早期圆锥角膜共焦显微镜形态学研究  

Corneal Morphology of Early Stage Keratoconus by Confocal Microscopy in Vivo

作　　者：肖启国[1] 罗丽辉 陈媛[1] 张梅[3] 刘祖国[3] 费志刚[1] 

机构地区：[1]南华大学第二附属医院,湖南衡阳421001 [2]美国Baylor医学院眼表疾病中心 [3]中山大学中山眼科中心

出　　处：《南华大学学报（医学版）》2006年第2期168-171,共4页Journal of Nanhua University(Medical Edition)

摘　　要：目的了解早期圆锥角膜共焦显微镜的影像特征,评价共焦显微镜(confocal microscopy)对早期圆锥角膜(keratoconus)的临床检查意义和诊断价值。方法对Orbscan角膜地形图检查诊断为早期圆锥角膜的患者18例(19只眼)进行共焦显微镜检查,同时对正常人14例(28只眼)进行共焦显微镜检查,比较两组之间共焦显微镜形态学特征、角膜基质、内皮细胞的密度以及角膜厚度的差异。结果共焦显微镜下,早期圆锥角膜患者18例(19只眼),有8例(9只眼)的角膜组织结构出现变化,表现为后基质层出现微小皱折,上皮层、前基质层及内皮层未发现异常改变。与正常组比较,早期圆锥角膜的角膜中央厚度轻度变薄(P=0.000),角膜基质、内皮细胞密度与正常组比较无显著性差异。结论共焦显微镜可活体检查早期圆锥角膜组织结构和细胞的病理改变,为早期圆锥角膜的诊断及研究提供一个新的手段。Objective To evaluate the value of confocal microscopy in the diagnosis and examination of early stage keratoconus. Methods 18 （19 eyes） early stage keratoconus patients and 14 （28 eyes） healthy, subjects were examined by confocal microscopy. Images were recorded by continuously focusing the optical section through the full thickness central comea. The density and area of the stmmal and endothelial cell were measured by NAVIS software, and the thickness of comea and its layers were detected. All patients with keratoconus were also evaluated by Orbscan comeal topography system Results The comeal thinkness of normal group was 566 ± 48 μm, and that of early stage keratoconus was 488 ±54μm. Significance difference could be found between two groups（ P 〈 0. 05）. In 9 of 19 examined eyes, slim and tiny gross striae （Vogt＇s striae） was found in posterior stmma, no abnormal structure was found in desquamating superficial cells, Bowman＇s membrane, the anterior stroma and endothelial cell. Conclusions Confocal scanning microscopy is a new tool for studying and diagnosing early stage keratoconus.

关 键 词：共焦显微镜 圆锥角膜 角膜地形图 

分 类 号：R772.2[医药卫生—眼科]