Chikama Tai-ichiro, Takahashi Norihisa, Wakuta Makiko, Morishige Naoyuki, Nishida Teruo
Department of Ocular Pathophysiology, Yamaguchi University School of Medicine, Ube, Yamaguchi, Japan.
Mol Vis. 2008;14:2333-9. Epub 2008 Dec 15.
Laser in vivo confocal microscopy noninvasively provides images that are equivalent to high quality histology. We have now applied this technique to identify pathological characteristics of traumatic recurrent corneal erosion (RCE).
Six eyes of six patients with traumatic RCE were studied. Corneas were examined with a slit lamp biomicroscope and with a laser in vivo confocal microscope (Heidelberg Retina Tomograph II-Rostock Cornea Module or HRTII-RCM) at various times after the onset of the most recent recurrence of corneal erosion.
Brightly reflective granular structures were detected by the HRTII-RCM system in the basal and wing cell layers of the corneal epithelium in all eyes affected by recurrent erosion. Activated keratocytes and scattered fine particles were also apparent in the shallow stroma of five of the six affected eyes. These features were not observed in the normal cornea.
The HRTII-RCM system allows detection of characteristic abnormal structures in the cornea of individuals with traumatic RCE. The presence of granular structures in the corneal epithelium as well as persistent inflammation in the shallow stroma may contribute to the deterioration of the corneal epithelial cell alignment and to the weakening of adhesion between the basal epithelial cells and the basement membrane in RCE lesions.
激光共聚焦显微镜活体成像技术能够无创地提供等同于高质量组织学的图像。我们现已将该技术应用于识别外伤性复发性角膜糜烂（RCE）的病理特征。
对6例患有外伤性RCE的患者的6只眼睛进行研究。在角膜糜烂最近一次复发后的不同时间，用裂隙灯生物显微镜和激光共聚焦显微镜（海德堡视网膜断层扫描仪II - 罗斯托克角膜模块或HRTII - RCM）对角膜进行检查。
在所有受复发性糜烂影响的眼睛中，HRTII - RCM系统在角膜上皮的基底细胞层和翼状细胞层检测到明亮反光的颗粒状结构。在6只受影响眼睛中的5只的浅层基质中也可见活化的角膜细胞和散在的细颗粒。在正常角膜中未观察到这些特征。
HRTII - RCM系统能够检测外伤性RCE患者角膜中的特征性异常结构。角膜上皮中颗粒状结构的存在以及浅层基质中的持续炎症可能导致RCE病变中角膜上皮细胞排列的恶化以及基底上皮细胞与基底膜之间粘附力的减弱。
