Abstract：
OBJECTIVE: The aim of this study was to evaluate the anterior segment swept source optical coherence tomography (SS-OCT) and in vivo confocal microscopy (IVCM) features in a patient with bleb-like epithelial basement membrane dystrophy (EBMD).
METHODS: A 67-year-old man was referred to the hospital for recurrent attacks of severe ocular pain, tearing, and photophobia, typically upon awakening in the right eye. Biomicroscopic examination revealed pebbled glass-like appearance in the corneal epithelium which was remarkable with retroillumination and the patient was suspected to have bleb-like EBMD. The cornea was further evaluated using SS-OCT DRI Triton (Topcon, Tokyo, Japan) and IVCM (Heidelberg Retina Tomograph 3, Rostock Cornea Module).
RESULTS: Using anterior segment SS-OCT, multiple, hyporeflective, round-oval structures within the size range of 30 to 90 μm were observed at the basal epithelial level. IVCM showed circular or oval hyporeflective areas with a diameter ranging from 30 to 140 μm at the level of the basal epithelium in a depth of 35 to 40 μm from the corneal surface and hyperreflective linear structures extending into the corneal epithelium. The corneal stroma was normal, while a few round hyperreflective deposits and guttae were noted at the endothelial cell layer.
CONCLUSIONS: Anterior segment SS-OCT and IVCM can be used in the diagnosis of bleb-like EBMD and are very helpful in differentiating from other epithelial/subepithelial corneal dystrophies and cystic disorders of the corneal epithelium.
METHODS: A 67-year-old man was referred to the hospital for recurrent attacks of severe ocular pain, tearing, and photophobia, typically upon awakening in the right eye. Biomicroscopic examination revealed pebbled glass-like appearance in the corneal epithelium which was remarkable with retroillumination and the patient was suspected to have bleb-like EBMD. The cornea was further evaluated using SS-OCT DRI Triton (Topcon, Tokyo, Japan) and IVCM (Heidelberg Retina Tomograph 3, Rostock Cornea Module).
RESULTS: Using anterior segment SS-OCT, multiple, hyporeflective, round-oval structures within the size range of 30 to 90 μm were observed at the basal epithelial level. IVCM showed circular or oval hyporeflective areas with a diameter ranging from 30 to 140 μm at the level of the basal epithelium in a depth of 35 to 40 μm from the corneal surface and hyperreflective linear structures extending into the corneal epithelium. The corneal stroma was normal, while a few round hyperreflective deposits and guttae were noted at the endothelial cell layer.
CONCLUSIONS: Anterior segment SS-OCT and IVCM can be used in the diagnosis of bleb-like EBMD and are very helpful in differentiating from other epithelial/subepithelial corneal dystrophies and cystic disorders of the corneal epithelium.
摘要：
目的：本研究的目的是评估一个泡状上皮基底膜营养不良（EBMD）患者的眼前段扫描源光学相干断层扫描（SS-OCT）和体内共聚焦显微镜（IVCM）特征。
方法：一名67岁的男子因反复发作严重的眼部疼痛而被转诊到医院，撕裂,和畏光，通常是在右眼醒来时。生物显微镜检查显示，角膜上皮呈卵石状玻璃样外观，在逆向照射下表现明显，怀疑患者患有泡状EBMD。使用SS-OCTDRITriton（Topcon，东京,日本）和IVCM（海德堡视网膜断层扫描仪3，罗斯托克角膜模块）。
结果：使用眼前节SS-OCT，多个,反思不足,在基底上皮水平观察到30至90μm大小范围内的圆椭圆形结构。IVCM在距角膜表面35至40μm的基底上皮水平处显示出直径为30至140μm的圆形或椭圆形的低反射区域，并且超反射线性结构延伸到角膜上皮。角膜基质正常,在内皮细胞层观察到一些圆形的高反射沉积物和内脏。
结论：前节段SS-OCT和IVCM可用于泡样EBMD的诊断，并且非常有助于与其他上皮/上皮下角膜营养不良和角膜上皮囊性疾病相鉴别。
方法：一名67岁的男子因反复发作严重的眼部疼痛而被转诊到医院，
结果：使用眼前节SS-OCT，
结论：前节段SS-OCT和IVCM可用于泡样EBMD的诊断，并且非常有助于与其他上皮/上皮下角膜营养不良和角膜上皮囊性疾病相鉴别。
