Guarnieri Adriano, Moreno-Montañés Javier, Alfonso-Bartolozzi Belén, Sabater Alfonso L, García-Guzmán María, Andreu Enrique J, Prosper Felipe
Department of Ophthalmology, Clínica Universidad de Navarra, Pamplona 31008, Spain.
Department of Cell Therapy, Clínica Universidad de Navarra, Pamplona 31008, Spain.
Int J Ophthalmol. 2014 Dec 18;7(6):988-95. doi: 10.3980/j.issn.2222-3959.2014.06.14. eCollection 2014.
To assess cultured limbal epithelial stem cell transplantation in patients with limbal stem cell deficiency by analyzing and quantifying corneal neovascularization.
This retrospective, interventional case series included eight eyes with total limbal stem cell deficiency. Ex vivo limbal epithelial stem cells were cultured on human amniotic membrane using an animal-free culture method. The clinical parameters of limbal stem cell deficiency, impression cytology, and quantification of corneal neovascularization were evaluated before and after cultured limbal stem cell transplantation. The area of corneal neovascularization, vessel caliber (VC), and invasive area (IA) were analyzed before and after stem cell transplantation by image analysis software. Best-corrected visual acuity (BCVA), epithelial transparency, and impression cytology were also measured.
One year after surgery, successful cases showed a reduction (improvement) of all three parameters of corneal neovascularization [neovascular area (NA), VC, IA], while failed cases did not. NA decreased a mean of 32.31% (P=0.035), invasion area 29.37% (P=0.018) and VC 14.29% (P=0.072). BCVA improved in all eyes (mean follow-up, 76±21mo). Epithelial transparency improved significantly from 2.00±0.93 to 0.88±1.25 (P=0.014). Impression cytology showed that three cases failed after limbal epithelial stem cell therapy before 1y of follow-up.
This method of analyzing and monitoring surface vessels is useful for evaluating the epithelial status during follow-up, as successful cases showed a bigger reduction in corneal neovascularization parameters than failed cases. Using this method, successful cases could be differentiated from failed cases.
通过分析和量化角膜新生血管，评估培养的角膜缘上皮干细胞移植治疗角膜缘干细胞缺乏症患者的效果。
本回顾性、干预性病例系列研究纳入了8例全角膜缘干细胞缺乏的患眼。采用无动物培养方法在人羊膜上培养角膜缘上皮干细胞。在培养的角膜缘干细胞移植前后，评估角膜缘干细胞缺乏的临床参数、印迹细胞学检查及角膜新生血管的量化情况。通过图像分析软件分析干细胞移植前后角膜新生血管的面积、血管管径（VC）和浸润面积（IA）。还测量了最佳矫正视力（BCVA）、上皮透明度和印迹细胞学检查结果。
术后1年，成功病例的角膜新生血管的所有三个参数（新生血管面积[NA]、VC、IA）均降低（改善），而失败病例则未降低。NA平均降低32.31%（P=0.035），浸润面积降低29.37%（P=0.018），VC降低14.29%（P=0.072）。所有患眼的BCVA均有改善（平均随访时间，76±21个月）。上皮透明度从2.00±0.93显著改善至0.88±1.25（P=0.014）。印迹细胞学检查显示，3例在随访1年之前角膜缘上皮干细胞治疗失败。
这种分析和监测表面血管的方法有助于在随访期间评估上皮状态，因为成功病例的角膜新生血管参数降低幅度大于失败病例。使用这种方法，可以区分成功病例和失败病例。
