Chan Eric H, Chen Luxia, Yu Fei, Deng Sophie X
Cornea Division, Stein Eye Institute, University of California, Los Angeles, Los Angeles, California; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California.
Cornea Division, Stein Eye Institute, University of California, Los Angeles, Los Angeles, California.
Am J Ophthalmol. 2015 Oct;160(4):669-77.e4. doi: 10.1016/j.ajo.2015.06.029. Epub 2015 Jul 7.
To investigate the epithelial thickness in the cornea and limbus in limbal stem cell deficiency (LSCD) by using in vivo laser scanning confocal microscopy.
Cross-sectional comparative study.
Confocal images of 48 eyes of 35 patients with LSCD collected by the Heidelberg Retina Tomograph III Rostock Corneal Module Confocal Microscope from 2010 to 2014 were analyzed. Volume Z-scans of the central cornea and the superior, nasal, inferior, and temporal limbus were included in the analysis. Eleven normal eyes served as control. Epithelial thickness in all locations was measured by 2 independent observers.
The mean epithelial layer thickness was 48.6 ± 2.3 μm in the central cornea and 63.7 ± 11.3 μm in the limbus in the control. Compared with the epithelial thickness in normal control, the epithelial thickness in LSCD patients was reduced by an average of 20.2% in the central cornea and 38.5% in the limbus (all P < .05). The mean corneal epithelial thickness in patients with LSCD reduced 7.6%, 20.8%, and 61.3% in the early, intermediate, and late stage, respectively, compared to the control. In the limbus, the overall epithelial thickness decreased 30.0%, 39.7%, and 62.8% in the early, intermediate, and late stage of LSCD, respectively (all P < .05). Epithelial thinning correlated with the severity of LSCD in both cornea and limbus. In eyes with sectoral LSCD, a similar degree of epithelial thinning was also detected in the clinically unaffected limbal regions.
Both corneal and limbal epithelia become progressively thinner in LSCD. Epithelial thickness could be used as a diagnostic measure of LSCD.
采用活体激光扫描共聚焦显微镜研究角膜缘干细胞缺乏（LSCD）患者角膜和角膜缘的上皮厚度。
横断面比较研究。
分析2010年至2014年使用海德堡视网膜断层扫描仪III罗斯托克角膜模块共聚焦显微镜收集的35例LSCD患者48只眼的共聚焦图像。分析中央角膜以及上方、鼻侧、下方和颞侧角膜缘的体积Z扫描。11只正常眼作为对照。由2名独立观察者测量所有部位的上皮厚度。
对照组中央角膜上皮层平均厚度为48.6±2.3μm，角膜缘为63.7±11.3μm。与正常对照组上皮厚度相比，LSCD患者中央角膜上皮厚度平均降低20.2%，角膜缘降低38.5%（均P<.05）。与对照组相比，LSCD患者早期、中期和晚期角膜上皮平均厚度分别降低7.6%、20.8%和61.3%。在角膜缘，LSCD早期、中期和晚期上皮总厚度分别降低30.0%、39.7%和62.8%（均P<.05）。角膜和角膜缘上皮变薄均与LSCD的严重程度相关。在扇形LSCD患者的眼中，在临床未受影响的角膜缘区域也检测到类似程度的上皮变薄。
LSCD患者角膜和角膜缘上皮均逐渐变薄。上皮厚度可作为LSCD的诊断指标。
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