The Superficial Stromal Scar Formation Mechanism in Keratoconus: A Study Using Laser Scanning In Vivo Confocal Microscopy.
The Superficial Stromal Scar Formation Mechanism in Keratoconus: A Study Using Laser Scanning In Vivo Confocal Microscopy.
复制标题
圆锥角膜浅层间质疤痕形成机制：体内激光扫描共焦显微镜研究
DOI：
10.1155/2016/7092938
复制
发表时间：
2016
影响因子：
--
通讯作者：
Gao H
中科院分区：
文献类型：
--
作者：
Song P;Wang S;Zhang P;Sui W;Zhang Y;Liu T;Gao H
为探讨晚期圆锥角膜浅层基质瘢痕形成的机制，应用激光共聚焦显微镜观察了3组患者角膜基质中角膜基质细胞的密度、分布、微形态及SNP。应用免疫组织化学方法对8例晚期圆锥角膜的角膜纽扣进行检测。三组间鲍曼下间质、前间质、后间质的角膜基质细胞密度及平均SNP密度差异均有统计学意义。轻、中度圆锥角膜间质内可见活化的角质细胞核和较高反射率的细胞外基质，而进展期圆锥角膜前间质内可见纤维状结构，反射率较高。轻、中度圆锥角膜前基质中暗带和亮带交替出现，在宽度和方向上有很大的差异。在圆锥角膜中，宽带主要分布在与Vogt纹对应的后基质中，而在晚期圆锥角膜中仅累及前基质。在组织病理学上，α-SMA、波形蛋白和FAP的高免疫原性在浅层基质瘢痕区域表达。体内共聚焦显微镜显示圆锥角膜的微结构改变。晚期圆锥角膜浅层基质瘢痕的形成可能与浅层角膜基质细胞的活化和ECM的异常重塑有关。
To investigate the mechanism of superficial stromal scarring in advanced keratoconus using confocal microscopy, the keratocyte density, distribution, micromorphology of corneal stroma, and SNP in three groups were observed. Eight corneal buttons of advanced keratoconus were examined by immunohistochemistry. The keratocyte densities in the sub-Bowman's stroma, anterior stroma, and posterior stroma and the mean SNP density were significantly different among the three groups. In the mild-to-moderate keratoconus group, activated keratocyte nuclei and comparatively highly reflective ECM were seen in the sub-Bowman's stroma, while fibrotic structures with comparatively high reflection were visible in the anterior stroma in advanced keratoconus. The alternating dark and light bands in the anterior stroma of the mild-to-moderate keratoconus group showed great variability in width and direction. The wide bands were localized mostly in the posterior stroma that corresponded to the Vogt striae in keratoconus and involved the anterior stroma only in advanced keratoconus. Histopathologically, high immunogenicity of α-SMA, vimentin, and FAP was expressed in the region of superficial stromal scarring. In vivo confocal microscopy revealed microstructural changes in the keratoconic cone. The activation of superficial keratocytes and abnormal remodeling of ECM may both play a key role in the superficial stromal scar formation in advanced keratoconus.