In vivo laser confocal microscopy of Bowman's layer of the cornea
In vivo laser confocal microscopy of Bowman's layer of the cornea
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DOI：
10.1016/j.ophtha.2006.05.058
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发表时间：
2006-12-01
期刊：
影响因子：
13.7
通讯作者：
Sugiyama, Kazuhisa
中科院分区：
文献类型：
--
作者：
Kobayashi, Akira;Yokogawa, Hideaki;Sugiyama, Kazuhisa
目的：利用角膜特异性体内激光扫描共聚焦显微镜（Heidelberg Retina Tomograph 2 Rostock Cornea Module, HRT2-RCM）研究正常人体内鲍曼层的显微结构。设计：单中心、前瞻性、观察性病例系列。参与者：19名正常志愿者（男性10名，女性9名，平均年龄46.21±21.7岁[范围18-77岁]）。方法：采用HRT2-RCM检查中央和周围角膜，特别是上皮、鲍曼层及其下基质。主要观察指标：选择角膜层的图像定性评价微观结构的形状和反射光的程度。结果：所有受试者均可见正常上皮细胞（浅表、翅状、基底）、基底下神经丛、鲍曼层及其下邻近造口。然而，在所有受试者中，在鲍曼层下观察到由纤维材料组成的多形性结构，其反射率低于角膜神经。在应用Tomo-cap加压后，我们观察到许多突起到上皮基底细胞层和翼细胞层。浅表间质纹也可见。这些脊状和条纹与位于上皮细胞下方的纤维结构的方向完全一致。结论：我们首次报道了HRT2-RCM在正常人鲍曼层下存在由纤维状材料组成的多态结构（k结构）。我们推测，这些微观结构可能与合并到鲍曼层的前基质胶原纤维/薄层的修饰和凝聚相对应，这些纤维材料可能负责前角膜马赛克的形成。进一步研究病变眼的这些微观结构可能有助于了解它们在鲍曼层中的病理生理作用。
Purpose: To investigate in vivo microstructures of Bowman's layer in normal human subjects using a cornea-specific in vivo laser scanning confocal microscope (Heidelberg Retina Tomograph 2 Rostock Cornea Module, HRT2-RCM).Design: Single-center, prospective, observational case series.Participants: Nineteen normal volunteers (10 male, 9 female; mean age, 46.21 +/- 21.7 years [range, 18-77]).Methods: The central and peripheral cornea, specifically the epithelium, Bowman's layer, and its subjacent stroma, were examined using the HRT2-RCM.Main Outcome Measures: Selected images of the corneal layers were evaluated qualitatively for the shape and degree of light reflection of the microstructures.Results: In all subjects, normal epithelial (superficial, wing, basal) cells, subbasal nerve plexus, Bowman's layer, and its subjacent stoma were observed clearly. However, in all subjects, polymorphic structures composed of fibrillar materials with less reflectivity than corneal nerves were observed beneath Bowman's layer. After application of pressure by a Tomo-cap, we observed numerous ridges that protruded into the epithelial basal and wing cell layers. Superficial stromal striae were also observed. These ridges and striae corresponded exactly to the orientation of the fibrous structures located beneath the epithelial cells.Conclusion: We report for the first time, the presence of polymorphic structures composed of fibrillar materials (K-structures) beneath Bowman's layer in normal human subjects, detected by HRT2-RCM. We surmise that these microstructures may correspond to the modified and condensed anterior stromal collagen fibers/lamellae that merge into Bowman's layer and that these fibrillar materials may be responsible for the formation of the anterior corneal mosaic. Further investigation of these microstructures in diseased eyes may provide insights into their pathophysiologic role in Bowman's layer.