Mehtani Amit, Agarwal Mahesh Chandra, Sharma Sushant, Chaudhary Santosh
Department of Ophthalmology, Deen Dayal Upadhyay, Hospital Hari Nagar, New Delhi, India.
DDU Post Graduate Institute of Medical Sciences, New Delhi, India.
Indian J Ophthalmol. 2017 Nov;65(11):1120-1126. doi: 10.4103/ijo.IJO_218_17.
The purpose of this study is to investigate the epithelial thickness in the cornea and limbus in limbal stem cell deficiency (LSCD) using anterior segment optical coherence tomography (AS-OCT).
This was a cross-sectional, comparative study. OCT images of 30 eyes of 19 patients with LSCD collected by AS-OCT were scanned. Corneal epithelial thickness was recorded at the central cornea and the superior, nasal, inferior, and temporal limbus. Measurment of the same region of 30 normal eyes served as control. Epithelial thickness in all locations was measured by 2 independent observers.
The mean epithelial layer thickness was 61.3 ± 2.9 μ in the central cornea and 62.7 ± 4.3 μ in the limbus in the control. The epithelial thickness in LSCD patients was found to be 41.33 ± 2.8 μ. An average reduction of 22.2% in the central cornea and 32.15% in the limbus was found in patients with LSCD (P < 0.05). 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 assessment using AS-OCT as a noninvasive tool could be used as a diagnostic measure of LSCD.
本研究旨在利用眼前节光学相干断层扫描（AS-OCT）研究角膜缘干细胞缺乏（LSCD）患者角膜和角膜缘的上皮厚度。
这是一项横断面比较研究。对19例LSCD患者的30只眼进行AS-OCT扫描，记录中央角膜及上方、鼻侧、下方和颞侧角膜缘的角膜上皮厚度。选取30只正常眼相同区域的测量结果作为对照。所有部位的上皮厚度由2名独立观察者测量。
对照组中央角膜上皮层平均厚度为61.3±2.9μm，角膜缘为62.7±4.3μm。LSCD患者的上皮厚度为41.33±2.8μm。LSCD患者中央角膜平均厚度降低22.2%，角膜缘降低32.15%（P<0.05）。角膜和角膜缘的上皮变薄与LSCD的严重程度相关。在扇形LSCD患者的眼中，在临床上未受影响的角膜缘区域也检测到了类似程度的上皮变薄。
LSCD患者的角膜和角膜缘上皮均逐渐变薄。使用AS-OCT作为无创工具评估上皮厚度可作为LSCD的诊断手段。
