Nebbioso Marcella, Zicari Anna Maria, Lollobrigida Valeria, Marenco Marco, Duse Marzia
Department of Sense Organs and.
Semin Ophthalmol. 2015 Jan;30(1):40-3. doi: 10.3109/08820538.2013.821508. Epub 2013 Sep 27.
Vernal keratoconjunctivitis (VKC) is a bilateral chronic, seasonally exacerbated inflammation of the ocular surface that especially affects male children and young boys.
To evaluate the corneal microscopic features of patients affected by VKC and to assess whether some corneal changes were associated with specific ocular symptoms and/or signs.
20 children aged between 4 and 14 years were enrolled. All patients underwent corneal confocal microscopy by Confoscan CS3 (Nidek). 350 images of the central cornea of each eye were obtained with a ×40 noncontact lens 3,5 micron gap in automode.
Some alterations of the sub-basal and stromal corneal nerves were detected. These alterations were more evident in patients with higher severity of photophobia. On the other hand, there were scarce other signs of the anterior segment of the eye.
Our preliminary findings show that there is another group of patients affected by VKC, characterized by an intense photophobia caused by corneal damage and without other significant ocular alterations. Therefore confocal microscopy may be useful for an early identification of corneal alterations before the onset of severe ocular symptoms and to set an appropriate therapeutic management.
春季角结膜炎（VKC）是一种双侧性、慢性、季节性加重的眼表炎症，尤其影响男童和年轻男性。
评估VKC患者的角膜微观特征，并评估某些角膜变化是否与特定的眼部症状和/或体征相关。
招募了20名年龄在4至14岁之间的儿童。所有患者均通过Confoscan CS3（尼德克）进行角膜共焦显微镜检查。使用×40非接触镜在自动模式下以3.5微米的间隙获取每只眼睛中央角膜的350张图像。
检测到角膜基底膜下和基质神经的一些改变。这些改变在畏光程度较高的患者中更为明显。另一方面，眼前节的其他体征较少。
我们的初步研究结果表明，存在另一组受VKC影响的患者，其特征是由角膜损伤引起的强烈畏光，且无其他明显的眼部改变。因此，共焦显微镜检查可能有助于在严重眼部症状出现之前早期识别角膜改变，并制定适当的治疗方案。
