In vivo confocal microscopic observations of eyes diagnosed with posterior corneal vesicles.

PURPOSE: To determine the morphological characteristics of the cornea in eyes with posterior corneal vesicles (PCV) determined by in vivo confocal microscopy (IVCM). In addition, to compare the morphological characteristics of the corneas of eyes with PCV to those of eyes with posterior polymorphous corneal dystrophy (PPCD).

METHODS: Three males and three females aged 17-75 years who were diagnosed with PCV by slit-lamp biomicroscopic findings were studied. The slit-lamp findings, specular microscopic images, corneal endothelial cell densities (CDs), central corneal thickness, and IVCM images were evaluated. Three cases that had been diagnosed with PPCD were also evaluated, and the findings were compared to those in eyes with PCV.

RESULTS: All six cases of PCV had unilateral lesions of Descemet's membrane and the corneal endothelium. Slit-lamp biomicroscopy showed broad, band-shaped lesions in five cases and multiple vesicle lesions in one case of PCV. The IVCM images of the six cases had a common appearance of the corneal endothelial cells in the affected areas showing iso-reflective nuclei and low reflective cell membranes as seen in normal corneal endothelial cells. The CDs in the affected eyes were about one-half of those of the not affected eyes. The IVCM images of the corneas of patients with PPCD showed polymorphic cells with hyperreflective nuclei, which are characteristics of epithelial cells.

CONCLUSIONS: The IVCM images demonstrated that the corneal endothelial cells of patients with PCV have normal morphology. These findings indicate that PCV is a distinct clinical entity different from PPCD.