共聚焦显微镜下后部多形性角膜营养不良的影像学特征

目的:探讨后部多形性角膜营养不良（PPCD）在共聚焦显微镜下的影像学特征。方法:回顾性病例系列研究。收集2013年1月至2019年12月期间在北京大学第三医院眼科诊断为PPCD的18例（27只眼）患者资料，其中男性10例，女性8例。年龄（23.61±14.81）岁。单眼和双眼发病的患者各9例。所有患者均行裂隙灯显微镜和...

Imaging features of posterior polymorphous corneal dystrophy observed by in vivo confocal microscopy

Objective To identify and analyze imaging features of posterior polymorphous corneal dystrophy(PPCD)by in vivo confocal microscopy(IVCM).Methods This retrospective case series enrolled 27 eyes of 18 patients(including 10 males and 8 females)who were diagnosed with PPCD at the Department of Ophthalmology in Peking University Third Hospital between January 2013 and December 2019.The mean age was(23.61±14.81)years.There were 9 monocular and 9 binocular cases.All patients were examined by slit-lamp biomicroscopy and IVCM.The visual acuity,the mean endothelial cell density,and the images of IVCM were analyzed in all cases.Results The mean best-corrected visual acuity was 0.76±0.33,and the mean endothelial cell density was(1723.6±698.3)cells/mm².The IVCM images of type 1 PPCD(vesicular lesions)showed hyperreflective,placoid or homocentric lesions at the level of the Descemet′s membrane,hyporeflective,oval or round lesions at the level of the Descemet′s membrane,and hyporeflective,crater-like lesions at the level of the endothelial cell layer.The IVCM images of type 2 PPCD(band lesions)displayed hyperreflective,band lesions and a fibrous strand structure at the level of the Descemet′s membrane,hyporeflective,vesicular lesions at the level of the Descemet′s membrane,and hyporeflective,trough-and ridge-like lesions at the level of the endothelial cell layer.The IVCM images of type 3 PPCD(geographic placoid opacities)showed loss of the hexagonal features of endothelial cells and epithelial-like cell transformation.Conclusions PPCD primarily affects the endothelium and Descemet′s membrane.IVCM could highlight the special characteristics of PPCD including hyperreflective lesions at the level of the Descemet′s membrane,hyporeflective lesions at the level of the endothelial cell layer,and epithelial-like cell transformation of endothelial cells.IVCM is an invaluable tool for clinical diagnosis and dynamic monitoring of PPCD.