Brooks A M, Grant G, Gillies W E
Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia.
Aust N Z J Ophthalmol. 1988 May;16(2):93-100. doi: 10.1111/j.1442-9071.1988.tb01256.x.
Changes on corneal endothelial specular microscopy were compared in 14 patients with cornea guttata, 4 patients with Fuchs' corneal dystrophy and 19 patients with various forms of bullous keratopathy. The patients with cornea guttata showed well marked guttae 1 to 6 endothelial cells in diameter in the endothelial mosaic and in the relief mode while the endothelial mosaic was usually otherwise within normal limits. In 2 patients with Fuchs' dystrophy the endothelium could be examined, showing gross guttae but a few areas of relatively normal endothelial cells. The unaffected eye of 3 other patients showed findings similar to cornea guttata, but with some reduction in endothelial cell count in 2 patients. The patients with bullous keratopathy fell into 2 groups, one with gross reduction in cell count in a markedly abnormal endothelial cell mosaic, the other a mixed group with moderate reduction in cell count and numerous guttae. Some miscellaneous cases included one of aphakic peripheral bullous keratopathy, one associated with cyclitis and aphakia and 2 with idiopathic non-surgical bullous keratopathy. We believe the corneal endothelium is not grossly abnormal away from the guttae in Fuchs' dystrophy, but the gross guttata formation determines the endothelial dysfunction.
对14例角膜滴状变性患者、4例富克斯角膜营养不良患者和19例各种形式大疱性角膜病变患者的角膜内皮镜面显微镜检查结果进行了比较。角膜滴状变性患者在内皮镶嵌图和浮雕模式下，内皮细胞中可见直径为1至6个细胞的明显滴状病变，而内皮镶嵌图通常在其他方面处于正常范围内。在2例富克斯营养不良患者中，可以检查内皮，显示有粗大滴状病变，但有一些相对正常的内皮细胞区域。另外3例患者的未受影响眼表现出与角膜滴状变性相似的结果，但其中2例患者的内皮细胞计数有所减少。大疱性角膜病变患者分为两组，一组内皮细胞计数明显减少，内皮细胞镶嵌图明显异常，另一组为混合组，细胞计数中度减少且有大量滴状病变。一些杂项病例包括1例无晶状体周边大疱性角膜病变、1例与睫状体炎和无晶状体相关的病例以及2例特发性非手术性大疱性角膜病变。我们认为，在富克斯营养不良中，远离滴状病变处的角膜内皮并无明显异常，但粗大滴状病变的形成决定了内皮功能障碍。
