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- 作者:李莹|发布时间:2008-11-29|浏览量:1696次
李莹 中国医学科学院 中国协和医科大学 北京协和医院眼科 100730
Use of In vivo confocal microscopy through focusing In corneal allograft rejection
Li Ying
Department of Ophthalmology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences.Beijing 100730, China北京协和医院眼科李莹
Corresponding author: LI Ying, Email: liyingpumch@sohu.com
Tel:010-65296352,65296359
[Abstract] Objective To demonstrates the features of corneal allograft early immunological rejection under confocal microscopy in human eyes. Methods the patients that had undergone penetrating keratoplasty were examined using in vivo confocal microscopic through focusing. Results The CMTF allows real-time viewing of structures in living cornea at the cellular level in four dimensions (X, Y, Z, and real time). Layers of the cornea were visualised in serial optical sections parallel to the epithelium after penetrating keratoplasty. Corneal immunological rejection signs appear during the different time and in epithelial rejection and straomal rejection. Small and highly inflammatory cells were visualised to form a linear rejection line mixed with larger damaged epithelial cells. Small refractive inflammatory cells could be seen in subepithelial infiltrates within the extracellular matrix and stromal edema. Stromal cellular structures turned into myofibroblast and cells arranged disturbedly. Conclusions Clinical confocal microscopy has the unique potential of providing non-invasive assessment of corneal stricture and allograft immunological rejection at the cellular level and maybe a valuable tool to provide more information for early diagnosis of rejection before slit-lamp finding.
Key words: confocal microscopy,penetrating keratoplasty,
corneal allograft rejection , cornea
摘要 目的 应用活体共聚焦显微镜(CMTF)观察角膜移植术后排斥反应。方法 对穿透角膜移植患者术后定期CMTF检查。结果 通过连续共聚焦扫描及焦点分析,得到角膜X、Y轴和Z轴多层精确的、可重复的图像及时间记录四维显示。角膜移植术后角膜可出现多种反应,如角膜上皮反应、基质反应。角膜移植排斥反应主要表现为移植片周围大量圆形细胞浸润、大的异常上皮细胞、基质水肿、基质细胞变为成纤维细胞及细胞排列紊乱。结论 应用共聚焦显微镜可直接观测活体角膜各层细胞形态、结构、病理转归及角膜移植免疫排斥的早期反应,以及反应过程的发展,为较早的诊断角膜移植排斥反应提供依据。这是裂隙灯检查所不及的。
关键词 共聚焦显微镜 角膜 移植排斥 穿透性角膜移植
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