Dry Eye and Corneal Langerhans Cells in Systemic Lupus Erythematosus

Figure 1

In vivo confocal microscopic images of corneal dendritic (Langerhans) cells (LC). Size of all images is 400 μm 400 μm. Bar indicates 50 μm. Simple arrow indicates LC without dendrite (LCM score = 1, probably immature), double arrow corresponds with LCM score = 2 (dendrite not longer than cell body), and triple arrow demonstrates LC with long dendrites (LCM score = 3, dendrite longer than cell body, sign of activation). Arrowhead points to subepithelial nerve plexus. (a) Image of the central cornea of a healthy volunteer. Note the normal subepithelial nerves. No LC is visible in the centre of the cornea (LCM score = 0) (depth of image from surface 43 μm). (b) Central cornea of a patient with SLE. Density of LCs is larger than that in normal corneas. Most of the LCs are of LCM score 1, but some are of LCM score 2 (depth of image from surface 48 μm). (c) Peripheral cornea of the same control eye as in Figure 1(a). Note that some LCs can be observed (only of LCM score 1). (d) Peripheral corneal image of the same patient as in Figure 1(b). Mixed population of LCs of LCM scores 1 and 3 can be seen (depth of image from surface 46 μm). (e) Image taken anteriorly from subepithelial nerve fibres (37 μm from surface) of the central cornea of an SLE patient. A large number of LCs are of LCM score 3 and some are of LCM score 1. (f) Peripheral cornea of the same patient as in Figure 1(e) (36 μm from the surface). Density of LCs (predominantly LCM Score 3) is larger than that in the centre of the same cornea.

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