Zhang Y, Qu J H, He Y, Sun X G
Beijing Institute of Ophthalmology,Beijing Tongren Eye Center,Beijing Key Laboratory of Ophthalmology and Visual Science,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China.
Zhonghua Yan Ke Za Zhi. 2020 Dec 11;56(12):938-943. doi: 10.3760/cma.j.cn112142-20200418-00228.
To investigate the imaging features of Fuchs endothelial corneal dystrophy (FECD) and to provide imaging evidence for the diagnosis of this disease. Retrospective case series study. A total of 128 eyes (64 patients, including 19 males and 45 females) diagnosed with FECD at the Beijing Tongren Eye Center of Capital Medical University from January 2014 to December 2016 were enrolled. The average age was 57.8±12.9 years. There were 25 eyes of stage Ⅰ (19.5%), 81 eyes of stage Ⅱ (63.3%), 16 eyes of stage Ⅲ (12.5%) and 6 eyes of stage Ⅳ (4.7%).All patients underwent specular microscopy, and 41 patients (82 eyes) had confocal microscopy (IVCM). The patients' general data, clinical stage, and image features of specular microscopy and IVCM were analyzed. The enumeration data was compared by chi-square test. Differences of measurement data were compared by ANOVA. Data which cannot be accurately measured was compared by rank sum test. As the disease progressed, the number, incidence rate, and fusing rate of dark"holes"on specular microscopy increased. The number of guttata on IVCM increased, and the fusing pattern of guttata developed from pair-like, chain-like to group-like. On specular microscopy, the mean rank of stage Ⅰ (78.2), stage Ⅱ (228.4), stage Ⅲ (284.5) and stage Ⅳ (288.5) was statistically different (χ²84.183, =0.000). All positions of all eyes of stage I had no fusion of the dark "holes". The incidence of fusion on the peripheral cornea gradually increased significantly (χ²27.167, =0.000) from stage Ⅱ (45.1%, 146/324), stage Ⅲ (76.3%, 45/59) to stage Ⅳ (83.3%, 15/18). The imaging features of specular microscopy and IVCM can be applied as an important basis for early diagnosis of FECD. Specular microscopy is a practical method for rapid screening of FECD. IVCM is an important imaging basis for clarifying the appearance of guttata and analyzing fusion features, so as to guide the differentiation of stages. .
探讨富克斯内皮性角膜营养不良（FECD）的影像学特征，为该病的诊断提供影像学依据。回顾性病例系列研究。纳入2014年1月至2016年12月在首都医科大学附属北京同仁眼科中心确诊为FECD的128只眼（64例患者，其中男性19例，女性45例）。平均年龄为57.8±12.9岁。Ⅰ期25只眼（19.5%），Ⅱ期81只眼（63.3%），Ⅲ期16只眼（12.5%），Ⅳ期6只眼（4.7%）。所有患者均接受了角膜内皮显微镜检查，41例患者（82只眼）进行了共焦显微镜检查（IVCM）。分析患者的一般资料、临床分期以及角膜内皮显微镜和IVCM的图像特征。计数资料采用卡方检验比较。计量资料的差异采用方差分析比较。无法准确测量的数据采用秩和检验比较。随着病情进展，角膜内皮显微镜下暗“孔”的数量、发生率及融合率增加。IVCM下角膜小滴数量增加，角膜小滴的融合形态从成对状、链状发展为团状。角膜内皮显微镜下，Ⅰ期（78.2）、Ⅱ期（228.4）、Ⅲ期（284.5）和Ⅳ期（288.5）的平均秩次差异有统计学意义（χ² =84.183，P =0.000）。Ⅰ期所有眼位均无暗“孔”融合。从Ⅱ期（45.1%，146/324）、Ⅲ期（76.3%，45/59）到Ⅳ期（83.3%，15/18），周边角膜融合的发生率逐渐显著增加（χ² =27.167，P =0.000）。角膜内皮显微镜和IVCM的影像学特征可作为FECD早期诊断的重要依据。角膜内皮显微镜是快速筛查FECD的实用方法。IVCM是明确角膜小滴外观及分析融合特征以指导分期鉴别的重要影像学依据。
