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高科技设备在神经营养性角膜病变患者角膜愈合评估中的作用

The Role of Hi-Tech Devices in Assessment of Corneal Healing in Patients with Neurotrophic Keratopathy.

作者信息

Inferrera Leandro, Aragona Emanuela, Wylęgała Adam, Valastro Antonio, Latino Gianluigi, Postorino Elisa I, Gargano Romana, Orzechowska-Wylęgała Bogusława, Wylęgała Edward, Roszkowska Anna M

机构信息

Eye Clinic, Department of Medical, Surgical Sciences and Health, University of Trieste, 34100 Trieste, Italy.

Ophthalmology Clinic, Department of Biomedical Sciences, University of Messina, 98100 Messina, Italy.

出版信息

J Clin Med. 2022 Mar 14;11(6):1602. doi: 10.3390/jcm11061602.

Abstract

To prove the role of high-tech investigation in monitoring corneal morphological changes in patients with neurotrophic keratopathy (NK) using Keratograph 5M (K5M) and anterior segment OCT (AS-OCT), corneal healing was monitored with Keratograph 5M (Oculus, Wetzlar, Germany) and AS-OCT (DRI, Triton, Topcon, Tokyo, Japan) in 13 patients (8F and 5M), aged from 24 to 93 years (67.8 ± 19) with severe NK, who were treated with Cenegermin 0.002% (20 μg/mL) (Oxervate, Dompè, Farmaceutici Spa, Milan, Italy). The surface defects were evaluated on Keratograph 5M with ImageJ software and the corneal thickness variations were measured using DRI-Triton OCT software. Instrumental procedures were performed at baseline, and after 4 and 8 weeks of the treatment, respectively. The main outcome measures were reduction of the ulcers' area and corneal thickness recovery. The mean area of the corneal ulcers was reduced between baseline and 4 weeks examination in all patients, and at 8 weeks all ulcers were completely healed. An increase of the corneal thickness was evidenced between the baseline visit and after the 4- and 8-week follow-up, respectively. Additionally, only in collaborating subjects the In Vivo Confocal Microscopy (IVCM) was performed with HRT Rostock Cornea Module (Heidelberg Eng GmbH) to study the corneal nerves fibres. High-tech diagnostics with K5M, AS-OCT and IVCM proved useful in the assessment of corneal morphology and the healing process in patients with NK and could be extended to assess other corneal pathologies.

摘要

为了证明使用角膜地形图仪5M(K5M)和眼前节光学相干断层扫描(AS-OCT)进行高科技检查在监测神经营养性角膜病变(NK)患者角膜形态变化中的作用,我们使用角膜地形图仪5M(德国韦茨拉尔奥culus公司)和AS-OCT(日本东京拓普康公司的DRI Triton)对13例年龄在24至93岁(平均67.8±19岁)的重度NK患者进行角膜愈合监测,这些患者接受了0.002%(20μg/mL)的西奈吉明(Oxervate,意大利米兰多姆佩制药公司)治疗。使用ImageJ软件在角膜地形图仪5M上评估表面缺损,并使用DRI-Triton OCT软件测量角膜厚度变化。分别在基线时、治疗4周和8周后进行仪器检查。主要观察指标为溃疡面积的缩小和角膜厚度的恢复。所有患者角膜溃疡的平均面积在基线检查和4周检查之间均有所减小,8周时所有溃疡均完全愈合。在基线检查与4周和8周随访后,角膜厚度均有增加。此外,仅对合作受试者使用海德堡视网膜断层扫描角膜模块(德国海德堡工程有限公司)进行了共聚焦显微镜活体检查(IVCM),以研究角膜神经纤维。使用K5M、AS-OCT和IVCM进行的高科技诊断在评估NK患者的角膜形态和愈合过程中被证明是有用的,并且可以扩展到评估其他角膜病变。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e4f9/8955972/47182e21345f/jcm-11-01602-g001.jpg

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