Department of Ophthalmology, University of Cologne, Cologne, Germany.
Department of Ophthalmology, University of Cologne, Cologne, Germany.
Surv Ophthalmol. 2018 May-Jun;63(3):365-380. doi: 10.1016/j.survophthal.2017.08.001. Epub 2017 Aug 9.
Corneal dystrophies are categorized according to the International Committee for Classification of Corneal Dystrophies (IC3D) classification, and their treatment depends on the affected structures and layer of the cornea. Therefore, estimating the depth and extent of the morphological changes due to the specific dystrophy is crucial when deciding between different treatment options. Besides superficial laser treatments and penetrating keratoplasty, minimal invasive lamellar keratoplasties such as Descemet membrane endothelial keratoplasty, deep anterior lamellar keratoplasty, or Descemet stripping automated keratoplasty have become increasingly popular to exchange the specific opaque layers in dystrophic eyes. To determine the morphological changes of the cornea in the different dystrophies, in addition to slit-lamp examination, anterior segment optical coherence tomography has become an important tool with nearly histological resolution. Nonetheless, only a few case series describe the characteristics of changes seen on anterior segment optical coherence tomography. Therefore, we summarize anterior segment optical coherence tomography signs and correlate with slit-lamp examination, as well as the histopathological findings, of corneal dystrophies according to the IC3D classification.
角膜营养不良根据国际角膜营养不良分类委员会(IC3D)分类进行分类,其治疗取决于受影响的结构和角膜层。因此,在决定不同治疗方案时,估计由于特定营养不良引起的形态变化的深度和程度至关重要。除了浅层激光治疗和穿透性角膜移植术外,微创板层角膜移植术(如 Descemet 膜内皮角膜移植术、深层前板层角膜移植术或 Descemet 撕除自动角膜移植术)已越来越受欢迎,以交换营养不良眼中特定的不透明层。为了确定不同营养不良症中角膜的形态变化,除了裂隙灯检查外,前段光学相干断层扫描已成为具有近乎组织学分辨率的重要工具。尽管如此,只有少数病例系列描述了前段光学相干断层扫描所见变化的特征。因此,我们根据 IC3D 分类总结了角膜营养不良的前段光学相干断层扫描征象,并与裂隙灯检查以及组织病理学发现相关联。