Osigian Carla J, Sayed Mohamed S, Kontadakis George, Venincasa Michael, Fernandez Maria P, Cavuoto Kara M, Chang Ta C, Abou Shousha Mohamed
Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 900 NW 17th Street, Miami, FL, 33136, USA.
University of Miami Miller School of Medicine, Miami, FL, USA.
Int Ophthalmol. 2019 Sep;39(9):2083-2088. doi: 10.1007/s10792-018-1048-2. Epub 2018 Dec 8.
To evaluate corneal edema in different-aged pediatric patients with Peters anomaly and to correlate in vivo with ex vivo histopathologic findings.
A retrospective cross-sectional study was performed. The medical records of patients diagnosed with Peters anomaly who underwent examination under anesthesia (EUA) between 2011 and 2015 were reviewed. Eyes in which central corneal thickness (CCT) measurements were taken were included. The thickest point in the CCT pachymetric map was used to objectively quantify corneal edema. Correlation between CCT and age was calculated. Additionally, a retrospective review of histopathologic studies of excised corneal buttons from pediatric eyes with Peters anomaly between 2011 and 2015 was performed.
Eighteen eyes of 12 children were included. Mean age was 14 ± 15 months, and mean CCT was 842 ± 304 µm. A significant inverse correlation was noted between the CCT and the age of the patients, with lower CCT values in older children (r = 0.6; P = 0.01). Seven excised corneal buttons that underwent penetrating keratoplasty were reviewed. All corneal buttons showed absence of Descemet membrane and localized absence of endothelium. However, three specimens showed presence of corneal endothelium in areas of absent or attenuated Descemet membrane.
In Peters anomaly, the CCT decreases with age, possibly due to a decrease in corneal edema. Histopathologic studies show cases of endothelial expansion in areas of absent or attenuated Descemet membrane. This may contribute to improved endothelial function and decreased edema with age.
评估不同年龄的彼得斯异常患儿的角膜水肿情况，并将活体检查结果与离体组织病理学发现进行关联分析。
进行一项回顾性横断面研究。回顾了2011年至2015年间被诊断为彼得斯异常并接受麻醉下检查（EUA）的患者的病历。纳入了测量中央角膜厚度（CCT）的眼睛。使用CCT测厚图中的最厚点来客观量化角膜水肿。计算CCT与年龄之间的相关性。此外，对2011年至2015年间患有彼得斯异常的小儿眼睛切除的角膜纽扣的组织病理学研究进行了回顾性分析。
纳入了12名儿童的18只眼睛。平均年龄为14±15个月，平均CCT为842±304μm。观察到CCT与患者年龄之间存在显著的负相关，年龄较大的儿童CCT值较低（r = 0.6；P = 0.01）。对7个接受穿透性角膜移植术的切除角膜纽扣进行了检查。所有角膜纽扣均显示后弹力层缺失和局部内皮细胞缺失。然而，3个标本在后弹力层缺失或变薄的区域显示有角膜内皮细胞。
在彼得斯异常中，CCT随年龄增长而降低，可能是由于角膜水肿减轻。组织病理学研究显示，在后弹力层缺失或变薄的区域存在内皮细胞扩张的情况。这可能有助于随着年龄增长内皮功能改善和水肿减轻。
