In vivo Confocal Microscopy for Corneal and Ocular Surface Pathologies: A Comprehensive Review.

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Background In vivo confocal microscopy (IVCM) is an advanced imaging technique that enables real-time, high-resolution visualization of corneal microstructures. Its clinical applications have expanded significantly, offering valuable insights into the pathophysiology of various ocular surface and corneal disorders. Despite its utility, challenges in standardization, accessibility, and integration into routine practice limit its widespread adoption. Methods A comprehensive literature review was conducted using PubMed with the keywords "in vivo confocal microscopy", "corneal diseases", and "ocular surface". From 1835 articles retrieved, studies published within the last seven years with clinical relevance were prioritized, yielding 51 articles. Data were synthesized to evaluate IVCM's diagnostic capabilities, technical advancements, and applications across corneal pathologies, including infectious keratitis, dystrophies, and post-surgical outcomes. Results IVCM was shown to provide unparalleled visualization of cellular and subcellular corneal structures, enabling early diagnosis and monitoring of conditions such as keratitis caused by Acanthamoeba and fungi, corneal dystrophies, and nerve regeneration following refractive or transplant surgeries. Innovative applications include its use in regenerative therapies, such as adipose-derived stem cell implantation, demonstrating incre

Evidence level

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

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