人活体角膜神经形态特征的激光共焦显微镜观察  

In vivo visualization of the morphology of human normal and diseased corneal nerves

作　　者：薛春燕[1] 黄振平[1] 吴艳[1] 周晓军[2] 

机构地区：[1]南京大学医学院临床学院,南京军区南京总医院眼科,南京210002 [2]南京大学医学院临床学院,南京军区南京总医院病理科,南京210002

出　　处：《南京大学学报（自然科学版）》2010年第2期210-215,共6页Journal of Nanjing University（Natural Science）

基　　金：南京军区医药卫生基金(07M086)

摘　　要：评价角膜激光共焦显微镜作为一种新的方法观察正常及病变角膜的神经形态特征变化.本研究对76人的76眼进行了角膜激光共焦显微镜的检查.包括20例健康志愿者,20例Ⅱ型糖尿病患者,15例因Sjogren综合征导致的角结膜干燥征患者,5例长期佩戴软性角膜接触镜超过10年的患者,8例圆锥角膜患者及8例翼状胬肉患者.角膜共焦显微镜的扫描结果显示,人角膜上皮层下神经丛平行于前弹力层走行,部分有分支和交叉.在多种眼表面疾病中均可观察到神经形态的改变.糖尿病患者的角膜神经分支减少而曲折度增加,Sjogren综合征患者的角膜神经细而不连续,角膜接触镜佩戴者可查见螺旋状的角膜神经,圆锥角膜和翼状胬肉患者的角膜神经可发生多种形态的改变.研究结果显示角膜激光共焦显微镜提供了研究角膜疾病中神经形态改变的基本方法.The study was an evaluation of a new method for in vivo visualization of the morphology of human normal and diseased corneal nerves. 76 eyes of 76 cases were investigated. Group 1 included 20 eyes of 20 healthy volunteers, group 2 included 20 eyes of 20 patients with type Ⅱ diabetes mellitus, group 3 included 15 eyes of 15 patients with keratoconjunctivitis sicca of Sjogren Syndrom, group 4 included 5 eyes of 5 patients who have wear contact lens more than 10 years, group 5 comprised 8 eyes of 8 patients with keratoconus and group 6 comprised 8 eyes of 8 patients with primary pterygium. The central cornea were examined for morphology of human anterior corneal nerves using laser scanning confocal microscopy. In human cornea, thin nerves run in the subepithelial plexus aligned parallel to Bowman＇s layer and are partially interconnected. The morphology of corneal nerves was found changed in various diseases. Patients with proliferative diabetic retinopathy had fewer branches from the main nerve trunk and increased tortuosity. Thin and intermittent nerve fiber were seen in patients with Sjogren symdrom. Contact lens wearers had spiral nerve fibers. And various nerve changes could be seen in keratoeonic and pterygium subjects. Laser scanning confocal microscopy provides a basis for further studies of alterations of the morphology of human corneal nerves in corneal disease.

关 键 词：人 类 角膜神经 激光共焦显微镜 

分 类 号：R246.82[医药卫生—针灸推拿学]