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超高分辨率眼前节光学相干断层扫描在评价前部角膜营养不良和变性中的应用。

Ultra high-resolution anterior segment optical coherence tomography in the evaluation of anterior corneal dystrophies and degenerations.

机构信息

Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.

出版信息

Ophthalmology. 2011 Jul;118(7):1291-6. doi: 10.1016/j.ophtha.2010.12.015. Epub 2011 Mar 21.

Abstract

PURPOSE

To evaluate the clinical usefulness of a spectral-domain ultra high-resolution anterior segment optical coherence tomography (UHR OCT) in examination, diagnosis, and management of various anterior corneal dystrophies and degenerations.

DESIGN

Noncomparative case series.

PARTICIPANTS

Fifty-nine eyes of 38 consecutive patients were enrolled in the study and included 28 eyes of 14 patients with anterior corneal dystrophies, 21 eyes of 19 patients with anterior corneal degenerations or neoplasia, and 10 eyes of 5 patients with normal corneas.

METHODS

Subjects were imaged using a novel custom-built UHR OCT. Images were used to evaluate and describe the characteristics of anterior corneal dystrophies and degenerations. Nineteen patients underwent surgical management, and those histopathologic specimens were analyzed and correlated with the UHR OCT images.

MAIN OUTCOME MEASURES

Comparison of clinical findings, UHR OCT images, and corresponding histopathologic specimens.

RESULTS

The UHR OCT provided clear delineation of corneal anatomic features and pathologic corneal deposits in most cases. The characteristics and depth of these deposits are illustrated and can be localized to specific layers of the cornea. When available, there was significant correlation between UHR OCT images and histopathologic features, providing a noninvasive confirmation of the clinical diagnosis.

CONCLUSIONS

Ultra high-resolution OCT is an innovative technique to perform in vivo optical biopsies and a promising research and clinical tool for the evaluation of corneal pathologic features in a noninvasive manner. The future use of this novel technology will evolve and increasingly is becoming a vital tool in the clinical and surgical management of corneal diseases.

摘要

目的

评估一种频域超高分辨率眼前节光学相干断层扫描(UHR OCT)在各种前部角膜营养不良和变性的检查、诊断和治疗中的临床应用。

设计

非对照病例系列。

参与者

38 例连续患者的 59 只眼纳入本研究,包括 14 例患者的 28 只眼前部角膜营养不良,19 例患者的 21 只眼前部角膜变性或肿瘤,以及 5 例患者的 10 只眼正常角膜。

方法

使用新型定制的 UHR OCT 对受试者进行成像。使用图像评估和描述前部角膜营养不良和变性的特征。19 例患者接受手术治疗,对这些组织病理学标本进行分析,并与 UHR OCT 图像相关联。

主要观察指标

临床发现、UHR OCT 图像和相应的组织病理学标本的比较。

结果

UHR OCT 在前部角膜病变的大多数情况下提供了角膜解剖特征和病理性角膜沉积物的清晰描绘。这些沉积物的特征和深度被描绘出来,并可以定位到角膜的特定层。在有条件的情况下,UHR OCT 图像与组织病理学特征之间存在显著相关性,为临床诊断提供了无创性的确认。

结论

超高分辨率 OCT 是一种进行体内光学活检的创新技术,是一种有前途的研究和临床工具,可无创评估角膜的病理性特征。这项新技术的未来应用将不断发展,越来越成为角膜疾病临床和手术管理的重要工具。

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