Cell Morphology as an In Vivo Parameter for the Diagnosis of Limbal Stem Cell Deficiency.
Cell Morphology as an In Vivo Parameter for the Diagnosis of Limbal Stem Cell Deficiency.
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DOI：
10.1097/ico.0000000000002955
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发表时间：
2022-08-01
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影响因子：
2.8
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中科院分区：
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目的：研究角膜缘干细胞缺乏症（LSCD）患者角膜中央和角膜缘区基底上皮细胞形态学（CM）。前瞻性、横断面比较研究。我们开发了一个CM评分系统的基础上，基底上皮细胞表型分级为0（正常）至3（严重形态学改变），该系统由2名独立的蒙面观察员进行评估。将CM评分与LSCD临床评分、平均最佳矫正视力（BCVA）和用于分期LSCD的体内激光扫描共聚焦显微镜（IVCM）参数（即，基底上皮细胞密度[BCD]、基底上皮厚度[ET]和基底下角膜神经纤维长度密度[CNFL]）。其中LSCD患者168眼，正常对照组63眼。与对照组相比，LSCD组中央角膜（分别为1.8 ± 0.7 vs 0.5 ± 0.4; P = 0.01）和角膜缘区域（分别为1.6 ± 0.2 vs 1.3 ± 0.0; P < 0.05）的CM评分均值（± SD）显著更高。角膜中央CM评分与临床评分呈正相关（P < 0.01，r = 0.66），与最佳矫正视力呈负相关（P < 0.01，r = 0.42）。在角膜中央和角膜缘区，CM评分与IVCM的所有其他参数均呈正相关（均P < 0.001）。基底上皮CM在患有LSCD的眼睛的中央角膜和利姆布斯中改变，因此可用于对疾病的临床严重程度进行分期。
To investigate basal epithelial cell morphology (CM) in the central cornea and limbal areas of eyes with limbal stem cell deficiency (LSCD). Prospective, cross-sectional comparative study. We developed a CM scoring system based on basal epithelial cell phenotypes graded from 0 (normal) to 3 (severe morphologic alterations); this system was evaluated by 2 independent masked observers. The CM score was compared with the LSCD clinical score, the mean best corrected visual acuity (BCVA), and in vivo laser scanning confocal microscopy (IVCM) parameters used to stage the LSCD (ie., basal epithelial cell density [BCD], basal epithelial thickness [ET], and sub-basal corneal nerve fiber length density [CNFL]). 168 eyes with LSCD and 63 normal eyes were included. Compared with the control group, the LSCD group had significantly higher mean (± SD) CM scores in the central cornea (1.8 ± 0.7 vs 0.5 ± 0.4, respectively; P = 0.01) and limbal areas (1.6 ± 0.2 vs 1.3 ± 0.0, respectively; P < 0.05). The mean CM score in the central cornea was positively correlated with the clinical score (P < 0.01, r = 0.66) and negatively correlated with the BCVA (P < 0.01, r = 0.42). The CM scores were positively correlated with all other IVCM parameters in the central cornea and limbal areas (all P < 0.001). Basal epithelial CM is altered in the central cornea and limbus of eyes with LSCD and thus can be used to stage the clinical severity of the disease.