Limbal stem cell deficiency diagnostics

Abstract

Relevance. Limbal stem cell deficiency (LSCD) is a pathology that leads to substantial vision decrease, corneal neovascularization, corneal epithelial persistent erosions and have a negative impact on patient's the quality of life. It is known that the efficiency of corneal transplantation in LSCD patients is low and requires repeated interventions. One of the important problems is the lack of a clear diagnostic algorithm and a standardized set of diagnostic techniques for this condition. Purpose. Systematically analyze domestic and foreign literature on the currently existing methods for diagnosing LSCD. Material and methods. A systematic analysis of scientific publications from 1992 to 2021 was carried out. Its included domestic and foreign authors on the resources of PubMed, Medline, eLibrary, as well as dissertations and textbooks devoted to currently existing methods for diagnosing LSCD. Results. In addition to biomicroscopy, the main in vivomethods for diagnosing LSCD are staining of the ocular surface, impression cytology with the detection of specific cytokeratins, confocal microscopy, optical coherence tomography of the anterior segment (OST) and OST-angiography. Conclusion. Physician awareness and vigilance are required for the diagnosis of LSCD, especially in patients with conjunctivalization and corneal neovascularization. It is impossible to use only biomicroscopy and the patient's complaints, since LSCD is not always obvious. That is why diagnostics should include an integrated approach, including all available research methods, which are briefly described in Table No. 1 with their disadvantages and advantages. Key words: limbal stem cell deficiency, impression cytology, laser confocal scanning microscopy, goblet cells, cytokeratin, penetrating keratoplasty, cytokines