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A pilot study on corneal Langerhans cells in keratoconus
Preeji S Mandathara1, Fiona J Stapleton1, Jim Kokkinakis2
1School of Optometry and Vision Science, UNSW, Australia.
Summary
Langerhans cells are present in the corneas of most keratoconus patients, suggesting inflammation. These cells associate with corneal nerve changes, indicating inflammation may drive these alterations in keratoconus.
Area of Science:
- Ophthalmology
- Immunology
- Corneal Diseases
Background:
- Keratoconus is a progressive thinning of the cornea.
- The role of immune cells, such as Langerhans cells, in keratoconus pathogenesis is not fully understood.
Purpose of the Study:
- To investigate the density and morphology of corneal Langerhans cells in individuals with keratoconus.
- To explore the associations between these cells and clinical parameters in keratoconus.
Main Methods:
- Prospective cross-sectional study of 21 keratoconus patients (18-65 years).
- In-vivo confocal microscopy was used to assess corneal Langerhans cells.
- Cell density and morphology were quantified; associations were analyzed using Spearman's correlation.
Main Results:
- Langerhans cells were detected in 91% of subjects, with a median density of 15 cells/mm².
- Cells with dendrites (grades 2-3) were observed in 71% of participants.
- Significant associations were found between cell density and male gender, and between cell density and nerve fiber tortuosity.
Conclusions:
- The presence of Langerhans cells suggests a potential inflammatory component in keratoconus.
- Corneal nerve alterations in keratoconus may be driven by inflammation, as indicated by associations with Langerhans cells.
