Diez-Feijóo Elío, Durán Juan A
*Instituto Clínico-Quirúrgico de Oftalmología, Bilbao, Spain; and †Instituto Clinico-Quirúrgico de Oftalmología, Spain Basque Country University, Bilbao, Spain.
Cornea. 2015 Mar;34(3):290-5. doi: 10.1097/ICO.0000000000000334.
To report the findings of optical coherence tomography (OCT) in the corneas of patients with recurrent corneal erosion syndrome (RCES).
Ten normal subjects and 25 patients with RCES were recruited for the study. Ten patients with RCES suffered from an acute episode of pain and 15 patients complained of typical chronic symptoms of RCES. All eyes were scanned with the anterior segment 5 line raster acquisition protocol of the Cirrus HD-OCT platform (Zeiss). The etiology of RCES was investigated and treatment was provided following a standard clinical protocol. Scans were obtained at different stages of the pathology and each patient was followed-up after treatment.
Tear film, epithelium, basement membrane, Bowman layer, stroma, and Descemet-endothelium complex were identified by OCT in all normal corneas. The same structures were identified in nonaffected areas of RCES corneas. The findings on OCT from patients suffering from acute RCES were as follows: anterior stromal hyper-reflectivity (100%), epithelial edema (100%), and irregular breaks in the epithelium (90%). Undetected epithelial basement membrane (100%), intraepithelial basement membrane (60%), intraepithelial inclusions (60%), and anterior stromal hyper-reflectivity (40%) were seen in patients with chronic RCES. These findings correlated well with the clinical symptoms and with previously described histological reports of RCES.
Corneal OCT can be useful to study and manage RCES. Specific OCT findings may clarify etiology, confirm a suspected diagnosis, and give advice on the decision to treat patients.
报告复发性角膜糜烂综合征(RCES)患者角膜的光学相干断层扫描(OCT)结果。
招募10名正常受试者和25名RCES患者进行研究。10名RCES患者经历了急性疼痛发作,15名患者主诉有典型的RCES慢性症状。所有眼睛均采用Cirrus HD-OCT平台(蔡司)的眼前段5线光栅采集协议进行扫描。对RCES的病因进行调查,并按照标准临床方案进行治疗。在病理的不同阶段进行扫描,每位患者治疗后进行随访。
在所有正常角膜中,OCT可识别泪膜、上皮、基底膜、Bowman层、基质和Descemet-内皮复合体。在RCES角膜的未受影响区域也可识别到相同结构。急性RCES患者的OCT表现如下:前基质高反射率(100%)、上皮水肿(100%)和上皮不规则破裂(90%)。慢性RCES患者可见未检测到的上皮基底膜(100%)、上皮内基底膜(60%)、上皮内包涵体(60%)和前基质高反射率(40%)。这些发现与临床症状以及先前描述的RCES组织学报告密切相关。
角膜OCT有助于研究和管理RCES。特定的OCT表现可能有助于明确病因、确诊疑似诊断,并为患者的治疗决策提供建议。