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LASIK术后扩张共聚焦显微镜和泪液细胞因子在体分析

Pahuja, N.K., Shetty, R., Deshmukh, R., et al.

期刊名称:The British journal of ophthalmology

卷期:2017年第101卷第12期

摘要

摘要:目的:角膜扩张是激光原位角膜磨削术(LASIK)相关的引起视力障碍的并发症之一。LASIK术后角膜扩张(PLE)的发病机制仍然不了解。我们报告了PLE眼的泪液细胞因子概况和体内共聚焦显微镜(IVCM)研究结果。方法:这项回顾性研究包括年龄相匹配的7例(14只眼)后LASIK对照(PLCs)和6PLE患者(12只眼)。使用角膜地形图将受试者分为PLCPLE组。根据标准问卷获得眼表疾病指数(OSDI)得分,并使用IVCM图像来确定角膜树突状细胞密度(DCD)和亚基底神经丛形态。使用基于流式细胞术的细胞计数珠阵列对泪液中的炎性细胞因子/趋化因子进行定量。结果:与PLC患者相比,PLE患者的Pentacam评分,OSDI评分和角膜DCD明显较高(P <0.05)。 OSDI评分的不适相关分量表与PLE队列角膜总DCD呈正相关。PLE队列的趋化因子(C-C基序)配体/单核细胞趋化蛋白-1ccl2 / mcp1)(3.4±0.6)的倍数差异明显较高(p <0.05),且CCL2/MCP1水平与总角膜DCD之间呈正相关。结论:目前的研究发现,正常眼和眼之间的泪膜细胞因子分布存在显着差异。角膜树突状细胞增多和泪液细胞因子变化表明持续的炎症反应。

AIM:Corneal keratectasia is one of the complications associated with laser in situ keratomileusis (LASIK) that results in vision impairment. The pathogenesis of post-LASIK ectasia (PLE) remains underexplored. We report the tear cytokine profile and in vivo confocal microscopy (IVCM) findings in eyes with PLE.METHODS:This retrospective study included age-matched 7 (14 eyes) post-LASIK controls (PLCs) and 6 (12 eyes) PLE subjects. Corneal topography was used to categorise the subjects into PLC and PLE groups. Ocular Surface Disease Index (OSDI) scores obtained were based on standard questionnaire and IVCM images were used to determine corneal dendritic cells density (DCD) and sub-basal nerve plexus morphology. Inflammatory cytokines/chemokines in the tears were quantified using flow cytometry based cytometric bead array.RESULTS:Pentacam-based scores, OSDI scores and corneal DCD were significantly (p<0.05) higher in patients with PLE compared with PLC. Discomfort-related subscale of OSDI score exhibited a positive correlation with total corneal DCD in the PLE cohort. The fold difference of chemokine (C-C motif) ligand/monocyte chemotactic protein-1 (CCL2/MCP1) (3.4±0.6) was found to be significantly (p<0.05) higher in the PLE cohorts and a positive correlation between CCL2/MCP1 levels and total corneal DCD was also observed in the PLE cohort.CONCLUSION:The current study found a significant difference in the tear film cytokine profile between normal and PLE eyes. Presence of increased corneal dendritic cells and altered tear cytokines suggests an ongoing inflammatory response in PLE.


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