应用活体共焦显微镜观察翼状胬肉组织结构  

In vivo confocal microscopy of the pterygium

作　　者：杨欣[1] 成拾明[1] 黄锦海[1] 李瑾[1] 毕延峰[1] 肖天林[1] 

机构地区：[1]温州医学院附属眼视光医院,浙江温州325027

出　　处：《中国实用眼科杂志》2011年第4期368-371,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的 应用活体共焦显微镜（德国海德堡视网膜激光断层扫描系统Ⅱ代与Rostock角膜模 块组成）对人眼翼状胬肉进行活体组织成像分析.方法 系列病例分析.采取2010年3月门诊就诊的翼 状胬肉患者中选择11例14只眼,应用活体共焦显微镜对翼状胬肉头部、颈部和体部进行检查,记录各部分图像,分析其组织形态特点.结果 应用共焦显微镜观察到翼状胬肉头部两种上皮结构：一种是翼状胬肉上皮细胞,包括浅表上皮细胞和深层上皮细胞.浅表上皮细胞呈边界高反光的不规则多边形,浅表上皮细胞间见核/浆比显著失调的不规则细胞,深层上皮细胞间可见大量成熟的朗格汉斯细胞浸润;另一种是角膜上皮细胞,细胞间散在炎性细胞浸润.头部角膜浅基质层可见一些基质细胞和层间走行的纤维组织.翼状胬肉颈部和体部的上皮细胞结构与头部胬肉上皮结构相似,颈部血管较正常结膜血管丰富,在头部形成栏栅样结构,未跨越透明角膜,同时可以看到血管中流动的血细胞.体部基质层清晰可辨,由大量纤维组织构成,走行与基质平面基本平行并相互交错成致密的网状结构,可见新生血管横跨其间.结论 活体共焦显微镜是一种非侵入性的组织观察方法,提供了翼状胬肉的活体、实时、动态的图像资料,是研究翼状胬肉组织结构的一种有效工具.Objective To study the histology of the pterygia in vivo by confocal microscopy. Methods Series of case study. Fourteen pterygium eyes in 11 patients were selected for using in vivo confocal mieroscopy. Results Two kinds of epithelial cells were observed in the transitional zone of cornea and pterygium. Superficial epithelium cells of the pterygium characterized as polygon cells with brightly refractive border. There were many mature Langerhans cells and big irregular cells with significantly decreased nuclear/cytoplasm ratio within the Epithelial. Irregularly brightly reflective cells presented in the corneal epithelia. Fibrous tissue from the pterygium and cornea stroma cells were found in the superficial stroma. The blood vessels became dilated in the neck and body of pterygium, terminated at the head as palisade-like structures with lots of blood cells. The stroma of the pterygium body was filled with a lot of fibers which formed a dense net with neovascular across. Conclusions IVCM is a powerful technique for studying the vivo histology of the pterygium.Noninvasive technique for living tissue has provided in vivo, real-time, dynamic image data. It is a useful tool for investigating the structures ofpterygium.

关 键 词：活体共焦显微镜 翼状胬肉 上皮细胞 

分 类 号：R[医药卫生]