Climatic Droplet Keratopathy (CDK) is an acquired degenerative disease of the human cornea characterized by progressive accumulation of unknown protein globular deposits on the sides of the cornea that spread centrally and change size and colour as the condition worsens. It is clinically divided in 3 stages (I, II, III) depending on the extension and severity of damage. In contrast to the central portion of the normal corneal epithelium the peripheral area and the limbus contain some Dendritic Cells (DC). Different types of cornea inflammations are associated with an increased density of DC. We studied the density of epithelial DC in CDK corneas using in vivo confocal microscopy (CFM) and correlated the findings with corneal progressive opacity and nerve abnormalities. In stage I we found reflective punctiform deposits in the basement membrane and Bowman?s layer, normal subepithelial nerve plexus, and present of DC in peripheral area (34±4 cells/mm2) and the limbus (87±7 cells/mm2). In moderate and advanced stages (II and III) there was increased reflectivity of the surface corneal epithelium and condensation of the punctiform deposits within Bowman?s layer and the corneal stroma, abnormal nerves and the DC were confluent at the limbus. In stage II the density of DC in peripheral area and limbus was 77±7 cells/mm2 and 101±7 cells/mm2, whereas in stage III the density of DC was 27±5 cells/mm2 and 237±8 cells/mm2. We did not observe DC in the central area at any stage of CDK. |