基质型单疱病毒性角膜炎共聚焦显微镜表现

The characteristics detected with confocal microscopy in corneas with stromal herpes simplex virus （I-ISV） keratitis

目的探讨单纯疱疹病毒性角膜炎基质型的共聚焦显微镜表现和对临床实践给予指导。方法收集2011年1月至12月在吉林大学第一医院眼科就诊的单纯疱疹病毒性角膜炎基质型共38例，采用日本Nidek公司提供的Confoscan4．0检测角膜各层形态学改变。结果单纯疱疹性角膜炎基质型其角膜各层在共聚焦显微镜下有典型改变，上皮基底膜下浅基质层内可见角膜神经丛及大量郎汉斯细胞，基质细胞呈纵横伸展相互交错的细胞轮廓，后基质可见宽大条状低反光暗区，基质内可见高反光物质。内皮细胞，形态正常，位于内皮细胞面可见条索状或分枝状高反光物质沉积。结论角膜共聚焦显微镜对于病毒性角膜炎的临床诊断、治疗及发病机制的研究具有很好地应用价值。

Objective To investigate the characteristics detected in corneas with stromal herpes simplex virus （HSV） keratitis. Methods Thirty-eight patients （38 eyes） were analyzed with confocal microscopy （Confoscan 4, Nidek Japan） in vivo and assess the morphology of the corneal. Results There were significant morphological changes in the cornea. Corneal nerve plexus and lots of Lang Hans＇ cells in the-corneal stroma next to the corneal epithelial basement membrane were found. Cor- neal stromal cells was detected in the form of focal and diffuse cellular infiltrates. Dark space and High reflection were also found in stroma. The morphology of corneal endothelial was normal, and High reflection deposit on the surface or corneal endothelial was found. Conclusions In vivo confo- cal microscopy provides information on corneal morphology. HSV keratitis can be usefully evaluated by confocal microscopy, giving information on diagnosis, treatment and the research of pathogenesis.