Clinica Oculistica, Dipartimento di Medicina, Chirurgia e Odontoiatria, Università degli Studi di Milano, Ospedale San Paolo, Milano, Italy.
Cornea. 2011 Jul;30(7):820-4. doi: 10.1097/ICO.0b013e31820143ed.
To report an advanced case of Terrien marginal corneal degeneration (TMD) analyzed by means of confocal microscopy.
A 62-year-old woman with TMD underwent a routine ophthalmological examination and was evaluated for the disease by using in vivo laser scanning confocal microscopy with the Heidelberg Retina Tomograph 2 Rostock Cornea Module.
The slit-lamp examination of the right eye showed an upper peripheral cornea thinning associated with a deposition of refractile yellow-white materials in the anterior stroma. Superficial radial vessels in the upper peripheral cornea were the only pathological findings of the left eye. Confocal microscopy of the right eye lesion showed deposition of hyperreflective material, and the stroma below presented a honeycomb-like pattern. Inflammatory cell infiltration, abnormal subbasal nerve plexus, epithelial basal membrane defects, irregular Bowman membrane, and the presence of activated keratocytes were observed in the cornea of both eyes.
In vivo confocal microscopy can detect subtle corneal changes in an advanced case of TMD, which may be signs of subclinical inflammation.
通过共焦显微镜报告一例晚期 Terrien 边缘性角膜变性（TMD）病例。
对一例 TMD 患者（62 岁女性）进行了常规眼科检查，并使用海德堡视网膜断层扫描仪 2 号 Rostock 角膜模块对活体激光共焦显微镜进行了疾病评估。
右眼裂隙灯检查显示上周边角膜变薄，前基质层有反光的黄白色物质沉积。左眼仅出现浅层放射状血管。右眼病变的共焦显微镜显示有高反射物质沉积，下方基质层呈蜂窝状。双眼角膜均可见炎性细胞浸润、异常的基底神经丛、上皮基底膜缺损、Bowman 膜不规则和活化的角膜细胞。
活体共焦显微镜可以检测晚期 TMD 中的细微角膜变化，这可能是亚临床炎症的迹象。
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