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In vivo confocal microscopy in amiodarone corneal deposits

PURPOSE: To describe in vivo confocal microscopy findings in patients with different stages of amiodarone-induced keratopathy, and correlate biomicroscopy stages with confocal stages. METHODS: Twenty eyes of 10 patients (6 men and 4 women), who receive treatment with amiodarone were selected for the study with confocal microscopy (MC). RESULTS: The average age was 58 ± 6.2 years (50-66 years) and time of use of the drug was 6 ± 3.2 years (2-11 years). All patients have best correct visual acuity ³ 20/40. There were two patients in stage 1, 4 patients in stage 2 and 4 in stage 3 of induced keratopathy. All corneas presented brilliant intracellular inclusions with high reflectivity in the basal epithelium layer. Patients in stage 2 and 3 have all corneal layers affected. There are thinning and increase of tortuosity of corneal nerves in patients in stage 2 and 3. The endothelial count was 2,524 ± 150,3 cell/mm². CONCLUSION: The basal epithelium was most affected in any of the keratopathy stages. In stage 1 patients only the superficial and basal epithelium are affected, while patients in stages 2 and 3 have all corneal layers affected. With the advance of keratophaty the corneal nerves became thinner and tortuous.

Corneal diseases; Epithelium; Amiodarone; Microscopy, confocal


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