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目的探讨共焦显微镜在角膜营养不良诊断中的应用价值。设计病例系列研究。研究对象6例角膜营养不良,包括4例ReisB櫣cklers角膜营养不良、1例角膜斑点状营养不良、1例Fuchs角膜内皮营养不良。方法患者双眼行裂隙灯显微镜及共焦显微镜检查,选择病变在不同角膜层次的共焦显微镜图像,对角膜沉淀进行形态学评价,并与裂隙灯检查比较。主要指标角膜病变的裂隙灯显微镜及共焦显微镜图像。结果共焦显微镜显示ReisB櫣cklers角膜营养不良病变主要累及前部基质,包括角膜上皮、基底细胞及前弹力层;斑点状角膜营养不良病变仅累及基质层,而角膜上皮层及内皮层正常;在Fuchs角膜内皮营养不良中,可直接观察角膜小滴及角膜内皮情况。结论共焦显微镜检查提供了一种评价角膜病变的方法,较裂隙灯显微镜的分辨率高。
Objective To investigate the value of confocal microscopy in the diagnosis of corneal dystrophy. Design case series research. The study included 6 cases of corneal dystrophy, including 4 cases of ReisB 櫣 cklers corneal dystrophy, 1 case of corneal speckle malnutrition and 1 case of Fuchs corneal endothelial dystrophy. Methods The patients underwent slit lamp microscopy and confocal microscopy. Confocal microscopic images of the lesion at different corneal levels were selected. Corneal deposition was evaluated morphologically and compared with slit lamp examination. The main indicators of keratopathy by slit lamp microscopy and confocal microscopy images. Results Confocal microscopy showed that the corneal dystrophy lesions of ReisB 櫣 cklers mainly involved the anterior stroma, including the corneal epithelium, basal cells and prefrontal elastic layer. The plaques of corneal dystrophy involved only the stromal layer, while the corneal epithelium and endothelium were normal. Fuchs corneal endothelial malnutrition, the corneal droplet and corneal endothelial can be observed directly. Conclusions Confocal microscopy provides a method of evaluating corneal disease, with a higher resolution than a slit lamp microscope.