孔源性视网膜脱离并发脉络膜脱离患者的角膜内皮形态学参数

Morphological parameters of corneal endothelium in patients with rhegmatogenous retinal detachment complicated with choroidal detachment

摘要:

目的：探讨孔源性视网膜脱离并发脉络膜脱离(RRD-CHD)患者的角膜内皮细胞形态学参数变化。

方法：连续收集RRD-CHD患者70例70眼，分为无高度近视组(A组)38眼38眼、高度近视组(B组)32例32眼，另收集正常组(C组)36例36眼。使用角膜内皮镜检测各组角膜内皮细胞最小面积(S_min)、最大面积(S_max)、平均面积、平均密度(CD)、细胞面积标准差(SD)、变异系数(CV)及六角形细胞比例(HG)。

结果：RRD-CHD患者和正常组的角膜内皮细胞CD、HG均有差异(P<0.001)。A组的CD与B组、C组均有差异(P<0.05)，B组与C组有差异(P<0.001)。在A组中，SD、CV与眼轴(r_s=-0.426、0.494， 均P<0.01)，CD与眼压、眼轴(r_s=-0.025、0.368， 均P<0.05)，HG与病程(r_s=0.552， P<0.05)均相关。在RRD-CHD患者中，SD、CV与眼轴(r_s=0.236、0.159， 均P<0.05)，HG与病程(r_s=0.142， P<0.05)，S_max与眼压(r_s=-0.314， P<0.01)均相关。

结论：RRD-CHD患者持续低眼压状态下角膜内皮细胞的HG和CD均明显降低，眼轴、病程和眼压可影响角膜内皮的形态学参数。

Abstract:

AIM: To explore the changes of morphological parameters of corneal endothelial cell in patients with choroidal detachment following rhegmatogenous retinal detachment(RDD-CHD).

METHODS: Seventy patients(70 eyes)with RDD-CHD were collected consecutively. In patients with RDD-CHD, thirty-eight cases(38 eyes)not with high myopia were enrolled in group A; 32 cases(32 eyes)associated with high myopia were enrolled in group B. Thirty-six normal controls(36 eyes)were enrolled in group C. We measured the related morphological parameters of corneal endothelial cells in all subjects using corneal specular microscope. The parameters of corneal endothelial cells included minimum size of cell area(S_min), maximum size of cell area(S_max), average size of cell area, standard deviation of cell area(SD), coefficient of variability cell area(CV), cell density of corneal endothelial cells(CD)and hexagonality(HG).

RESULTS: There were statistically differences in the CD(P<0.001)and hexagonality(P<0.001)between the patients with RDD-CHD and normal subjects. There were statistically differences in the CD between groups A and B(P<0.05), between groups A and C(P<0.05), between groups B and C(P<0.001). SD correlated with axis length(r_s=-0.426, P<0.01); CV correlated with axis length(r_s=0.494, P<0.01), CD correlated with intraocular pressure(r_s=-0.025, P<0.05), CD correlated with axis length(r_s=0.368, P<0.05), HG correlated with course(r_s=0.552, P<0.05). In patients with RDD-CHD, SD correlated with axis length(r_s=0.236, P<0.05); CV correlated with axis length(r_s=0.159, P<0.05), HG correlated with course(r_s=0.142, P<0.05), S_max correlated with intraocular pressure(r_s=-0.314, P<0.01).

CONCLUSION: The valus of HG and CD of corneal endothelial cells in patients with RDD-CHD were both lower than that of the normal subjects. Axis length, course and intraocular pressure might influence the morphological parameters of corneal endothelium in RDD-CHD patients.