CAJ | 학술논문

目的应用角膜激光共焦显微镜观察Chandler综合征患者活体角膜各层组织的形态特点.方法对21例(21只眼)的Chandler综合征患者,采用角膜激光共焦显微镜观察其活体角膜的各层结构,总结其图像特点.结果共焦显微镜下Chandler综合征患者角膜有如下特点:(1)角膜上皮细胞及角膜基质细胞在共焦显微镜下可有不同程度的水肿.(2)角膜营养不良是Chandler综合征患者的特征性改变之一,在共焦显微镜下角膜内皮细胞出现不同程度的疣锥状突起,病变的内皮细胞彻底丧失六边形结构,细胞变圆、变大,在中高反光的细胞体外有一圈由于细胞突起引起的暗反光圈结构,严重的患者可以形成山脊状隆起.(3)部分患者的虹膜在共焦显微镜下可出现粗细不同的支架状结构,这些虹膜支架结构在共焦显微镜下呈中-高度反光,部分呈树枝状排列,部分呈树干状排列,其周围可散在大小不同的色素颗粒附着.结论共焦显微镜在临床诊断Chandler综合征中有重要作用,角膜营养不良是Chandler综合征患者的特征性改变之一,在共焦显微镜下角膜内皮细胞出现不同程度的疣锥状突起,这种内皮细胞是Chandler综合征与其他类型ICE综合征鉴别的特点之一.
목적 응용각막격광공초현미경관찰Chandler종합정환자활체각막각층조직적형태특점.방법 대21례(21지안)적Chandler종합정환자,채용각막격광공초현미경관찰기활체각막적각층결구,총결기도상특점.결과 공초현미경하Chandler종합정환자각막유여하특점:(1)각막상피세포급각막기질세포재공초현미경하가유불동정도적수종.(2)각막영양불량시Chandler종합정환자적특정성개변지일,재공초현미경하각막내피세포출현불동정도적우추상돌기,병변적내피세포철저상실륙변형결구,세포변원、변대,재중고반광적세포체외유일권유우세포돌기인기적암반광권결구,엄중적환자가이형성산척상륭기.(3)부분환자적홍막재공초현미경하가출현조세불동적지가상결구,저사홍막지가결구재공초현미경하정중-고도반광,부분정수지상배렬,부분정수간상배렬,기주위가산재대소불동적색소과립부착.결론 공초현미경재림상진단Chandler종합정중유중요작용,각막영양불량시Chandler종합정환자적특정성개변지일,재공초현미경하각막내피세포출현불동정도적우추상돌기,저충내피세포시Chandler종합정여기타류형ICE종합정감별적특점지일.
Objective To research the morphological characteristics of different layers tissue of cornea with Chandler syndrome by laser confocal microscopy in vivo.Methods Twenty-one eyes of 21 patients with Chandler syndrome were examined by laser confocal microscopy in vivo,and the characteristics of images were studied and analyzed. Results The characteristics of cornea with Chandler syndrome observed by in vivo confocal microscopy were as follows:There was different edema of corneal epithelial cells and stromal cells.Corneal dystrophy was one of the characteristics of Chandler syndrome.The different cone warts protrusions of corneal endothelial cells were observed by laser confoeal microscopy.The endothelial cells of the lesions completely lost the hexagonal structure; the cells became round and larger.There was dark-reflective structure out of the high-reflective circle due to cell protrusions.The stent-like support structure of the iris with different thickness was observed by confocal microscope in vivo.The support structure of iris was moderate to high reflection under the in vivo confocal microscope,some of which were dendritic arrangements,some of which were trunk-like arrangements,attached to it there were scattered pigment granules in different sizes.Conclusions Confocal microscopy has an important role in the clinical diagnosis of Chandler syndrome.Corneal dystrophy is one of the characteristic changes in patients with Chandler syndrome.The different warts cone protrusions of corneal endothelial cells are observed by confocal microscopy in vivo.The special endothelial cells are one of the characteristics to distinguish Chandler syndrome from other ICE syndrome.