PT  - JOURNAL ARTICLE
AU  - Andrea Leonardi
AU  - Gianni Carraro
AU  - Rocco Luigi Modugno
AU  - Valentino Rossomando
AU  - Tania Scalora
AU  - Daniela Lazzarini
AU  - Lorenzo Calò
TI  - Cornea verticillata in Fabry disease: a comparative study between slit-lamp examination and in vivo corneal confocal microscopy
AID  - 10.1136/bjophthalmol-2019-314249
DP  - 2020 May 01
TA  - British Journal of Ophthalmology
PG  - 718--722
VI  - 104
IP  - 5
4099  - http://bjo.bmj.com/content/104/5/718.short
4100  - http://bjo.bmj.com/content/104/5/718.full
SO  - Br J Ophthalmol2020 May 01; 104
AB  - Purpose To compare the diagnostic power of slit-lamp examination with the in vivo corneal confocal microscopy (IVCM) as the gold standard in assessing the presence of corneal epithelial deposits in patients with Fabry disease (FD).Methods Fourteen patients with FD (4 males, 10 females; mean age, 46.8 years) and eight healthy controls (4 males, 4 females; mean age, 36.75 years) were included. All subjects underwent slit-lamp examination and IVCM of both central and peripheral corneal quadrants with the Heidelberg Retina Tomograph-III in combination with the Rostock Cornea Module.Results In patients with FD, 9 of 28 eyes (32%) showed the presence of cornea verticillata at the slit-lamp examination and 25 eyes (89%) showed the presence of epithelial hyper-reflective deposits at the IVCM. Of the 19 eyes negative at the slit-lamp examination, 16 eyes showed the presence of epithelial deposits at the IVCM. Compared with controls, patients with FD had a significantly reduced number, density and length of nerve fibres at the level of corneal sub-basal nerve plexus, but a significantly higher grade of fibres tortuosity.Conclusions The slit-lamp examination has a limited diagnostic power in the detection of epithelial deposits in patients with FD when compared with the IVCM. In fact, the slit-lamp examination suffers from a high number of false negative results and, consequently, from a low negative predictive value (16%). IVCM allows the detection of corneal microstructural changes in patients with FD and may represent a reliable tool for the early diagnosis and follow-up of the disease.