In vivo confocal microscopic study of cornea verticillata and limbus deposits in patients with Fabry disease

PurposeThis study was aimed to investigate the microstructure characteristics of cornea verticillata and limbus deposits in patients with Fabry disease (FD) using in vivo confocal microscopy (IVCM).MethodsA total of 60 eyes from 30 patients diagnosed with FD were examined and compared with 36 eyes f...

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Main Authors: Xuecong Zhou, Yawen Zhao, Yingsi Li, Yujing Yuan, Xiaoming Yan, Wei Zhang, Yuan Wu
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-02-01
Series:Frontiers in Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1541510/full
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author Xuecong Zhou
Yawen Zhao
Yingsi Li
Yujing Yuan
Xiaoming Yan
Wei Zhang
Yuan Wu
author_facet Xuecong Zhou
Yawen Zhao
Yingsi Li
Yujing Yuan
Xiaoming Yan
Wei Zhang
Yuan Wu
author_sort Xuecong Zhou
collection DOAJ
description PurposeThis study was aimed to investigate the microstructure characteristics of cornea verticillata and limbus deposits in patients with Fabry disease (FD) using in vivo confocal microscopy (IVCM).MethodsA total of 60 eyes from 30 patients diagnosed with FD were examined and compared with 36 eyes from 18 healthy controls in this prospective, cross-sectional, controlled, single-center study. The initial assessment of cornea verticillata (CV) was conducted using slit-lamp microscopy. Subsequently, IVCM was performed to assess deposits in the corneal and limbal epithelium. We compared the differences between the sexes (heterozygous and hemizygous) and phenotypes (classical and non-classical).ResultsThe epithelial deposit detection rate with IVCM was statistically higher (52/60, 86.67%) compared to the biomicroscopic evaluation of CV using a silt lamp (46/60, 76.67%) (p = 0.031). A higher prevalence of corneal epithelial deposits was observed in the classical phenotype as compared to the non-classical phenotype (p = 0.023). Surprisingly, cardiac variants previously lacking cornea verticillata show a high prevalence (85.71%) of corneal epithelial deposits under IVCM. The prevalence and severity of deposits, especially in limbal epithelial rete pegs, were higher in FD than in controls (p < 0.001).ConclusionCompared with slit-lamp microscopy, IVCM provides a more effective tool for examining the epithelial deposits in patients with FD. Patients with FD demonstrated a profound bilateral increase in corneal epithelial deposits and limbal hyperreflective cells compared to controls, with more prominent pathological changes observed in classical phenotype individuals. The high prevalence of epithelial deposits observed through IVCM in the cardiac variant highlights the essential ability of IVCM as an effective diagnostic tool.
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spelling doaj-art-0a5ef166b2434efbb5ea8a221c64af7e2025-02-05T07:33:03ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-02-011210.3389/fmed.2025.15415101541510In vivo confocal microscopic study of cornea verticillata and limbus deposits in patients with Fabry diseaseXuecong Zhou0Yawen Zhao1Yingsi Li2Yujing Yuan3Xiaoming Yan4Wei Zhang5Yuan Wu6Department of Ophthalmology, Peking University First Hospital, Peking University, Beijing, ChinaDepartment of Neurology, Peking University First Hospital, Peking University, Beijing, ChinaDepartment of Ophthalmology, Peking University First Hospital, Peking University, Beijing, ChinaDepartment of Neurology, Peking University First Hospital, Peking University, Beijing, ChinaDepartment of Ophthalmology, Peking University First Hospital, Peking University, Beijing, ChinaDepartment of Neurology, Peking University First Hospital, Peking University, Beijing, ChinaDepartment of Ophthalmology, Peking University First Hospital, Peking University, Beijing, ChinaPurposeThis study was aimed to investigate the microstructure characteristics of cornea verticillata and limbus deposits in patients with Fabry disease (FD) using in vivo confocal microscopy (IVCM).MethodsA total of 60 eyes from 30 patients diagnosed with FD were examined and compared with 36 eyes from 18 healthy controls in this prospective, cross-sectional, controlled, single-center study. The initial assessment of cornea verticillata (CV) was conducted using slit-lamp microscopy. Subsequently, IVCM was performed to assess deposits in the corneal and limbal epithelium. We compared the differences between the sexes (heterozygous and hemizygous) and phenotypes (classical and non-classical).ResultsThe epithelial deposit detection rate with IVCM was statistically higher (52/60, 86.67%) compared to the biomicroscopic evaluation of CV using a silt lamp (46/60, 76.67%) (p = 0.031). A higher prevalence of corneal epithelial deposits was observed in the classical phenotype as compared to the non-classical phenotype (p = 0.023). Surprisingly, cardiac variants previously lacking cornea verticillata show a high prevalence (85.71%) of corneal epithelial deposits under IVCM. The prevalence and severity of deposits, especially in limbal epithelial rete pegs, were higher in FD than in controls (p < 0.001).ConclusionCompared with slit-lamp microscopy, IVCM provides a more effective tool for examining the epithelial deposits in patients with FD. Patients with FD demonstrated a profound bilateral increase in corneal epithelial deposits and limbal hyperreflective cells compared to controls, with more prominent pathological changes observed in classical phenotype individuals. The high prevalence of epithelial deposits observed through IVCM in the cardiac variant highlights the essential ability of IVCM as an effective diagnostic tool.https://www.frontiersin.org/articles/10.3389/fmed.2025.1541510/fullFabry diseasein vivo confocal microscopycornea verticillataepithelial depositslimbus
spellingShingle Xuecong Zhou
Yawen Zhao
Yingsi Li
Yujing Yuan
Xiaoming Yan
Wei Zhang
Yuan Wu
In vivo confocal microscopic study of cornea verticillata and limbus deposits in patients with Fabry disease
Frontiers in Medicine
Fabry disease
in vivo confocal microscopy
cornea verticillata
epithelial deposits
limbus
title In vivo confocal microscopic study of cornea verticillata and limbus deposits in patients with Fabry disease
title_full In vivo confocal microscopic study of cornea verticillata and limbus deposits in patients with Fabry disease
title_fullStr In vivo confocal microscopic study of cornea verticillata and limbus deposits in patients with Fabry disease
title_full_unstemmed In vivo confocal microscopic study of cornea verticillata and limbus deposits in patients with Fabry disease
title_short In vivo confocal microscopic study of cornea verticillata and limbus deposits in patients with Fabry disease
title_sort in vivo confocal microscopic study of cornea verticillata and limbus deposits in patients with fabry disease
topic Fabry disease
in vivo confocal microscopy
cornea verticillata
epithelial deposits
limbus
url https://www.frontiersin.org/articles/10.3389/fmed.2025.1541510/full
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