[Epidemic keratoconjunctivitis. In vivo images of corneal structures with the confocal Rostocker laser scanning microscope (RLSM)].

PURPOSE: Epidemic keratoconjunctivitis (EKC) is a highly contagious infection caused by adenovirus types 8, 19, and 37. The formation of subepithelial nummular infiltrates may lead to permanent visual disturbance. These infiltrates consist histopathologically of an accumulation of lymphocytes, histiocytes, and fibroblasts.

PATIENT AND METHOD: The reasons for the persistence of these nummular infiltrates are not fully understood. We examined a 28-year-old female patient with typical signs of EKC infection clinically and additionally with the RLSM.

RESULTS

Nummuli were identified by the RLSM as areas with an accumulation of dendritic cells (supposed to be Langerhans cells) as well as so far unidentified punctiform structures located in the basal cell layer and in the region of the subepithelial nerve plexus.

CONCLUSIONS

The RLSM allows us to investigate corneal microstructures in vivo with precise depth localization related to epidemic keratoconjunctivitis. Further investigations may disclose the role of dendritic cells in the pathogenesis of the nummular formation as well as their contribution to the variable persistence of partially threatening vision opacities.