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健康与疾病状态下的Bowman层和角膜厚度

Bowman's layer and corneal thickness in health and disease.

作者信息

Shen Yaochun, Zheng Yalin, Borgia Alfredo, Posarelli Matteo, Herbert Rose, Sharp Tom, Pagano Luca, Romano Vito, Madden Andrea, Undan Alexander, Kaye Stephen B

机构信息

Electrical Engineering and Electronics, University of Liverpool, Liverpool, UK.

Department of Eye and Vision Science, University of Liverpool, Liverpool, UK.

出版信息

BMJ Open Ophthalmol. 2025 May 22;10(1):e002167. doi: 10.1136/bmjophth-2025-002167.

DOI:10.1136/bmjophth-2025-002167
PMID:40404340
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12104951/
Abstract

PURPOSE

To investigate central Bowman's layer thickness (BT) in relation to central corneal thickness (CCT) and curvature, and epithelial thickness in healthy and disease corneas.

METHODS

Patients with keratoconus (KC), corneal dystrophies (CD) and healthy controls (HC) were included. Linnik and Mirau versions of an ultra-high axial resolution line field spectral domain optical coherence tomography device were used to image the cornea, in addition to commercially available devices. A supervised automated segmentation process was used to extract the quasi-point thickness of Bowman's layer.

RESULTS

62 participants: 24 with KC, 20 with CD and 18 HC were included. Mean central BT was 15.41 µm (SD 0.49; min-max: 12.28-19.54) in HC, 14.27 µm (SD:0.43; min-max: 11.22-18.25) in KC and 15.65 µm (SD 0.64; min-max: 12.42-20.06) in CD (mainly Fuchs CD). Patients with KC had thinner central BT than those with CD (p=0.03), but not compared with HC (p=0.13). Central BT was significantly associated with CCT (p<0.01), being on average 3% of CCT. The ratio of BT to CCT was independent of diagnosis (CD 0.028, HC 0.030, KC 0.028, p=0.88), age (p=0.23), sex (p=0.67), Kmax (p=0.77) or epithelial thickness (p=0.72).

CONCLUSIONS

Over sample populations of healthy, keratoconic and dystrophic corneas, central BT was consistently associated with corneal thickness and was independent of age, sex, Kmax, and epithelial thickness.

TRIAL REGISTRATION NUMBER

ISRCTN40558.

摘要

目的

研究健康角膜和病变角膜中央鲍曼层厚度(BT)与中央角膜厚度(CCT)、曲率以及上皮厚度之间的关系。

方法

纳入圆锥角膜(KC)患者、角膜营养不良(CD)患者和健康对照者(HC)。除了市售设备外,还使用了Linnik和Mirau版本的超高轴向分辨率线场光谱域光学相干断层扫描设备对角膜进行成像。采用监督自动分割程序提取鲍曼层的准点厚度。

结果

共纳入62名参与者,其中24名KC患者、20名CD患者和18名HC。HC的平均中央BT为15.41µm(标准差0.49;最小值 - 最大值:12.28 - 19.54),KC患者为14.27µm(标准差:0.43;最小值 - 最大值:11.22 - 18.25),CD患者(主要是Fuchs角膜营养不良)为15.65µm(标准差0.64;最小值 - 最大值:12.42 - 20.06)。KC患者的中央BT比CD患者薄(p = 0.03),但与HC相比无差异(p = 0.13)。中央BT与CCT显著相关(p < 0.01),平均占CCT的3%。BT与CCT的比值与诊断(CD为0.028,HC为0.030,KC为0.028,p = 0.88)、年龄(p = 0.23)、性别(p = 0.67)、最大角膜曲率(Kmax,p = 0.77)或上皮厚度(p = 0.72)无关。

结论

在健康、圆锥角膜和角膜营养不良的样本群体中,中央BT始终与角膜厚度相关,且与年龄、性别、Kmax和上皮厚度无关。

试验注册号

ISRCTN40558

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e23a/12104951/badc690adb0b/bmjophth-10-1-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e23a/12104951/2349f477a7d9/bmjophth-10-1-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e23a/12104951/14226ef062ed/bmjophth-10-1-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e23a/12104951/0c2a15ffe1e7/bmjophth-10-1-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e23a/12104951/badc690adb0b/bmjophth-10-1-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e23a/12104951/2349f477a7d9/bmjophth-10-1-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e23a/12104951/14226ef062ed/bmjophth-10-1-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e23a/12104951/0c2a15ffe1e7/bmjophth-10-1-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e23a/12104951/badc690adb0b/bmjophth-10-1-g004.jpg

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本文引用的文献

1
Accurate In Vivo Bowman's Thickness Measurement Using Mirau Ultrahigh Axial Resolution Line Field Optical Coherence Tomography.利用 Mirau 超高轴向分辨率线场光学相干断层扫描术进行活体 Bowman 层厚度的精确测量。
Transl Vis Sci Technol. 2022 Aug 1;11(8):6. doi: 10.1167/tvst.11.8.6.
2
Large Field of View Corneal Epithelium and Bowman's Layer Thickness Maps in Keratoconic and Healthy Eyes.大视场角膜上皮和 Bowman 层厚度图在圆锥角膜和正常眼中的应用。
Am J Ophthalmol. 2020 Jan;209:168-177. doi: 10.1016/j.ajo.2019.05.025. Epub 2019 Jun 3.
3
Mapping of Corneal Layer Thicknesses With Polarization-Sensitive Optical Coherence Tomography Using a Conical Scan Pattern.
利用锥形扫描模式的偏振敏感光学相干断层扫描对角膜层厚度进行映射。
Invest Ophthalmol Vis Sci. 2018 Nov 1;59(13):5579-5588. doi: 10.1167/iovs.18-25311.
4
Value of corneal epithelial and Bowman's layer vertical thickness profiles generated by UHR-OCT for sub-clinical keratoconus diagnosis.超高分辨率光学相干断层扫描(UHR-OCT)生成的角膜上皮和Bowman层垂直厚度剖面图在亚临床圆锥角膜诊断中的价值。
Sci Rep. 2016 Aug 11;6:31550. doi: 10.1038/srep31550.
5
The use of Bowman's layer vertical topographic thickness map in the diagnosis of keratoconus.利用 Bowman 层垂直地形厚度图诊断圆锥角膜。
Ophthalmology. 2014 May;121(5):988-93. doi: 10.1016/j.ophtha.2013.11.034. Epub 2014 Jan 24.
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Age-related thinning of Bowman's layer in the human cornea in vivo.人眼角膜中 Bowman 层的年龄相关性变薄。
Invest Ophthalmol Vis Sci. 2013 Sep 11;54(9):6143-9. doi: 10.1167/iovs.13-12535.
7
Keratoconus diagnosis with optical coherence tomography pachymetry mapping.基于光学相干断层扫描测厚成像的圆锥角膜诊断
Ophthalmology. 2008 Dec;115(12):2159-66. doi: 10.1016/j.ophtha.2008.08.004. Epub 2008 Nov 5.
8
Corneal and epithelial thickness in keratoconus: a comparison of ultrasonic pachymetry, Orbscan II, and optical coherence tomography.圆锥角膜的角膜和上皮厚度:超声测厚仪、Orbscan II和光学相干断层扫描的比较
J Refract Surg. 2006 May;22(5):486-93. doi: 10.3928/1081-597X-20060501-11.
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Group index of the human cornea at 1.3-microm wavelength obtained in vitro by optical coherence domain reflectometry.通过光学相干域反射测量法在体外获得的人角膜在1.3微米波长处的群折射率。
Opt Lett. 2004 Jan 1;29(1):83-5. doi: 10.1364/ol.29.000083.
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