Study of corneal copper deposits in Wilson's disease by in vivo confocal microscopy

Ophthalmologica. 2014;231(3):147-52. doi: 10.1159/000355090. Epub 2013 Oct 2.

Abstract

Purpose: To study corneal copper deposits in Wilson's disease (WD) patients by traditional biomicroscopy and in vivo laser scanning confocal microscopy (LSCM).

Methods: Twenty WD patients and 20 matched controls underwent an ophthalmic examination in one eye randomly chosen, including slit lamp biomicroscopy with Goldmann's three-mirror contact lens examination and LSCM, in order to evaluate copper deposits in the peripheral cornea.

Results: No control subjects had corneal changes at both traditional biomicroscopy and LSCM. Only 25% of WD patients had detectable slit lamp changes, compared with 75% with LSCM examination. All cases detected by slit lamp were detected by LSCM. A significant correlation (p < 0.01) was found between deposit intensity at LSCM and daily urinary copper excretion.

Conclusion: LSCM could detect copper deposition in WD corneas in more patients than traditional examination; it may therefore provide important information in cases of suspected WD diagnosis.

MeSH terms

  • Adult
  • Ceruloplasmin / metabolism
  • Copper / metabolism*
  • Corneal Diseases / diagnosis
  • Corneal Diseases / etiology
  • Corneal Diseases / metabolism*
  • Cross-Sectional Studies
  • Female
  • Hepatolenticular Degeneration / complications
  • Hepatolenticular Degeneration / diagnosis
  • Hepatolenticular Degeneration / metabolism*
  • Humans
  • Male
  • Microscopy
  • Microscopy, Confocal

Substances

  • Copper
  • Ceruloplasmin