Analysis of corneal morphologic and pathologic changes in early-stage congenital aniridic keratopathy

摘要

AIM:To determine typical corneal changes of congenital aniridic keratopathy(CAK)using corneal topography and confocal systems,and to identify characteristics that might assist in early diagnosis.METHODS:Patients with CAK and healthy control subjects underwent detailed ophthalmic examinations including axial length,corneal thickness,tear film condition,corneal topography,and laser-scanning in vivo confocal microscopy(IVCM). RESULTS:In early stage aniridic keratopathy,Schirmer I test(SIT),break-up time(BUT),mean keratometry(mean K)and simulated keratometry(sim K)were reduced relative to controls(P<0.05),while simulation of corneal astigmatism(sim A)and corneal thickness were increased(P<0.05). In addition,significantly more eyes exhibited flat cornea compared with the control group. Inflammatory dendritic cells were present in the aniridic epithelium,with significantly increased density relative to controls(P<0.05). Palisade ridge-like features and abnormal cell morphology were observed in six out of sixteen CAK cases. In central cornea area,the aniridic corneas had the increased subbasal nerve density. CONCLUSION:These changes in corneal morphology in borderline situations can be useful to confirm the diagnosis of CAK.