Turkiye Klinikleri Journal of Ophthalmology

In Vivo Kesit Tarayan Konfokal Mikroskopla Normal İnsan Kornea Dokusunun Değerlendirilmesi
EVALUATION OF NORMAL HUMAN CORNEAL TISSUE BY IN VIVO CONFOCAL MICROSCOPY
Nurgül YILMAZ*, Ömür Ö. UÇAKHAN**, Ayfer KANPOLAT***
* Arş.Gör., Ankara Üniversitesi Tıp Fakültesi Göz Hastalıkları AD**, Ankara Üniversitesi Tıp Fakültesi Göz Hastalıkları AD***, Ankara Üniversitesi Tıp Fakültesi Göz Hastalıkları AD, ANKARA
Turkiye Klinikleri J Ophthalmol. 2003;12(2):76-81
Article Language: TR
Full Text
ÖZET
 Amaç: Sağlam kornea dokusunun in vivo kesit tarayan konfokal mikroskopla değerlendirilmesi.Gereç ve Yöntem: Göz muayenesi normal olan 22 sağlıklı, gönüllü olgunun 44 gözü in vivo kesit tarayan konfokal mikroskopla (Confoscan 2.0, NIDEK Co. Ltd., Osaka, Japonya) incelendi. Görüntüler kornea merkezinden alındı ve kornea yapıları niteliksel ve niceliksel olarak değerlendirildi.Bulgular: Olguların yaş ortalaması 39.9±14.0 yıl olup, 15i kadın (%68.2), 7si erkekti (%31.8). Tüm olgularda epitel, bazal membran, stroma, endotel ve sinir lifleri tabakaları konfokal mikroskopi ile görüntülenebildi ve normal olarak değerlendirildi. Ortalama yüzeyel epitel hücre yoğunluğu 1435±368 hücre/mm2, yüzeyel epitel hücre alanı 697±60 mm2, bazal epitel hücre yoğunluğu 5394±1511 hücre/mm2, bazal epitel hücre alanı 200±55 mm2, ön keratosit hücre yoğunluğu 696±190 hücre/mm2, ön keratosit hücre alanı 1537±399 mm2, arka keratosit hücre yoğunluğu 503±114 hücre/mm2, arka keratosit hücre alanı 2084 ± 465 mm2, endotel hücre yoğunluğu 2732 ± 338 hücre/mm2, endotel hücre alanı 373±49 mm2, endotel kenar sayısı 6±0.2, hexagonalite 50.6±11.4 olarak hesaplandı. Ortalama hücre yoğunlukları ve alanlarının, kadın ve erkekler arasında (p>0.05), ve sağ ve sol gözler arasında (p>0.05) istatistiksel olarak anlamlı fark göstermediği saptandı. Ortalama ön keratosit hücre yoğunluğu arka keratosit hücre yoğunluğundan istatistiksel olarak anlamlı derecede yüksekdi (p<0.001). Endotel hücre yoğunluğunun yaş arttıkça azaldığı gözlendi ancak bu korelasyon istatistiksel olarak anlamlı değildi (r=-0.306, p=0.062).Sonuç: Kesit tarayan konfokal mikroskop ile normal kornea dokusunun tüm katmanlarının niteliksel ve niceliksel olarak incelenebilmesi mümkündür.

Anahtar Kelimeler: Konfokal mikroskop, Kornea, Epitel, Bazal lamina, Stroma, Descemet membranı,Endotel
ABSTRACT
 Purpose: Evaluation of normal corneal tissue by in vivo slit scanning confocal microscopy.Materials and Methods: 44 eyes of 22 healthy volunteers were evaluated by in vivo slit scanning confocal microscopy (Confoscan 2.0, NIDEK Co. Ltd., Osaka, Japan). Scans obtained from central corneas and corneal structures were evaluated qualitatively and quantitavely.Results and Conclusion: The mean age of the patients were 39.9±14.0 years, 15 were women (%68.2), 7 were men (%31.8). Epithelium, basal membrane, stroma, endothelium and nerve fiber layers could be imaged and evaluated as normal. The mean superficial epithelial cell density was 1435±368 cells/mm2, the mean superficial epithelial cell area was 697±60 mm2, the mean basal epithelial cell density was 5394±1511 cells/mm2, the mean basal epithelial cell area was 200±55 mm2, the mean anterior keratocyte density was 696±190 cells/mm2, the mean anterior keratocyte area was 1537±399 mm2, the mean posterior keratocyte density was 503±114 cells/mm2, the mean posterior keratocyte area was 2084±465 mm2, the mean endothelial density was 2732±338 cells/mm2, the mean endothelial area was 373±49 mm2, the mean endothelial sides 6±0.2, the mean hexagonality was 50.6±11.4. There were no statistically significant differences in regards to the mean cell densities and areas between men and women (p>0.05), and right and left eyes (p>0.05). The mean anterior stromal keratocyte density was significantly higher than the mean posterior keratocyte density (p<0.001). Endothelial cell density decreased with increasing age, however this did not reach statistical significance (r=-0.306, p=0.062).Conclusion: It is possible to examine all corneal layers quantitavely and qualitatively by slit scanning confocal microscopy.

Keywords: Confocal microscopy, Cornea, Epithelium, Basal lamina, Stroma, Descemet's membrane, Endothelium

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