Morgan Philip B, Maldonado-Codina Carole
Eurolens Research, Faculty of Life Sciences, The University of Manchester, Manchester, United Kingdom.
Cont Lens Anterior Eye. 2009 Apr;32(2):48-54. doi: 10.1016/j.clae.2008.09.004. Epub 2009 Jan 31.
Sodium fluorescein ('fluorescein') is widely utilised for the evaluation of ocular surface integrity. It is particularly well suited to this task due to its fluorescent properties and its high visibility at low concentrations. Ocular surface fluorescence observed clinically is affected by a number of factors including concentration of fluorescein, thickness of the fluorescein layer, the wavelength of the exciting light source and whether or not a barrier filter is used as part of the viewing system. In this review we have attempted to provide a critical evaluation of the published literature relating to three potential cellular mechanisms involved in corneal surface fluorescence: surface pooling, uptake by cells and ingress around cells. Despite the widespread adoption of use of fluorescein for the assessment of the ocular surface, we contend that the clinical understanding and interpretation of corneal surface fluorescence is based upon assumption, extrapolation and clinical intuition rather than solid evidence-based science underpinning the basic causative mechanisms of this phenomenon. Further research in order to understand the basic interactions between the ocular surface cells and fluorescein should be made a priority in the fields of optometry and ophthalmology.
荧光素钠（“荧光素”）被广泛用于评估眼表完整性。由于其荧光特性以及在低浓度下的高可见性，它特别适合这项任务。临床上观察到的眼表荧光受多种因素影响，包括荧光素浓度、荧光素层厚度、激发光源的波长以及观察系统是否使用了阻挡滤光片。在本综述中，我们试图对已发表的文献进行批判性评估，这些文献涉及角膜表面荧光的三种潜在细胞机制：表面聚集、细胞摄取和细胞周围进入。尽管荧光素在眼表评估中的应用广泛，但我们认为，角膜表面荧光的临床理解和解释是基于假设、推断和临床直觉，而非基于该现象基本致病机制的坚实循证科学。为了理解眼表细胞与荧光素之间的基本相互作用，进一步的研究应成为验光和眼科领域的优先事项。
