Research Article

Meibomian Glands or Not? Identification of In Vivo and Ex Vivo Confocal Microscopy Features and Histological Correlates in the Eyelid Margin

Table 1

List of in vivo and ex vivo CLSM features of healthy skin part of the eyelid margin and their histological correlates in H&E staining.

AnatomicalIn vivo CLSMEx vivo CLSMH&E staining

Stratum corneum ↓ 0–10 μmHighly reflective, polygonal, flat, nonnucleated cells (25 μm-35 μm)Medium reflection, polygonal, flat, nonnucleated cellsMultiple layers of pink, flat, nonnucleated keratinocytes
Stratum granulosum ↓ 10–20 μm1–3 layers, flat, low-reflective cytoplasm (20–30 μm)1–3 layers, flat, medium-reflective cytoplasm, highly reflective nucleiMultiple layers of pink cytoplasm with dark granules and dark blue or purple nuclei
Stratum spinosum ↓ 20–100 μm2–7 layers, polygon, high-reflective cell junctions, and low-reflective cells with invisible nuclear (15–25 μm)2–7 layers, polygon, high reflective nucleus, low-reflective cytoplasmic cellsMultilayer, purple nuclei in the center of the pink cytoplasm
Stratum basale ↓ 50–100 μmMonolayer, cube-shaped, highly reflective nuclei and medium-reflective cytoplasmic cells (10 μm)Same as in vivo CLSMMonolayer, purple nuclei in the center of the pink cytoplasm, darker than stratum spinosum
Papillary dermis ↓ 60–120 μmThe low-reflection area is surrounded by a highly reflective layer, and highly reflective cells (inflammatory cells, red blood cell) are visible insideSame as in vivo CLSMCrispy pink collagen fibers surrounded by stratum basale
Reticular dermisLow reflection background and high reflection net-like collagen fibersCrispy medium reflective collagen fibersCrispy pink collagen fibers
Hair follicleHighly reflective hair shaft surrounded by highly reflective root sheaths with cells arranged in columnsSame as in vivo CLSMHair shafts as columns of pink to brownish keratinized cells
Glands of ZeisTubular high reflection duct and blurred medium reflection aciniRound, sharply demarcated structures filled with low-reflective cytoplasm, highly reflective nucleiOpens into the acetabulum, large cells packed with lipids and centrally located nuclei
Glands of MollUnable to observe1–2 layers of small highly reflective nuclei cells, lining the low-reflective lumenLocated near the lash follicles within the margins of the lids, tubular composed of flat cells, others with cuboidal cells

↓, depth under surface.