泡性眼炎的激光扫描共焦显微镜下表现  

Laser scanning confocal microscopy findings of phlyctenular ophthalmia

作　　者：吴艳[1] 黄振平[1] 薛春燕[1] 闫峰[1] 石尧[1] 

机构地区：[1]南京军区南京总医院眼科,210002

出　　处：《中华实验眼科杂志》2013年第5期489-492,共4页Chinese Journal Of Experimental Ophthalmology

基　　金：江苏省博士后科研资助项目（0702040c）

摘　　要：背景泡性眼炎是一种是由微生物蛋白质引起的迟发型变态反应性疾病，主要发生在青少年，近年来发病率逐年提高。目的应用激光扫描共焦显微镜观察泡性眼炎的组织结构变化，评价激光扫描共焦显微镜在诊断泡性眼炎方面的应用价值。方法收集2009--2010年在南京军区南京总医院眼科门诊就诊并诊断为泡性眼炎的患者27例29眼，以年龄匹配的正常人10人20眼为对照组。患者及对照组均行胸部x线摄片、结核菌素试验、结膜囊细菌培养及分枝杆菌培养。出现角膜病者行角膜细菌培养。最后行眼表激光扫描共焦显微镜观察角膜和结膜组织结构的变化。结果泡性眼炎患眼的球结膜可见树枝样细胞的增多及聚集，球结膜表面可出现炎性细胞的聚集，上皮细胞变形及鳞状细胞化生，周边毛细血管扩张、充盈及杯状细胞变形。泡性结膜炎患眼的角膜结膜缘可见完整的Vogt栅栏，侵犯角膜后可见角巩膜缘Vogt栅栏结构细胞边界不清及树枝样细胞侵入。泡性角膜炎患眼可见角膜上皮缺失，角膜上皮下神经丛弯曲、断裂，广泛树枝样细胞和炎性细胞浸润。角膜基质层中出现瘢痕化改变。结论激光扫描共焦显微镜对泡性眼炎的诊断和发病机制研究具有重要的临床意义。Background Phlyctenular ophthalmia is a delayed hypersensitivity reaction to some microprotein and affected mainly by adolescent in high incidence.Objective This study was to investigate the microscopy findings of phlyctenular ophthalmia and evaluate the histological changes by laser scanning confocal microscope.Methods Twenty-nine eyes suffered from phlyctenular ophthalmia and twenty normal eyes were examined using laser scanning confocal microscope.The pictures were taken by a CCD camera.All the cases had initially chest X-ray,tuberculin test,bacterial and mycobacteria culture.Results Dendritic and inflammatory cells were increased and concentrated in conjunctiva,and epithelial cells were deformed and squamatizated.The capillaries engorged and the goblet cells were injured.The corneoscleral Vogt meshing of the phlyctenular keratitis was obscured and dendritic cells were intruded into the corneas.The corneal epithelium of phlyctenular keratitis was absent and the subepithelial nerve plexus were bended and fractured,and the dendritic and inflammatory cells were intruded.Scarring of corneal stroma was seen under the laser scanning confocal microscope.Conclusions Laser scanning confocal microscopy is valuable for basic research and clinical diagnosis of phlyctenular ophthalmia.

关 键 词：泡性眼炎 激光扫描共焦显微镜 组织结构 

分 类 号：R772.2[医药卫生—眼科]