Evidence map›Paper›PMID 40501480›Full record

ReviewClinical ophthalmology (Auckland, N.Z.)2025

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

Arturo Ramirez-Miranda, Jesus Guerrero-Becerril, Manuel Ramirez, Guillermo Raul Vera-Duarte, Simran Mangwani-Mordani, Gustavo Ortiz-Morales, Alejandro Navas, Enrique O Graue-Hernandez, Jorge L Alio

Abstract readReview
In one paragraph

Review in Clinical ophthalmology (Auckland, N.Z.), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed.

  1. Review
  2. Review
  3. Review
  4. Review
  5. Review
  6. Article
  7. Review
  8. Article
  9. Enhanced Imaging of Ocular Surface Lesions.Journal of clinical medicine · 2025
    Review
  10. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Arturo Ramirez-MirandaDepartamento de Córnea y Cirugía Refractiva, Instituto de Oftalmología Fundación Conde de Valenciana IAP, Mexico City, Mexico.ORCID 0000-0001-6419-5116
Jesus Guerrero-BecerrilDepartamento de Córnea y Cirugía Refractiva, Instituto de Oftalmología Fundación Conde de Valenciana IAP, Mexico City, Mexico.
Manuel RamirezDepartamento de Córnea y Cirugía Refractiva, Asociación para Evitar la Ceguera en México, Hospital Luis Sánchez Bulnes, Universidad Nacional Autónoma de México, Mexico City, Mexico.ORCID 0000-0003-1646-1605
Guillermo Raul Vera-DuarteDepartamento de Córnea y Cirugía Refractiva, Instituto de Oftalmología Fundación Conde de Valenciana IAP, Mexico City, Mexico.ORCID 0000-0002-3417-256X
Simran Mangwani-MordaniDepartamento de Córnea y Cirugía Refractiva, Instituto de Oftalmología Fundación Conde de Valenciana IAP, Mexico City, Mexico.
Gustavo Ortiz-MoralesDepartamento de Córnea y Cirugía Refractiva, Instituto de Oftalmología Fundación Conde de Valenciana IAP, Mexico City, Mexico.
Alejandro NavasDepartamento de Córnea y Cirugía Refractiva, Instituto de Oftalmología Fundación Conde de Valenciana IAP, Mexico City, Mexico.ORCID 0000-0002-9417-5711
Enrique O Graue-HernandezDepartamento de Córnea y Cirugía Refractiva, Instituto de Oftalmología Fundación Conde de Valenciana IAP, Mexico City, Mexico.
Jorge L AlioResearch and Development Department, VISSUM Miranza, Alicante, Spain.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

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 increases in keratocyte density and stromal integrity. However, limitations include operator dependency, high costs, and the need for further technological refinements, such as wide-field imaging and non-contact modalities. Conclusion: IVCM represents a transformative tool in ophthalmology, bridging the gap between clinical evaluation and cellular-level diagnostics. Advances in imaging technologies and the integration of artificial intelligence hold the potential to overcome current limitations, enhancing its diagnostic precision and applicability. Standardization of protocols and expanded access will be pivotal in establishing IVCM as a cornerstone in the management of corneal diseases and ocular surface disorders.

Indexed as

corneal imagingcorneal nervesIn vivo confocal microscopyIVCMocular surface diseasesregenerative medicine

Identifiers

PMID40501480
PMCPMC12153954

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.