiodarone. In Fabry disease, the highly reflective epithelial cells were consistently observed extending from the limbus to the central cornea. Conclusion. These findings suggest that the corneal epithelial cells most likely endocytose amiodarone from the tear film in the amiodarone-induced keratopathy. In Fabry disease, globotriaosylceramide deposits are taken up by the lysosomes of the limbal epithelial stem cells, and they differentiate and migrate to the center of the cornea to form the whorl pattern.http://dx.doi.org/10.1155/2018/5315137 |
| spellingShingle | Yasuhito Ikegawa Atsushi Shiraishi Yasuhito Hayashi Akiyoshi Ogimoto Yuichi Ohashi In Vivo Confocal Microscopic Observations of Vortex Keratopathy in Patients with Amiodarone-Induced Keratopathy and Fabry Disease Journal of Ophthalmology |
| title | In Vivo Confocal Microscopic Observations of Vortex Keratopathy in Patients with Amiodarone-Induced Keratopathy and Fabry Disease |
| title_full | In Vivo Confocal Microscopic Observations of Vortex Keratopathy in Patients with Amiodarone-Induced Keratopathy and Fabry Disease |
| title_fullStr | In Vivo Confocal Microscopic Observations of Vortex Keratopathy in Patients with Amiodarone-Induced Keratopathy and Fabry Disease |
| title_full_unstemmed | In Vivo Confocal Microscopic Observations of Vortex Keratopathy in Patients with Amiodarone-Induced Keratopathy and Fabry Disease |
| title_short | In Vivo Confocal Microscopic Observations of Vortex Keratopathy in Patients with Amiodarone-Induced Keratopathy and Fabry Disease |
| title_sort | in vivo confocal microscopic observations of vortex keratopathy in patients with amiodarone induced keratopathy and fabry disease |
| url | http://dx.doi.org/10.1155/2018/5315137 |
| work_keys_str_mv | AT yasuhitoikegawa invivoconfocalmicroscopicobservationsofvortexkeratopathyinpatientswithamiodaroneinducedkeratopathyandfabrydisease AT atsushishiraishi invivoconfocalmicroscopicobservationsofvortexkeratopathyinpatientswithamiodaroneinducedkeratopathyandfabrydisease AT yasuhitohayashi invivoconfocalmicroscopicobservationsofvortexkeratopathyinpatientswithamiodaroneinducedkeratopathyandfabrydisease AT akiyoshiogimoto invivoconfocalmicroscopicobservationsofvortexkeratopathyinpatientswithamiodaroneinducedkeratopathyandfabrydisease AT yuichiohashi invivoconfocalmicroscopicobservationsofvortexkeratopathyinpatientswithamiodaroneinducedkeratopathyandfabrydisease |