Highlights
- •Density, distribution and morphology of corneal epithelial dendritic cells (CEDC) do not differ in established contact lens wearers.
- •Reduced CEDC density in the corneal centre observed in orthokeratology lens wear requires confirmation in a larger group.
- •CEDC in the central cornea were similar in density and morphology to CEDC cells in the mid-peripheral cornea.
- •A lower ratio of central relative to mid-peripheral density of CEDC occurs with younger age.
- •A relatively lower density of CEDC in the corneal centre vs mid-periphery in younger patients may reflect a more naive immune status.
Abstract
Purpose
Contact lens wearers aged 15–25 years are at higher risk of corneal inflammation,
yet little is known about corneal inflammatory state in this group. Previous investigations
show density of corneal epithelial dendritic cells (CEDC) may increase with contact
lens wear. However, it is not known how corneal distribution or morphology of CEDC
alters with lens wear or whether these markers are affected by age. This study characterised
CEDC in adolescent and young adult contact lens wearers to determine effects of contact
lens wear and age on CEDC density, distribution and morphology.
Method
Forty participants (20 contact lens wearers, 20 healthy non-wearers; age 16–36 years;
16M:24F) completed this pilot study. Corneal images were captured using in vivo confocal microscopy (HRTII, Rostock). CEDC were manually counted in a 1 mm2 area of the central and mid-peripheral cornea, and ratio of central to midperipheral
density was calculated. CEDC morphology and dendrite length were graded. Differences
between groups and between regions, and associations with age were examined. Significance
was determined at P < 0.05.
Results
A lower ratio of central to mid-peripheral CEDC density was found with younger age
(ρ = 0.42, P = 0.01). CEDC morphology was not associated with age or contact lens
wear. CEDC density in the mid-peripheral cornea was higher in soft lens wearers than
non-wearers (P = 0.04), but central density did not differ. CEDC density and morphology
were not significantly different between centre (median density 11 cells/mm2, range 0–120) and mid-periphery (10 cells/mm2, 0–58).
Conclusion
Density, distribution and morphology of CEDC do not differ in established contact
lens wearers. A relatively lower density of CEDC in the central cornea of younger
patients may allude to a more naive immune status in this group and warrants further
study. Decreased central CEDC density identified in orthokeratology lens wear requires
confirmation in a larger group.
Keywords
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Article info
Publication history
Published online: June 18, 2019
Accepted:
May 22,
2019
Received in revised form:
May 17,
2019
Received:
March 25,
2019
Identification
Copyright
© 2019 Published by Elsevier Ltd on behalf of British Contact Lens Association.
