Stein Eye Institute, Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, CA.
Cornea Department, Cochin Hospital, Paris University, AP-HP, Paris, France.
Cornea. 2022 Aug 1;41(8):995-1001. doi: 10.1097/ICO.0000000000002955. Epub 2021 Dec 22.
The aim of this study was to investigate basal epithelial cell morphology (CM) in the central cornea and limbal areas of eyes with limbal stem cell deficiency (LSCD).
This was a prospective, cross-sectional comparative study. We developed a CM scoring system based on basal epithelial cell phenotypes graded from 0 (normal) to 3 (severe morphologic alterations); this system was evaluated by 2 independent masked observers. The CM score was compared with the LSCD clinical score, mean best-corrected visual acuity, and in vivo laser scanning confocal microscopy parameters used to stage LSCD (ie, basal epithelial cell density, basal epithelial thickness, and subbasal corneal nerve fiber length density).
One hundred sixty-eight eyes with LSCD and 63 normal eyes were included. Compared with the control group, the LSCD group had significantly higher mean (±SD) CM scores in the central cornea (1.8 ± 0.7 vs. 0.5 ± 0.4, respectively; P = 0.01) and limbal areas (1.6 ± 0.2 vs. 1.3 ± 0.0, respectively; P < 0.05). The mean CM score in the central cornea was positively correlated with the clinical score ( P < 0.01, r = 0.66) and negatively correlated with the best-corrected visual acuity ( P < 0.01, r = 0.42). The CM scores were positively correlated with all other in vivo laser scanning confocal microscopy parameters in the central cornea and limbal areas (all P < 0.001).
Basal epithelial CM is altered in the central cornea and limbus of eyes with LSCD and thus can be used to stage the clinical severity of the disease.
本研究旨在探讨伴有边缘干细胞缺乏症（LSCD）的眼角膜中央部和角膜缘区基底上皮细胞形态（CM）。
这是一项前瞻性、横断面对比研究。我们开发了一种基于基底上皮细胞表型的 CM 评分系统，从 0（正常）到 3（严重形态改变）进行分级；该系统由 2 位独立的、盲法观察者进行评估。CM 评分与 LSCD 临床评分、平均最佳矫正视力以及用于分期 LSCD 的活体激光扫描共聚焦显微镜参数（即基底上皮细胞密度、基底上皮厚度和角膜基质神经纤维长度密度）进行比较。
纳入 168 只伴有 LSCD 的眼和 63 只正常眼。与对照组相比，LSCD 组的眼角膜中央部（1.8 ± 0.7 比 0.5 ± 0.4，分别；P = 0.01）和角膜缘部（1.6 ± 0.2 比 1.3 ± 0.0，分别；P < 0.05）的 CM 评分均值明显更高。眼角膜中央部的 CM 评分均值与临床评分呈正相关（P < 0.01，r = 0.66），与最佳矫正视力呈负相关（P < 0.01，r = 0.42）。CM 评分与眼角膜中央部和角膜缘部的所有其他活体激光扫描共聚焦显微镜参数均呈正相关（均 P < 0.001）。
伴有 LSCD 的眼角膜中央部和角膜缘部的基底上皮 CM 发生改变，因此可用于分期评估疾病的临床严重程度。
