Ku Judy Y F, Niederer Rachael L, Patel Dipika V, Sherwin Trevor, McGhee Charles N J
Department of Ophthalmology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
Ophthalmology. 2008 May;115(5):845-50. doi: 10.1016/j.ophtha.2007.04.067. Epub 2007 Sep 6.
Keratoconus is a form of progressive noninflammatory corneal ectasia. Although abnormalities have been documented at every level of the keratoconic cornea, the exact underlying pathophysiologic process remains unknown. This study aimed to determine the keratocyte density in human corneas with keratoconus imaged by laser scanning in vivo confocal microscopy.
Prospective cross-sectional study.
Thirty-six eyes of 26 subjects with keratoconus compared with 33 eyes of 33 control subjects.
Subjects were assessed via ophthalmic examination, computed topography, and laser scanning in vivo confocal microscopy.
Anterior and posterior stromal keratocyte density.
Mean age was 34.7+/-12.1 years in the control group, 38.4+/-11.0 years in the keratoconic with no contact lens wear group, and 38.5+/-10.3 years in the keratoconic with contact lens wear group. No significant difference was noted in age or gender between the groups. Mean keratocyte density in the control group was 786+/-244 cells/mm(2) in the anterior stroma and 293+/-35 cells/mm(2) in the posterior stroma. Anterior keratocyte density was higher than posterior keratocyte density (P<0.001). Anterior keratocyte density was significantly lower in contact lens-wearing keratoconic subjects in comparison with controls (463 vs. 786 cells/mm(2); P<0.001). Posterior keratocyte density was significantly lower in keratoconic subjects with no contact lens wear (236 vs. 293 cells/mm(2); P<0.001) and in keratoconic subjects with contact lens wear (208 vs. 293 cells/mm(2); P<0.001). In subjects with keratoconus, anterior keratocyte density correlated with central corneal thickness (r = 0.426, P = 0.012) and inversely with steepest keratometry values (r = -0.383, P = 0.028).
Keratocyte density is significantly lower in subjects with keratoconus, and the decline in keratocyte density correlates with indices of disease severity. In vivo confocal microscopy offers the opportunity to study early microstructural changes in the keratoconic cornea.
圆锥角膜是一种进行性非炎性角膜扩张症。尽管在圆锥角膜的各个层面均有异常记录，但确切的潜在病理生理过程仍不清楚。本研究旨在通过激光扫描活体共聚焦显微镜成像确定圆锥角膜患者角膜基质细胞密度。
前瞻性横断面研究。
26例圆锥角膜患者的36只眼与33例对照者的33只眼。
通过眼科检查、计算机断层扫描和激光扫描活体共聚焦显微镜对受试者进行评估。
前、后基质角膜细胞密度。
对照组平均年龄为34.7±12.1岁，未佩戴隐形眼镜的圆锥角膜组为38.4±11.0岁，佩戴隐形眼镜的圆锥角膜组为38.5±10.3岁。各组间年龄和性别无显著差异。对照组前基质角膜细胞平均密度为786±244个/mm²，后基质为293±35个/mm²。前基质角膜细胞密度高于后基质角膜细胞密度（P<0.001）。佩戴隐形眼镜的圆锥角膜患者的前基质角膜细胞密度显著低于对照组（463对786个/mm²；P<0.001）。未佩戴隐形眼镜的圆锥角膜患者（236对293个/mm²；P<0.001）和佩戴隐形眼镜的圆锥角膜患者（208对293个/mm²；P<0.001）的后基质角膜细胞密度均显著降低。在圆锥角膜患者中，前基质角膜细胞密度与中央角膜厚度相关（r = 0.426，P = 0.012），与最陡角膜曲率值呈负相关（r = -0.383，P = 0.028）。
圆锥角膜患者的角膜细胞密度显著降低，角膜细胞密度的下降与疾病严重程度指标相关。活体共聚焦显微镜为研究圆锥角膜早期微观结构变化提供了机会。
