Chen Ting, Li Qiangxiang, Tang Xiangbo, Liao Min, Wang Hua
Department of Ophthalmology, Xiangya Hospital, Central South University, Changsha, Hunan Province, China.
Department of Ophthalmology, Xiangya Changde Hospital, Changde, Hunan Province, China.
J Ophthalmol. 2019 Jul 11;2019:3161843. doi: 10.1155/2019/3161843. eCollection 2019.
This study was aimed at observing the morphological changes of the cornea with ocular in vivo confocal microscopy (IVCM) in patients with Terrien's marginal degeneration (TMD). Ten patients (20 eyes) with TMD treated in the Department of Ophthalmology, Xiangya Hospital, and 10 healthy controls (20 eyes) were included in the current study. A detailed slit lamp microscopy, anterior segment photography, and corneal IVCM examination were performed for each eye. The density of central and marginal corneal epithelial cells, stromal cells, and subepithelial nerve fibers was compared between the two groups using the Wilcoxon rank sum test. Compared with the control group, the corneal epithelial and endothelial cells in the TMD group showed granular highly reflective substances and thinner subepithelial nerve fibers. The uneven dot-like highly reflective substances without cell structures appeared in the stromal layer of the cornea. The density of central and marginal corneal epithelial cells, stromal cells, and subepithelial nerve fibers was lower in the TMD group ( < 0.05), and they were negatively correlated with severity of the disease ( < 0.05). Our study demonstrated that the density of corneal epithelial cells, stromal cells, and sensory plexus nerve fibers was significantly reduced in the TMD group. The pathological changes were more obvious in the marginal cornea, and it is correlated with severity of the disease.
本研究旨在通过眼部活体共聚焦显微镜(IVCM)观察Terrien边缘变性(TMD)患者角膜的形态学变化。本研究纳入了在湘雅医院眼科接受治疗的10例TMD患者(20只眼)和10名健康对照者(20只眼)。对每只眼睛进行详细的裂隙灯显微镜检查、眼前节照相及角膜IVCM检查。采用Wilcoxon秩和检验比较两组中央和周边角膜上皮细胞、基质细胞及上皮下神经纤维的密度。与对照组相比,TMD组角膜上皮细胞和内皮细胞出现颗粒状高反射物质,上皮下神经纤维更细。角膜基质层出现无细胞结构的点状高反射物质,分布不均匀。TMD组中央和周边角膜上皮细胞、基质细胞及上皮下神经纤维的密度均较低(<0.05),且与疾病严重程度呈负相关(<0.05)。我们的研究表明,TMD组角膜上皮细胞、基质细胞及感觉神经丛纤维的密度显著降低。周边角膜的病理改变更明显,且与疾病严重程度相关。