共焦显微镜在角膜营养不良诊断中的应用  

The role of confocal microscopy in diagnosis of corneal dystrophies

作　　者：王琪[1] 陈家祺[1] 肖迎[1] 邵妙荣[1] 

机构地区：[1]中山大学中山眼科中心,广州510060

出　　处：《眼科》2005年第3期172-175,共4页Ophthalmology in China

基　　金：本课题为"211工程"重点学科建设项目(98004);卫生部临床研究重点项目(20013955);教育部博士学位点专项科研基金资助项目(20020558087)

摘　　要：目的探讨共焦显微镜在角膜营养不良诊断中的应用价值。设计病例系列研究。研究对象6例角膜营养不良,包括4例ReisB櫣cklers角膜营养不良、1例角膜斑点状营养不良、1例Fuchs角膜内皮营养不良。方法患者双眼行裂隙灯显微镜及共焦显微镜检查,选择病变在不同角膜层次的共焦显微镜图像,对角膜沉淀进行形态学评价,并与裂隙灯检查比较。主要指标角膜病变的裂隙灯显微镜及共焦显微镜图像。结果共焦显微镜显示ReisB櫣cklers角膜营养不良病变主要累及前部基质,包括角膜上皮、基底细胞及前弹力层;斑点状角膜营养不良病变仅累及基质层,而角膜上皮层及内皮层正常;在Fuchs角膜内皮营养不良中,可直接观察角膜小滴及角膜内皮情况。结论共焦显微镜检查提供了一种评价角膜病变的方法,较裂隙灯显微镜的分辨率高。Objective To assess the role of confocal microscopy in diagnosis of corneal dystrophy.Design Observational case series.Participants 6 patients of corneal dystrophies were collected,including 4 patients of Reis-Bücklers corneal dystrophy,1 patient of fleck corneal dystrophy,1 patient of Fuchs endothelium corneal dystrophy.Methods Slit-lamp and confocal microscopy were performed on binocular of 6 patients.Corneal deposits were evaluated from selected confocal microscopic images in different corneal layers,and compared those with images of slit-lamp biomicroscopy.Main Outcome Measures Slit-lamp microscopic and confocal microscopic images of corneal dystrophy.Results Confocal microscopy of Reis-Bücklers corneal dystrophy showed the deposits involved in anterior stroma including epithelium,basal cell and Bowman membrane.In fleck corneal dystrophy,the lesion only involved stroma,epithelium and endothelium levels were normal.Corneal gutta and enlarged endothelium cells of Fuchs endothelium dystrophy were directly observed with confocal microscopy.Conclusions Confocal microscopy provides an examination method for corneal diseases in vivo. Resolution of confocal microscopy is higher than that of slit-lamp biomicroscopy.

关 键 词：角膜营养不良 遗传性/诊断 显微镜 共焦 

分 类 号：R772.21[医药卫生—眼科]