目的:探讨Fuchs角膜内皮营养不良（FECD）的影像学特征，为该病的诊断提供影像学依据。方法:回顾性系列病例研究。收集北京同仁眼科中心门诊2014年1月至2016年12月临床诊断为FECD的患者64例（128只眼），其中男性19例，女性45例，年龄（57.8±12.9）岁。FECDⅠ期25只眼（19.5%）、Ⅱ期81只眼（63.3%）、Ⅲ期16只眼（12.5%）、Ⅳ期6只眼（4.7%）。所有患者均行角膜内皮显微镜检查，41例（82只眼）同时行角膜共聚焦显微镜（IVCM）检查。分析患者一般资料，患眼FECD分期、角膜内皮显微镜及IVCM检查结果。计数资料进行卡方检验，计量资料进行方差分析，无法准确测量的资料进行秩和检验。结果:随着疾病进展，所有患眼在角膜内皮显微镜下均可见暗区数量、出现率、融合率均出现上升，IVCM小滴状结构的数量增多，小滴有成对、成串融合发展至成片融合。Ⅰ~Ⅳ期FECD患眼的角膜内皮暗区数量的秩均次分别为78.2、228.4、284.5、288.5，各期间差异有统计学意义（χn 2=84.183，n P=0.000）。Ⅰ期所有患眼角膜各部位均未见暗区融合，Ⅱ期（45.1%，146/324）、Ⅲ期（76.3%，45/59）、Ⅳ期（83.3%，15/18）周边角膜内皮暗区融合的出现率逐渐升高（χn 2=27.167，n P=0.000）。n 结论:角膜内皮显微镜及IVCM影像特征可以作为早期FECD诊断的重要依据。角膜内皮显微镜可快速筛查FECD，IVCM可通过分析角膜小滴状结构影像融合特征指导疾病分期。n （中华眼科杂志，2n 02n 0，56：938-943）“,”Objective:To investigate the imaging features of Fuchs endothelial corneal dystrophy (FECD) and to provide imaging evidence for the diagnosis of this disease.Methods:Retrospective case series study. A total of 128 eyes (64 patients, including 19 males and 45 females) diagnosed with FECD at the Beijing Tongren Eye Center of Capital Medical University from January 2014 to December 2016 were enrolled. The average age was 57.8±12.9 years. There were 25 eyes of stage Ⅰ (19.5%), 81 eyes of stage Ⅱ (63.3%), 16 eyes of stage Ⅲ (12.5%) and 6 eyes of stage Ⅳ (4.7%).All patients underwent specular microscopy, and 41 patients (82 eyes) had n in vivo confocal microscopy (IVCM). The patients′ general data, clinical stage, and image features of specular microscopy and IVCM were analyzed. The enumeration data was compared by chi-square test. Differences of measurement data were compared by ANOVA. Data which cannot be accurately measured was compared by rank sum test.n Results:As the disease progressed, the number, incidence rate, and fusing rate of dark“holes”on specular microscopy increased. The number of guttata on IVCM increased, and the fusing pattern of guttata developed from pair-like, chain-like to group-like. On specular microscopy, the mean rank of stage Ⅰ (78.2), stage Ⅱ (228.4), stage Ⅲ (284.5) and stage Ⅳ (288.5) was statistically different (χ2n =84.183, n P=0.000). All positions of all eyes of stage I had no fusion of the dark “holes”. The incidence of fusion on the peripheral cornea gradually increased significantly (χ2n =27.167, n P=0.000) from stage Ⅱ (45.1%, 146/324), stage Ⅲ (76.3%, 45/59) to stage Ⅳ (83.3%, 15/18).n Conclusions:The imaging features of specular microscopy and IVCM can be applied as an important basis for early diagnosis of FECD. Specular microscopy is a practical method for rapid screening of FECD. IVCM is an important imaging basis for clarifying the appearance of guttata and analyzing fusion features, so as to guide the differentiation of stages. n (Chin J Ophthalmol, 2020, 56:938-943)