ⅢA型格子状角膜营养不良患者角膜前弹力层神经侵噬现象的自身对照研究

A self-controlled study on corneal nerve invasion phenomenon of Bowman’s membrane in patients withⅢA lattice corneal dystrophy

目的:采用角膜激光共焦显微镜研究分析ⅢA型格子状角膜营养不良(LCD)患者的角膜神经侵噬现象,对10a连续观察图像数据进行定量分析后进行自身对照研究。方法:收集2007-09/2018-12确诊的ⅢA型LCD患者10例13眼,采用角膜激光共焦显微镜对患者的角膜进行连续的扫描检测,观察分析其前弹力层神经的检查情况。结果:随着观察时间的延长,ⅢA型LCD患者的正常角膜基质神经(0级神经)逐渐减少,Ⅰ级~Ⅴ级受累神经(淀粉样物包裹的神经纤维)逐渐增多,提示ⅢA型LCD患者角膜前弹力层神经侵噬情况(淀粉样沉积物)是随着时间延长而逐渐加重的。结论:ⅢA型LCD患者角膜前弹力层神经存在着嗜神经现象,随着病变的加重而逐渐加重,该病变能从侧面解释该型LCD复发性上皮损害的情况。利用角膜激光共焦显微镜对ⅢA型LCD患者进行连续的观察,能够很好地了解该病变的发展情况,解释其临床表现。

·AIM:To analyze and study the corneal nerve invasion phenomenon of Bowman’s membrane in patients with IIIA lattice corneal dystrophy by confocal laser scanning microscopy.Quantitative analysis of 10a continuous observation image data was performed,followed by self-control studies.·METHODS:A total of 10 patients(13 eyes)with IIIA Lattice corneal dystrophy were continuously examined by confocal laser scanning microscopy.The data were observed and analyzed.·RESULTS:The normal corneal nerve of Bowman’s membrane(Grade 0)of IIIA LCD patients gradually decreased with the prolongation of observation time.The nerves of grade I to V involved(amyloid-wrapped nerve fibers)gradually increased correspondingly.So suggested that the corneal nerve invasion of Bowman’s membrane(amyloid deposits)in patients with IIIA LCD were gradually increasing with time.·CONCLUSION:In patients with typeⅢA lattice corneal dystrophy,there is a neurotropic phenomenon in Bowman’s membrane,which gradually worsens with the aggravation of the lesion.This lesion can explain the recurrent epithelial damage of the IIIA LCD from some degrees.Continuous observation of patients with type IIIA LCD by corneal laser confocal microscopy can well understand the development of the lesion and explain its clinical manifestations.