激光共焦显微镜在阿米巴性角膜炎诊断中的应用  

Diagnosis evaluation of Acanthamoeba keratitis with Heidelberg Retina Tomograph Ⅲ-RCM

作　　者：张琛[1] 邓世靖[1] 王智群[1] 李然[1] 孙旭光[1] 

机构地区：[1]首都医科大学附属北京同仁眼科中心北京市眼科研究所,北京100005

出　　处：《眼科研究》2007年第10期772-774,共3页Chinese Ophthalmic Research

摘　　要：目的探讨激光共焦显微镜HRT3-RCM在阿米巴性角膜炎诊断中的应用价值。方法对临床拟诊阿米巴性角膜炎患者9例(10眼)行HRT3-RCM检查,同时进行角膜刮片细胞学检查及阿米巴原虫培养。结果9例患者中,HRT3-RCM显示7例角膜组织内阿米巴包囊为阳性,其中3例查到阿米巴滋养体,2例在角膜组织内查见真菌菌丝。包囊表现为圆形,双壁,高密度影像,直径15～20μm;滋养体表现为不规则高密度影像,其中心或偏中心可见致密的核,直径25～40μm。角膜刮片见阿米巴包囊7例,阿米巴培养阳性6例。结论HRT3-RCM是利用激光作为光源的新一代共焦显微镜,分辨率更高,是一种快速无创的检查方法,可作为阿米巴性角膜炎早期病原学诊断以及治疗随访观察的重要辅助检查手段。Objective Acanthamoeba keratitis is a sight-threatening and progressive corneal disease. Clinical diagnosis is very difficult in the early phase of the disease. The purpose of this paper was to evaluate the diagnose value of Heidelberg Retina Tomograph Ⅲ Rostock-cornea-module （HRTⅢ-RCM） to Acanthamoeba keratitits. Methods Ten eyes of nine patients with a clinical determined Acanthamoeba keratitis were observed with HRT Ⅲ-RCM examination. The corneal smear and Acanthamoeba culture were performed for all cases. Results Acanthamoeba cysts or trophozoites were observed in the corneas of 7 patients by HRTⅢ-RCM,of which 7 patients showed the positive results for corneal scraping cytological analysis and 6 were positive for culture of Acanthamoeba. Conclusion HRTⅢ-RCM is an useful noninvasive technique in the early diagnosis of Acanthamoeba keratitis and monitor of therapy response.

关 键 词：阿米巴 角膜炎 激光共焦显微镜 

分 类 号：R772.21[医药卫生—眼科]