Patel Dipika V, Grupcheva Christina N, McGhee Charles N J
Department of Ophthalmology, University of Auckland, New Zealand.
Cornea. 2005 Jul;24(5):550-4. doi: 10.1097/01.ico.0000153557.59407.20.
This study was designed to delineate the morphologic features of posterior polymorphous dystrophy (PPD) using in vivo confocal microscopy.
Six patients with clinically diagnosed PPD were examined by slit-lamp biomicroscopy, Orbscan II slit-scanning elevation topography, and in vivo confocal microscopy.
Endothelial cell densities ranged from 613 to 3,405 cells/mm and endothelial polymegathism was noted in all cases, whereas endothelial pleomorphism was not a prominent feature. Three cases exhibited bright endothelial nuclei. A variety of abnormal curvilinear and vesicular abnormalities were imaged by in vivo confocal microscopy, with lesions ranging between 6 and 159 microm in diameter. Abnormal endothelial cells were visible within some of these lesions. Six cases showed hyperreflectivity at the level of Descemet's membrane around the lesions. Deep stromal keratocytes appeared to aggregate around, or were compressed by, the endothelial lesions in one case.
We report the largest case series of PPD imaged by in vivo confocal microscopy. The ability of in vivo confocal microscopy to assess the living cornea over time enables monitoring of disease progression and thus the potential to identify and correlate development of, or changes in, microstructural features. As more data become available, these analyses may enable the formulation of prognostic and diagnostic criteria.
本研究旨在利用活体共聚焦显微镜描绘后弹力层多形性营养不良（PPD）的形态学特征。
对6例临床诊断为PPD的患者进行裂隙灯生物显微镜检查、Orbscan II裂隙扫描高度地形图检查及活体共聚焦显微镜检查。
内皮细胞密度范围为613至3405个细胞/mm，所有病例均观察到内皮细胞大小不均，而内皮细胞异形性并非显著特征。3例出现明亮的内皮细胞核。活体共聚焦显微镜成像显示多种异常曲线和囊泡样异常，病变直径在6至159微米之间。部分病变内可见异常内皮细胞。6例在病变周围的后弹力层水平显示高反射性。1例深基质角膜细胞似乎在内皮病变周围聚集或被其挤压。
我们报告了通过活体共聚焦显微镜成像的最大系列PPD病例。活体共聚焦显微镜随时间评估活体角膜的能力有助于监测疾病进展，从而有可能识别和关联微观结构特征的发展或变化。随着更多数据的获取，这些分析可能有助于制定预后和诊断标准。
